left side c. the left ureter inserted into the bladder neer to r. dd the spermatick vein which goeth to the left testicle marked with i. ee the spermatick vein which goeth to the left testicle with i also f. the trunk of the great artery from whence the spermatical arteries do proceed gh the spermatical arteries ii the two testicles ll a branch which from the spermatick vessels reacheth unto the bottom of the womb mm. the leading vessel of the Seed which Fallopius calleth the tuba or trumpet because it is crooked and reflected n. a branch of the spermatick vessel compassing the leading vessel oo a vessel like a worm which passeth to the womb some call it Cremaster p. the bottom of the womb called fundus uteri b. a part of the right gut r. s the bottom of the bladder whereto is inserted the left Ureter and a vein led from the neck of the wome neer unto r. t. the neck of the bladder u. the same inserted into the privity or lap x. a part of the neck of the womb above the privity yy certain skinny Caruncles of the Privities in the midst of which is the slit and on both sides appear little hillocks The Figures belonging to the Dugs and Breasts αα The veins of the Dugs which come from those which descending from the top of the shoulder are offered to the skin β. the veins of the Dugs derived from those which through the arm-hole are led into the hand γ. the body of the Dug or Breast δδ the kernels and fat between them εε the vessels of the Dugs descending from the lower part of the neck called Jugulum under the breast-bone It hath a middle temper between hot and cold moist and dry It hath the same use as a mans Praeputium or fore-skin that is that together with the Nymphae it may hinder the emeance of the air by which the womb may be in danger to take cold The lips of the Privities called by the Greeks 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 by the Latines Alae contain all that region which is invested with hairs Alae 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 and because we have faln into mention of these Nymphae you must know that they are as it were productions of the musculous skin which descend on both sides from the upper part of the share-bone downwards even to the orifice of the neck of the bladder oft-times growing to so great a bigness that they will stand out like a man's yard Wherefore in some they must be cut off in their young years yet with a great deal of caution lest if they be cut too rashly so great an effusion of blood may follow that it may cause either death to the woman or barrenness of the womb by reason of the refrigeration by the too great effusion of blood 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 joyns together those wings we formerly mentioned Cleitoris tentigo Columbus calls 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 read the Authors which I cited CHAP. XXXV Of the Coats containing the Infant in the womb and of the Navel THe membranes or coats containing the Infant in the womb of the Mother are of a spermatick and nervous substance Their substance magnitude figure and composure having their matter from the seed 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 near the time of deliverance they are round in figure like the womb Their composition is of veins arteries and their proper substance The veins and arteries are distributed to them whether obscurely or manifestly more or fewer from the womb by the Cotyledones which have the same office as long as the child is contained in the womb as the nipples or paps of the nurses after it is born For thus the womb brings the Cotyledones or veins degenerating into them through the coats like certain paps to the Infant shut up in them These coats are three in number according to Galen one called the Chorion Secundine or After-birth The number the other Allantoides the third Amnios I find this number of coats in Beasts but not in Women unless peradventure any will reckon up in the number of the coats the Cotyledones swollen up and grown into a fleshy mass which many skilful in Anatomy do write which opinion notwithstanding we cannot receive as true I could never in any place find the Allantoides in Women with child neither in the Infant born in the sixth seventh eight or in the full time being the ninth month although I sought it with all possible diligence the Midwives being set apart which might have violated some of the coats But thus I went about this business I divided the dead body of the Mother croswise upon the region of the womb and taking away all impediments which might either hinder or obscure our diligence with as much dexterity as was possible we did not only draw away that receptacle or den of the Infant from the inward surface of the womb to which it stuck by the Cotyledones but we also took 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 poured forth no moisture whereby it might be said that any coat made for the containing of that humor was rent or torn And then we diligently looked having many witnesses and spectators present if in any place there did appear 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 took the Amnios filled with moisture on the upper side and having opened it two servants holding the apertion that no moisture might flow out of it into the circumference of the Chorion or Womb then presently with spunges we drew out by little and little all the humidity contained in it the Infant yet contained in it which was fit to come forth that so the coat Amnios being freed of this moisture we might see whether there were any other humor contained in any other coat besides But having done this with singular diligence and fidelity we could we see no other humor nor no other separation of the membranes besides He shews by three several reasons that there is no Allantoides So that from that time I have confidently held this opinion that the Infant in the womb is only wrapped in two coats the Chorion and Amnios But yet not satisfied by this experience that I might yet
much oyl and the in testines that are full and loaded must be underburthened of the excrements and then the expulsive faculty provoked with a sharp glyster and the tumors and swelling of the birth concurring therewith the more easie exclusion may be made But I like it rather better that the woman in travail should be placed in a chair that hath the back thereof leaning back-wards then in her bed but the chair must have a hole in the bottom whereby the bones that must be dilated in the birth may have more freedome to close themselves again CHAP. XXX The cause of Abortion or untimely birth ABortion or untimely birth is one thing and effluxion another What Abortion is They call Abbortion the sudden exclusion of the childe already formed and alive before the perfect maturity thereof But that is called effluxion which is the falling down of seeds mixed together and coagulated but for the space of a few dayes only in the formes of membrane or tunicles congealed blood and of an unshapen or deformed piece of flesh What Effluxion is the Midwives of our country call it a false branch or bud This effluxion is the cause of great pain and most bitter and cruel torment to the woman leaving behinde it weakness of body far greater then if the childe were born at the due time The causes of abortion or untimely birth Women are in more pain by reason of th effluxion then at the true birth The causes of Abortion whereof the childe as called an abortive are many as a greatscouring a strangury joined with heat and inflammation sharp fietting of the guts a great and continual cough exceeding vomiting vehement Labour in running leaping and dancing and by a great fall from an high carrying of a great burthen riding on a trotting-horse or in a Coach by vehement often and ardent copulation with men or by a great blow or stroke on the belly For all these and such like vehement and inordinate motions dissolve the ligaments of the womb and so cause abortion and untimely birth Also whatsoever presseth or girdeth in the mothers belly and therewith also the womb that is within it as are those Ivory or Whale-bone buskes which women wear on their bodies thereby to keep down their belsies by these and such like things the childe is letted or hindred from growing to his full strength so that by expression or as it were by compulsion Girding of the belly may cause untimely birth he is often forced to come forth before the legitimate and lawful time Thundering the noise of the shooting of great Ordnance the sound and vehement noise of the ringing of Bells constrain women to fall in travel before their time especially women that are young whose bodies are soft slack and tender then those that be of riper years Long and great fasting a great flux of blood especially when the infant is grown somewhat great but if it be but two moneths old the danger is not so great bacause then he needeth not so great quantity of nourishment also a long disease of the mother which consumeth the blood causeth the childe to come forth being destitute of store of nourishment before the fit time Moreover fulness by reason of the eating great store or meats often maketh or causeth untimely birth because it depraveth the strength and presseth down the childe as likewise the use of meats that are of an evil juice which they lust or long for But baths because they relax the ligaments of the womb and hot houses How bathes and hot houses cause untimely birth for that the fervent and choaking air is received into the body provoke the infait to strive to go forth to take the cold air and so cause abortion What women soever being indifferently well in their bodies travail in the second or third moneth without any manifest cause those have the Cotylidones of their womb full of filth and matter and cannot hold up the infant by reason of the weight thereof but are broken Moreover sudden or continual petrurbations of the minde whether they be through anger or fear Hip apb 53. 37. sect 5. Hip. aph 45. sect 5. may cause women to travail before their time and are accounted to the causes of abortions for that they cause great and vehement trouble in the body Those women that are like to travail before their time their dugs will wax little therefore when a woman is a great with childe if her dugs suddenly was small and slender it is a sign that she will travail before her time the cause of such shrinking of the dags is that the matter of the milke is drawn back into the womb by reason that the infant wanteth nourishment to nourish and succor it withall Which scarcity the infant not long abiding Hip. aph 38. sect 5. striveth to go forth to seek that abroad which he cannot have within for among the causes which do make the infant to come out of the womb those are most usually named with Hippocrates the necessity of a more large nutriment and air Women are in more pain at the untimely birth then at the due time of birth The error of the first childe-birth continues afterwards A plaster staying the infant in the womb Therefore if a woman that is with childe have one of her dugs small if she have two children she is like to travail of one of them before the full and perfect time so that if the right dug be small it is a man-childe but if it be the left dug it is a female Women are in far more pain when they bring forth their children before the time then if it were at the full and due time because that whatsoever is contrary to nature is troublesome painfull and also oftentimes dangerous If there be any error committed at the first time of childe-birth it is commonly seen that it happeneth alwaies after at each time of childe-birth Therefore to finde out the causes of that error you must take the counscel of some Physician and after his counscel endeavor to amend the same Truly this plaister following being applyed to the reines doth confirm the womb and stay the infant thereâ—n â„ž ladaniÊ’ii galang â„¥ i. nucis moschat nucis cupressi boli armeni terrae figil sanguin dracon balaust an Ê’ ss acatia psidiorum hypâ—cistid an â„¥ i. mastich myrrhae an Ê’ii gummi arabic Ê’i terebâ—nthi Venet. Ê’ii picis naval â„¥ i. ss cerae quantum sufficit fiat emplast secundum artem spread it for your use upon leather If the part begin to itch let the plaister be taken away and in stead thereof use unguent rosat or refrig Galen or this that followeth â„ž â—lei myrtini mastich cydâ—nior an â„¥ i. hypo boli armen sang dracon acatiae an Ê’i sant citrini â„¥ ss cerae quant suf make thereof an ointment according unto art What children are ten or eleven moneths in the
of bloud-letting yet remain that is the greatness of the disease and the constant strength of the Patient The two chief Indications in bloud-letting I being glad of this took three Saucers more of bloud he standing by and was ready to take more but that he wished me to defer it until the afternoon 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 bloud at five times within the space of four days Now the ensuing night was very pleasing to him the Feaver left him about noon the tumor grew much less the heat of the inflammation was asswaged in all parts except in his eye-lids and the laps of his ears which being ulcerated cast forth a great quantity of Pus or matter I have recited this history purposely to take away the childish fear which many have to draw bloud in the constant strength of the Patient and that it might appear how speedy and certain a remedy it is in inflammations of the head and brain Now to return from whence we digressed The discommodity of venery in wounds of the head you must note that nothing is so hurtful in fractures and wounds of the head as venery not only at that time the disease is present but also long after the cure thereof For great plenty of spirits are contained in a small quantity of seed and the greatest part thereof flows from the Brain hence therefore all the faculties but chiefly the Animal are resolved whence I have divers times observed death to ensue in small wounds of the head yea when they have been agglutinated and united How hurtful noyse is to the fractures of the skull All passions of the mind must in like sort be avoided because they by contraction and dissipation of the spirits cause great trouble in the body and mind Let a place be chosen for the Patient as far from noise as can be as from the ringing of Bells beatings and knocking 's of Smiths Coopers and Carpenters and from high-ways through which they use to drive Coaches for noise encreases pain causes a Feaver and brings many other symptoms I remember when I was at Hisdin at the time that it was besiged by the forces of Charles the fifth A History that when the wall was beaten with the Cannon the noise of the Ordnance caused grievous torment to all those which were sick 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 angered herewith that they bled much and by their pain and Feavers encreased were forced with much sighing to breathe their last Thus much may serve to be spoken of the cure in general now we will out of the monuments of Ancients treat of the particular CHAP. XV. Of the particular cure of wounds of the head and of the musculous skin LEt us begin with a simple wound Of a simple wound of the flesh and the skin for whose cure the Chirurgeon must propose one only scope to wit Union for unless the wound pierce to the skull it is cured like other wounds of the fleshy parts of our bodies But if it be compound as many wayes as it is complicate so many Indications shew themselves In these the chiefest care must be had of the more urgent order and cause Therefore if the wound shall be simple and superficiary then the hair must first be shaven away then a plaister applyed made of the white of an Egge Bole Armenic and Aloes The following day you must apply Emplastrum de Janua or else de gratia Dei until the wound be perfectly healed But if it be deeper and penetrate even to the Pericranium the Chirurgeon shall not do amiss if at the second dressing he apply a digestive medicine as they call it which may be made of Venice-Turpentine A digestive medicine the yolks of Egges Oyl of Roses and a little Saffron and that shall be used so long until the wound come to maturation for then you must add Honey of Roses and Barly flour to the digestive Hence must we pass to these medicines into whose composition no oyly or unctuous body enters A sarcotick medicine such as this â„ž Terebinth venetae â„¥ ij syrupi rosar â„¥ j pul Aloes Myrrhae Mastich an Ê’ ss Let them all be incorporated and made into an unguent which shall be perfectly regenerated An Epulotick then it must be cicatrized with this following powder â„ž Aluminiis combusti corticis granatorum combust an Ê’ i. Misceantur simul fiat pulvis but if the wound be so large that it require a suture it shall have so many stitches with a Needle as need shall seem to require A H story Whilst I was at Hisdin a certain Souldier by falling of the earth whilst he undermined had the Hairy scalp so pressed down even to the Pericranium and so wholly separated from the beginning of the hind-part of his head even to his fore-head that it hung over his face I went about the cure in this manner I first washt all the wound with Wine a little warmed that so I might wash away the congealed bloud mixed with the earth then I dryed it with a soft linnen cloth and laid upon it Venice-Turpentine mixed with a little Aqua-vitae What things we must observe in sewing wherein I had dissolved some Sanguis Draconis Mastick and Aloes then I restored the hanging skin to its former place and there stayed it with some stitches being neither too strait nor too close together for fear of pain and inflammation which two chiefly happen whilst the wound comes to suppuration but only as much as should serve to stay it on every side and to keep forth the air which by it entrance doth much harm to wounds the lower sides of the wound I filled with somewhat long and broad tents that the matter might have passage forth Then I applyed this following cataplasm to all the head â„ž farinae hâ—rd falarum an â„¥ vi olei rosatiÊ’ iij aceti quantum sufficit fiat cataplasma ad formam pultis this hath a faculty to dry cool repel mitigate pain and inflammation and stay bleeding When we must not let bloud in wounds I did not let him blood because he had bled much especially at certain arteries which were broken neer his Temples he being dressed after this manner grew well in a short time But if the wound be made by the biting of a wild Beast it must be handled after another manner as shall appear by this following History As many people on a time stood looking upon the King's Lyons who were kept in the Tilt-yard at Paris A History for the delight of King Henry the second and at his charges it happened that one
aceti rosar an lb. ss sant rub ros rub anÊ’iii flor nenuph. violar camphur an Ê’ss methridat theriac an Ê’ii terantur misceantur simul omnia When you intend to use them take some portion of them in a vessel by its self wherewith let the affected bowel be fomented warm CHAP. XXIV Whether purging and blood-letting be necessary in the beginning of pestilent diseases SO soon as the heart is strengthened and corroborated with cordials and antidotes Reasons for and against blood-letting in the Plague we must come to phlebotomy and purging As concerning blood-letting in this case there is a great controversie among Physicians Those that wish it to be used say or affirm that the pestilent Fever doth infix it self in the blood and therein also the pestilent malignity taketh its seat and therefore it will soon infect the other humors unless that the blood be evacuated and the infection that remaineth in the blood be thereby taken away Contrariwise those that do not allow phlebotomy in this case alledg that it often cometh to pass that the blood is void of malignity when the other humors are infected with the venomous contagion If any man require my judgment in this doubtful question I say that the pestilence sometimes doth depend on the default of the Air this default being drawn through the passages of the body doth at length pierce unto the intrails as we may understand by the abscesses which break out The composing of this controversie one while behind the ears sometimes in the arm-holes and sometimes in the groins as the brain heart or liver are infected And hereof also come Carbuncles and other collections of matter and eruptions which are seen in all parts of the body by reason that nature using the strength of the expulsive faculty doth drive forth whatsoever is noisom or hurtful Therefore if the Physician will follow this motion of nature he must neither purge nor let blood 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 we often see in those who are purged or let blood for such Buboes as come through unlawful copulation that the matter is thereby made contumacious and by drawing it inwardly it speedily causeth the French Pox. Wherefore When Bubes Carbuncles and other pestilent eruptions appear which come through the default of the air we ought to abstain from purging and phlebotomy but it is sufficient to fore-arm the heart inwardly and outwardly with Antidotes that are endued with a proper virtue of resisting the poison For it is not to be doubted but that when nature is debilitated with both kinds of evacuation and when the spirits together with the blood are exhausted the venomous air will soon pierce and be received into the empty body where it exerciseth its tyranny to the utter destruction thereof An history In the year of our Lord God 1566. in which year there was great mortality throughout all France by reason of the pestilence and pestilent diseases I earnestly and diligently inquired of all the Physicians and Chyrurgions of all the Cities through which King Charls the Ninth passed in his progress unto Bayon what success their patients had after they were let blood and purged whereunto they all answered alike that they had diligently observed that all that were infected with the Pestilence and were let bleed some quantity of blood or had their bodies somewhat strongly purged thence forwards waxed weaker and weaker and so at length died but others which were not let blood nor purged but took cordial Antidotes inwardly and applied them outwardly for the most part escaped and recovered their health for that kind of Pestilence took its original of the primitive and solitary default of the Air and not of the corruption of the humors When purging and bleeding may be used The like event was noted in the hoarsness that we spake of before that is to say that the patients waxed worse and worse by purging and phlebotomy but yet I do not disallow either of those remedies if there be great fulness in the body especially in the beginning and if the matter have a cruel violence whereof may be feared the breaking in unto some noble part For we know that it is confirmed by Hippocrates Aph. 22 sect 2. Aph. 10 sect 4. that what disease soever is caused by repletion must be cured by evacuation and that in diseases that are very sharp if the matter do swell it ought to be remedied the same day for delay in such diseases is dangerous but such diseases are not caused or inflicted upon mans body by reason or occasion of the pestilence but of the diseased bodies and diseases themselves commixed together with the pestilence therefore then peradventure it is lawful to purge strongly and to let a good quantity of blood least that the pestilent venom should take hold of the matter that is prepared and so infect it with a contagion whereby the pestilence taketh new and far greater strength especially as Celsus admonisheth us Cap. 7. lib. 3. where he saith that by how much the sooner those sudden invasions do happen by so much the sooner remedies must be used yea or rather rashly applyed therefore if the veins swell the face wax fiery red if the arteries of the temples beat strongly if the patient can very hardly breath by reason of a weight in his stomach if his spittle be bloody then ought he to be let blood without delay for the causes before mentioned It seems best to open the Liver-vein on the left arm whereby the heart and spleen may be better discharged of their abundant matter Why blood must be let on the left arm in the Plague yet blood-letting is not good at all times for it is not expedient when the body beginneth to wax stiff by reason of the coming of a Fever for then by drawing back the heat and spirits inwardly the outward parts being destitute of blood wax stiff and cold therefore blood cannot be let then without great loss of the strength and perturbation of the humors And it is to be noted that when those phlethorick causes are present there is one Indication of blood-letting in a simple pestilent Fever and another in that which hath a Bubo id est a Botch or a Carbuncle joined therewith For in one or both of these being joined with a vehement and strong burning Fever blood must be letten by opening the vein that is nearest unto the tumor or swelling against nature keeping the straitness of the fibres that this being open the blood might be drawn more directly from the part affected for all and every retraction of putrefied blood unto the noble parts is to be avoided because it is noisom and hurtful to nature and to the patient Therefore for example sake admit the patient be plethorick by repletion which is called Ad Vasa id
is done for the most part within twenty dales after the birth if the woman be not in danger of a fever nor have any other accident let her enter into a bath made of marjerom mint sage rosemary mugwort agrimony penniroyal the flowrs of camomil melilote dill being boiled in most pure and clear running water All the day following let another such like bath be prepared whereunto let these things following be added â„ž farin fabarum aven an lb iii. farin orobi lupinor gland an lb i. aluminis râ—ch â„¥ iv salis com lb ii gallarum nucum cupressiâ— an â„¥ iii. rosar rub m. vi caryophyl nucum moschat an Ê’iii boil them all in common water then sew them all in a clean linnen cloth as is were in a bag and cast them therein into the bath wherein Iron red hot hath been extinguished and let the woman that hath lately travailed sit down therein so long as she pleaseth and when she commeth out let her be laid warm in bed and let her take some preserved Orange-pill or bread toasted and dipped in Hippocras or in wine brewed with spices and then let her sweat if the sweat will come forth of its own accord A stringent so mentations for the privy parts On the next day let astringent fomentations be applied to the genitals on this wise prepared â„ž gallar nucum cupressi corticum granat an â„¥ i. rosar rub m. i. thymi majotan an m. ss alaminis rochae salis com an Ê’ii boil them all together in red wine and make thereof a decoction for a fomentation A distilled liquor for to draw together the dugs that are loose and slack for the fore-named use The distilled liquor following is very excellent and effectual to confirm and to draw in the dugs or any other loose parts â„ž caryophil nucis moschat nucum cupressi an â„¥ iss mastich â„¥ ii alumin. rech â„¥ iss glandium corticis querni an lb ss rosar rubr m. i. cort granat â„¥ ii terrae sigillat â„¥ i. cornn cervi usti â„¥ ss myrtillor sanguinis dracon an â„¥ i. boli amini â„¥ ii ireos florent â„¥ i. sumach berber Hippuris an m. ss conquassentur omnia macerentur spatio duorum dierum in lb. F. aquae rosarum lb.ii. prunorum syvestr mespilerum pomorum quernorum lb. ss aquae fabrorum aceti denique fortiss â„¥ iv afterward distill it over a gentle fire and keep the distilled liquor for your use wherewith let the parts be fomented twice in a day And after the fomentation let wollen cloaths or stupes of linnen cloth be dipped in the liquor and then pressed out and laid to the place When all these things are done and past the woman may again keep company with her husband CHAP. XXIX What the causes of difficult and painful travail in childe-birth are The causes of the difficult childe-birth that are in the woman that travaileth THe fault dependeth sometimes on the mother and sometimes on the infant or child within the womb On the mother if she be more fat if she be given to gormanoize or great eating if she be too lean or young as Savanarola thinketh her to be that is great with childe at nine years of age or unexpert or more old or weaker then she should be either by nature or by some accident as by diseases that she hath had a little before the time of childe-birth or with a great flux of blood But those that fall in travail before the full and prefixed time are very difficult to deliver because the fruit is yet unripe and not ready or easie to be delivered If the neck or orifice of the womb be narrow either from the first conformation or afterwards by some chance as by an ulcer cicatrized or more hard and callous by reason that it hath been torn before at the birth of some other childe and so cicatrized again so that if the cicatrized place be not cut even in the moment of the deliverance both the childe and the mother will be in danger of death also the rude handling of the midwife may hinder the free deliverance of the childe The passions of the minde binder the birth Oftentimes women are letted in travail by shamefac'tness by reason of the presence of some man or hate to some woman there present If the secundine be pulled away sooner then it is necessary it may cause a great flux of blood to fill the womb so that then it cannot perform his exclusive faculty no otherwise then the bladder when it is distended by reason of over-abundance of water that is therein cannot cast it forth so that there is a stoppage of the urine But the womb is much rather hindred or the faculty of childe-birth is stopped or delayed if together with the stopping of the secundine there be either a Mole or some other body contrary to nature in the womb In the secundines of two women whom I delivered of two children that were dead in their bodies I found a great quantity of sird like unto that which is found about the banks of rivers so that the gravel or sand that was in each secundine was a full pound in weight Also the infant may be the occasion of difficult childe-birth as if too big The causes of d fficult child-birth thâ—t are in the infant if it come overthwart if it come with its face upwards and its buttocks forwards if it come with its feet and hands both forwards at once it it be dead and swoun by reason of corruption if it be monstrous if it have two bodies or two heads if it be manifold or seven-fold as Allucrasis affirmeth he hath seen if there be a mole annexed thereto if it be very weak if when the waters are stowed out it doth not move nor stir or offer its self to come forth Yet notwithstanding it happeneth sometimes that the fault is neither in the mother nor the childe but in the air which being cold The exâ—ernal causes of difficult childe-birth doth so binde congeal and make stiff the genital parts that they cannot be relaxed or being contrariwise too hot it weakneth the woman that is in travail by reason that it wasteth the spirits wherein all the strength consisteth or in the ignorant or unexpert midwife who cannot artificially rule and govern the endeavors of the woman in travail The birth is wont to be easie if it be in the due and prefixed natural time Which is an easie birth What causeth easiness of child-birth if the childe offer himself lustily to come forth with his head forwards presently after the waters are come forth and the mother in like manner luâ—ty and strong those which are wont to be troubled with very difficult childe-birth ought a little before the time of the birth to go into an half-tub filled with the decoction of mollifying roots and seeds to have their genitals womb and neck thereof to be annointed with
all over the superficial and inward parts of the womb and neck thereof descending into the wrinkles which in those that have not yet used the act of generation are closed as if they were glewed together although that those maids that are at their due time of marriage feel no pain nor no flux of blood especially if the mans yard be answerable to the neck of the womb What virgins at the fiâ—st time of copulaâ—ion do not bleed as their privy parts Lib. 3. whereby it appears evidently how greatly the inhabitants of Fez the Metropolitan citie of Mauritania are deceived for Leo the African wâ—iteth that it is the custome amongst them that so soon as the married man and his spouse are returned home to their house from the church where they have been married they presently shut themselves into a chamber and make fast the door while the marriage dinner is preparing in the mean while some old or grave matron standeth waiting before the chamber door to receive a bloody linnen cloth the new married husband is to deliver her there which when she hath received she brings it into the midst of all the company of guests as a fresh spoil and testimony of the married wives virginity and then for joy thereof they all fall to banquetting solemnly But if through evil fortune it happeneth that in this time of copulation the spouse bleedeth not in the privie parts she is restored again unto her parents which is a very great reproach unto them and all the guests depart home sad heavie and without dinner Moreover there are some that having learned the most filthie and infamous arts of baudery The filthy deceit of bands and harlots prostitute common harlots make gain thereof makeing men that are naughtily given to beleive that they are pure virgins making them to think that the act of generation is very painful and grievous unto them as if they had never used it before although they are very expert therein indeed for they do cause the neck of the womb to be so wrinkled and shrunk together so that the sides thereof shall even almost close or meet together then they put thereinto the bladders of fishes or galls of beasts filled full of blood and so deceive the ignorant and young letcher by the defraud and deceit of their evil arts and in time of copulation they mix sighs with groanes and woman like cryings and crocodiles tears that they may seem to be virgins and never to have dealt with man before CHAP. XLIII A memorable history of the membrane called Hymen JOhn Wierus writeth that there was a Maid at Camburge Lib. de prost damon cap. 3â— who in the midst of the neck of the womb had a thick and strong membrane growing overthwart so that when the monethly terms should come out it would not permit them so that thereby the menstrual matter was stopped and flowed back again which caused a great tumor and distention in the belly with great torment as if she had been in travail with childe the midwives being called and having seen and considered all that had been done and did appear did all with one voice affirm that she sustained the pains of childe-birth although that the maid her self denied that she ever dealt with man Therefore then this foresaid Author was called who when the Midwives were void of counsel might help this wretched maid having already had her urine stopped now three whole weeks and perplexed with great watchings loss of appetite and loathing and when he had seen the grieved place and marked the orifice of the neck of the womb he saw it stopped with a thick membrane he knew also that that sudden breaking out of blood into the womb and the vessels thereof and the passage for those matters that was stopped was the cause of her grievous and tormenting pain And therefore he called a Chyrurgeon presently and willed him to divide the membrane that was in the midst that did stop the flux of blood which being done there came forth as much black congealed and putrified blood as weighed some eight pounds In three dayes after she was well and void of all disease and pain I have thought it good to set down this example here because it is worthy to be noted and profitable to be imitated as the like occasion shall happen CHAP. XLIV Of the strangulation of the Womb. What is the strangulation of the womb THe strangulation of the womb or that which cometh from the womb is an interception or stopping of the liberty in breathing or taking winde because that the womb swollen or puffed up by reason of the access of gross vapours and humors that are contained therein and also snatched as it were by a convulsive motion by reason that the vessels and ligaments distended with fullness are so carried upwards against the midriff and parts of the breast that it maketh the breath to be short and often as it a thing lay upon the breast and pressed it Why the womb swelleth Moreover the womb swelleth because there is contained or inclosed in it a certain substance caused by the defluxion either of the seed or flowers or of the womb or whites or of some other humor tumor abscess rotten apostume or some ill juyce putrifying or getting or ingendring an ill quality The accidents that come of the strangling of the womb and resolved into gross vapours These as they affect sundry or divers places infer divers and sundry accidents as rumbling and noise in the belly if it be in the guts desire to vomit after with seldom vomiting cometh weariness and loathing of meat if it trouble the stomach Choaking with strangulation if it assail the breast and throat swooning if it vex the heart madness or else that which is contrary thereto sound sleep or drowsiness if it grieve the brain all which oftentimes prove as malign as the biting of a mad dog or equal the stinging or bitings of venemous beasts Why the strangulation that cometh of the corruption of the seed is more dangerous then that that comes of the corruption of the blood It hath been observed that more greivous symptoms have proceeded from the corruption of the seed then of the menstrual blood For by how much every thing is more perfect and noble while it is contained within the bounds of the integrity of its own nature by so much it is the more grievous and perillous when by corruption it hath once transgressed the laws thereof But this kinde of accident doth very seldom grieve those women which have their menstrual flux well and orderly and do use copulation familiarly but very often those women that have not their menstrual flux as they should and do want and are destitute of husbands especially if they be great eaters and lead a solitary life When the vessels and ligaments of the womb are swollen and distended as we said before so much as is added to their latitude
pale Of Taste bitter It provoketh the expulsive faculty of the guts attenuates the Phlegm 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 Consistence gross and muddy Of Colour blackish Of Taste acide sour or biting Stirs up the Appetite nourishes the Spleen and all the parts of like temper to it as the bones Blood hath its nearest matter from the better portion of the Chylus and being begun to be laboured in the veins at length gets form and perfection in the Liver but it hath its remote matter from meats of good digestion and quality seasonably eaten after moderate exercise but for that one age is better than another and one time of the year more convenient than another For blood is made more copiously in the Spring because that season of the year comes nearest to the temper of the bloud by reason of which the blood is rather to be thought temperate than hot or moist for that Galen makes the Spring temperate and besides at that time blood-letting is performed with the best success Lib. 1. de temp Youth is an age very fit for the generation of blood or by Galens opinion rather that part of life that continues from the 25 to the 35 year of our age Those in whom this Humor hath the dominion are beautified with a fresh and rosie colour gentle and wel-natured pleasant merry and facetious The generation of Phlegm is not by the imbecillity of heat as some of the Ancients thought who were perswaded that Choler was caused by a raging Blood by a moderate and Phlegm and Melancholy by a remiss heat But that opinion is full of manifest error for if it be true that the Chylus is laboured and made into blood in the same part One and the same Heat is the efficient cause of all humors at the same time and by the same fire that is the Liver from whence in the same moment of time should proceed that strong and weak heat seeing the whole mass of the blood different in its four essential parts is perfected and made at the same time and by the same equal temper of the same part action and blood-making faculty therefore from whence have we this variety of Humors From hence for that those meats by which we are nourished enjoy the like condition that our bodies do from the four Elements and the four first Qualities for it is certain and we may often observe In what kind soever they be united or joyned together they retain a certain hot portion imitating the fire another cold the water another dry the earth and lastly another moist like to the air Neither can you name any kind of nourishment how cold soever it be not Lettuce it self in which there is not some fiery force of heat Therefore it is no marvail if one and the same heat working upon the same matter of Chylus varying with so great dissimilitude of substances do by its power produce so unlike humors as from the hot Choler from the cold Phlegm and of the others such as their affinity of temper will permit There is no cause that any one should think that variety of humors to be caused in us The heat of the Sun alone doth melt was and harden clay rather by the diversity of the active heat than wax and a flint placed at the same time and in the same situation of climat and soil this to melt by the heat of the Sun and that scarse to wax warm Therefore that diversity of effects is not to be attributed to the force of the efficient cause that is of Heat which is one and of one kind in all of us but rather to the material cause seeing it is composed of the conflux or meeting together of various substances gives the heat leave to work 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 Phlegm Yet I will not deny but that more Phlegm or Choler may be bred in one and the same body according to the quicker or slower provocation of the heat yet nevertheless it is not consequent that the Original of Choler should be from a more acide and of Phlegm from a more dull heat in the same man Every one of us naturally have a simple heat and of one kind which is the worker of divers operations not of it self seeing it is always the same and like it self but by the different fitness pliableness or resistance of the matter on which it works Wherefore Phlegm is generated in the same moment of time The divers condition of the matter alone is the cause of variety in the fire of the same part by the efficiency of the same heat with the rest of the blood of the more cold liquid crude and watery portion of the Chylus Whereby it comes to pass that it shews an express figure of a certain rude or unperfect blood for which occasion nature hath made it no peculiar receptacle but would have it to run friendly with the blood in the same passages of the veins that any necessity hapning by famin or indigency and in defect of better nourishment it may by a perfecter elaboration quickly assume the form of blood Cold and rude nourishment make this humor to abound principally in Winter and in those which incline to old-age by reason of the similitude which Phlegm hath with that season and age It makes a man drowsie dul fat The effect of Phlegm swollen up and hastneth gray-hairs Choler is as it were a certain heat and fury of humors which generated in the Liver together with the blood is caryed by the veins 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 sweats It is somewhat probable that the arterial blood is made more thin hot quick and pallid than the blood of the Veins by the commixture of this Alimentary Choler This Humor is chiefly bred and expel'd in youth and acid and bitter meats give matter to it but great labours of body and mind give the occasion It maketh a man nimble quick ready for all performance lean and quick to anger and also to concoct meats The effects of Choler The melancholick humor or Melancholy being the grosser portion of the blood is partly sent from the Liver to the Spleen to nourish it and partly carryed by the vessels into the rest of the body and spent in the nourishment of the parts endued with an earthly dryness it is made of meats of gross juyce and by the perturbations of the mind turned to fear and sadness The effects of Melancholy It is augmented in Autumn and in the first and crude Old-age it makes men sad harsh constant froward envious and fearful
which awhile agone was Sanguine may now be Cholerick Melancholick or Phlegmatick not truly by the changing of the blood into such Humors but by the mutation of Diet and the course or vocation of life For none of a Sanguine complexion but will prove Cholerick if he eat hot and dry meats How one may become Cholerick as all like things are cherished and preserved by the use of their like and contraries are destroyed by their contraries and weary his body by violent exercises and continual labors and if there be a suppression of Cholerick excrements which before did freely flow either by nature or art But whosoever feeds upon Meats generating gross blood How Melancholick as Beef Venison Hare old Cheese and all salt Meats he without all doubt sliding from his nature will fall into a Melancholy temper especially if to that manner of diet he shall have a vocation full of cares turmoils miseries strong and much study careful thoughts and fears also if he sit much wanting exercise for so the inward heat as it were defrauded of its nourishment faints and grows dull whereupon gross and drossie humors abound in the body To this also the cold and dry condition of the place in which we live doth conduce and the suppression of the Melancholy humor accustomed to be evacuated by the Haemorrhoides courses and stools How Phlegmatick But he acquires a Phlegmatick temper whosoever useth cold and moist nourishment much feeding who before the former meat is gone out of the belly shall stuff his paunch with more who presently after meat runs into violent exercises who inhabit cold and moist places who lead their life at ease in all idleness and lastly who suffer a suppression of the Phlegmatick humor accustomly evacuated by vomit cough or blowing the nose or any other way either by nature or art Certainly it is very convenient to know these things that we may discern if any at the present be Phlegmatick Melancholick or of any other temper whether he be such by nature or necessity Having declared those things which concern the nature of Temperaments and deferred the description of the parts of the body to our Anatomy we will begin to speak of the Faculties governing this our life when first we shall have shewn by a practical demonstration of examples the use and certainty of the aforesaid rules of Temperaments CHAP. VII Of the Practice of the aforesaid Rules of Temperaments Four bounds or Regioâ—â— of the the world THat we may draw the Theorick of the Temperaments into practice it hath seemed good for avoiding of confusion which might make this our Introduction seem obscure if we would prosecute the differences of the Tempers of all men of all Nations to take those limits which Nature hath placed in the world as South North East and West and as it were the Center of those bounds that the described variety of Tempers in colour habâ—t manners studies actions and form of life oâ— men that inhabit those Regions situated so far distant one from another may be as a sure rule by which we may certainly judg of every mans temperature in particular as he shall appear to be nearer or further off from this or that Region The forces of temperatures in particulars Those which inhabit the South as the Africans Aethiopians Arabians and Egyptians are for the most part deformed lean duskie coloured and pale with black eyes and great lips curled hair and a small and shrill voyce Those which inhabit the Northern parts The temperature of the Southern people as the Scythians Muscovites Polonians and Germans have their faces of colour white mixed with a convenient quantity of blood their skin soft and delicate their hair long hanging down and spreading abroad and of a yellowish or reddish colour of stature they are commonly tall and of a well proportioned fat and compact habit of body their eyes gray Of the Northern their voice strong loud and big But those who are situated between these two former as the Italians and French have their faces somewhat swart are well favoured nimble strong hairy slender well in flesh with their eyes resembling the colour of Goats-eye and often hollow eyed having a cleer shrill and pleasing voyce The Southern people prevail in wit the Northern in strength The Southern people are exceeded so much by the Northern in strength and ability of body as they surpass them in wit and faculties of the mind Hence is it you may read in Histories that the Scythians Goths and Vandals vexed Africk and Spain with infinite incursions and most large famous Empires have been founded from the North to South but few or none from the South to the North. Therefore the Northern people thinking all right and law to consist in Arms did by Duel only determine all causes and controversies arising amongst the Inhabitants as we may gather by the ancient laws and customs of the Lumbards English Burgonians Danes and Germans and we may see in Saxo the Grammarian that such a law was once made by Fronto King of Denmark The which custom at this day is every where in force amongst the Muscovites But the Southern people have alwayes much abhorred that fashion and have thought it more agreeable to Beasts than Men. Wherefore we never heard of any such thing used by the Assyrians Aegyptians Persians or Jews But moved by the goodness of their wit they erected Kingdomes and Empires by the only help of Learning and hidden Sciences For seeing by nature they are Melancholick by reason of the dryness of their temperature they willingly addict themselves to solitariness and contemplation being endued with a singular sharpness of wit Wherefore the Aethiopians Egyptians Africans Jews Phoenicians Persians Assyrians and Indians The Southern people learned and religious have invented many curious Sciences revealed the Mysteries and secrets of Nature digested the Mathematiques into order observed the motions of the Heavens and first brought in the worship and religious sacrifices of the gods Even so far that the Arabians who live only by stealth and have only a Waggon for their house do boast that they have many things diligently and accurately observed in Astrology by their Ancestors which every day made more accurate and copious they as by an hereditary right commend to posterity as it is recorded by Leo the African The Northern famous Warriers and Artificers But the Northern people as the Germans by reason of the aboundance of humors and blood by which the mind is as it were opprest apply themselves to works obvious to the senses and which may be done by the hand For their minds opprest with the earthly mass of their bodies are easily drawn from heaven and the contemplation of coelestial things to these inferior things as to find out Mines by digging to buy and cast metalls to draw and hammer out works of Iron steel and brass In which things they
hereupon the face grows sodainly pale the extreme parts cold all the body trembles or shakes the belly in some is loosed the voyce as it were stays in the jaws the heart beats with a violent pulsation because it is almost opprest by the heat strangled by the plenty of blood and spirits aboundantly rushing thither The hair also stands upright because the heat and bloud are retired to the inner parts Hiâ—pach lib. 4. 〈◊〉 Miâ— and the utmost parts are more cold and drie than a stone by reason whereof the utmost skin and the pores in which the roots of the hairs are fastned are drawn together Shame is a certain affection mixed as it were of Anger and Fear therefore Shame if in that conflict of as it were contending passions Fear prevail over Anger the face waxeth pale the blood flying back to the heart and these or these Symptoms rise according to the vehemency of the contracted and abated heat But if on the contrary Anger get the dominion over Fear the blood runs violently to the face the eyes look red and sometimes they even fome at the mouth There is another kind of shame which the Latins call Verecundia we Shamefastness Shamefastness in which there is a certain flux and reflux of the heat and blood first recoiling to the heart then presently rebounding from thence again But that motion is so gentle that the heart thereby suffers no oppression nor defect of spirits wherefore no accidents worthy to be spoken of arise from hence this affect is familiar to young maids and boys who if they blush for a fault committed unawares or through carelesness it is thought an argument of a vertuous and good disposition But an agony which is a mixt passion of a strong fear and vehement anger An agony involves the heart in the danger of both motions wherefore by this passion the vital faculty is brought into very great danger To these six Passions of the mind all other may be revoked as Hatred and Discord to Anger Mirth and Boasting to Joy Terrors Frights and Swoundings to Fear Envy Despair and Mourning to Sorrow By these it is evident how much the Passions of the mind can prevail to alter and overthrow the state of the body and that by no other means than that by the compression and dilatation of the heart they diffuse and contract the spirits blood and heat from whence happens the dissipation or oppression of the spirits The signs of these Symptoms quickly shew themselves in the face the heart Why the first signs of passions of the mind appear in the face by reason of the thinness of the skin in that part as it were painting forth the notes of its affections And certainly the face is a part so fit to disclose all the affections of the inward parts that by it you may manifestly know an old man from a young a woman from a man a temperate person from an untemperate an Ethiopian from an Indian a Frenchman from a Spaniard a sad man from a merry a sound from a sick a living from a dead Wherefore many affirm that the manners and those things which we keep secret and hid in our hearts may be understood by the face and countenance Now we have declared what commodity and discommodity may redound to the man from these fore-mentioned passions and have shewed that anger is profitable to none The use of passions of the mind unless by chance to some dull by reason of idleness or opprest with some cold clammy and phlegmatick humor and Fear convenient for none unless peradventure for such as are brought into manifest and extream danger of their life by some extraordinary sweat immoderate bleeding or the like unbrideled evacuatâ—on Wherefore it behoves a wise Chirurgeon to have a care lest he inconsiderately put any Patient committed to his charge into any of these passions unless there be some necessity thereof by reason of any of the fore-mentioned occasions CHAP. XIX Of things against Nature and first of the Cause of a Disease HAving intreated of things natural and not-natural What things against nature are What and how many the causes of diseases be The Primitive cause Internal antecedent now it remains we speak of things which are called against nature because they are such as are apt to weaken and corrupt the state of our body And they be three in number The Cause of a Disease a Disease and a Symptome The cause of a disease is an affect against nature which causes the disease Which is divided into Internal and External The External Original or Primitive comes from some other place and outwardly into the body such be meats of ill nourishment and such weapons as hostilely wound the body The Internal have their essence and seat in the body and are subdivided into antecedent and conjunct That is called an antecedent cause which as yet doth not actually make a disease but goes near to cause one so humors copiously flowing or ready to flow into any part are the antecedent cause of diseases The conjunct is that which actually causes the disease Internal conjunct and is so immediately joyned in affinity to the disease that the disease being present it is present and being absent it is absent Again of all such causes some are born together with us as the over-great quantity and malign quality of both the seeds and the menstruous blood from diseased Parents are causes of many diseases and specially of those which are called Hereditary Other happen to us after we be born by our diet and manner of life a stroke fall or such other like Those which be bred with us cannot be wholly avoided or amended but some of the other may be avoided as a stroke and fall some not as those which necessarily enter into our body as Air Meat Drink and the like But if any will reckon up amongst the internal inherent and inevitable causes the dayly The congenit or inevitable cause of death nay hourly dissipation of radical moisture which the natural heat continually preys upon I do not gainsay it no more than that division of Causes celebrated and received of Philosophers divided into Material Formal Efficient and Final for such a curious contemplation belongs not to a Chirurgeon whom I only intend plainly to instruct Wherefore that we have written may suffice him CHAP. XX. Of a Disease What a disease is and how various A Distemperature A Disease is an affect against Nature principally and by it self hurting and depraving the action of the part in which it resides The division of a Disease is threefold Distemperature ill Conformation and the Solution of Continuity Distemperature is a Disease of the similar parts dissenting and changed from their proper and native temper That digression from the native temper happens two ways either by a simple distemperature from the excess of one quality and this is fourfold Hot Cold Moist
the evacuation of the conjunct matter Galen by a dream cures the Sciatica by the artery the Anckle of the same side being opened yet because it was not cut for this purpose but happened only by chance I judged it was not much dissenting from this argument Pliny writes that there was one named Phalereus which casting up blood at his mouth and at the length medicines nothing availing being weary of his life went unarmed in the front of the battel against the Enemy and there receiving a wound in his breast shed a great quantity of blood which gave an end to his spitting of blood the wound being healed and the vein which could not contain the blood being condensate At Paris Anno 1572. in July a certain Gentleman being of a modest and curteous cariage fell into a continual Feaver and by that means became Frantick moved with the violence of which he cast himself headlong out of a window two stories high and fell first upon the shoulder of Valterra the Duke of Alenzons Physitian and then upon the pavement with which fall he cruelly bruised his ribs and hip but was restored to his former judgment and reason There were present with the Patient besides Valterra witnesses of this accident these Physitians Alexis Magnus Duretus and Martinus The same happened in the like disease and by the like chance to a certain Gascoyn lying at the house of Agrippa in the Paved street Othomannus Doctor of Physick of Monpelier and the King's Professor told me that a certain Carpenter at Broquer a village in Switzerland being frantick cast himself headlong out of an high window into a river and being taken out of the water was presently restored to his understanding The cause of the last recited cures But if we may convert casualties into counsel and Art I would not cast the Patients headlong out of a window But would rather cast them sodainly and thinking of no such thing into a great cistern filled with cold water with their heads foremost neither would I take them out until they had drunk a good quantity of water that by that sodain fall and strong fear the matter causing the Frenzy might be carryed from above downwards from the noble parts to the ignoble the possibility of which is manifest by the forecited examples as also by the example of such as bit by a mad Dog fearing the water are often ducked into it to cure them CHAP. XXIV Of certain juggling and deceitful ways of Curing HEre I determin to treat of those Impostors who taking upon them the person of a Chirurgeon do by any means either right or wrong put themselves upon the works of the Art but they principally boast themselves amongst the ignorant common sort of setting bones which are out of joynt and broken Sciences are not hereditary affirming as falsly as impudently that they have knowledg of those things from their Ancestors as by a certain hereditary right which is a most ridiculous fiction for our minds when we are born is as a smooth table upon which nothing is painted Otherwise what need we take such labour and pains to acquire and exercise Sciences God hath endued all brute beasts with an inbred knowledge of certain things necessary for to preserve their life more than man But on the contrary he hath enriched him with a wit furnished with incredible celerity and judgment by whose diligent and laborious fatigation he subjects all things to his knowledg For it is no more likely that any man should have skill in Chirurgery because his father was a Chirurgeon than that one who never endured sweat dust nor Sun in the field should know how to ride and govern a great Horse and know how to carry away the credit in tilting only because he was begot by a Gentleman and one famous in the Art of War A most impudent sort of Impostors There is another sort of Impostors far more pernicious and less sufferable boldly and insolently promising to restore to their proper unity and seat bones which are broken and out of joynt by the only murmuring of some conceited charms so that they may but have the Patients name and his girdle In which thing I cannot sufficiently admire the idleness of our Countreymen so easily crediting so great and pernicious an error not observing the inviolable law of the ancient Physitians and principally of Divine Hippocrates by which it is determined that three things are necessary to the setting of bones dislocated and out of joynt to draw the bones asunder to hold the bone receiving firmly immoveable with a strong and steddy hand to put the bone to be received into the cavity of the receiving For which purpose the diligence of the Ancients hath invented so many Engines Three things necessary for the cure of a Luxation Glossocomies and Bands lest that the hand should not be sufficient for that laborious work What therefore is the madness of such Impostors to undertake to do that by words which can scarse be done by the strong hands of so many Servants and by many artificial Engines Of late years another kind of Imposture hath sprung up in Germany they beat into fine powder a stone which in their mother tongue they call Bemâ—ruch and give it in drink to any who have a bone broken or dislocated and affirm that it is sufficient to cure them Through the same Germany there wander other Impostors who bid to bring to them the Weapon with which any is hurt they lay it up in a secret place and free from noise and put and apply medicines to it as if they had the patient to dress and in the mean time they suffer him to go about his business and impudently affirm that the wound heals by little and little by reason of the medicine applyed to the weapon But it is not likely that a thing in animate which is destitute of all manner of sense should feel the effect of any medicine and less probable by much that the wounded party should receive any benefit from thence Neither if any should let me see the truth of such juggling by the events themselves and my own eyes would I therefore believe that it were done naturally and by reason but rather by Charms and Magick In the last assault of the Castle of Hisâ—in the Lord of Martigues the elder was shot through the breast with a Musket bullet I had him in cure together with the Physitians and Chrirurgeons of the Emperour Charles the fifth and Emanuel Phiâ—rt the Duke of Savoy who because he entirely loved the wounded prisoner caused an Assembly of Physitians and Chirurgeons to consult of the best means for his cure They all were of one opinion that the wound was deadly and incurable because it passed through the midst of his lungs and besides had cast forth a great quantitv of knotted blood into the hollowness of his breast There was found at that time a certain Spaniard
brute Beasts as Pliny affirmeth The infallible vertue of the herb Dictammus in drawing darts out of the flesh was taught us by the Hart who wounded with the Huntsman's darts or arrows by means hereof draws out the weapons which remain sticking in her Which is likewise practised by the Goats of Candy as Aristotle writeth The wonderful effect which Celandine hath upon the sight was learnt by the practice of Swallows who have been observed with it to have besmeared and so strengthened the eyes of their young Serpents rub their eye-lids with fennel and are thought by that means to quicken and restore the decaying sight of their eyes The Tortois doth defend and strengthen her self against the biting of Vipers by eating of savory Bears by eating of Pismires expel that poison that they have contracted by their use of Mandrakes And for correction of that drousiness and sloth which grows upon them by their long sleep in their dens The craftiness of Bears they eat the herb of Aron i. Cuckopint But the Art they use in the enticing and catching of Pismires is very pretty they go softly to the holes or hils of the Pismires and there lay themselves all their length upon the ground as if they were dead hanging out their tongue wet with their foam which they draw not again into their mouth before they feel them full of Pismires which are enticed by the sweetness of the foam And having taken this as a purging medicine they expel by the guts those ill humors wherewith they were offended We see that Dogs give themselves a vomit by eating a kind of grass which is from thence called Dog-grass Swine when they find themselves sick will hunt after smalt or river-lobsters Stockdoves Blackbirds and Partridges purge themselves by Bay-leaves Pigeons Turtles and all sort of Pullen disburden themselves of gross humors by taking of Pellitory of the wall The bird Ibis the first inventer or shewer of Clysters The invention of removing a Cataract The invention of Phlebotomy The Bird Ibis being not much unlike the Stork taught us the use of Clysters For when he finds himself oppressed with a burden of hurtful humors he fills his bill with salt-water and so purgeth himself by that part by which the belly is best discharged The invention of the way of removing the Cataract of the eye we must yield unto the Goat who by striking by chance against the thorny bushes pulls off the Cataract which hinders the sight and covers the ball of the eye and so recovers his sight The benefit of Phlebotomy we owe unto the Hippotamus or River-horse being a kind of horse and the Inhabitant of the River Nilus who being a great devourer when he finds himself surcharged with a great deal of blood doth by rubbing his thigh against the sharp sands on the bankside open a vein whereby the superfluous bloud is discharged which he stoppeth likewise when it is fit by rowling himself in the thick mud The Tortois having chanced to eat any of the flesh of a Serpent doth make Origanum and Marjoram her Antidote The Ancients found help from brute beasts A preservative against thunder even against the dreadful and non-sparing force of lightning for they were of opinion that the wings of an Eagle were never struck with lightning and therefore they put about their heads little wreaths of these feathers They were perswaded the same thing of the Seal or Sea-calf and therefore were wont to encompass their bodies with his skin as a most certain safe-guard against lightening It were a thing too long and laborious to speak of all those other muniments of life and health observed here and there by Aristotle and Pliny which we have learnt of brute beasts I will therefore end this Chapter after that I have first added this That we are beholding to Beasts not only for the skill of curing diseases and of preservation of health but for our food our rayment and the ornament and beautifying of our bodies Of the Faculty of brute Beasts in presaging THe first knowledg and skill of Prognostication and observation of weather by the Air was first delivered unto us from Beasts of the land and water and from Fowl What the butting of Rams signifies For we see in dayly observation that it is a sign of change of weather when Lambs and Rams do butt at one another with their horns and playing wantonly do kick and keep up their heels The same is thought to be presaged when the Ox licks himself against the hair and on the sodain fils the Air with his lowing and smels to the ground and when he feeds more greedily than he used to do But if the Pismires in great multitudes fetch their prey so hastily Presages of rain that they run and tumble one upon another in their narrow paths it is thought a sign of rain As is also the busie working of Moals and the Cats rubbing and stroaking of her head and neck and above her ears with the bottom of her feet Also when Fishes play and leap a little above the water it is taken for a sign of rain But if the Dolphins do the same in the Sea and in great companies The sign at Sea of a storm at hand it is thought to presage a sodain storm and tempest Whereby the Mariners fore-warned use all care possible for the safety of themselves and their ships and if they can cast Anchor And it is sufficiently known what the louder croaking of Frogs than ordinary portends But the faculty of Birds in this kind of presaging is wonderful If Cranes flie through the air without noise it is a sign of fair weather and of the contrary if they make a great noise and flie straglingly As also if Sea-fowl flie far from the Sea and light on the land The cry or scrieching of Owls portends a change of the present weather whether foul or fair Plutarch saith that the loud cawing of the Crow betokens winds and showers as also when he slaps his side with his wings Geese and Ducks when they dive much and order and prune and pick their feathers with their beaks and cry to one another fore-tel rain and in like manner Swallows when they flie so low about the water that they wet themselves and their wings And the Wren when he is observed to sing more sweetly than usual and to hop up and down And the Cock when he chants or rather crows presently after the setting of the Sun And Gnats and Fleas when they bite more then ordinary If the Hern soar aloft into the air it betokeneth fair weather if on the contrary he flie close by the water rain If Pigeons come late home to the Dove-house it is a sign of rain If Bats fly in the evening they fore-shew wet weather And lastly the Crocodile lays her egs in that place The Crocodile by laying her egs shews the bounds of the River Nilus which must be
so it may bind them together and strengthen and beautifie the whole joint or connexion for these three be the principal uses of a ligament then diffusing it self into the membranes and muscles to strengthen those parts The treefold use of a Ligament What a Nerve is A Nâ—rve to speak properly is also a simple part of our body bred and nourished by a gross and pâ—legmatick humour such as the brain the original of all the nerves and also the Spinal marrow endued with the faculty of feeling and oftentimes also of moving For there be divers parts of the body which have nerves yet are destitute of all voluntary motion having the sense only of â—eeling as the membranes veins arteries guts and all the entrails A nerve is covered with a double cover from the two membranes of the brain and besides also with a third proceeding from the ligaments which fasten the hinder part of the head to the Vertebra's or else from the Pericranium What we mean by the nervous and ligamentous fibers We understand no other things by the fibers of a Nerve or of a Ligament than long and slender threds white solid cold strong more or less according to the quantity of the substance which is partly nervous and sensible partly ligamentous and insensible You must imagine the same of the fleshy fibers in their kind but of these threds some are streight for attraction others oblique for retention of that which is convenient for the creature and lastly some transverse for expulsion of that which is unprofitable But when these transverse threds are extended in length they are lessened in bredth but when they are directly contracted they are shortned in length But when they are extended all together as it were with an unanimous consent the whole member is wrinkled as contracted into it self as on the contrary it is extended when they are relaxed Some of these are bestowed upon the animal parts to perform voluntary motions others upon the vital to perform the agitation of the heart and arteries others upon the natural for attraction By what power the similar parts principally draw or attract What and of how many sorts the flesh is retention and expulsion Yet we must observe that the attraction of no similar part is performed by the help of the foresaid fibers or threds but rather by the heat implanted in them or by the shunning of emptiness or the familiarity of the substance The flesh also is a simple and soft part composed of the pure portion of the blood insinuating it self into the spaces between the fibers so to invest them for the uses formerly mentioned This is as it were a certain wall and bulwark against the injuries of heat and cold against all falls and bruises as it were a certain soft pillow or cushion yielding to any violent impression There be three sorts of flesh one more ruddy as the musculous flesh of perfect creatures and such as have blood for the flesh of all tender and young things having blood as Calves and also of all sorts of fish is whitish by reason of the too much humidity of the blood The second kind is more pallid even in perfect creatures having blood such is the flesh of the heart stomach weason guts bladder womb The third is belonging to the entrails or the proper substance of each entrail as that which remains of the Liver the veins arteries and coat being taken away of the bladder of the gall brains kidnies milt Some add a fourth sort of flesh which is spongy that they say is proper to the tongue alone What a vein is A Vein is the vessel pipe or channel of the blood or bloody matter it hath a spermatick substance consists of one coat composed of three sorts of fibers What an Artery is An Artery is also the receptacle of blood but that spirituous and yellowish consisting in like manner of a spermatick substance But it hath two coats with three sorts of fibers the utmost whereof is most thin consisting of right fibers and some oblique But the inner is five times more thick and dense than the utmost interwoven with transverse fibers and it doth not only contain blood and spirit but also a serous humour which we may believe because there be two emulgent Arteries as well as Veins Why an artery is more thick and dense than a vein But the inner coat of an Artery is therefore more thick because it may contain blood which is more hot subtil and spirituous for the spirit seeing it is naturully more thin and light and in perpetual motion would quickly fly away unless it were held in a stronger hold There is other reason for a Vein as that which contains blood gross ponderous and slow of motion Wherefore if it had acquired a dense and gross coat it could scarce be distributed to the neighbouring parts The mutual Anastomasis of the veins and arteries Where it is manifest God the maker of the Universe foreseeing this made the coats of the vessels contrary to the consistence of the bodies contained in them The Anastomasis of the Veins and Arteries that is to say the application of the mouths of the one to the other is very remarkable by benefit of which they mutually communicate and draw the matters contained in them and so also transfuse them by insensible passages although that Anastomasis is apparent in the Vein and Artery that meet together at the joint and bending of the arm which I have sometimes shewed in the Physick schools at such time as I there dissected Anatomies From whence a muscle hath its beginning or head But the action or function of a Muscle is either to move or confirm the part according to our will into which it is implanted which it doth when it draws it self toward its original that is to say its head But we define the head by the insertion of the nerve which we understand by the manner of the working of the Muscle CHAP. XI Of the Muscles of the Epigastrium or lower Belly NOw seeing that we have taught what a Muscle is and what the differences thereof are and what simple and compound parts it hath and what the use action and manner of action in each part is it remains that we come to the particular explication of each Muscle beginning with those of the lower belly as those which we first meet withal in dissection Eight muscles of the Epigastrium These are eight in number four oblique two on each side two right or direct one on the right another on the left side and in like manner two transverse All these are alike in force magnitude and action so mutually composed that the oblique descendant of one side is conjoined with the other oblique descendant on the other side and so of the rest We may add to this number the two little Supplying or Assisting muscles which are of a Pyramidal form The oblique
see it comes to pass in most Beasts which have one Gut stretched straight out from the stomach to the fundament as in the Lynx and such other Beasts of insatiable gluttony always like plants regarding their food CHAP. XV. Of the Mesentery The substance Magnitude Figure Composure AFter the Guts follows the Mesentery being partly of a fatty and partly of spermatick substance The greatness of it is apparent enough although in some it be bigger and in some lesser according to the greatness of the body It is of a round figure and not very thick It is composed of a double coat arising from the beginning and root of the Peritonaeum In the midst thereof it admits nerves from the Costal of the sixt Conjugation veins from the Vena Porta or Gate-vein Arteries from the descendent artery over and besides a great quantity of fat and many glandulous bodies to prop up the division of the vessels spred over it as also to moisten their substance It is in number one situate in the middle of the guts from whence it took its name Number The connexion Yet some divide it into two parts to wit into the Meseraeum that is the portion interwoven with the smal guts and into the Meso-colon which is joyned with the Great It hath connexion by it vessels with the principal parts by its whole substance with the guts and in some sort with the kidneys from whose region it seems to take its coats The temper It is of a cold and moist temper if you have respect to his fatty substance but if to the rest of the parts cold and dry The action and use The action and use of it is to bind and hold together the guts each in his place lest they should rashly be folded together and by the Meseraick-veins which they term the hands of the Liver carry the Chylus to the Liver All the miseraick veins come from the liver In which you must note that all the Meseraick Veins come from the Liver as we understand by the dissection of bodies although some have affirmed that there be some veins serving for the nourishment of the guts no ways appertaining to the Liver but which end in certain Glandulous bodies dispersed through the Mesentery of whose use we will treat hereafter CHAP. XVI Of the Glandules in general and of the Pancreas or Sweet-bread A Glandule is a simple part of the body sometimes of a spongy and soft substance Substance of the glandules sometimes of a dense and hard Of the soft Glandules are the Tonsillae or Almonds like in substance to blanched Almonds the Thymus Pancreas Testicles Prostatae But the dense and hard are the Parotides and other like The Glandules differ amongst themselves in quantity and figure for some are greater than othersome and some are round and others plain Quantity and figure as the Thymus and Pancreas Others are compounded of veins nerves arteries and their proper flesh Composition as the Almonds of the ears the milky glandules in the breasts and the testicles Others want nerves at least which may be seen as the Parotides the axillary or those under the arm-holes and others The number of glandules is uncertain by reason of the infinite multitude and variety of sporting nature Number You shall find them always in those places where the great divisions of vessels are made as in the middle ventricle of the brain in the upper part of the Chest in the Mesentery and other like places Although othersome be seated in such places as nature thinks needful to generate and cast forth of them a profitable humor to the creature as the Almonds at the root of the tongue the kernels in the dugs the spermatick vessels in the scrotum and at the sides of the womb or where Nature hath decreed to make emunctories for the principal parts as behind the ears under the arm-holes and in the groins The connexion of glandules is not only with the vessels of the parts concurring to their composition but also with those whose division they keep and preserve Connexion They are of a cold temper wherefore Physitians say the blood recrudescere i to become raw again in the dugs when it takes upon it the form of milk But of these some have action as the Almonds Temper Action and use which pour out spattle useful for the whole mouth the dugs milk the Testicles seed others use only as those which are made to preserve under-prop and fill up the divisions of the vessels The substance of the Pancreas Besides this we have spoken of glandules in general we must know that the Pancreas is a glandulous and flesh-like body as that which hath every-where the shape and resemblance of flesh It is situate at the flat end of the Liver under the Duodenum with which it hath great connexion The site and under the Gate-vein to serve as a Bulwark both to it and the divisions thereof whilst it fils up the empty spaces between the vessels themselves and so hinders that they be not pluckt asunder nor hurt by any violent motion as a fall or the like CHAP. XVII Of the Liver HAving gone thus far order of dissection now requires that we should treat of the distribution of the gate-vein but because it cannot well be understood unless all the nature of the Liver from whence it arises be well known therefore putting it off to a more fit place we will now speak of the Liver Wherefore the Liver according to Galen's opinion What the Liver is lib. de form foetus is the first of all the parts of the body which is finished in conformation It is the shop and Author of the blood and the original of the veins the substance of it It s substance and quantity is like the concrete mud of the blood the quantity of it is divers not only in bodies of different but also of the same species as in men amongst themselves of whom one will be gluttonous and fearful another bold and temperate or sober for he shall have a greater Liver than this because it must conceive and concoct a greater quantity of Chylus yet the Liver is great in all men because they have need of a great quantity of blood for the repairing of so many spirits and the substantifick moisture which are resolved and dissipated in every moment by action and contemplation But there may be a twofold reason given why such as are fearful have a larger Liver Why Cowards have great Livers The first is because in those the vital faculty in which the heat of courage and anger resides which is in the heart is weak and therefore the defect of it must be supplyed by the strength of the natural faculty For thus nature is accustomed to recompence that which is wanting in one part by the increase and accession of another The other reason is because cold men have a great
into the bladder Their Substance The substance of the Kidneys is fleshy dense and solid lest they should be hurt by the sharpness of the urine Their magnitude is large enough as you may see Their figure is somewhat long and round Magnitude Figure almost resembling a semicircle and they are lightly flatted above and below They are partly hollow and partly gibbous the hollow lies next the hollow vein and on this side they receive the Emulgent Veins and Arteries and send forth the Ureters their gibbous part lies towards the loins They are composed of a coat coming from the Peritonaeum their own peculiar flesh Composition with the effusion of blood about the proper vessels as happens also in other entrails generates a small nerve which springing from the Costal of the sixth conjugation is diffused to each Kidney on his side into the coat of the kidney it self although others think it always accompanies the vein and artery But Fallopius that most diligent Author of Anatomy hath observed that this nerve is not only oftentimes divaricated into the coat of the Kidneys but also pierces into their substance They are two in number Number that if the one of them should by chance be hurt the other might supply those necessities of nature Site for which the Kidneys are made They lie upon the loyns at the sides of the great vessels on which they depend by their proper veins and arteries and they stick to them as it were by a certain second coat lest that they might be shaken by any violent motions Wherefore we may say that the Kidneys have two coats one proper adhering to their substance the other as it were coming from the Peritonaeum on that part they stick to it The right Kidney is almost alwayes the higher for those reasons I gave speaking of the original of the Emulgent vessels Columbus seems to think the contrary but such like controversies may be quickly decided by the Eye Connexion They have connexion with the Principal vessels by the veins nerves and arteries by the coats with the loins and the other parts of the lower belly but especially with the bladder by the ureters Temper Action They are of a hot and moist temper as all fleshy parts are Their action is to cleanse the Mass of the blood from the greater part of the serous and cholerick humour I said the greater part because it is needful that some portion thereof should go with the alimentary blood to the solid parts to serve instead of a vehicle lest otherwise it should be too thick Their Strainer Besides you must note that in each Kidney there is a cavity bounded by a certain membrane encompassed by the division of the Emulgent veins and arteries through which the urine is strained partly by the expulsive faculty of the Kidneys partly by the attractive of the Ureters which run through the substance of the Kidneys on the hollow side no otherwise than the Porus cholagogus through the body of the Liver CHAP. XXVI Of the spermatick Vessels Ureters NOw we should have spoken of the Ureters because as we said before they are passages derived from the Kidneys to carry the urine to the bladder But because they cannot be distinguished and shewed unless by the corrupting and vitiating the site of the spermatick vessels therefore I have thought it better to pass to the explication of all the spermatick parts And first of all you must gently separate them that so the Declaration of them may be more easie and manifest and that from the coat which comes from the peritonaeum and the fat which invests them even to the sharebone having diligently considered their site before you separate them Their Substance Then you shall teach that the substance of these vessels is like to that of the veins and arteries Their quantity is small in thickness but of an indifferent length by reason of the distance of their original from the Testicles Quantity They are longer in men than in women because these have their Testicles hanging without their belly but women have them lying hid within their belly Their figure and composure is wholly like the figure and composition of the veins and arteries Figure and Composure except in this one thing that from that place where they go forth of the great capacity of the Peritonaeum they are turned into many intricate windings like crooked swoln veins even to the Testicle That the spermatick matter in that one tract which yet is no other than blood may be prepared to concoction or rather be turned into Seed in these vessels by the irradiation of the faculty of the Testicles Number These vessels are six in number four preparing and two ejaculatory of which we will speak hereafter Therefore on each side there be two preparing vessels that is a vein and an artery arising as we told you when we spoke of the distribution of the hollow vein They are inserted into the Testicles through that coat which we call Epididymis others Darton Site Their site is oblique above the loins and flanks whilst they run down between the ends of the share and haunchbone they are knit to the parts lying under them both by certain fibers which they send from them as also by the membrane they have from the Peritonaeum They have like temperature as the veins and arteries have Their action is to carry blood to the Testicles for generating of seed CHAP. XXVII Of the Testicles or Stones THe Testicles are of a Glandulous white soft and loose substance Their Substance that so they may the more easily receive the spermatick matter their magnitude and figure equal and resemble a small pullet's Egg somewhat flatted their composure is of veins arteries Magnitude and Figure Composition coats and their proper flesh Their veins and arteries proceed from the spermatick vessels their nerves from the sixth conjugation by the roots of the ribs and out of the Holy-bone They are wrapped in four coats two whereof are common and two proper The common are the Scrotum or skin of the Cods proceeding from the true skin and the fleshy coat which consists of the fleshy Pannicle in that place receiving a great number of vessels through which occasion it is so called The proper coats are first the Erythrois arising from the process of the Peritonaeum The Coat Erythrois going into the Scrotum together with the spermatick vessels which it involves and covers this appears red both by reason of the vessels as also of the Cremaster-muscles of the Testicles The Epididymis or Dartos Then the Epididymis or Dartos which takes its original of the membrane of the spermatick preparing vessels The flesh of the Testicles is as it were a certain effusion of matter about the vessels as we said of other entrails But you must observe that the Erythrois encompasses the whole stone except
vein which ariseth near to u. x y The double original of the left spermatical vein x From the Emulgent y From the hollow vein α The original of the spermatical arteries β Certain branches from the spermatick arteries which run unto the Peritonaeum γ The passage of the spermatical vessels through the productions of the Peritonaeum which must be observed by such as use to cut for the Rupture δ The spiry bodden hidie's entrance into the testicle it is called Corpus varicosum pyramidale ε The Parastatae ζ The stone or testicle covered with his inmost coat η The descent of the leading vessel called Vas deferens VV The bladder * The right gut ξ The glandules called prostatae into which the leading vessels are inserted Ï The muscle of the bladder στυ Two bodies of the yard σ and Ï„ and Ï… his vessels φχ The coat of the Testicle ψω The muscle of the Testicle ψ his vessels ω. For thus of three passages that is of the two leading vessels and one passage of the bladder there is one common one in men for the casting forth of seed and urine A Caruncle rising like a crest at the beginning of the neck of the bladder argues this uniting of the passages which receiving this same passage which is sufficiently large is oft-times taken by such as are ignorant in Anatomy for an unnatural Caruncle then especially when it is swoln through any occasion These leading vessels are two in number Their Number and Action on each side one Their action is to convey the seed made by the testicles to the Prostates and so to the neck of the bladder so to be cast forth at the common passage But if any ask whether that common passage made by the two leading vessels between the glandulous bodies be so obvious to sense or no We answer it is not manifest though reason compel us to confess that that way is perforated by reason of the spermatick gross and viscous matter carried that way But peradventure the reason why that passage cannot be seen is because in a dead carkass all small passages are closed and hid the heat and spirits being gone and the great appear much less by reason all the perforations fade and fall into themselves Yet certainly these passages must needs be very strait even in a living man seeing that in a dead they will not admit the point of a needle Wherefore we need not fear lest in searching whilst we thrust the Catheter into the Bladder it penetrate into the common passage of the leading vessels which runs within the Caruncle unless peradventure by some chance as a Gonorrhaea or some great Phlegmon This Caruncle must be observed and distinguished from a Hypersarcosis or fleshy excrescence it be much dilated besides nature For I have sometimes seen such passages so open that they would receive the head of a Spathern which thing should admonish us that in searching we take great care that we do not rashly hurt this Caruncle for being somewhat rashly handled with a Catheter it casts forth blood especially if it be inflamed But also the concourse of the spirits flowing with great violence together with the seed much helps forward such ejaculation thereof performed through these strait passages by the power of the imaginative faculty in the Act of generation After the leading vessels follow the Prostatae The Prostatae being glandulous Bodies of the same substance and temper that other Glandules are Their quantity is large enough their figure round Their quantity and figure and somewhat long sending forth on each side a soft production of an indifferent length They are composed of veins nerves arteries a coat which they have from the neighbouring parts and lastly their proper flesh which they have from their first conformation Number and site They are two in number situate at the root of the neck of the Bladder somewhat straitly bound or tied to the same to the leading vessels and the parts annexed to them But alwayes observe An Anatomical Axiom that every part which enjoyes nourishment life and sense either first or last hath connexion with the principal parts of the body by the intercourse of the vessels which they receive from thence The use of the Prostates is to receive in their proper Body the seed laboured in the testicles Their uses and to contain it there until it be troublesom either in quantity or quality or both Besides they contain a certain oily and viscid humour in their glandulous Body that continually distilling into the passage of the urine it may preserve it from the acrimony and sharpness thereof But we have observed also on each side other Glandules Rond in method med ad morbos which Rondeletius calls Appendices Glandulosae Glandulous dependences to arise from these prostates in which also there is seed reserved CHAP. XXIX Of the Ureters NOw it seems fit to speak of the Ureters Bladder and parts belonging to the Bladder The substance magnitude figure and composure of the Ureters Therefore the Ureters are of a spermatick white dense and solid substance of an indifferent bigness in length and thickness Their figure is round and hollow They are composed of two coats one proper consisting of right and transverse fibers which comes from the emulgent veins and arteries the other common from the Peritonaeum besides they have veins nerves and arteries from the neighbouring parts They be two in number on each side one Number and Site they are situate between the Kidneys out of whose hollow part they proceed and the Bladder But the manner how the Ureters insert or enter themselves into the Bladder and the Porus Cholagogus into the Duodenum exceeds admiration for the Ureters are not directly but obliquely implanted neer the orifice of the Bladder and penetrate into the inner space thereof for within they do as it were divide the membrane or membranous coat of the Body of the Bladder and insinuate themselves into that as though it were double But this is opened at the entrance of the urine but shut at other times the cover as it were falling upon it so that the humour which is faln into the capacity of the Bladder cannot be forced or driven back no not so much as the air blown into it can come this way out as we see in Swine's Bladders blown up and filled with air For we see it is the Air contained in these which fills them thus neither can it be pressed forth but with extraordinary force For as this skin or coat turned in by the force of the humour gives way so it being pressed out by the body contained within thrusts its whole body into the passage as a stopple like to this is the insertion of the Porus Cholagogus into the Guts The Ureters have connexion with the above-mentioned parts with the muscles of the loins Connexion upon which they run from the Kidneys to the Bladder
time appointed by nature and also besides to receive and evacuate the menstruous blood The compound parts of the womb are the proper body and neck thereof That body is extended in women big with child even to the navel in some higher in some lower The Cotyledones In the inner side the Cotyledones come into our consideration which are nothing else than the orifices and mouths of the veins ending in that place They scarce appear in women unless presently after child-bearing or their menstrual purgation but they are apparent in Sheep Goats and Kine at all times like wheat-corns unless when they are with young for then they are of the bigness of hasel nuts but then also they swell up in women and are like a rude piece of flesh of a finger and a half thick which begirt all the natural parts of the infant shut up in the womb out of which respect this shapeless flesh according to the opinion of some is reckoned amongst the number of coats investing the infant and called Chorion because As in beasts the Chorion is interwoven with veins Columbus justly reproved and arteries whence the umbilical Vessels proceed so in women this fleshy lump is woven with veins and arteries whence such vessels have their original Which thing how true and agreeable to reason it is let other men judge There is one thing whereof I would admonish thee that as the growth of the Cotyledones in beasts are not called by the name of Chorion but are only said to be the dependents thereof so in women such swollen Cotyledones merit not the name of Chorion but rather of the dependences thereof The orifice of the Womb. This body ends in a certain straitness which is met withall in following it towards the privities in women which have born no children or have remained barren some certain time for in such as are lately delivered The proper orifice of the Womb is not always exactly shut in Women with child you can see nothing but a cavity and no straitness at all This straitness we call the proper orifice of the womb which is most exactly shut after conception especially until the membrane or coats encompassing the child be finished and strong enough to contain the seed that it flow not forth nor be corrupted by entrance of the air for it is opened to send forth the seed and in some the courses and serous humours which are heaped up in the womb in the time of their being with child The neck of the Womb. From this orifice the neck of the womb taking its original is extended even to the privities It is of a musculous substance composed of soft flesh because it might be extended and contracted wrinckled and stretched forth and unfolded and wrested and shaken at the coming forth of the child and after be restored to its former soundness and integrity In process of age it grows harder both by use of venery and also by reason of age by which the whole body in all parts thereof becomes dry and hard But in growing and in young women it is more tractable and flexible for the necessity of nature It s Magnitude The magnitude is sufficiently large in all dimensions though divers by reason of the infinite variety of bodies Composition The figure is long round and hollow The composition is the same with the womb but it receives not so many vessels as the womb for it hath none but those which are sent from the Hypogastrick veins by the branches ascending to the womb This neck on the inside is wrinckled with many crests like the upper part of a dogs mouth so in copulation to cause greater pleasure by that inequality and also to shorten the act Number and Site It is only one and that situate between the neck of the bladder and the right gut to which it closely sticketh as to the womb by the proper orifice thereof and to the privities by its own orifice but by the vessels to all the parts from whence they are sent Temper It is of a cold and dry temper and the way to admit the seed into the womb to exclude the infant out of the womb as also the menstrual evacuation But it is worth observation that in all this passage there is no such membrane found No Hymen as that they called Hymen which they feigned to be broken at the first coition Yet notwithstanding Columbus Fallopius Wierus and many other learned men of our time think otherwise and say that in Virgins a little above the passage of the Urine may be found and seen such a nervous membrane placed overthwart as it were in the middle way of this neck and perforated for the passages of the courses But you may find this false by experience it is likely the Ancients fel into this errour through this occasion Because that in some a good quantity of blood breaks forth of these places at the first copulation From whence the blood proceeds that breaks forth in some virgins at the first coition But it is more probable that this happens by the violent attrition of certain vessels lying in the inward superficies of the neck of the womb not being able to endure without breaking so great extention as that nervous neck undergoes at the first coition For a maid which is manageable and hath her genital parts proportionable in quantity and bigness to a man's shall find no such effusion of blood as we shall shew more at large in our Book of Generation This neck ends at the privities where its proper orifice is which privy parts we must treat of as being the productions and appendices of this neck This Pudendum or privity is of a middle substance between the flesh and a nerve the magnitude is sufficiently large the figure round hollow long It is composed of veins arteries nerves descending to the neck of the womb and a double coat proceeding from the true skin and fleshy pannicle both these coats are firmly united by the flesh coming between them whereupon it is said that this part consists of a musculous coat It is one in number situate above the Peritonaeum It hath connexion with the fundament the neck of the womb and bladder by both their peculiar orifices The thirteenth Figure shewing the parts of women different from those in men A.B.C.D. The Peritonaeum reflected or turned backward above and below E.F. The gibbous part of the liver E the cave or hollow part F. G. the trunk of the gate-vein H. the hollow vein I. the great artery K. the roots of the Coeliacal artery which accompanieth the gate-vein L.M. the fatty vein going to the coat of the Kidneys N.O. the fore-part of both the kidneys T.V. the emulgent veins and arteries aa the right Ureter at the lowest a cut from a part which neer to b sticketh yet to the bladder because the bottom of the bladder is drawn to the
Ventricles of the Heart where kept in by the density thereof they turn into yellowish moisture as we see it happens in an Alembeck The Consistence Nature would have the Pericardium of a dense and hard consistence that by the force thereof the Heart might be kept in better state for if the Pericardium had been bony it would have made the Heart like iron by the continual attrition on the contrary if it had been soft and fungous it would have made it spongy and soft like the Lungs CHAP. XI Of the Heart What the Heart is and of what substance THe Heart is the chief mansion of the Soul the organ of the vital faculty the beginning of life the fountain of the vital spirits and so consequently the continual nourisherer of the vital heat the first living and last dying which because it must have a natural motion of it self was made of a dense solid and more compact substance than any other part of the body The three sorts of fibers of the Heart The flesh thereof is woven with three sorts of fibers for it hath the right in the inner part descending from the basis into the point that they might dilate it and so draw the blood from the Hollow-vein into the receptacles thereof and the breath or air from the Lungs by the Arteria venosa it hath the transverse without which pass through the right at right angles to contract the Heart and so drive the vital spirits into the great Artery Aorta and the cholerick blood to the Lungs by the Vena arteriosa for their nourishment It hath the oblique in the midst to contain the air and blood drawn thither by the forementioned vessels until they be sufficiently elaborate by the Heart All these fibers do their parts by contracting themselves towards the original as the right from the point of the Heart towards the basis whereby it comes to pass that by this contraction of the fibers the Heart dilated becomes shorter but broader no otherwise than it is made more long and narrow by the contraction of the tranverse but by the drawing of the oblique it is lessened in that part which looks towards the Vertebra's which chiefly appears in the point thereof The Magnitude It is of an indifferent bigness but yet in some bigger in some less according to the diverse temper of cold or hot men as we noted in the Liver Figure The figure thereof is pyramidal that is it is broader in the basis and narrower at his round point Composition It is composed of the most dense flesh of all the body by the affusion of blood at the divisions and foldings of the vessels and there concrete as it happens also to the other entrails For the blood being there a little more dryed than that which is concrete for the making of the Liver turns into a fleshy substance more dense than the common flesh even as in hollow ulcers when they come to cicatrize The proper Vessels It hath the Coronal veins and arteries which it receives either on the right side from the Hollow vein or on the left from the basis at the entrance of the artery Aorta You cannot by your eye discern that the Heart hath any other nerves than those which come to it with the Pleura The Nerves Yet I have plainly enough observed others in certain Beasts which have great hearts as Swine they appeared seated under the fat which covers the vessels and basis of the Heart lest the humid substance of these parts should be dissolved and dissipated by the burning heat of the heart Whereby you may perceive that the heat of the Heart is different from the Elementary heat as that which suffers fat to grow about this entrail where otherwise it doth not concrete unless by cold or a remiss heat which thing is chiefly worth admiration The Heart is one alone situate most commonly upon the fourth vertebra of the Chest Number and site which is in the midst of the Chest Yet some think that it inclines somewhat to the left side because we there feel the motion or beating thereof but that happens by reason of its left ventricle which being it is filled with many spirits and the beginning of the Arteries it beats far more vehemently than the right It required that seat by the decree of Nature because that region is the most safe and armed besides it is here on every side covered as it were with the hands of the Lungs It hath connexion with the fore-mentioned Vertebra's but by the parts composing it Connexion with those parts from whence it hath them with the Lungs by the Vena arteriosa and the Arteria venosa and lastly with all the parts of the body by the Arteries which it sends to them all It is of a hot and moist temper as every fleshy part is The action thereof is Temper and action first to prepare the blood in its right ventricle for the fit nourishment of the Lungs for from hence it is that Galen saith This right ventricle was made for the necessity of the Lungs Secondly to generate the vital spirits in its left ventricle for the use of the whole body What the vital spirit is But this spirit is nothing else than a certain middle substance between air and blood fit to preserve and carry the native heat wherefore it is named the Vital as being the author and preserver of life In the inner parts of the heart there present themselves to our consideration the ventricles and the parts contained in the ventricles and between them such are the Valvulae or Valves the Vessels and their mouths their distribution into the Lungs the wall or partition and the two productions or Ears of the Heart which because they are doubtful whether they may be reckoned amongst the external or internal parts of the heart I will here handle in the first place Therefore these Auriculae or Ears are of a soft and nervous substance The Auriculae Cordis or ears of the heart compact of three sorts of fibers that so by their softness they might the more easily follow the motions of the Heart and so break the violence of the matter entering the Heart with great force when it is dilated For otherwise by their violent and abundant entrance they might hurt the Heart and as it were overwhelm and suffocate it but they have that capacity which we see given by nature that so they might as it were keep in store the blood and air and then by little and little draw it forth for the use of the necessity of the Heart But if any enquire if such matters may be drawn into the Heart by the only force of the Diastole ad fugam vacui for avoiding of emptiness I will answer That that drawing in or attraction is caused by the heat of the Heart which continually draws these matters to it no otherwise than
a fire draws the adjacent air and the flame of a Candle the Tallow which is about the wiek for nourishments sake Whilst the Heart is dilated it draws the air whilst it is drawn together or contracted it expels it This motion of the Heart is absolutely natural as the motion of the Longs is animal Some add a third cause of the attraction of the Heart to wit the similitude of the whole substance But in my judgment this rather takes place in that attraction which is of blood by the venae coronales for the proper nourishment of the Heart than in that which is performed for attraction of matters for the benefit of the whole Body These Ears differ in quantity for the right is far more capacious than the left Their magnitude and Number because it was made to receive a greater abundance of matter They are two in number on each side one situate at the basis of the Heart The greater at the entrance of the hollow vein into the Heart the less at the entrance of the veinous and of the great Artery with which parts they both have connexion We have formerly declared what use they have that is Their use to break the violence of the matters and besides to be stays or props to the Arteria venosa and great Artery which could not sustain so rapid and violent a motion as that of the Heart by reason of their tenderness of substance Of the Ventricles of the Heart THe Ventricles are in number two on each side one The partition between the ventricles of the heart distinguished with a fleshy partition strong enough having many holes in the superficies yet no where piercing through The right of these Ventricles is the bigger and encompassed with the softer and rarer flesh the left is the lesser but is engirt with a threefold more dense and compact flesh for the right Ventricle was made for a place to receive the blood brought by the hollow-vein and for distributing of it partly by the Vena arteriosa into the lungs for their nourishment partly into the left ventricle by sweating through the wall or partition to yield matter for the generation of the vital spirits Therefore because it was needful there should be so great a quantity of this blood Why the right ventricle is more capacious and less compact it was likewise fit that there should be a place proportionable to receive that matter And because the blood which was to be received in the right ventricle was more thick it was not so needful that the flesh to contain it should be so compact but on the contrary the arterious blood and vital spirit have need of a more dense receptacle for fear of wasting and lest they should vanish into air and also less room that so the heat being united might become the stronger and more powerfully set upon the elaboration of the blood and spirits Therefore the right Ventricle of the Heart is made for preparation of the blood appointed for the nourishment of the Lungs and the generation of the vital spirits The action of the right ventricle as the Lungs are made for the mitification or qualifying of the Air. Which works were necessary if the Physical Axiome be true That like is nourished by like as the rare and spongious Lungs with more subtil blood the substance of the Heart gross and dense with the veinous blood as it flows from the Liver that is gross The action of the left ventricle And it hath its Coronal veins from the Hollow-vein that it might thence draw as much as should be sufficient But the left Ventricle is for the perfecting of the vital spirit and the preservation of the native heat Of the Orifices and Valves of the Heart The uses of the four orifices of the Heart THere be four Orifices of the Heart two in the right and as many in the left Ventricle the greater of the two former gives passage to the vein or the blood carryed by the Hollow-vein to the Heart the lesser opens a passage to the Vena arteriosa or the cholerick blood carried in it for the nourishment of the Lungs The larger of the two other makes a way for the distribution of the Artery Aorta and the vital spirit through all the body but the lesser gives egress and regress to the Ateria venosa or to the air and fuliginous vapors And because it was convenient that the matters should be admitted into their proper Ventricles by these orifices by the Diastole to wit into the right ventricle by the greater orifice and into the left by the lesser and because on the contrary it was fit that the matters should be expelled by the Systole from their ventricles by the fore-mentioned orifices The Valves Therefore nature to all these orifices hath put eleaven valves that is to say six in the right ventricle that there might be three to each orifice five in the left that the greater orifice might have three and the lesser two for the reason we will presently give How they differ These Valves differ many ways First in action for some of them carry in matter to the Heart others hinder that which is gone out that it come not back again Secondly they differ in site Action Site Figure for those which bring in have membranes without looking in those which carry out have them within looking out Thirdly in figure for those which carry in have a Pyramidal figure but those which hinder the coming back again are made in the shape of the Roman letter C. Fourthly Substance in substance for the former for the most part are fleshy or woven with fleshy fibers into certain fleshy knots ending towards the point of the heart The latter are wholly membranous Number Fiftly they differ in number for there be only five which bring in three in the right ventricle at the greater orifice and two in the left at the lesser orifice those which prohibit the coming back Motion are six in each ventricle three at each orifice Lastly they differ in motion for the fleshy ones are opened in the Diastole for the bringing in of blood and spirit and contrariwise are shut in the Systole that they may contain all or the greater part of that they brought in The membranous on the contrary are opened in the Systole to give passage forth to the blood and spirits over all the body but shut in the Diastole that that which is excluded might not flow back into the Heart But you shall observe that Nature hath placed only two Valves at the orifice of the Arteria venosa Why there be only two Valves at the Orifice of the Arteria venosa because it was needful that this Orifice should be always open either wholly or certainly a third part thereof that the air might continually be drawn into the Heart by this Orifice in Inspiration and sent forth by
The three bones of the Auditory passage and affect it with its qualities before it be elaborated by its lingring in the way There are besides also six other little Bones lying hid in the stony Bones at the hole or auditory-passage on each side three that is to say the Incus or Anvil the Malleolus or Hammer and the Stapes or stirrop because in their figure they represent these three things the use of these we will declare hereafter But also in some skulls there are found some divisions of Bones as it were collected fragments to the bigness almost of ones thumb furnished and distinguished by their proper commissures or sutures which thing is very fit to be known to a Chirurgion in the use of a Trepan By what means a Chirurgeon may conjecture that there are extraordinary Sutures in certain places of the skull The skulls of such as inhabit the Southern countreys are more hard and dense Verily he may give a conjecture hereof whilst he separates the pericranium from the skull for the pericranium is with greater difficulty pluckt away from the sutures because the Crassa meninx hath straiter connexion therewith by his nervous fibers sent forth in such places The skulls in women are softer and thinner than in men and in children more than in women and in young men more than in men of a middle age Also the Aethiopians or Black-moors as also all the people inhabiting to the South have their skulls more hard and composed with fewer sutures Therefore as it is written by Hippocrates such as have their Skulls the softer the Symptoms in fractures are more dangerous and to be feared in them But the Skull by how much the softer it is by so much it more easily and readily yields to the perforating Trepan Moreover in some skulls there be bunches standing out besides nature made either round or cornered which the Chirurgeon must observe for two causes We must observe the extuberancies besides nature which are in some skulls the first is for the better consideration of a blow or fracture For in these bunches or knots the solution of the continuity cannot be if it seem to be stretched in length but that the wound must penetrate to the inner parts For in a round body there can be no long wound but it must be deep by the weapon forced the deeper because as a round body touches a plain but only in puncto in a prick or point so whatsoever fals only lightly or superficially upon it touches a point thereof But on the contrary a long wound must be upon a plain surface which may be but only superficial The Site and Substance of the Diploe Another cause is because such Bunches change the figure and site of the Sutures And the Chirurgeon must note that the skull hath two tables in the midst whereof the Diploe is which is a spongy substance into which many veins and arteries and a certain fleshiness are inserted that the skull should not be so heavy and that it might have within it self provision for the life thereof and lastly that there might be freer passage out for the fuliginous vapors of the brain The upper table is thicker denser stronger and smoother than the lower For this as it is the slenderer so it is the more unequal that it may give place to the internal veins and arteries which make a manifest impression into the second table on the inside thereof from which Branches enter into the skull by the holes which contain the eyes Which thing fastens the Crassa meninx to the skull and is therefore very worthy to be observed There may be a deadly rupture of the Vessels of the Brain without any fracture of the skull Caution to be had in the use of the Trepan For in great contusions when no fracture and fissure appears in the skull by reason of the great concussion or shaking of the Brain these vessels are often broken whence happens a flux of blood between the skull and membranes and lastly death But it is fit the Chirurgeon take good heed to the tender and soft substance of the Diploe that when he comes to it having passed the first table he may carefully use his Trepan lest by leaning too hard it run in too violently and hurt the membranes lying underneath it whence convulsion and death would follow To which danger I have found a remedy by the happy invention of a Trepan as I will hereafter more at large declare in handling the wounds of the head CHAP. V. Of the Meninges that is the two Membranes called Dura Mater and Pia Mater Why the Bone Ethmoides is perforated THe Crassa meninx is one of the first and principal Membranes of the Body it goes forth by the sutures and holes of the nerves that proceed out of the skull and it passes forth by the Bone Ethmoides perforated for that purpose to carry smells to the Brain and purge it of excrementitious humors This same Crassa meninx invests the inner coat of the Nose also it passes forth of the great hole through which the spinal marrow passes vested with this Crassa meninx with all the nerves and membranes For which cause if any membrane in the whole body be hurt by reason of that continuation which it hath with the Meninges it straight communicates the hurt to the head by consent The consistence of the Crassa meninx The Crassa meninx is thicker and harder then all other membranes in the Body whereupon it hath got the name of the Dura mater besides also it begirts produces and defends the other membranes The use The use of it is to involve all the Brain and to keep it when it is dilated that it be not hurt by the hardness of the skull For the course of nature is such that it always places some third thing of a middle nature betwixt two contraries Also the Crassa meninx yields another commodity which is that it carries the veins and arteries entring the skull for a long space For they insinuate themselves into that part where the duplicate or folded Meninges separate the Brain from the Cerebellum and so from thence they are led by the sides of the Cerebellum until they come as it were to the top thereof where being united they insinuate themselves into that other part of the Crassa meninx where in like manner being duplicated and doubled it parts the Brain at the top into the right and left These united veins run in a direct passage even to the forehead after the manner of the Sagittal suture They have called this passage of the mutually infolded veins the Torcular or Press What the Torcular is because the blood which nourishes the Brain is pressed and drops from thence by the infinite mouths of these small veins Therefore also here is another use of the Crassa meninx to distinguish the Brain by its duplication being it thrusts it self deep into its Body into two parts
above and as many below The grinding teeth that they may grind chaw and break the meat that so it may be the sooner concocted in the stomach for so they vulgarly think that meat well chawed is half concocted those grinders which are fastned in the upper Jaw have most commonly three roots and oft-times fower Why the upper grinding teeth have more roots But these which are fastned in the lower have only two roots and sometimes three because this lower Jaw is harder then the upper so that it cannot be so easily hollowed or else because these teeth being fixed and firmly 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 use of the teeth the Dog-teeth break it because they are sharp pointed and firm but the Grinders being hard broad and sharp chaw and grind it asunder But if the grinders had been 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 unequal Wherefore they sharpen their Milstones when they are smoother then they should be The teeth are fastened in the Jaws by Gomphosis The fastening of the teeth into the Jaws is to be observed by picking them with a sharp Iron The Teeth are fastened in the Jaws by Gomphosis that is as a stake or nail so are they fixed into the holes of the Jaws for they adhere so firmly thereto in some that when they are pluckt out part thereof followes together with the tooth which I have often observed to have been also with great effusion of blood This adhesion of the teeth fastned in the Jaws is besides strengthened with a ligament which applyes it self to their roots together with the nerves and vessels The teeth differ from the other bones because they have action whilst they chaw the meat because being lost they may be generated and for that they grow as long as the party lives for otherwise by the continual use of chawing they would be worn 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 then the rest because it is not worn by its opposite Wherein the teeth differ from the other bones For what use the teeth have sense Beside also they are more hard and solid 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 remains of the nerve they have such quick sense that with the tongue they might judg of tastes But how feel the teeth seeing they may be filled without pain Fallopius answers that the teeth feel 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 The fore-teeth help for the articulation of the voyce for those that want them faulter in speaking as also such as have them too short or too long or ill-ranked Besides children speak not distinctly before they have their fore-teeth And you must note that the Infant as yet shut up in its Mothers womb hath solid and bony teeth which you may perceive by dissecting it presently after it is born But even as there are two large cavities in the fore-head bone at the eye-brows filled with a viscous humor serving for the smelling and in like manner the air shut up in the mamillary processes is for hearing so in the Jaws there be two cavities furnished with a viscid humor for the nourishment of the teeth CHAP. III. Of the Broad Muscle NOw we should prosecute the containing parts of the face to wit the skin the fleshy pannicle and fat but because they have been spoken off sufficiently before I will only describe the fleshy pannicle before I come to the dissection of the eye that we may the more easily understand all the motions performed by it whether in the face or fore-head First that you may more easily see it you must curiously separate the skin in some part of the face For unless you take good heed you will pluck away the fleshy pannicle together with the skin as also this broad muscle to which it immediately adheres and in some places so closely and firmly as in the lips eye-lids and the whole forehead that it cannot be separated from it Nature hath given motion or a moving force to this broad muscle that whilst it extends or contracts it self 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 fore-part of the clavicles even to the chin ascending in a right line and then turnig back as far as you can for thus you shall shew how it mixes it self with the skin and the muscles of the lips There are no particular Muscles appointed to open and shut the Eye for that is the broad muscle only Divers reasons to that purpose 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 three sorts of fibers although by the opinion of all who hitherto have 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 self to the middle of the gristle Tarsus it meets with the former ending there but they are in part extended over all the Eye-lid whereby it commeth to pass that it also in some sort becometh moveable But although in publick dissections these two muscles are commonly wont to be solemnly shewed after the manner I have related yet I think that those which shew them know no more of them than I do I have grounded my opinion from this that there appears no other musculous flesh in these places to those which separate the fleshy pannicle or broad muscle than that which is of the pannicle it self whether you draw your Incision-knife from the fore-head downwards or from the cheek upwards Why you must take heed of making a transverse incision upon the Eye-brows Besides when there is occasion to make incision on the Eye-brows we are forbidden to do it transverse lest 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 wholly depends and is performed by the broad muscle Now if these same
digested and ripened thirdly by induration when it degenerates into a Scirrhus 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 violence or the abundance or quality of the humor or both it comes to that distemper that it loses its proper action It is best to terminate a tumor by resolution and the worst by corruption suppuration and induration are between both although that is far better than this The signs of a tumor to be terminated by resolution The signs by which the Chirurgeons may presage that an Impostume may be terminated by resolving are the remission or slacking of the swelling pain pulsation tension heat and all other accidents and the unaccustomed liveliness and itching of the part and hot Impostumes are commonly thus terminated because the hot humor is easily resolved by reason of its subtilty Signs of suppuration are the intension or encrease of pain heat swelling pulsation The signs of suppuration and the Feaver for according to Hippocrates Pain and the Feaver are greater when the matter is suppurating than when it is suppurated The Chirurgeon 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 thickness of the part lying above or over it The signs of an Impostume degenerating into a Scirrhous hardness The signs and causes of a tumor terminated in a Scirrhus are the diminution of the tumor and hardness remaining in the part The causes of the hardness not going away with the swelling are the weakness of nature the grosness and toughness of the humor and unskilfulness of the Chirurgeon who by too long using resolving things hath occasioned that the more subtil part of the humor being dissolved the rest of the grosser nature like earthy dregs remains concret in the part For so Potters vessels dryed in the Sun grow hard But the unskilful Chirurgeon may occasion a Scirrhous hardness by another means as by condensating the skin and incrassating the humors by too much use of repercussives The signs of a Gangrene at hand But you may perceive an Impostume to degenerate into a Gangrene thus if the accidents of heat redness pulsation and tension shall be more intense than they are wont to be in suppuration if the pain presently cease without any manifest cause if the part wax lived or black and lastly if it stink But we shall treat of this more at large when we come to treat of the Gangrene and Sphacelus Of disappearance of a tumor and the signs thereof A sodain diminution of the tumor and that without manifest cause is a sign of the matter fallen back and turned into the body again which may be occasioned by the immoderate use of refrigerating things And sometimes much flatulency mixed with the matter although there be no fault in those things which were applyed Feavers and many other malign Symptoms as Swoundings and Convulsion by translation of the matter to the noble parts follow this flowing back of the humor into the body CHAP. IV. Of the Prognostique in Impostumes TUmors arising from a melancholy phlegmatick gross tough or viscous humor Cold tumors require a longer cure ask 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 natural than those which are of humors yet contained in the bounds of nature For those humors which are rebellious offend rather in quality than in quantity Tumors made of matter not natural are more difficultly cured and undergo the divers forms of things dissenting from Nature which are joyned by no similitude or affinity with things natural as Suet Poultis Hony the dregs of Oil and Wine yea and of solid bodies as Stone Sand Coal Straws and sometimes of living things as Worms Serpents and the like monsters The tumors which possess the inner parts and noble entrails are more dangerous and deadly is also those which are in the joynts or neer to them And these tumors which seise upon great vessels as veins arteries and nerves for fear of great effusion of blood Hippo. Aph. 8. sect 6. wasting of the spirits and convulsion So Impostumes of a monstrous bigness are often deadly by reason of the great resolution of the spirits caused by their opening Those which degenerate into a Scirrhus are of long continuance and hard to cure as also those which are in hydropick leprous scabby and corrupt bodies for they often turn into malign and ill-conditioned Ulcers CHAP. V. Of the General cure of Tumors against Nature THere be three things to be observed in the cure of Impostumes What must be considered in undertaking the cure of tumors 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 drawn from the essence that is from the greatness or smalness of the tumor varies the manner of curing for the medicines must be increased or diminished according to the greatness of the tumor The second taken from the nature of the humor also changes our counsel for a Phlegmon must be otherwise cured than an Erysipelas and an Oedema than a Scirrhus and a simple tumor otherwise than a compound And also you must cure after another manner a tumor coming of an humor not natural than that which is of a natural humor and otherwise that which is made by congestion than that which is made by defluxion What we must understand by the nature of the part The third Indication is taken from the part in which the tumor resides by the nature of the part we understand its temperature conformation site faculty and function The temperature indicates that some medicines are convenient for the fleshy parts as those which are more moist others for the nervous as more drie for you must apply some things to the eye and others to the throat one sort of things to these parts which by reason of their rarity are easily subject to defluxion another to those parts which by their density are not obnoxious to it But we must have good regard to the site of the part as if it have any connexion with the great vessels and if it be fit to pour forth the matter and humor when it is suppurated What we must understand by the faculty of the part Galen by the name of Faculty understands the use and sense of the part This hath a manifold indication in curing for some parts are principal as the Brain Heart and Liver for their vertue is communicated to the whole body by the Nerves Arteries and Veins Others truly are not principal but yet so necessary that none can live without them as the Stomach Some are endued with a most quick sense as the Eye the
Membranes Nerves and Tendons What we must consider in performing the cure wherefore they cannot indure acrid and biting medicines Having called to mind these indications the indication will be perfected by these three following intentions as if we consider the humor flowing down or which is ready to flow the conjunct matter that is the humor impact in the part the correction of accidents yet so that we alwayes have care of that which is most urgent and of the cause Therefore first repercussives must be applyed for the antecedent matter strong or weak having regard to the tumor as it is then only excepting six conditions of tumors What things disswade us from using repercussives the first is if the matter of the tumor be venenate the second if it be a critical abscess the third if the defluxion be neer the noble parts the fourth if the matter be gross tough and viscid the fifth when the matter lies far in that is flows by the veins which lies more deep the sixth when it lies in the Glandules But if the whole body be plethorick a convenient diet purging and Phlebotomy must be appointed frictions and bathes must be used Ill humors are amended by diet and purging If the weakness of the part receiving draw on a defluxion it must be strengthned If the part be inferior in its site let the patient be so seated or layed that the part receiving as much as may be may be the higher If pain be the cause of defluxion we must asswage it by things mitigating it If the thinness or lightness of the humor cause defluxion it must be inspissate by meats and medicines But for the matter contained in the part because it is against Nature it requires to be evacuate by resolving things as Cataplasms Ointments Fomentations Cupping-glasses or by evacuation as by scarifying or suppurating things as by ripening and opening the Impostume Lastly for the conjunct accidents as the Feaver pain and such like they must be mitigated by asswaging mollifying and relaxing medicines as I shall shew more at large hereafter CHAP. VI. Of the four principal and general Tumors and of other Impostumes which may be reduced to them THe principal and chief Tumors which the abundance of humors generate are four a Phlegmon What tumors may be reduced to a Phlegmon Which to an Eâ—â—sipelas Which to an Oedema Erysipelas Oedema and Scirrhus innumerable others may be reduced to these distinguished by divers names according to the various condition of the efficient cause and parts receiving Wherefore a Phygethlum Phyma Fellon Carbuncle Inflammation of the Eyes Squincy Bubo and lastly all sorts of hot and moist tumors may be reduced to a Phlegmon The Herpes miliaris the eating Herpes Ring-worms and Tetters and all Impostumes brought forth by choler are contained under an Erysipelas Atheromata Steatomata Melicerides the Testudo or Talpa Ganglion Knots Kings-Evils Wens watery Ruptures the Ascites and Lencophlegmatia may be reduced to an Oedema as also all flatulent tumors which the abundance of corrupt Phlegm produces Which to a Scirrhus In the kindred of the Scirrhus are reckoned a Cancer Leprosie Warts Corns a Thymus a Varix Morphew black and white and other Impostumes arising from a Melancholy humor Now we will treat of these Tumors in particular beginning with a Phlegmon CHAP. VII Of a Phlegmon What a true Phlegmon is A Phlegmon one thing and a Phlegmonous tumor another A Phlegmon is a general name for all Impostumes which the abundance of inflamed bloud produces That is called a true Phlegmon which is made of laudable bloud offending only in quantity But a bastard Phlegmon or a Phlegmonous Impostume hath some other and proper name as a Carbuncle Fellon Gangrene Sphacel and the like malign Pustuls So when there is a conflux of divers humors into one tumor divers kinds of Phlegmonous Impostumes called by divers names according to the more abundant humor arise as if a small portion of Phlegm shall be mixed with a greater quantity of bloud it shall be called an Oedematous Phlegmon but if on the contrary the quantity of phlegm be the greater it shall be named a phlegmonous Oedema and so of the rest always naming the tumor from that which is predominant in it Therefore we must observe that all differences of such tumors arise from that either because the bloud causing it offends only in quantity which if it do it causes that tumor which is properly called a Phlegmon if in quality it makes a Phlegmonous tumor because the matter thereof is much departed from the goodness of bloud But bloud is said to offend in quantity either by admixture of some other matter as Phlegm Choler or Melancholy from whence proceeds Oedematous Erysipelous and Scirrhous Phlegmons or by corruption of its proper substance from whence Carbuncles and all kinds of Gangrenes or by concretion and when Nature is disappointed of its attempted and hoped for suppuration either by default of the Air or Patient or by the error of the Physitian and hence oft-times happen Atherema's Steatoma's and Melicerides Although these things be set down by the Ancients of the simple and similar matter of the true Phlegmon yet you must know that in truth there is no Impostume whose matter exquisitely shews the Nature of one and that simple humor without all admixture of any other matter for all humors are mixed together with the bloud yet from the plenty of bloud predominating they are called Sanguine as if they were of bloud alone Wherefore if any tumors resemble the nature of one simple humor truly they are not of any natural 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 Gal. lib. de tumoribâ—n c. ad Glauc Hippoc. lib. de vuln cap. Gal. lib. de tumor praeter naturam 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 witness A Phlegmon is made and generated thus when bloud flows into any part in too great a quantity first the greater veins and arteries of the part affected are filled then the middle and lastly the smallest and capillary so from those thus distended the bloud sweats out of the pores and small passages like dew and with this the void spaces which are between the similar parts are first filled and 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 pain also happens at the same time both by reason of the tension and preternatural heat And there is a manifest pulsation in the part specially whilst it suppurates because the veins The cause of a beating pain in a Phlegmon arteries and nerves are much being they are not only heated within by the influx of the fervid humor but pressed without by the adjacent parts Therefore seeing the pain comes to all the foresaid parts because they are too immoderately heated and pressed the arteries which are in the perpetual motion of their systole diastole whilst they are dilated strike upon the other inflamed parts whereupon proceeds that beating pain Hereunto add The Arteries then filled with more copious and hot bloud have greater need to seek refrigeration by drawing in the encompassing Air wherefore they must as of necessity have a conflict with the neighbouring parts which are swollen and pained Comm. ad Aph. 21. sect 7. Therefore from hence is that pulsation in a Phlegmon which is defined by Galen An agitation of the arteries painful and sensible to the Patient himself for otherwise as long as we are in health we do not perceive the pulsation of the arteries Wherefore these two causes of pulsation or a pulsifick pain in a phlegmon are worthy to be observed that is the heat and abundance 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 straitning of the said arteries by reason of the repletion and distention of the adjacent partts by whose occasion the parts afflicted and beaten by the trembling and frequent pulsation of arteries are in pain Hence they commonly say that in the part affected with a Phlegmon they feel as it were Another kind of Pulsation in a Phlegmon 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 heat in a Phlegmon is bloud which whilst it flows more plentifully into the part is as it were trodden or thrust down and causes obstruction from whence necessarily follows a prohibition of transpiration and putrefaction of the bloud by reason of the preternatural heat But the Phlegmon looks red by reason of the bloud contained it because the humor predominant in the part shines through the skin CHAP. VIII Of the Causes and Signs of a Phlegmon THe Causes of a Phlegmon are of three kinds for some are primitive some antecedent The Primitive causes of a Phlegmon The Antecedent and Conjunct and some conjunct Primitive are falls contusions 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 veins The conjunct the collection or gathering together of bloud impact in any part The signs of a Phlegmon The signs of a Phlegmon are swelling tension resistance feaverish heat pain pulsation especially while it suppurates redness 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 Scirrhus or a Tumor like a Scirrhus but otherwhiles in a Gangrene that is when the faculty and native strength of the part affected is over-whelmed by the greatness of the defluxion Gal. l. de Tum as it is reported by Galen The Chirurgeon 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 What kind of diet must be prescribed in a Phlegmon THe Chirurgeon in the cure of a true Phlegmon must propose to himself four intentions The first of D et This because a Phlegmon is a hot affect and causes a Feaver must be ordained of refrigerative and humecting things with the convenient use of the six things not natural that is air meat and drink motion and rest sleep and waking repletion inaninition and lastly the passions of the mind Therefore let him make choice of that air which is pure and clear not too moist for fear of defluxion but somewhat cool let him command meats which are moderately cool and moist shunning such as generate bloud too plentifully such will be Broths not too fat seasoned with a little Borage Lettuce Sorrel and Succory let him be forbidden the use of all Spices and also of Garlick and Onions and all things which heat the bloud as are all fatty and sweet things as those which easily take fire Let the Patient drink small Wine and much allayed with water or if the Feaver be vehement the water of the decoction of Licoris Barly sweet Almonds or Water and Sugar alwayes having regard to the strength age and custom 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 wax hot by motion but let him chiefly have a care that he do not exercise the part possessed by the Phlegmon for fear of a new defluxion Let his sleep be moderate neither if he have a full body let him sleep by day specially presently after meat Let him have his belly soluble if not by Nature then by Art as by the frequent use of Clysters and Suppositories Let him avoid all vehement perturbations of minde as hate anger brawling let him wholly abstain from venery How to divert the defluxion of humors This maner of diet thus prescribed we must come to the second scope that is the diversion of the defluxion which is performed by taking away its cause that is the fulness and illness of the humors Both which we may amend by purging and bloud-letting if the strength and age of the Patient permit The pain must be asswaged But if the part receiving be weak it must be strengthned with those things which by their astriction amend the openness of the passages the violence of the humor being drawn away by Cupping-glasses Frictions Ligatures But if pain trouble the part which is often the occasion of defluxion it must be mitigated by Medicines asswaging pain The third scope is to overcome the conjunct cause That we may attain to this we must enter into the consideration of the tumor according to its times that is the beginning increase state and declination When we must use repercussives For from hence the indications of variety of medicines must be drawn For in the beginning we use repercussives to drive away the
transpiration or by the moisture of the skin The unputrid Synochus or by a sweat natural gentle and not ill smelling to this Diary we may refer the unputrid Synochus generated of bloud not putrid but only heated beyond measure For usually there arises a great heat over all the body by means of the bloud immoderately heated whence the veins become more tâ—mid the face appears fiery the Eyes red and burning the breath hot and to conclude the whole habit of the body more full by reason of that ebullition of the bloud and the diffusion of the vapours thence arising over all the body Whence it is that this kind of Synochus may be called a vaporous Feaver To this Children are incident as also all sanguine bodies which have no ill humors The cure of this and the Ephemera or Diary is the same because it may scarse seem different from the Ephemera in any other thing than that it may be prolonged for three or four dayes Wherefore whatsoever we shall say for the cure of the Ephemera may be applyed to the Synochus bloud-letting excepted which in an unputrid Synochus is very necessary Now the cure of a Diary-Feaver consists in the decent use of things not natural The cure of a Diary Feaver contrary to the the cause of a disease wherefore bathes of warm and natural water are very profitable so that the Patient be not Plethorick nor stuft with excrements nor obnoxious to Catarrhs and defluxions because a Catarrh is easily caused and augmented by the humors diffused and dissolved by the heat of a Bath therefore in this case we must eschew frictions and anointing with warm Oil which things notwithstanding are thought very useful in these kinds of Feavers especially when they have their original from extreme labour by astriction of the skin or a Bubo Let this be a general rule that to every cause whence this Feaver proceeded you oppose the contrary for a remedy as to labour rest to watching sleep to anger and sorrow grateful society of friends and all things replenished with pleasant good will and to a Bubo the proper cure thereof The use of Wine in a Diary Wine moderately tempered with water according to the custom of the sick Patient is good and profitable in all causes of this Feaver except he be pained in his head or that the Feaver drew its original from anger or a Bubo for in this last case especially the patient must abstain wholly from Wine until the inflammation come to the state and begins to decline This kind of Feaver often troubles Infants and then you must prescribe such medicines to their Nurses as if they were sick that so by this means their milk may become medicinable Also it will be good to put the Infant himself into a Bath of natural and warm water and presently after the Bath to anoint the ridg of the Back and Brest with Oyl of Violets But if a Phlegmon possess any inward part or otherwise by its nature be great or seated near any principal Bowel so that it may continually send from it either a putrid matter or exhalation to the heart and not only affect it by a quality of preternatural heat by the continuity of the parts thence will arise the putrid Synochus if the blood by contagion putrefying in the greater vessels consists of one equal mixture of the four humors This Feaver is thus chiefly known How a putrid Synochus is caused it hath no exacerbations or remissions but much less intermissions it is extended beyond the space of twenty four hours neither doth it then end in vomit sweat moisture or by little and little insensible transpiration after the manner of intermitting Feavers or Agues but remains constant until it leaves the Patient for altogether it commonly happens not unless to those of a good temper and complexion which abound with much bloud and that tempered by an equal mixture of the four humors It commonly indures not long because the bloud by some peculiar putrefaction degenerating into Choler or Melancholy will presently bring forth another kind of Feaver to wit a Tertian or continued Quartain Phlebotomy necessary in a putrid Synochus The cure of this Feaver as I have heard of most learned Physitians chiefly consists in blood-letting For by letting of bloud the fulness is diminished and therefore the obstruction is taken away and lastly the putrefaction And seeing that in this kind of Feaver there is not only a fault of the matter by the putrefaction of the bloud but also of the Temper by excess of heat certainly Phlebotomy helps not only as we said the putrefaction but also the hot distemper For the bloud in which all the heat of the creature is contained whilst it is taken away the acrid and fuliginous excrements exhale and vanish away with it which kept in encrease the Feaverish heat Moreover the veins to shun emptiness which Nature abhors are filled with much cold air in stead of the hot bloud which was drawn away which follows a cooling of the habit of the whole body yea and many by means of Phlebotomy have their Bellies loosed and sweat both which are much to be desired in this kind of Feaver What benefit we may reap by drawing bloud even to fainting This moved the ancient Physitians to write that we must draw bloud in this disease even to the fainting of the Patient Yet because thus not a few have poured out their lives together with their bloud it will be better and safer to divide the evacuations and draw so much bloud at several times as the greatness of the disease shall require and the strength of the Patient may bear Why we must give a Clyster presently after bloud-letting When you have drawn bloud forthwith inject an emollient and refngerative Clyster lest that the veins emptied by Phlebotomy may draw into them the impurity of the Guts but these Clysters which cool too much rather bind the belly than loose it The following day the Morbisick matter must be partly evacuated by a gentle Purge as a bole of Cassia or Catholicon then must you appoint Syrups which have not only a refrigerative quality When Syrrups profitable in this case but also to resist putrefaction such as the Syrup of Limmons Berberries of the Juyce of Citrons of Pomgranates Sorrel and Vinegar Why a slender Diet must be used after letting much bloud let his diet be absolutely cooling and humecting and also slender for the native heat much debilitated by drawing of great quantity of bloud cannot equal a full diet Therefore it shall suffice to feed the Patient with Chicken and Veal Broths made with cooling Herbs as Sorrel Lettice and Purslin Let his drink be Barly-water Syrrup of Violets mixed with some pretty quantity of boyled water Julepum Alexandrium especially if he be troubled with scouring or lask But the Physitian must chiefly have regard to the fourth day for if then
there appear any signs of concoction in the excrements the Crisis must be expected on the seventh day and that either by a loosness of the belly or an abundance of urin by vomits sweats or bleeding Therefore we must then do nothing but commit the whole business to Nature When drinking of water is to be permitted in a putrid Synochus But for drinking cold water which is so much commended by Galen in this kind of Feaver it is not to be suffered before there appear signs of concoction moreover in the declining of the disease the use of Wine will not be unprofitable to help forwards sweats CHAP. XII Of an Erysipelas or Inflammation HAving declared the cure of a Phlegmon caused by laudable bloud we must now treat of those Tumors which acknowledg Choler the material cause of their generation by reason of that affinity which intercedes between Choler and Bloud The definition of an Erysipelas Therefore the Tumors caused by natural Choler are called Erysipelata or Inflammations these contain a great heat in them which chiefly possesses the skin as also oftentimes some portion of the flesh lying under it For they are made by most thin and subtle bloud which upon any occasion of inflammation easily becomes Cholerick or by bloud and choler hotter than is requisite and sometimes of choler mixed with an acrid serous humor That which is made by sincere and pure choler is called by Galen a true and perfect Erysipelas Gal. cap. 2. lib. 14. Meth. med 2. ad Glau. But there arise three differences of Erysipelas by the admixture of choler with the three other kinds of humors For if it being predominant be mixed with bloud it shall be termed Erysipelas Phlegmonades if with Phlegm Erysipelas oedematodes if with Melancholy Erysipelas Scirrhodes So that the former and substantive-word shews the humor bearing dominion but the latter or adjective that which is inferior in mixture But if they concurr in equal quantity there will be thereupon made Erysipelas Phlegmone Erysipelas oedema Erysipelas scirrhus Galen acknowledges two kinds of Erysipelas one simple and without an ulcer Two kinds of Erysipelas the other ulcerated For choler drawn and severed from the warmness of the bloud running by its subtilty and acrimony unto the skin ulcerates it but restrained by the gentle heat of the bloud as a bridle it is hindered from piercing to the top of the skin and makes a tumor without an ulcer But of unnatural choler are caused many other kinds of cholerick tumors as the Herpes exedens and miliaris and lastly all sorts of tumors which come between the Herpes and Cancer You may know Erysipelas chiefly by three signs as by their colour which is a yellowish red by their quick sliding back 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 Erysipelas is called a disease of the skin lastly by the number of the Symptoms as heat pulsation pain The heat of an Erysipelas is far greater than that of a Phlegmon but the pulsation is much less for as the heat of the bloud is not so great as that of choler so it far exceeds choler in quantity and thickness which may cause compression and obstruction of the adjacent muscle Gal. lib. 2. ad Glauc For Choler easily dissipable by reason of its subtlety quickly vanishes neither doth it suffer it self to be long contained in the empty spaces between the muscles Hip. Apho. 79. Sect. 7. Aph. 25. Sect. 16. Aph. 43. Sect. 3. neither doth an Erysipelas agree with a Phlegmon in the propriety of the pain For that of an Erysipelas is pricking and biting without tension or heaviness 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 assails the face by reason of the rarity of the skin of that place and the lightness of the cholerick 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 shews that there is obstruction by the admixture of a gross humor whence there is some danger of erosion in the parts next under the skin It is good when Erysipelas comes from within outwards but ill when from without it retires inward But if an Erysipelas possess the womb 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 Brain 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 here is more need of cooling than in a Phlegmon Gal. 14. Meth. the chief scope must be for refrigeration Which being done the contained matter must be taken away and evacuated with moderately resolving medicines Four things to be performed in curing an Erysipelas We must do four things to attain unto these fore-mentioned ends First of all we must appoint a convenient manner of Diet in the use of the six things not natural 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 vein and by medicines purging choler and that by cutting the Cephalick vein if there be a portion of the bloud mixed with Choler if the Erysipelas possess the face and if it be spread much over it But if it shall invade another part although it shall proceed of pure choler In what Erysipelas it is convenient to let bloud in what not Phlebotomy will not be so necessary because the bloud which is as a bridle to the Choler being taken away there may be danger lest it become more fierce yet if the body be plethorick it will be expedient to let bloud because this as Galen teacheth is oft-times the cause of an Erysipelas It will be expedient to give a Clyster of refrigerating and humecting things before you open a vein but it belongs to a learned and prudent Physitian to prescribe medicines purging choler What topick medicines are fit to be used in the beginning of an Erysipelas The third care must be taken for Topick or local medicines which in the beginning and encrease must be cold and moist without any either dryness or astriction because the more acrid matter by use of astringent things being driven in would ulcerate and fret the adjacent particle Galen and Avicen much commend this kind of remedy Take fair water â„¥ vi of the sharpest Vinegar â„¥ i make an Oxycrate in which you may wet linnen clothes and apply to the affected part and the circumjacent places and renew them often Or â„ž Succi solani plantag sempervivi an â„¥ ij aceti
all be mixed together and make a liniment with which anoint the part after the fomentation â„ž Farinae fabar crobi an â„¥ iij coquantur in de cocto pulegii origani calamenth salviae addita pulverum chamaem melilot an m ss furfur farinae fab orobi an â„¥ ij coquantur cum lixivio communi addendo terebinth â„¥ iij oleor aneth rut an â„¥ ij make an emplaister for the foresaid use The emplaister of Vigo with Mercury and without is very good for the same purpose But you must note that such medicines must be applyed to the part actually hot and the same heat must be contained and renewed by putting about it linnen Clothes Bricks Bottles and such like hot things Corroborating medicines The humor and flatulency which were kept shut up in the part being resolved the part must be strengthened lest now and then it receive or generate the like matter That may be done by the following fomentation and cataplasm â„ž Nucum cupressi corticum granat sumach berberis â—alaust an Ê’ i caudae equin arnogloss tupsi barb absinth salviae rorism lavendul m. ss flor chamaem melil rosar anthos an p. i alum salis com an â„¥ i bulliant omnia in aequis partibus aquae fabrorum vini austeri make bags for a fomentation or use the decoction for the same purpose with a spunge â„ž Farinae fab hordei lupin an â„¥ ij terebinth commun â„¥ iiij pulver radicis ireos mastic an â„¥ ss mellis com â„¥ ij ss of the foresaid decoction as much as shall suffice so to make a Capalasm to the form of a poultis liquid enough let it be applyed hot to the affected part having used the fomentation before The signs of a waterish tumor The signs of a waterish tumor are the same as of a flatulent but over and besides it shines and at the pressing with your fingers there is heard a noise or murmur as of a bladder half filled with water Why a waterish tumor must be opened with an instrument Therefore the waterish tumor if it shall not yield to the fore-mentioned resolving medicines the way must be opened with an Incision-Knife after the same manner as we mentioned in a Phlegmon For oftentimes this kind of remedy must be necessarily used not only by reason of the contumacy of the humor which gives no place to the resolving medicines but also because it is shut up in its proper cist or bag the thickness of which frustrates the force of the resolving medicines neither suffers it to penetrate into the humor A History As I some years ago found by experience in a maid of 7 years old which troubled with a Hydrocele or waterish rupture to whom when I had rashly applyed to dissolve it resolving medicines of al sorts at length I was forct to open it with my knife not only to evacuate the contained matter but also that I might pluck out the bag which unless it were cut up by the root would be a mean to cause a relapse John Aâ—tine Doctor of Physick called me to this business James Guilemeau the Kings Chirurgeon over saw the cure CHAP. XIX Of an Atheroma Steatoma and Meliceris ALthough these tumors may be thought to be comprehended under one genus with the other Oedematcus tumors yet they differ as thus that is their matter is shut up in its bladder or bag as it were in a peculiar cell But their difference amongst themselves is thus In what an Atheroma Steatoma and Meliceris differ the matter of the Steatoma as the name signifieth is like unto Tallow for 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 in Greek signifieth Tallow or Seam yet it oft-times is found stuffed with other divers hard bodies stony bony or callous like unto the claws of an Hen. For Philoxenus reports that he sometimes saw flyes in a Steatoma at the opening thereof and such other like things wholly dissenting from the common matter of Tumors The matter contained in an Atheroma is like to pap with which they feed little Children A Meliceris contains matter resembling Honey in colour and consistence these tumors appear and rise without any inflammation going before them Thus you shall know these tumors a Steatoma is harder than the other two neither yields it to the pressure of your finger but when it once yields it doth not speedily and easily return to its former figure because the matter is more gross it is of the same colour as the skin without pain and of a longish figure The Meliceris yields to the touch as being a loose and soft body and as it is easily disposed and diffused so it quickly returns to its former place and tumor It differs from the Atheroma in figure and substance For it is more globous and of a subtiler and more shining matter besides also it takes up a large space and is more obsequious to the touch and for the rest without pain Of Chirurgey to be used to these tumors As for the manual operation of the Chirurgeon in their cure it seems to be of no great consequence of what sort the matter is whether resembling Tallow Honey or Pap for there is one simple manner of operation which is that you pluck away the contained humor as also the receptacle in which it is contained Yet you must note such tumors sometimes as it were hanging in the surface of the skin are easily to be moved this way and that way but othersome again deeper fastned firmly cohere with the adjacent bodies and these require an exquisite hand and also industry for fear of a great flux of bloud and convulsion by cutting a vein There are many other kinds of tumors as the Testudo or Mole the Nata the Glandula Nodus Botium Lupia which as in matter for they are all of a thick clammy and viscous Phlegmatick humor so also in kind they agree with an Atheroma Steatoma and Meliceris But also in these for the most part when they are opened What the cause may be that we sometimes find Insecta in these Tumors you may see bodies of all sorts far different from the common matter of tumors as stones chalk sand coals snails straws or awnes of corn hey horn hairs flesh both hard and spongeous gristles bones whole creatures as well living as dead The generation of which things by the corruption and alteration of humors shall not make us much to admire it if we consider that as Nature of all seeds and elements of the whole great world hath made man the Microcosm or little world that he might be as it were the lively Image of that greater world so in him it being never idle in us would have all the kinds of all motions and actions to shew themselves as long as matter for generation is not wanting But because there is little or rather no mention of these tumors amongst the Ancients we will briefly shew the opinions of the latter Writers concerning
he open not the Scrophulae A note to be observed in opening Scrophulous tumors Natural heat the cause of suppuration before that all the contained humor be fully and perfectly turned into pus or matter otherwise the residue of the humor will remain crude and will scarse in a long time be brought to maturation which precept must be principally observed in the Scrophulae also sometimes in other abscesses which come to suppuration For we must not assoon as any portion of the contained humors appear converted into pus procure and hasten the apertion For that portion of the suppurated humor causes the rest sooner to turn into pus which you may observe in inanimate bodies For fruits which begin to perish and rot unless we presently cut away the putrefying part the residue quickly becomes rotten there is also another reason The native heat is the efficient cause of suppuration it therefore the sore being opened diminished and weakned by reason of the dissipation of the spirits evacuated together with the humor will cause the remaining portion of the humor not to suppurate or that very hardly and with much difficulty Yet if the tumefied part be subject by its own nature to corruption and putrefaction as the fundament if the contained matter be malign or critical it will be far better to hasten the apertion The Chirurgical manner of curing Scrophulae There is also another way of curing the Scrophulae which is performed by the hand For such as are in the neck and have no deep roots by making Incision through the skin are pulled and cut away from those parts with which they were intangled But in the performance of this work we take especial care that we do not violate or hurt with our Instrument the Jugular Veins the Sleepy Arteries or Recurrent Nerves If at any time there be danger of any great efflux of bloud after they are plucked from the skin they must be tyed at their roots by thrusting through a needle and thred and then by binding the thred strait on both sides that so bound they may fall off by themselves by little and little without any danger The remainder of the cure may be performed according to the common rules of Art CHAP. XXIII Of the Feaver which happens upon an oedematous Tumor How an intermitting Quotidian happens upon oedematous tumor The cause of a Quotidian Feaver HAving shewed all the differences of oedematous tumors it remains that we briefly treat of the Symptomatical Feaver which is sometimes seen to happen upon them This therefore retaining the motion of the humor by which it is made is commonly of that kind which they name intermitting Quotidians Now the fit of a Quotidian comes every day and in that repetition continues the space of eighteen hours the residue of the day it hath manifest intermission The primitive causes of this Feaver are the coldness and humidity of the air encompassing us the long use of cold meats and drinks and of all such things as are easily corrupted as Summer-fruits crude fishes and lastly the omission of our accustomed exercise The antecedent causes are a great repletion of humors and these especially phlegmatick The conjunct cause is phlegm putrefying in the habit of the body and first region thereof without the great veins The Signs The signs of this Feaver are drawn from three things as first natural for this Feaver or Ague chiefly seizes upon those which are of a cold and moist temper as Old-men Women Children Eunuchs because they have abundance of phlegm and it invades Old-men by its own nature because their native heat being weak they cannot convert their meats then taken in a small quantity How children come to be subject to Quotidian Feavers into laudable bloud and the substance of the parts But it takes children by accident not of its self and their own nature for children are hot and moist but by reason of their voracity or greediness and their violent inordinate and continual motion after their plentiful feeding they heap up a great quantity of crude humors fit matter for this Feaver whereby it comes to pass that fat children are chiefly troubled with this kind of Feaver because they have the passages of their bodies strait and stopped or because they are subject to Worms they are troubled with pain by corruption of their meat whence ariseth a hot distemper by putrefaction and the elevation of putrid vapors by which the heart being molested is easily taken by this kind of feaver From things not natural the signs of this feaver are thus drawn It chiefly takes one in Winter and the Spring in a cold and moist region in a sedentary and idle life by the use of meats not only cold and moist but also hot and dry if they be devoured in such plenty that they overwhelm the native heat How phlegmatick humors happen to be generated by hot and dry meats For thus Wine although it be by faculty and nature hot and dry yet taken too immoderately it accumulates phlegmatick humors and causes cold diseases Therefore drunkenness gluttony crudity bathes and exercises presently after meat being they draw the meats as yet crude into the body and veins and to conclude all things causing much phlegm in us may beget a Quotidian Feaver But by things contrary to nature because this Feaver usually follows cold diseases the Center Circumference and habit of the body being refrigerated The Symptoms of Quotidians The symptoms of this Feaver are the pain of the mouth of the Stomach because that phlegm is commonly heaped up in this place whence follows a vomiting or casting up of phlegm the face looks pale and the mouth is without any thirst oftentimes in the fit it self because the Stomach flowing with phlegm the watery and thinner portion thereof continually flows up into mouth and tongue by the continuity of the inner coat of the ventricle common to the gullet and mouth The manner of the pulse and heat in a Quotidian It takes one with coldness of the extream parts a small and deep pulse which notwithstanding in the vigour of the fit becomes more strong great full and quick Just after the same manner as the heat of this Feaver at the first touch appears mild gentle moist and vaporous but at the length it is felt more acrid no otherwise than fire kindled in green wood which is small weak and smokie at the first but at the length when the moisture being overcome doth no more hinder its action it burns and flames freely Critical sweats The Urin. The Patients are freed from their fits with small sweats which at the first fits break forth very sparingly but more plentifully when the Crisis is at hand the urin at the first is pale and thick and sometimes thin that is when there is obstruction But when the matter is concoct as in the state it is red if at the beginning of the fit they
moderate feeding tending to humidity and indifferent heat for his manner of life let it be quiet and free from all perturbation of anger grief and sadness as also abhorring the use of venery The second is placed in the evacuation of the antecedent matter as by Phlebotomy if need require and by purging by procuring the Haemorrhoids in men and the Courses in women let purgations be prescribed of Diacatholicon Hicra diasenna Polypody Epithymum according to the mind of the learned Physitian The third consists in the convenient use of Topick medicines that is emollient at the beginning and then presently resolving Lib. 2. ad Glauconem or rather such as are mixed both of resolving and emollient faculties as Galen teaches for by the use of only emollient things there is danger of putrefaction and a Cancer and only of resolving there is fear of concretion the subtiler part being resolved and the grosser subsiding Emollients The emollient shall be thus â„ž Rad. alth lib. s rad liliorum â„¥ iij coquantur in aqua com pistentur trajiciantur per setaceum addendo olei chamaem lilior an â„¥ ij oesipi humid â„¥ ss emplastri diachyl alb cum oleo liliorum dissoluti â„¥ iij cerae albae quantum sit satis fiat cerotum Or â„ž gummi ammoniaci galb bdellii styracis liquidae in aceto dissolutorum an â„¥ i diachyl mag â„¥ i ss olei liliorum axungiae anseris an â„¥ i ceroti oesip descriptione Philagr â„¥ ij liquescant omnia simul cerae quantum sit satis ut inde fiat cerotum satis molle When you have sufficiently used emollient things fume the tumor with strong Vinegar and Aqua vitae poured upon a piece of a Milstone Flint or Brick heated very hot for so the mollified humor will be rarified attenuated and resolved then some while after renew your emollients and then again apply your resolvers to wast that which remains which could not be performed together and at once for thus Galen healed a scirrhus in Cercilius his son Goats-dung is very good to discuss Scirrhous tumors Lib. ad Glauc The efficacy of the Empl. of Vigo with Mercury but the Emplaister of Vigo with a double of Mercury is effectual above the rest as that which mollifies resolves and wastes all tumors of this kind CHAP. XXVI Of a Cancer already generated What a Cancer is A Cancer is an hard tumor rough and unequal round immoveable of an ash or livid colour horrid by reason of the veins on every side swollen with black bloud and spread abroad to the similitude of the stretched out legs and claws of a Crab. It is a tumor hard to be known at the first as that which scarse equals the bigness of a Chick or Cicer after a little time it will come to the greatness of a Hasel-nut unless peradventure provoked by somewhat too The figure of the Crab called Cancer in Latin acrid medicins it sodainly increase being grown bigger according to the measure of the encrease it torments the Patient with pricking pain with acrid heat the gross bloud residing in the veins growing hot and inferring a sense like the pricking of Needles from which notwithstanding the Patient hath oft-times some rest The nature of the pain The reason of the name But because this kind of tumor by the veins extended and spread about it like claws and feet being of a livid and ash-colour associated with a roughness of the skin and tenacity of the humor represents as it were the toothed claws of the Crab therefore I thought it not amiss to insert as before the figure of the Crab that so the reason both of the name and thing might be more perspicuous CHAP. XXVII Of the causes kinds and prognosticks of a Cancer HEre we acknowledg two causes of a Cancer the antecedent and conjunct The causes of a Cancer The antecedent cause depends upon the default of irregular diet generating and heaping up gross feculent bloud by the morbifick affection of the Liver disposed to the generation of that bloud by the infirmity or weakness of the Spleen in attracting and purging the bloud by the suppression of the Courses or Haemorrhoids or any such accustomed evacuation The conjunct cause is that gross and melancholick humor sticking and shut in the affected part as in a strait That melancholick bloud which is more mild and less malign The causes of a not ulcerated Cancer only increased by a degree of more fervid heat breeds a not ulcerated Cancer but the more malign and acrid causes an ulcerated For so the humor which generateth Carbuncles when it hath acquired great heat acrimony and malignity corrodes and ulcerates the part upon which it alights A Cancer is made more fierce and raging by meats inflaming the bloud by perturbations of the mind anger heat and medicines too acrid oily and emplastick unfitly applyed both for time and place Amongst the sorts or kinds of Cancers there be two chiefly eminent that is The sorts and differences of Cancers the ulcerated or manifest Cancer and the not ulcerated or occult But of Cancers some possess the internal parts as the Guts Womb Fundament others the external as the Brests also there is a recent or late bred Cancer and also an inveterate one There is one small another great one raging and malign another more mild Every Cancer is held almost incurable or very difficult to be cured for it is a disease altogether malign to wit a particular Leprosie Therefore saith Aetius Aetius lib. 6. The parts most subject to Cancers A Cancer is not easily stayed until it hath eaten even to the innermost of the part which it possesses It invades women more frequently than men and those parts which are lax rare fungous and glandulous and therefore opportune to receive a defluxion of a gross humor such are the brests and all the emunctories of the noble parts When it possesses the brests it often causes inflammation to the Arm-holes and sends the Swelling ever to the glandules thereof whereupon the Patients do complain that a pricking pain even pierces to their hearts But this same pain also runs to the clavicles and even to the inner side of the shoulder-blades and shoulders When it is increased and covers the noble parts it admits no cure but by the hand but in decayed bodies whose strength fail especially if the Cancers be inveterate we must not attempt the cure neither with Instrument nor with Fire neither by too acrid medicines as potential Cauteries but we must only seek to keep them from growing more violent and from spreading further by gentle medicines and a palliative cure For thus many troubled with a Cancer have attained even to old age What Cancers one must not undertake truly to cure Therefore Hippocrates admonishes us that it is better not to cure occult or hidden Cancers for the Patients cured saith he do quickly die but such as are
two ounces of Aqua vitae also sometimes by two or three grains of Musk dissolved in Muskadine given at the beginning of a particular fit towards the general declination of the disease after general purgations the humor and body being prepared and the powers strong And certainly an inveterate Quartain can scarse ever be discussed unless the body be much heated with meats and medicines Therefore it is not altogether to be disproved which many say that they have driven away a quartain by taken a draught of Wine every day assoon as they came forth of their beds in which some leaves of Sage had been infused all the night Also it is good a little before the fit to anoint all the Spine of the back with Oyls heating all the nervous parts such as are the Oyl of Rue Walnuts of the Peppers mixing therewith a little Aqua vitae but for this purpose the Oyl of Castoreum which hath been boyled in an Apple of Coloquintida the Kernels taken out upon hot coles to the Consumption of the half part mixing therewith some little quantity of the Powders of Pepper Pellitory of Spain and Euphorbium is excellent Certainly such like Inunctions are good not only to mitigate the vehemency of the terrible shaking but also to provoke sweats for because by their humid heat they discuss this humor being dull and rebellious to the expulsive faculty for the Melancholy is as it were the dross and mud of the bloud Therefore if on the contrary the Quartain Feaver shall be caused by adult choler What quartains must be cured with refrigerating things we must hope for and expect a cure by refrigerating and humective medicins such as Sorrel Lettuce Purslane broths of the decoction of Cowcumbers Gourds Mellons and Pompions For in this case if any use hot medicines he shall make this humor most obstinate by the resolving of the subtiler parts Thus Trallianus boasts that he hath cured these kinds of Quartain Feaver by the only use of refrigerating Epithemaes being often repeated a little before the beginning of the fit And this is the sum of the Cure of true and legitimate intermitting Feavers That is What bastard Agues are and how they must be cured of those which are caused by one simple humor whereby the Cure of those which they call Bastard intermitting Feavers may be easily gathered and understood as which are bred by a humor impure and not of one kind but mixt or composed by admixture of some other matter for example according to the mixture of divers humors Phlegmatick and Cholerick the Medicins must also be mixt as if it were a confused kind of Feaver of a Quotidian and Tertian it must be cured by a medicin composed of things evacuating flegm and choler CHAP. XXXII Of an Aneurisma that is the dilatation or springing of an Artery Vein or Sinew AN Aneurisma is a soft tumor yielding to the touch What it is made by the bloud and spirit poured forth under the flesh and Muscles by the dilatation or relaxation of an Artery Yet the Author of the definitions seems to call any dilatation of any veinous vessel by the name or an Aneurisma Galen calls an Aneurisma An opening made of the Anatomists of an Artery Also an Aneurisma is made when an Artery that is wounded closeth too slowly the substance which is above it being in the mean time agglutinated filled with flesh and cicatrized which doth not seldom happen in opening of Arteries unskilfully performed and negligently cured therefore Aneurisma's are absolutely made by the Anastomôsis In what parts they chiefly happen 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 painful travail For when as they more strongly strive to hold their breath for the more powerful expulsion of the birth it happens that the Artery is dilated and broken whence follows an effusion of bloud and spirits under the skin The signs are a swelling one while great another small with a pulsation and a colour not varying from the native constitution of the skin It is a soft tumor and so yielding to the impression of the fingers that if it paradventure be small it wholly vanisheth the Arterious bloud and spirits flying back into the body of the Artery but presently assoon as you take your fingers away they return again with like celerity Some Aneurismaes do not only when they are pressed but also of themselves make a sensible hissing if you lay your ear near to them by reason of the motion of the vital spirit rushing with great violence through the straitness of the passage Prognostick Wherefore in Aneurismaes in which there is a great rupture of the Artery such a noise is not heard because the spirit is carryed through a larger passage Great Aneurismaes under the Arm-pits in the Groins and other parts wherein there are large vessels admit no cure because so great an eruption of bloud and spirit often follows upon such an Incision that death prevents both Art and Cure A History Which I observed a few years ago in a certain Priest of Saint Andrews of the Arches Mr. John Maillet dwelling with a chief President Christopher de Thou Who having an Aneurisma at the setting on of the shoulder about the bigness of a Wall-nut Aneurismaes must not rashly be opened I charged him he should not let it be opened for if he did it would bring him into manifest danger of his life and that it would be more safe for him to break the violence thereof with double clothes steeped in the juyce of Night-shade and Housleek with new and wheyey cheese mixt therewith Or with Unguentum de Bolo or Emplastrum contra rupturam and such other refrigerating and astringent medicines if he 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 he might fasten his breeches in stead of a swathe and in the mean time he should eschew all things which attenuate and inflame the bloud but especially he should keep himself from all great straining of his voyce Although he had used his dyet for a year 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 kind of vulgar Impostumes applyes to it in the Evening a Caustick causing an Eschar so to open it In the Morning such an abundance of bloud flowed forth from the tumor being opened that he therewith astonished implores all possible aid and bids that I should be called to stay this his great bleeding and he repented that he had not followed my direction Wherefore I was called but when I was scarse over the threshold How they must be cured he gave up his ghost with his bloud Wherefore I diligently admonish the Chirurgeon that he do not rashly
open Aneurismaes unless they be smal in an ignoble part not indued with large vessels but rather let him perform the cure after this manner Cut the skin which lies over it until the Artery appear 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 bind it then cut it off and so expect the falling off of the thread of it self whiles Nature covers the orifices of the cut Artery with the new flesh then the residue of the cure may be performed after the manner of simple wounds Those of the inward parts incurable The Aneurismaes which happen in the internal parts are incurable Such as frequently happen to those who have often had the unction and sweat for the cure of the French disease because being so attenuated and heated therewith that it cannot be contained in the receptacles of the Artery it distends it to that largeness as to hold a man's Fist Which I have observed in the dead body of a certain Taylor who by an Aneurisma of the Arterious vein suddenly whilst he was playing at Tennis fell down dead A History and vessel being broken his body being opened I found a great quantity of bloud poured forth into the capacity of the Chest but the body of the Artery was dilated to that largness I formerly mentioned and the inner coat thereof was boney For which cause within a while after I shewed it to the great admiration of the beholders in the Physitians School whilest I publiquely dissected a body there whilst he lived he said he felt a beating and a great heat over all his body the force of the pulsation of all the Arteries by the occasion whereof he often swounded Doctor Sylvius the Kings Professor of Physick at that time forbad him the use of Wine and wished him to use boyled water for his drink and Curds and new Cheeses for his meat and to apply them in form of Cataplasms upon the grieved and swoln part At night he used a Ptisan of Barly meal and Poppy-seeds and was purged now and then with a Clyster of refrigerating and emollient things or with Cassia alone by which medicines he said he found himself much better The cause of such a bony constitution of the Arteries by Aneurismaes is for that the hot and fervid bloud first dilates the Coats of an Artery then breaks them which when it happens it then borrows from the neighbouring bodies a fit matter to restore the loosed continuity thereof This matter whilest by little and little it is dryed and hardened it degenerates into a gristly or else a bony substance just by the force of the same material and efficient causes by which stones are generated in the reins and bladder For the more terrestrial portion of the bloud is dryed and condensed by the power of the unnatural heat contained in the part affected with an Aneurisma whereby it comes to pass 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 Hand-maid of God is shewed as that which as it were by making and opposing a new wall or bank would hinder and break the violence of the raging bloud swelling wich the abundance of the vital spirits unless any had rather to refer the cause of that hardness to the continual application of refrigerating and astringent medicines Which have power to condensate and harden Lib 4. cap. ult de praesaex pulsu A Caution in the knowing Aneurismaes as may not obscurely be gathered by the writings of Galen But beware you be not deceived by the fore-mentioned signs for sometimes in large Aneurismaes you can perceive no pulsation neither can you force the bloud into the Artery by the pressure of your fingers either because the quantity of such bloud is greater than which can be contained in the Ancient receptacles of the Artery or because it is condensate and concrete into clods whereupon wanting the benefit of ventilation from the heart it presently putrefies Thence ensue great pain a Gangrene and mortification of the part and lastly the death of the Creature The End of the Seventh Book The Eighth BOOK Of Particular TVMORS against NATVRE The Preface BEcause the Cure of Diseases must be varyed according to the variety of the temper not only of the body in general but also of each part thereof the strength figure form site and sense thereof being taken into consideration I think it worth my pains having already spoken of Tumors in general if I shall treat of them in particular which affect each part of the body beginning with those which assail the head Therefore the Tumor either affects the whole head or else only some particle thereof as the Eyes Ears Nose Gums and the like Let the Hydrocephalos and Physocephalos be examples of those tumors which possess the whole head CHAP. I. Of an Hydrocephalos or watry tumor which commonly affects the heads of Infants THe Greeks call this Disease Hydrocephalos as it were a Dropsie of the Head What it is The causes by a waterish humor being a disease almost peculiar to Infants newly born It hath for an external cause the violent compression of the head by the hand of the Midwife or otherwise at the birth or by a fall contusion and the like For hence comes a breaking of a vein or artery an effusion of the bloud under the skin Which by corruption becoming whayish lastly degenerateth into a certain waterish humor It hath also an inward cause which is the abundance of serous and acrid bloud which by its tenuity and heat sweats through the pores of the vessels sometimes between the Musculous skin of the head and the Pericranium sometimes between the Pericranium and the skull and sometimes between the skull and membrane called Dura mater Differences by reason of place and otherwhiles in the ventricles of the Brain The signs of it contained in the space between the Musculous skin and the Pericranium Signs are a manifest tumor without pain soft and much yielding to the pressure of the fingers The Signs when it remaineth between the Pericranium and the skull are for the most part like the fore-named unless it be that the Tumor is a little harder and not so yielding to the finger by reason of the parts between it and the finger And also there is somewhat more sense of pain But when it is in the space between the skull and Dura-mater or in the ventricles of the Brain or of the whole substance thereof there is a dulness of the senses as of the sight and hearing the tumor doth not yield to the touch unless you use strong impression for then it sinketh somewhat down especially in Infants newly born who have their skuls almost as soft as wax and the junctures of their Sutures lax both by nature as also
thither by the Crisis The cure must be performed by diet The cure Lib 3. de comp med see Locoâ— Hip. aph 21 lib. 1. which must be contrary to the quality of the humor in the temper and consistence of the meats If the inflammation and redness be great which indicate aboundance of bloud Phlebotomy will be profitable yea very necessary But here we must not use the like judgment in application of local medicines as we do in other tumors as Galen admonisheth us that is we must not use repercussives at the beginning especially if the abscess be critical for so we should infringe or fore-slow the indeavours of Nature forcibly freeing it self from the morbifique matter But we must much less repel or drive it back if the matter which hath flowed thither be venenate for so the reflow thereof to the noble parts would prove mortal Wherefore the Chirurgeon shall rather assist Nature in attracting and drawing forth that humor Yet if the defluxion shall be so violent if the pain so fierce that thence there may be fear of watchings and a Feaver which may deject the powers Galen thinks it will be expedient with many resolving medicines to mix some repelling Wherefore at the beginning let such a Cataplasm be applyed â„ž Far. hord sem lin ana â„¥ ij coquantur cum mulso aut dececto cham addendo but. recen Gentle resolving medicines olei cham ana â„¥ i fiat cataplasma And the following Oyntment will also be good â„ž But. recen â„¥ ij olei cham lilior an â„¥ i uuguen de Althea â„¥ ss cerae parum make an Oyntment to be applyed with moist and greasie wooll to mitigate the pain also somewhat more strong discussing and resolving medicines will be profitable as â„ž Rad. Altheae lryon an â„¥ ij fol. rutae puleg. orig an m. i flo chamae m. melil an p. i Stronger resolvers coquantur in hydromelite pistentur trajiciantur addendo farin faenugraec orobi an â„¥ i pul Ireos cham melilot an â„¥ ij olei aneth rutac. an â„¥ i fiat cataplasma But if you determin to resolve it any more you may use Emplastrum oxycroceum Melilot-Plaister If the humor doth there concrete and grow hard you must betake you to the medicins which were prescribed in the Chapter of the Scirrhus but if it tend to suppuration you shall apply the following Medicine â„ž Rad. liliorum ceparum sub cineribus coct an â„¥ iij Vitell. ovor num ij axung suillae unguent A ripening medicine bafilicon an â„¥ i fari sem lini â„¥ i ss fiat Cataplasma But if the matter do so require let the tumor be opened as we have formerly prescribed CHAP. IV. Of the Epulis or over-growing of the flesh of the Gums THE Epulis is a fleshy excrescence of the Gums between the Teeth What it is which is by little and little oft-times encreased to the bigness of an Egge so that it both hinders the speech and eating it casts forth salvious and stinking filth The Symptomes and not seldom degenerates into a Cancer which you may understand by the propriety of the colour pain and other accidents for then you must by no means touch it with your hand But that which doth not torment the Patient with pain may be pluckt away and let this be the manner thereof Let it be tyed with a double thred which must be straiter twitched until such time as it fall off when it shall fall away the place must be burnt with a cautery put through a trunk or pipe The Chirurgical cure or with Aqua fortis or Oyl of Vitriol but with great care that the sound parts adjoyning thereto be not hurt for if so be that it be not burnt it usually returns I have often by this means taken away such large tumors of this kind that they hung out of the mouth in no small bigness to the great disfiguring of the face which when as no Chirurgeon durst touch because the flesh looked livid I ventured upon because they were free from pain and by taking them away and cauterizing the place I perfectly healed them not truly sodainly and at once for although I burnt the place after dissection yet nevertheless they sprung up again because a certain portion of the Bone and Sockets in which the Teeth stand fastned were become rotten I have often observed such like flesh by continuance of time to have turned into a gristly and bony substance Wherefore the cure must be begun as speedily as may be Why the cure must not be deferred for being but little and having fastened no deep roots it is more easily taken away being then only filled with a viscid humor which in success of time is hardened and makes the taking away thereof more difficult CHAP. V. Of the Ranula THere is oft-times a tumor under the Tongue which takes away the liberty of pronuntiation or speech wherefore the Greeks call it Batrachium the Latins Ranula The Reason why it is so called because such as have this disease of the Tongue seem to express their minds by croaking rather than by speaking It is caused by the falling down of a cold moist gross tough viscid and phlegmatick matter The Cause from the Brain upon the Tongue which matter in colour and consistence resembles the white of an Egge yet sometimes it looks of a citrin or yellowish colour The Cure That you may safely perform the cure you must open the Tumor rather with a Cautery of hot Iron than with a Knife for otherwise it will return again The manner of opening it must be thus You shall get a bended hollow and perforated Iron-plate with a hole in the midst and making the Patient to hold open his mouth you shall so fit it that the hole may be upon the part which must be opened Then there you must open it with an hot Iron for so you shall hurt no part of the mouth which is whole but when you are ready to burn it by thrusting your thumb under the Patients Chin you may somewhat elevate the Tumor whereby you may open it with more certainty when it is opened you must thrust out the matter contained therein and then wash the Patients mouth with some Barly-water Hony and Sugar of Roses for so the Ulcer will be safely and quickly healed The Delineation of the Iron-plate and crocked actual Cautery CHAP. VI. Of the swelling of the Glandules or Almonds of the Throat Why the Glandules are called Almonds Their use NAture at the Jaws near the roots of the Tongue hath placed two Glandules opposite to one another in figure and magnitude like to Almonds whence also they have their name their office is to receive the spittle falling down from the Brain both lest that the too violent falling down of the humor should hinder the Tongue in speaking as also that the tongue might always have moisture as it were laid
up in store lest by continual speaking it should grow dry and fail For thus this spittle being consumed by feaverish heats the Patients are scarse able to speak unless they first moisten their tongue by much washing their mouth The Cruse of their tumor These Glandules because they are seated in a hot and moist place are very subject to inflammations for there flows into these oft-times together with the bloud a great quantity of crude phlegmatick and viscous humors whence arises a tumor which is not seldom occasioned by drinking m ch and that vaporous Wine by too much Gluttony and staying abroad in the open air Symptoms Swallowing is painful and troublesome to the Patient and commonly he hath a Feaver Oft-times the neighboring Muscles of the Throttle and Neck are so swoln together with these Glandules that as it usually happens in the Squinzy the passage of the breath and air is stopped and the Patient strangled Cure We resist this imminent danger by purging and bloud-letting by applying Cupping-Glasses to the Neck and Shoulders by frictions and ligatures of the extream parts and by washing and gargling the mouth and throat with astringent Gargarisms But if they come to suppuration you must with your Incision-Knife make way for the evacuation of the Pus or Matter but if on the contrary Extreme diseases must have extreme remedies these things performed according to Art defluxion be increased and there is present danger of death by stopping and intercepting the breath for the shunning so great and imminent danger the top or upper part of the Aspera arteria or Weazon must be opened in that place where it uses to stand most out and it may be done so much the safer because the Jugular-veins and Arteries are furthest distant from this place and for that this place hath commonly little flesh upon it And that the Incision may be the fitlier made How you must open the Weazon the Patient must be wished to bend his head back that so the Artery may be the more easily come to by the Instrument then you shall make an Incision overthwart way with a crooked Knife between two Rings not hurting nor touching the gristly substance that is to say the membrane which tyes together the gristly Rings being only cut you shall then judg that you have made the Incision large enough when you shall perceive the breath to break out by the wound the wound must be kept open so long until the danger of suffocation be past and then it must be sowed up not touching the gristle But if the lips of the wound shall be hard and callous they must be lightly scarified that so they may become bloudy for their easie agglutination and union as we shall shew more at large in the cure of Hare-lips I have had many in cure who have recovered that have had their Weazon together with the gristly rings thereof out with a great wound as we shall note when we shall come to treat of the cure of the Wounds of that part CHAP. VII Of the Inflammation and Relaxation in the Uvula or Columella THE Uvula is a little body spongy and somewhat sharpened to the form of a Pine-Apple What the Vvula is and what the use thereof hanging even down from the upper and inner part of the Palat so to break the force of the Air drawn in in breathing and carryed to the Lungs and to be as a quill to form and tune the voyce It often grows above measure by receiving moisture falling down from the brain The Cause of the swelling thereof becoming sharp by little and little from a broader and more swoln Basis Which thing causes many Symptoms for by the continual irritation of the distilling humor the Cough is caused Symptoms which also hinders the sleep and intercepts the liberty of speech as also by hindering respiration the Patients cannot sleep unless with open mouth they are exercised with a vain indeavouring to swallow having as it were a morsel sticking in their jaws and are in danger of being strangled This disease must be resisted and assailed by purging bleeding cupping taking of clysters The Cure using astringent Gargles and a convenient dyet but if it cannot thus be over come the cure must be tryed by a caustick of Aqua-fortis which I have divers times done with good success The cure by Chirurgery But if it cannot be so done it will be better to put to your hand than through idleness to suffer the Patient to remain in imminent and deadly danger of strangling yet in this there must very great caution be used for the Chirurgeon shall not judg the Uvula fit to be touched with an instrument or caustick which is swoln with much inflamed or black bloud after the manner of a Cancer but he shall boldly put to his hand if it be longish grow small by little and little into a sharp loose and soft point if it be neither exceeding red neither swoln with too much bloud but whitish and without pain Therefore that you may more easily and safely cut away that which redounds and is superfluous desire the Patient to sit in a light place and hold his mouth open then take hold of the top of the Uvula with your Sizzers and cut away as much thereof as shall be thought unprofitable Otherwise you shall bind it with the instrument here-under described The invention of this Instrument is to be ascribed to Honoratus Tastellanus that diligent and learned man the Kings Physitian ordinary and the chief Physitian of the Queen-mother Which also may be used in binding of Polypi and warts in the neck of the womb The Delineation of Constrictory-Rings fit to twitch or bind the Columella with a twisted thread A Shews the Ring whose upper part is somewhat hollow B A double waxed thred which is couched in the hollowness of the Ring and hath a running or loose knâ—t upon it C An Iron rod into the eye whereof the fore-mentioned dou le Thread is put and it is to twitch the Columella when as much thereof is taken hold of as is unprofitable and so to take it away without any flux of bloud When you would straiten the Thread draw it again through this Iron-rod and so strain it as much as you shall think good letting the end of the thred hang out of the mouth But every day it must be twitched harder than other until it fall away by means thereof and so the part and patient be restored to health I have delineated three of these instruments that you may use which you will as occasion shall be offered A Figure of the Speculum oris by which the mouth is held and kept open whilest the Chirurgeon is busied in the cutting away or binding the Uvula But if an eating Ulcer shall associate this relaxation of the Uvula together with a flux of bloud then it must be burnt and seared with an hot
Lastly all such as have the menstrual or haermorrhoidall blood suppressed or too immoderately flowing contrary to their custome either overwhelms diminisheth or extinguisheth the native heat no otherwise than fire which is suffocated by too great a quantity of wood or dieth and is extinguished for want thereof We must look for the same from the excrements of the belly or bladder cast forth either too sparingly or too immoderately Or by too large quantity of meats too cold and rashly devoured without any order To conclude by every default of external causes through which occasion error may happen in diet or exercise The Ascites is distinguished from the two other kinds of Dropsies The signs of an Ascites both by the magnitude of the efficient cause as also by the violence of the Symptoms as the dejected appetite thirst and swelling of the Abdomen And also when the body is moved or turned upon either side you may hear a sound as of the jogging of water in a vessel half full Lastly The Symptomes the humor is diversly driven upwards or downwards according to the turning of the body and compression of the Abdomen It also causeth various Symptoms by pressure of the parts to which it floweth For it causeth difficulty of breathing and the cough by pressing the Midriffe by sweating through into the capacity of the Chest it causeth like Symptoms as the Empyema Besides also the patients often seem as it were by the ebbing and flowing of the waterish humor one while to be carried to the skies and another whiles to be drowned in the water which I have learnt not by reading of any author but by the report of the Patients themselves But if these waterish humors be fallen down to the lower parts they suppress the excrements of the guts and bladder by pressing and straitning the passages When the patient lies on his back the tumor seems less because it is spread on both sides On the contrary when he stands or sits it seems greater for that all the humor is forced or driven into the lower belly whence he feels a heaviness in the Pecten or share The upper parts of the body fall away by defect of the blood fit for nourishment in quality and consistence but the lower parts swel by the flowing down of the serous and waterish humor to them The pulse is little quick and hard with tension This disease is of the kind of Chronical or long diseases wherefore it is scarce Prognosticks or never cured especially in those who have it from their mothers womb who have the Action of their stomach depraved and those who are cachectick and old and lastly all such as have the natural faculty languishing and faulty On the contrary young and strong men especially if they have no feaver and finally all who can endure labour and those exercises which are fit for curing this disease easily recover principally if they use a Physitian before the water which is gathered together do putrefie and infect the bowels by its contagion CHAP. XII Of the cure of the Dropsie THe beginning of the cure must be with gentle and milde medicins neither must we come to a Paracentesis unless we have formerly used and tried these Therefore it shall be the part of the Physitian to prescribe a drying diet and such medicines as carry away water Hip. lib. 4. de acut lib. de intern both by stool and urine Hippocrates ordains this powder for Hydropick persons â„ž Canthar ablatis capitib alis â„¥ ss comburantur in furno fiat pulvis of which administer two grains in white wine for nature helped by this and the like remedies hath not seldome been seen to have cured the Dropsie But that we may hasten the cure it will be available to stir up the native heat of the part by application of those medicines which have a discussing force as bags baths ointments Bags and Emplaisters Let bags be made of dry and harsh Bran Oats Salt Sulphur being made hot or for want of them of Sanders or Ashes often heated Bathes The more effectual baths are salt nitrous and sulphurous waters whether by nature or art that is prepared by the dissolution of salt nitre and Sulphur to which if Rue Marjoram the leaves of Fennel Liniments and tops of Dill of Stoechas and the like be added the business will goe better forwards Emplaisters Let the ointments be made of the oyl of Rue Dill Baies and Squills in which some Euphorbium Pellitory of Spain or Pepper have been boiled Let Plaisters be made of Frankincense Vesicatories Myrrh Turpentine Costus Bay-berries English Galengall hony the dung of Oxen Pigeons Goats Horses and the like which also may be applied by themselves If the disease continue we must come to Sinapisms and Bhoenigms that is to rubrifying and vesicatory medicines When the blisters are raised they must be anointed again that so the water may by little and little flow so long untill all the humor be exhausted and the patient restored to health Gal. lib. de facul natur 1. Galen writes the Husbandmen in Asia when they carried wheat out of the Country into the City in Carrs when they would steal away and not be taken hide some stone-jugs fill'd with water in the midst of the wheat for that will draw the moisture through the jugs into it self and encrease both the quantity and weight When certain pragmatical Physitians had read this they thought that wheat had force to draw out the water so that if any sick of the Dropsie should be buried in a heap of wheat it would draw out all the water Divers opinions of Paracentâ—sit or opening of the belly Reasons against it But if the Physitian shall profit nothing by these means he must come to the exquisitly chief remedy that is to Paracentesis Of which because the opinions of the ancient Physitians have been divers we will produce and explain them Those therefore which disallow Paracentesis conclude it dangerous for three reasons The first because by pouring out the contained water together with it you dissipate and resolve the spirits and consequently the natural vital and animal faculties Another opinion is because the Liver wanting the water by which formerly it was born up thence-forward hanging down by its weight depresseth and draweth downwards the midriffe and the whole Chest whence a dry cough and a difficulty of breathing proceed The third is because the substance of the Peritonaeum as that which is nervous cannot be pricked or cut without danger neither can that which is pricked or cut be easily agglutinated and united by reason of the spermatick and bloudlesse nature thereof Erasistratus moved by these reasons condemned Paracentesis as deadly also he perswaded that it was unprofitable for these following reasons viz. Because the water powred forth Erasistratus his Reasons against it doth not take away with it the cause of the Dropsie and
of the wound before as much water shall be issued forth as we desire and the tumor requireth for once drawn forth it cannot easily be put in again and without force and pain be fitted to the lips of the wound because the skin and fleshy pannicle cover it by their falling into the wound of the flesh or muscle But whilst the water is in evacuation we must have a diligent care of feeding the patient as also of his strength for if that fail and he seem to be debilitated the effusion of the water must be staied for some daies which at the length performed according to our desire the wound must be so consolidated that the Chirurgeon beware it degenerate not into a Fistula The figure of a Pipe in form of a Quill to evacuate the water in Dropsies Others perform this businesse after another manner for Another manner of evacuating the water after the apertion making an incision they thrust through the lips of the wound with a needle and thred but they take up much of the fleshie substance with the needle lest that which is taken up should be rent and torn by the forcible drawing of the lips together Then the thred it self is wrapped up and down over both ends of the needle so thrust through as is usually done in a hare-lip that so the lips of the wound may so closely cohere that not a drop of water may get out against the Chirurgeons will Sometimes such as are cured and healed of the Dropsie fall into the Jaundise A medicine for the Jaundise whom I usually cure after this manner â„ž sterc anser Ê’ij dissolve it in â„¥ iij vini alb coletur make a Potion and let it be given two hours before meat CHAP. XIII Of the tumor and relaxation of the Navell The divers causes thereof THe Exomphaelos or swelling of the Navel is caused by the Peritonaeum either relaxed or broken for by this occasion oft-times the guts and oft-times the kal fal into the seat of the Navel and sometimes superfluous flesh is there generated otherwise this tumor is as an Aneurisma by too great a quantity of blood poured forth in that place otherwise by a flatulent matter and sometimes by a waterish humor If the humor be occasioned by the kall the part it self will retain his proper colour Signs hereof occasioned by the kall that is the colour of the skin the tumor will be soft and almost without pain and which will reside without noise either by the pressure of your fingers or of it self when the Patient lieth on his back but tumor caused by the guts is more unequal and when it is forced in by the pressure of your fingers By the guts By flesh there is such a noise heard as in the Enterocele but if the tumor proceed of superfluous flesh it will be harder and more stubborn not easily retiring into the body although the patient lie upon his back and you presse it with your fingers By wind By a waterish humor By bruised blood Which may be cured by Chirurgety which not The cure by Chirurgery The tumor is softer which proceeds of wind but which will not retire into the body and sounds under your nail like a taber If the swelling be caused by a waterish humor it hath all things common with the flatuous tumor except that it is not so visible and without noise If it be from effusion of blood it is of a livid colour but if the effused blood shall be arterial then there are the signs of an Aneurisma Wherefore when the tumor is caused by the guts kall wind or a waterish humor it is cured by Chirurgery but not if it proceed from a fleshy excrescence or suffusion of blood The tumor of the navell proceeding from the kall and guts the Patient must lie upon his back to be cured and then the kall and guts must with your fingers be forced into their due place then the skin with which the tumor is circumscribed must be taken up with your fingers and thrust through with a needle drawing after it a double twined and strong thred then it must be scarified about the sides that so it may be the easier agglutinated Then must it be thrust through with a needle three or four times according to the manner and condition of the distention and tumor And so twitch it strongly with a thred that the skin which is so bound may at length fall off together with the ligatures But also you may cut off the skin so distended even to the ligature and then cicatrize it as shall be fit A flatulent tumor of the navell shall be cured with the same remedies as we shall hereafter mention in the cure of a windy rupture but the watery may be poured forth by making a small incision And the wound shall be kept open so long untill all the water be drained forth CHAP. XIIII Of the Tumors of the Groins and Cods called Herniae that is Ruptures These are only 3 sorts of Ruptures THe ancient Physicians have made many kinds of Ruptures yet indeed there are only three to be called by that name that is the Intestinalis or that of the guts the Zirbalis or that of the kall and that which is mixed of them both The other kinds of Ruptures have come into this order rather by similitude than any truth of the thing for in them the gut or kall doe not forsake their places Bubonocele Enterocele and Epiplocele The Greeks have given to all these several names both from the seat of the tumor as also from their matter For thus they have called an unperfect rupture which descends not beyond the Groins nor fals down into the Cods Bubonocele but the compleat which penetrates into the Cod if it be by falling down of the gut Enterocele if from the kall Epiplocele if from them both together Hydrocele Physocele they name it Enterâ—-â—piplocele but if the tumor proceed from a waterish humor they term it Hydrocele if from wind Physocele if from both Hydro-physocele if a fleshly excrescence shall grow about the testicle or in the substance thereof it is named Sarcocele If the veins interwoven Sarcocele Cirsocele and divaricated divers ways shall be swoln in the cod and testicles the tumor obtains the name of a Cirsocele But if the humors shall be shut up or sent thither the name is imposed upon the tumor The Causes from the predominant humor as we have noted in the beginning of our Tractate of Tumors The causes are many as all too violent motions a stroak a fall from a high place vomiting a cough leaping riding upon a trotting horse the sounding of trumpets or sackbuts the carrying or lifting up of a heavy burden racking also the too immoderate use of viscid and flatulent meats for all such things may either relax or break the Peritonaeum as that which is a thin and extended membrane The
of the Peritonaeum being made more strait by reason of the future for the rest the wound shall be cured according to Art But before you undertake this work consider diligently whether the strength of the Patient be sufficient neither attempt any thing before you have foretold and declared the danger to the Patient's friends CHAP. XVI Of the Golden Ligature or the Punctus Aureus as they call it IF the Rupture will not be cured by all these means by reason of the great solution of the continuity of the relax'd or broken Peritonaeum and the Patient by the consent of his friends there present is ready to undergo the danger in hope of recovery the cure shall be attempted by that which they call the Punctus aureus or Golden tie For which purpose a Chirurgeon which hath a skilful and sure hand is to be imployed He shall make an Incision about the Share-bone into which he shall thrust a Probe like to the Cane a little before described and thrust it long-ways under the Process of the Peritonaeum and by lifting it up separate it from the adjoyning fibrous and nervous bodies to which it adheres then presently draw aside the spermatick vessels with the Cremaster or hanging muscle of the testicle which being done he shall draw aside the process it self alone by it self And he shall take as much thereof as is too lax with small and gentle mullets perforated in the midst and shall with a Needle having five or six threds thrust it through as near as he can to the spermatick vessels and Cremaster muscles But the Needle also must be drawn again in to the midst of the remnant of the process taking up with it the lips of the wound then the thred must be tyed on a strait knot and so much thereof must be left after the Section as may be sufficient to hang out of the wound This thread will of it self be dissolved by little and little by putrefaction neither must it be drawn out before that nature shall regenerate and restore flesh into the place of the ligature otherwise all our labour shall be spent in vain And lastly let the wound be cleansed filled with flesh and cicatrized whose callous hardness may withstand the falling of the gut or kall Another manner thereof There are some Chirurgeons who would perform this golden ligature after another manner They cut the skin above the share-bone where the falling down commonly is even to the process of the Peritonaeum and they wrap once or twice about it being uncovered a small golden wire and only straiten the passage as much as may suffice to amend the loosness of this process leaving the spermatick vessels at liberty then they twist the ends of the wire twice or thrice with small mullets and cut off the remnant thereof that which remains after the cutting they turn in lest with the sharpness they should prick the flesh growing upon it Then leaving the golden wire there they cure the wound like to other simple wounds and they keep the Patient some fifteen or twenty dayes in his Bed with his Knees something higher and his head something lower Many are healed by this means others have fallen again into the disease by reason of the ill twisting of the wire A Shews a crooked Needle having an eye not far from the point through which you may put the golden wire B B The golden wire put through the Eye of the Needle C The Mullets or Pincers to cut away the wast or superfluous ends of the wire D The spring of the mullets E The mullets to twist the ends of the wire together The third manner thereof There is also another manner of this golden tie which I judg more quick and safe even for that there is no external body left in that part after the cure Wherefore they wrap a leaden wire in stead of the golden which comes but once about the process of the Peritonaeum then twine it as much as need requires that is not too loosly lest it should leave way for the falling down of the Body neither too straitly lest a Gangrene should come by hindering the passage of the spirits and nourishment The ends thereof are suffered to hang out when in the process of time this contraction of the Peritonaeum seems callous then the wire is untwisted and gently drawn out And the rest of the cure performed according to Art But let not the Chirurgeon thrust himself upon his work rashly A thing to be noted without the advice of the Physitian for it divers times comes to pass that the Testicles are not as yet fallen down into the Cod by the two great sluggishness of Nature in some of a pretty growth but remains long in the groins causing a tumor with pain which thing may make a good Chirurgeon believe that it is an Enterocele Therefore whilst he labours by repelling medicines trusses to force back this tumor he encreaseth the pain and hinders the falling down of the testicles into the Cod. I observed this not long ago in a Boy A History which an unskilful Chirurgeon had long and grievously troubled as if he had had a rupture for when I had observed that there was but one Stone in the Cod and knew the Boy was never gelt I bid them cast away the Plaisters and Trusses and wisht his Parents that they should suffer him to run and leap that so the idling Stone might be drawn into the Cod which thing by little and little and without pain had the event as I fore-told That the reason of this affect may be understood we must know a man differs from a woman only in efficacy of heat but it is the nature of strong heat to drive forth as of cold to keep in Hence it is that the Stones in men hang forth in the Cod but in women they lie hid in the lower Belly Therefore it happens that in some males more cold by nature the Testicles are shut up some certain time until at length they are forc't down in the Cod by youthful heat But that we may return to our former Treatise of the Cod although that way of Curing Ruptures wants not pain danger yet it is safer than that which is performed by Gelding which by the cruelty thereof exposes to the to Patient manifest danger of death For the Gelders whilst they fear lest when the cure is finished the relaxation may remain pull with violence the process of the Peritonaeum from the parts to which it adheres together with it a nerve of the sixth conjugation which runs to the Stones they offer the same violence to the spermatick vessels by which things ensue great pain convulsion efflux of bloud inflammation putrefaction and lastly death as I have observed in many whom I have dissected having died a few dayes after their gelding Although some escape these dangers yet they are deprived of the faculty of
all means for the quick recovery of the Patient lest that which was of its own nature small may by his negligence become great Therefore it is expedient he should know what wounds are to be accounted great This as Galen saith is three ways to be known The first is by the magnitude and principality of the part affected for thus the wounds of the Brain Heart and of the greater vessels Lib. 4. Meth. cap. 6.1 though small of themselves yet are thought great Wounds are called Great out of three respects Then from the greatness of the solution of continuity for which cause wounds may be judged great in which much of the substance of the part is lost in every dimension though the part be one of these which are accounted servile Then from the malignity through which occasion the wounds of the joynts are accounted great because for the most part they are ill conditioned CHAP. IV. Of Prognosticks to be made in Wounds THose Wounds are thought dangerous wherein any large Nerve vein or Artery are hurt What wounds are dangerous From the first there is fear of Convulsion but from the other large effusion of the veinous or arterious bloud whence the powers are debilitated also these are judged evil which are upon the Arm-pits groins leggs joynts and between the fingers and likewise those which hurt the head or tail of a Muscle They are lest dangerous of all other which wound only the fleshy substance But they are deadly which are inflicted upon the Bladder Brain Heart Liver Lungs Stomach and small guts But if any Bone Gristle Nerve or portion of the cheek What least dangerous What deadly Hip. aphor 19. Lib. 6. or prepuce shall be cut away they cannot be restored Contused wounds are more difficult to cure than those which are from a simple solution of continuity for before you must think to heal them up you must suppurate and cleanse them which cannot be done in a short time Wounds which are round and circular are so much the worse for there can be no unity unless by an angle that is a meeting together of two lines which can have no place in round wounds because a circular figure consists of one oblique line Besides wounds are by so much thought the greater by how much their extreams and lips are the further disjoyned which happens to round wounds Why round Wounds are difficult to heal Contrary to these are cornered wounds or such as are made alongst the fibers as such as may be healed Wounds may be more easily healed in young men than in old because in them Nature is more vigorous and there is a greater plenty of fruitful or good bloud by which the loss of the flesh may be the better and more readily restored which is slowlier done in old bodies by reason their bloud is smaller in quantity and more dry and the strength of nature more languid Wounds received in the Spring Hip. lib. de ulcer Hip. aph 66. lib. 5. are not altogether so difficult to heal as those taken in Winter or Summer For all excess of heat and cold is hurtful to them it is ill for a Convulsion to happen upon a Wound for it is a sign that some Nervous body is hurt the Brain suffering together therewith as that which is the original of the Nerves A Tumor coming upon great wounds is good for it shews the force of nature is able to expel that which is harmful and to ease the wounded part The organical parts wholly cut off cannot again be united because a vital part once severed and plucked from the trunk of the body cannot any more receive influence from the heart as from a root without which there can be no life The loosed continuity of the Nerves Veins Arteries and also the Bones is sometimes restor'd not truly and as they say according to the first intention but by the second that is by reposition of the like but not of the same substance The first intention takes place in the fleshy parts by converting the Alimentary bloud into the proper substance of the wounded part But the second in the spermatique in which the lost substance may be repaired by interposition of some heterogeneous body which nature diligent for its own preservation substitutes in place of that which is lost for thus the body which restores and agglutinates What a Callus is and whence it proceeds is no Bone but a Callus whose original matter is from an humor somewhat grosser than that from whence the Bones have their original and beginning This humor when it shall come to the place of the fracture agglutinateth the ends of the Bones together which otherwise could never be so knit by reason of their hardness The Bones of Children are more easily and speedily united by reason of the pliantness of their soft and tender substance Small and contemptible Wounds often prove mortal Aphor. 1. sect 1. Lastly we must here admonish the Chirurgeon that small Wounds and such as no Artisan will judg deadly do divers times kill by reason of a certain occult and ill disposition of the wounded and incompassing Bodies for which cause we read it observed by Hippocrates that it is not sufficient for the Physitian to perform his duty but also external things must be rightly prepared and fitted CHAP. V. Of the Cure of Wounds in general The general Indication of Wounds THe Chirurgeon ought for the right cure of wounds to propose unto himself the common and general indication that is the uniting of the divided parts which indication in such a case is thought upon and known even by the vulgar for that which is dis-joyned desires to be united because union is contrary to division But by what means such union may be procured is only known to the skilful Artisan Therefore we attain unto this chief and principal Indication by the benefit of Nature as it were the chief Agent and the work of the Chirurgeon as the servant of Nature And unless Nature shall be strong the Chirurgeon shall never attain to his conceived and wished for end therefore that he may attain hereto he must perform five things Five things necessary for uniting wounds the first is that if there be any strange Bodies as pieces of Wood Iron Bones bruised Flesh congealed Bloud or the like whether they have come from without or from within the Body and shall be by accident fastened or stuck in the wound he must take them away for otherwise there is no union to be expected Another is that he joyn together the lips of the Wound for they cannot otherwise be agglutinated and united The third is that he keep close together the joyned lips The fourth that he preserve the temper of the wounded part for the distemper remaining it is impossible to restore it to its unity The fifth is that he correct the accidents if any shall happen because these urging
the Physitian is often forced to change the order of the cure All strange and external Bodies must be taken away as speedily as is possible because they hinder the action of Nature intending unity especially if they press or prick any Nervous Body or Tendon whence pain or an Abscess may breed in any principal part or other serving the principal Yet if by the quick and too hasty taking forth of such like Bodies there be fear of cruel pain or great effusion of Bloud it will be far better to commit the whole work to Nature than to exasperate the Wound by too violent hastening For Nature by little and little will exclude as contrary to it or else together with the Pus what strange body soever shall be contained in the wounded part But if there shall be danger in delay it will be fit the Chirurgeon fall to work quickly safely and as mildly as the thing will suffer for effusion of Bloud swooning convulsion and other horrid symptoms follow upon the too rough and boystrous handling of Wounds whereby the Patient shall be brought into greater danger than by the Wound it self Therefore he may pull out the strange Bodies either with his fingers or with instruments fit for that purpose but they are sometimes more easily and sometimes more hardly pulled forth according as the Body infixed is either hard or easie to be found or pulled out Which thing happens according to the variety of the figure of such like Bodies according to the condition of the part it self soft hard or deep in which these Bodies are fastned more straitly or more loosly and then for fear of inferring any worse harm as the breaking of some Vessel but how we may perform this first intention and also the expression of the instruments necessary for this purpose shall be shown in the particular Treaties of Wounds made by Gun-shot Arrows and the like Ligatures and Sutures for to conjoyn and hold together the lips of wounds But the Surgeon shall attain to the second and third scope of curing Wounds by two and the same means that is by Ligatures and Sutures which notwithstanding before he use he must well observe whether there be any great flux of Bloud present for he shall stop it if it he too violent but provoke it if too slow unless by chance it shall be poured out into any capacity or belly that so the part freed from the superfluous quantity of Bloud may be less subject to inflammation Therefore the lips of the Wound shall be put together and shall be kept so joyned by suture and ligatures Not truly of all but only of those which both by their nature and magnitude as also by the condition of the parts in which they are are worthy and capable of both the remedies For a simple and small solution of continuity stands only in need of the Ligature which we call incarnative especially if it be in the Arms or Legs but that which divides the Muscles transversly stands in need of both Suture and Ligature that so the lips which are somewhat far distant from each other and as it were drawn towards their beginning and ends may be conjoyned If any portion of a fleshy substance by reason of some great Cut shall hang down it must necessarily be adjoyned and kept in the place by Suture The more notable and large Wounds of all the parts stand in need of Suture which do not easily admit a Ligature by reason of the figure and site of the part in which they are as the Ears Nose Hairy-scalp Eye-lids Lips Belly and Throat There are three sorts of Ligatures by the joynt consent of all the Ancients Three sorts of Ligatures They commonly call the first a Glutinative or Incarnative the second Expulsive the third Retentive The Glutinative or Incarnative is fit for simple green and yet bloudy Wounds What an incarnative Ligature is This consists of two ends and must so be drawn that beginning on the contrary part of the Wound we may so go upwards partly crossing it and going downwards again we may closely joyn together the Lips of the Wound But let the Ligature be neither too strait lest it may cause inflammation or pain nor too loose lest it be of no use and may not well contain it The Expulsive Ligature is fit for sanious and fistulous Ulcers to press out the filth contained in them This is performed with one Rowler having one simple head What an expulsive the beginning of binding must be taken from the bottom of the Sinus or bosom thereof and there it must be bound more straightly and so by little and little going higher you must remit something of that rigour even to the mouth of the Ulcer that so as we have said the sanious matter may be pressed forth The Retentive Ligature is fit for such parts as cannot suffer strait binding such are the Throat What the retentive What the rowlers must be made of Belly as also all parts oppressed with pain For the part vexed with pain abhorreth binding The use thereof is to hold to local Medicines It is performed with a Rowler which consists somewhiles of one some whiles of more heads All these Rowlers ought to be of linnen and such as is neither too new nor too old neither too coorse nor too fine Their breadth must be proportionable to the parts to which they shall be applyed the indication of their largeness being taken from their magnitude figure and site As we shall shew more at large in our Tractates of Fractures and Dislocations The Chirurgeon shall perform the first scope of curing Wounds Why and how the temper of the wounded part must be preserved which is of preserving the temper of the Wounded part by appointing a good order of diet by the Prescript of a Physitian by using universal and local Medicines A slender cold and moist Diet must be observed until that time be passed wherein the Patient may be safe and free from accidents which are usually feared Therefore let him be fed sparingly especially if he be plethorick he shall abstain from Salt and spiced flesh and also from Wine if he shall be of a cholerick or sanguine nature in stead of Wine he shall use the Decoction of Barly or Liquorice or Water and Sugar He shall keep himself quiet for Rest is in Celsus opinion the very best Medicine He shall avoid Venery Contentions Brawls Anger and other perturbations of the mind When he shall seem to be past danger it will be time to fall by little and little to his accustomed manner and diet of life Universal remedies are Phlebotomies and Purging which have force to divert and hinder the defluxion whereby the temper of the part might be in danger of change For Phlebotomy it is not alwayes necessary as in small Wounds and Bodies In what wounds blood-letting is not necessary which are neither troubled with ill humors or Plethorick
But it is only required in great Wounds where there is fear of defluxion pain Delirium Raving and unquietness and lastly in a Body that is Plethorick and when the joynts tendons or nerves are wounded Gentle purgations must be appointed because the humors are moved and inraged by stronger whence there is danger of defluxion and inflammation wherefore nothing is to be attempted in this case without the advice of a Physitian The Topick and particular Medicines are Agglutinative What medicines are to be judged agglutinative which ought to be indued with a drying and astrictive quality whereby they may hold together the lips of the wound and drive away defluxion having always regard to the nature of the part and the greatness of the disease The Simple Medicines are Olibanum Aloes Sarcocolla Bole-Armenick Terra sigillata Sanguis Draconis Common Venice Turpentine Gum Elemni Plantane Horse-tail the greater Comfry Parina Volatilis many other things of this kind which we shall speak of hereafter in our Antidotary The fifth scope of healing Wounds is the correction of those Symptoms or Accidents which are accustomed to follow Wounds which thing verily makes the Chirurgeon have much to do For as he is often forced to omit the proper cure of the disease so to resist the accidents and symptoms as Bleeding Pain Inflammation a Feaver Convulsion Palsie talking Idly or distraction and the like Of which we shall treat briefly and particularly after we have first spoken of Sutures as much as we shall think sitting for this place CHAP. VI. Of Sutures WHen Wounds are made alongst the Thighs Legs and Arms they may easily want Sutures because the Solution of continuity is easily restored by Ligatures What wounds stand in no need of a Suture but when they are made overthwart they require a Suture because the flesh and all such like parts being cut are drawn towards the sound parts whereby it comes to pass that they part the further each from other wherefore that they may be joyned and so kept they must be sewed and if the Wound be deep you must take up much flesh with your Needle for if you only take hold of the upper part the wound is only superficially healed but the matter shut up and gathered together in bottom of the wound will cause abscesses and hollow Ulcers Wherefore now we must treat of making of Sutures The first called Interpunctus leaves the distance of a fingers breadth The first manner of Suture and therefore is fit for the green wounds of the fleshy parts which cannot be cured with a Ligature and in which no heterogeneous or strange body remains The form of your Needle It is performed after this manner You must have a smooth Needle with a thred in it having a three-square point that so it may the better enter the skin with the head of it somewhat hollowed that the thred amy lie therein for so the Needle will the better go through The form of the pipe with a window in it You must also have a little Pipe with a hole or window in the end which you must hold and thrust against the lip of the wound that it be not moved to the one side or other whilst you thrust through the Needle And that we may see through that window when the Needle is thrust through and also draw it together with the thread and withal hold the lip of the Wound in more firmly that it follow not at the drawing forth of the Needle and thred Having thus pierced the lips of the Wound tie a knot near to which cut off the thread lest that if any of it be left below the knot it may so stick to the Emplasters that it cannot be plucked and separated from them without pain when they are taken off But you must note the first stitch must be thrust through the midst of the Wound and then the second must be in that space which is between the midst and one of the ends but when you have made your stitches the lips of the Wound must not be too closely joyned but a little space must be left open between them that the matter may have free passage forth and inflammation and pain may be avoided otherwise if they shall be closely joyned together without any distance between a tumor after arising when the matter shall come to suppuration the lips will be so much distended that they may easily be broken by the stifness of the thred But you must neither take hold of too much nor too little flesh with your Needle for too little will not hold and too much causeth pain and inflammation And besides leaves an ill favoured scar Yet in deep wounds such as are those which are made in the thicker Muscles the Needle must be thrust home that so it may comprehend more of the fleshy substance lest the thred drawn away by the weight of the flesh not taken hold of may be broken But oft-times wounds are seen made in such places as it would be needful the Chirurgeon should have a crooked Needle and Pipe otherwise the Suture will not succeed according to his desire Wherefore I have thought good to set forth both their figures that you may use either as occasion shall serve The Figures of Pipes with Fenestels in them and Needles fit for Sutures The second means of Suture The second Suture is made just after the same manner as the Skinner sows their fels or furs 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 manner of Suture The third Suture is made by one or more Needles having thred in them thrust through the wound the thred being wrapped to and again at the head and the point of the Needle as Boys use to fasten their Needle for fear 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 termed Gastroraphia The fourth kind of Suture is termed 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 shall shew in due place The fift kind called the Dry Suture The fifth kind is called the dry Suture which we use only 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 The signs of bloud flowing from an artery OFt-times great bleeding follows upon wounds by reason of some vessel cut broken or torn which there is need to heal and help diligently because the Bloud is the treasure of Nature without which life cannot consist The Bloud which floweth from an Artery is thus known
and Sanies may pass and be drawn forth lest that matter being suppressed may corrupt the Bone and cause an inflammation in the Brain But the broken Bone must be taken forth within three days You may use the Trepan after the tenth day if it be possible especially in Summer for fear of inflammation Yet I have often taken forth with a Trepan and with Scrapers the Bones of the Skull after the seventeenth day both in Winter and Summer and that with happy success Which I have the rather noted lest any should at any time suffer the wounded to be left destitute of remedy for it is better to try a doubtful remedy than none Yet the By-standers shall be admonished and told of the danger for many more dye who have not the broken bones of the Skull taken out than those that have But the Instruments with which the wounded or cleft Bones may be cut out are called Scalpri or Radulae of which I have caused divers sorts to be here decyphered that every one might take his choyce according to his mind and as shall be best for his purpose But all of them may be scrued into one handle the figure whereof I have exhibited Radulae or Scalpri i. Shavers or Scrapers Radulae of another form for the better cutting of the greater Bones To conclude When the Skull shall be wounded or broken with a simple Fissure It is sufficient in a simpâ—e fissure to dilate it with your Scalpri only and not to Trepan it the Chirurgeon must think he hath done sufficient to the Patient and in his Art if he shall divide the Bone and dilate the Fissure or cleft with the described Instruments though he have used no Trepan although the Fissure pierce through both the Tables But if it doth not exceed the first Table you must stay your scrapers assoon as you come to the second according to the opinion of Paulus but if the bone shall be broken and shivered into many pieces they shall be taken forth with fit Instruments using also a Trepan if need shall require after the same manner as we shall shew you hereafter CHAP. V. Of a Contusion which is the second sort of Fracture AN Ecchymosis that is effusion of bloud What an Ecchymosis is presently concreting under the musculous skin without any wound is oft caused by a violent contusion This Contusion if it shall be great so that the skin be divided from the Skull it is expedient that you may make an Incision whereby the bloud may be evacuated and emptied How a contusion of the skull must be cured For in this case you must wholly desist from suppurative medicines which otherwise would be of good use in a fleshy part by reason that all the moist things are hurtful to the Bones as shall be shown hereafter But if the Bone shall bee too strong thick and dense so that this Instrument will not serve to pluck it forth then you must perforate the Skull in the very center of the depression and with this threefold Instrument or Levatory put into the hole lift up and restore the Bone to its natural site for this same Instrument is of strength sufficient for that purpose It is made with three feet that so it may be applyed to any part of the head which is round but divers heads may be fitted to the end thereof according as the business shall require as the figure here placed doth shew A three-footed Levatory But if at any time it comes to pass that the Bone is not totally broken or deprest but only on one side it will be fit so to lift it up as also to make a vent for the issuing out of the filth to divide the Skull with little Saws like these which ye see here expressed for thus so much of the Bone as shall be thought needful may be cut off without compression neither will there be any danger of hurting the Brain or Membrane with the broken Bone The figures of Saws fit to divide the Skull But if by such signs as are present and shall appear we perceive or judg that the contusion goes but to the second Table or scarse so far the baring or taking away of the Bone must go no further than the contusion reaches for that will be sufficient to eschew and divert inflammations and divers other symptoms And this shall be done with a scaling or Desquamatory Trepan as they term it with which you may easily take up as much of the Bone as you shall think expedient And I have here given you the figure thereof A Desquamatory or Scaling Trepan A Delineation of other Levatories A A. Shews the point or tongue of the Levatory which must be somewhat dull that so it may be the more gently and easily put between the Dura Mater and the Skull and this part thereof may be lifted up so much by the head or handle taken in your hand as the necessity of the present operation shall require B. Intimates the body of the Levatory which must be four square lest the point or tongue put thereon should not stand fast but the end of this Body must rest upon the sound bone as on a sure foundation The use thereof is thus put the point or tongue under the broken or depressed Bone then lift the handle up with your hand that so the deprâ—ssed bone may be elevated C. Shews the first Arm of the other Levatory whose crooked end must be gently put under the depressed Bone D. Shews the other Arm which must rest on the sound Bone that by the firm standing thereof it may lift up the depressed Bone CHAP. VI. Of an Effracture or depression of the Bone being the third kind of Fracture BEfore I come to speak of an Effracture I think it not amiss to crave pardon of the curteous and understanding Reader for this reason especially that as in the former Chapter when I had determined and appointed to speak of a Contusion I inserted many things of a Depression so also in this Chapter of an Effracture What a Consion is I intend to intermix something of a Contusion we do not this through any ignorance of the thing it self for we know that it is called a Contusion when the Bone is deprest and crusht but falls not down But an Effracture is What an Effracture is when the Bone falls down and is broken by a most violent blow But it can scarse come to pass but that the things themselves must be confounded and mixt both as they are done and also when they are spoken of so that you shall scarse see a Contusion without an Effracture or this without that Therefore the Bones are often broken off and driven down with great and forcible blows The cause of Effractures with clubs whether round or square or by falling from a high place directly down more or less according to the force of the blow kind of weapon and condition of the
opposite to that which received the blow What a Resonitus is as if the right side be struck the left is cloven this kind of Fracture is very dangerous because we cannot find it out by any certain sign as it is written by Hippocrates Lib. de vuln Capitis Wherefore if at any time the Patient dye of such a Fracture the Chirurgeon must be pardoned And although Paulus Aegineta laugh at this kind of Fracture and thinks that it cannot happen to a mans head as that which is hard and full as it happens in empty glass Bottles Lib. 6. cap 90. yet I have sometimes seen and observed it Neither is their reason of any vailidity who think Nature therefore to have framed the head of many bones knit together by sutures lest the fracture of the one side In whom this fracturâ— may take place in diverâ— bones of the Skull should be stretched to the other For peradventure this may take place in such as have express Sutures seated and framed according to Nature But it takes no place in such as either want them or have them not seated according to Nature or have them very close and so defaced that it may seem one Bone grown together of many This shall be made manifest by recital of the following History A servant of Massus the Post-master had a grievous blow with a stone upon the right Bregma A History which made but a small wound yet a great Contusion and Tumor Wherefore that it might more plainly appear whether the Bone had received any harm and also that the congealed bloud might be pressed forth the wound was dilated the skin being opened by Theodore Hereus the Chirurgeon who as he was a skilful workman and an honest man omitted nothing which Art might do for his cure When he had divided the skin the bone was found whole although it was much to be feared that it was broken because he fell presently to the ground with the blow vomited and shewed other signs of a fractured Skull so it happened that he dyed on the one and twentieth day of his sickness But I being called to learn and search how he came by his death dividing the Skull with a Saw found in the part opposite to the blow a great quantity of Sanies or bloudy matter and an Abscess in the Crossa Meninx and also in the substance of the very Brain but no Sutures but the two scaly ones Therefore that is certain which is now confirmed by the authority of Hippocrates as also by reason and experience that a blow may be received on the one side and the bone may be fractured on the opposite especially in such as have either no Sutures or else so firmly united and closed that they are scarse apparent The Resonitus may be in the same bone of the Skull Neither is it absurd that the part opposite to that which received the stroak of the same bone and not of divers bones may be cloven and in those men who have their Skulls well made and naturally distinguished and composed with Sutures and this both was and is the true meaning of Hippocrates That this may be the better understood we must note that the opposite part of the same bone may be understood two manner of ways First when the fracture is in the same surface of the smitten bone as if that part of one of the bones of the Bregma which is next to the Lambdal suture be smitten and the other part next to the Coronal suture be cloven Secondly when as not the same superficies and table which receives the blow but that which lyes under it is cleft which kind of fracture I observed in a certain Gentleman a Horseman of Captain Stempans Troop He in defending the breach of the wall of the Castle of Hisdin A History was struck with a Musket bullet upon the Bregma but had his helmet on his head the bullet dented in the helmet but did not break it no nor the musculous skin nor skull for as much as could be discerned yet notwithstanding he died apoplectick upon the sixt day after But I being very desirous to know what might be the true cause of his death dividing his Skull observed that the second Table was broken and cast off scales and splinters wherewith as with Needles the substance of the Brain was continually pricked the first and upper Table being whole for all this I afterwards shewed the like example to Capellanus and Castellanus the King and Queens cheif Physitians in the expedition of Roane But Hippocrates prescribes no method of curing this fifth kind of fracture by reason he thinks it cannot be found out by any circumstance whence it happens that it is for the most part deadly Yet must we endeavour to have some knowledge and conjecture of such a fracture Why Hippocrates set down no way to cure a Resoritus if it shall at any time happen Wherefore having first diligently shaven away the hair we must apply an Emplaister of Pitch Tar Wax Turpentine the Powder of Iris or Flower-deluce roots and Mastich now if any place of the head shall appear more moist The manner to know when the Skull is fractured by a Resonitus soft and swoln it is somewhat likely that the bone is cleft in that place so that the Patient though thinking of no such thing is now and then forc'd to put his hand to that part of the Skull Confirmed with these and other signs formerly mentioned let him call a counsel of learned Physitians and foretell the danger to the Patients friends which are there present that there may no occasion of calumny remain then let him boldly perforate the Skull for that is far better than forsake the Patient ready to yield to the greatness of the hidden disease so consequently to dye within a short while after There are four sorts or conditions of fractures by which the Chirurgeon may be so deceived that when the Skull is broken indeed yet he may think there is no fracture The first is when the bone is so depressed that it presently rises up into its true place and native equability The second is when the fissure is only capillary The third is when the bone is shaken on the inside the utter surface nevertheless remaining whole forasmuch as can be discerned The fourth is when the bone is stricken on the one side and cleft on the other CHAP. IX Of the moving or Concussion of the Brain Gal. lib. 2. de comp m dic cap 6. Com. ad Aph. 58. sect 7. BEsides the mentioned kinds of fractures by which the Brain also suffers there is another kind of affect besides Nature which also assails it by the violent Incursion of a cause in l ke manner external they call it the Commotion or shaking of the Brain whence Symptomes like those of a broken Skull ensue Falling from aloft upon a solid and hard body dull and heavy
blows as with Stones Clubs Staves the report of a peece of Ordnance or crack of Thunder and also a blow with ones hand Lib. 5. Epidem Thus as Hippocrates tells that beautiful Damosel the daughter of Nerius when she was twenty yeers old was smitten by a woman a friend of hers playing with her with her flat hand upon the fore-part of the head and then she was taken with a giddiness and lay without breathing and when she came home she fell presently into a great Feaver her head aked and her face grew red The seventh day after there came forth some two or three ounces of stinking and bloudy matter about her right Ear and she seemed somewhat better and to be at somewhat more ease The Feaver encreased again and she fell into a heavy sleepiness and lost her speech and the right side of her face was drawn up and she breathed with difficulty she had also a convulsion and trembling both her tongue failed her and her eyes grew dull on the ninth day she dyed But you must note that though the head be armed with a helmet yet by the violence of a blow the Veins and Arteries may be broken not only these which pass through the Sutures The vessels of the brain broken by the commotion thereof but also those which are dispersed between the two Tables in the Diploe both that they might bind the Crassa meninx to the Skull that so the Brain might move more freely as also that they might carry the alimentary juyce to the Brain wanting Marrow that is bloud to nourish it as we have formerly shewed in our Anatomy But from hence proceeds the efflux of bloud running between the Skull and Membranes Signs or else between the Membranes and Brain the bloud congealing there causeth vehement pain and the Eyes become blind Vomitting is caused Celsus the mouth of the Stomach suffering together with the Brain by reason of the Nerves of the sixt conjugation which run from the Brain thither and from thence are spread over all the capacity of the ventricle whence becoming a partaker of the offence it contracts it self and is presently as it were overturned whence first The cause of vomitting when the head is wounded those things that are contained therein are expelled and then such as may flow or come thither from the neighbouring and common parts as the Liver and Gall from all which Choler by reason of its natural levity and velocity is first expelled and that in greatest plenty and this is the true reason of that vomitting which is caused and usually follows upon fractures of the Skull and concussions of the Brain Within a short while after inflammation seizes upon the Membranes and Brain it self which is caused by corrupt and putrid bloud proceeding from the vessels broken by the violence of the blow and so spread over the substance of the Brain Such inflammation communicated to the Heart and whole body by the continuation of the parts causes a Feaver But a Feaver by altering the Brain 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 Aph. 14. sect 7. But if to these evils a Sphacel and corruption of the Brain ensue together with a great difficulty of breathing by reason of the disturbance of the Animal faculty which from the Brain 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 History a little before he dyed He having set in order the affairs of France and entred into amity with the neighbouring Princes desirous to honour the marriages of his daughter and sister with the famous and noble exercise of Tilting and he himself running in the Tilt-yard with a blunt-lance received so great a stroak upon his Brest that with the violence of the blow the vizour of his helmet flew up and the trunchion of the broken Lance hit him above the left Eyebrow and the musculous â—kin of the Fore-head was torn even to the lesser corner of the left Eye many splinters of the same Trunchion being struck into the substance of the fore-mentioned Eye the Bones being not touched or broken but the Brain was so moved and shaken that he dyed the eleventh day after the hurt What was the necessary cause of the death of King Henry the second of France His Skull being opened after his death there was a great deal of bloud found between the Dura and Pia Mater poured forth in the part opposite to the blow at the middle of the Suture of the hind-part of the Head and there appeared signs by the native colour turned yellow that the substance of the Brain was corrupted as much as one might cover with ones Thumb Which things caused the death of the most Christian King and not only the wounding of the Eye as many have falsly thought For we have seen many others who have not dyed of farr more grievous wounds in the Eye The History of the Lord Saint-Johns is of late memory he in the Tilt-yard A History made for that time before the Duke of Guises house was wounded with a splinter of a broken Lance of a fingers length and thickness through the visour of his Helmet it entring into the Orb under the Eye and piercing some three fingers bredth deep into the head by my help and Gods favour he recovered Valeranus and Duretus the Kings Physitians and James the Kings Chirurgeon assisting me What shall I say of that great and very memorable wound of Francis of Lorain the Duke of Guise He in the fight of the City of Bologne had his head so thrust through with a Lance A History that the point entring under his right Eye by his Nose came out at his Neck between his Ear and the Vertebrae the head or Iron being broken and left in by the violence of the stroak which stuck there so firmly that it could not be drawn or plucked forth without a pair of Smith's pincers But although the strength and 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 Veins and Arteries and other parts yet the generous Prince by the favour of God recovered By which you may learn that many dye of small wounds and other recover of great yea Why some die of small wounds and others recover of great very large and desperate ones The cause of which events is chiefly and primarily to be attributed to God the Author and Preserver of Mankind but secondarily to the variety and condition of Temperaments And thus much of the commotion or concussion of the Brain whereby it happens that although all the Bone remains perfectly whole yet some veins broken
within by the stroak may cast forth some bloud upon the Membranes of the Brain which being there concrete may cause great pain by reason whereof it blinds the Eyes if soâ—e that the place can be found against which the pain is and when the skin is opened the bone look pale it must presently be cut out as Celsus hath written Now it remains that we tell you how to make your Prognosticks in all the fore-mentioned fractures of the Skull CHAP. X. Of Prognosticks to be made in fractures of the Skull Hip. de vul cap. WE must not neglect any Wounds in the Head no not those which cut or bruise but only the hairy scalp but certainly much less those which are accompanyed by a fracture in the skull for oft-times all horrid symptoms follow upon them consequently death it self especially in bodies full of ill humors or of an ill habit such as are these which are affected with the Lues venerea Leprosie Dropsie Pthysick Consumption for in these simple wounds are hardly or never cured for union is the cure of wounds but this is not performed unless by the strength of nature and sufficient store of laudable bloud but those which are sick of hectick Feavers and Consumptions want store of bloud and those bodies which are repleat with ill humors and of an ill habit have no afflux or plenty of laudable bloud 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 Whether the wounds of children or old people are better to heal Those wounds which are bruised are more difficult to cure than those which are cut When the Skull is broken then the continuity of the flesh lying over it must necessarily be hurt and broken unless it be in a Resonitus The bones of children are more soft thin and replenished with a sanguine humidity than those of old men and therefore more subject to putrefaction Wherefore the wounds which happen to the bones of children though of themselves and their own nature they may be more easily healed because they are more soft wherby it comes to pass that they may be more easily agglutinated neither is there fit matter wanting for their agglutination by reason of the plenty of bloud laudable both in consistence and quality than in old men whose Bones are dryer and harder and so resist union which comes by mixture and their bloud is serous and consequently a more unfit bond of unity and agglutination yet oft-times through occasion of the symptoms which follow upon them that is putrefaction and corruption which sooner arise in a hot and moist body and are more speedily encreased in a soft and tender they usually are more suspected and difficult to heal The Patient lives longer of a deadly fracture in the Skull in Winter than in Summer for that the native heat is more vigorous in that time than in this besides also the humors putrefie sooner in Summer because then unnatural heat is then easily inflamed and more predominant as many have observed out of Hippocrates Aph. 15. sect 1. The wounds of the Brain and of the Meninges or Membranes thereof are most commonly deadly because the action of the Muscles of the Chest and others serving for respiration is divers times disturbed and intercepted whence death insues If a swelling happening upon a wound of the head presently vanish away it is an ill sign unless there be some good reason therefore as bloud-letting Aph. 65. sect 5. purging or the use of resolving local medicines as may be gathered by Hippocrates in his Aphorisms If a Feaver ensue presently after the beginning of a wound of the head that is upon the fourth or seventh day which usually happens you must judg it to be occasioned by the generating of Pus Aph. 47. sect 2. or Matter as it is recited by Hippocrates Neither is such a Feaver so much to be feared as that which happens after the seventh day in which time it ought to be terminated but if it happen upon the tenth or fourteenth day with cold or shaking it is dangerous because it makes us conjecture that there is putrefaction in the Brain the Meninges or Skull through which occasion it may arise chiefly if other signs shall also concurr which may shew any putrefaction as if the wound shall be pallid and of a faint yellowish colour as flesh looks after it is washed Wounds which are dry rough livid and black are evil For as it is in Hippocrates Aphoris 2. Sect. 7. It is an ill sign if the flesh look livid when the Bone is affected for that colour portends the extinction of the heat through which occasion the lively or indifferently red colour of the part faints and dyes and the flesh thereabout is dissolved into a viscid Pus or filth Commonly another worse affect follows hereon wherein the wound becoming withered and dry looks like salted flesh sends forth no matter is livid and black whence you may conjecture that the Bone is corrupted especially if it become rough whereas it was formerly smooth and plain for it is made rough when Caries or corruption invades it but as the Caries increases it becomes livid and black sanious matter with all sweating out of the Diploe as I have observed in many all which are signs that the native heat is decayed and therefore death at hand but if such a Feaver be occasioned from an Erysipelas which is either present or at hand it is usually less terrible The signs of a Feaver caused by an Erysipelas But you shall know by these signs that the Feaver is caused by an Erysipelas and conflux of cholerick matter if it keep the form of a Tertian if the fit take them with coldness and end in a sweat if it be not terminated before the cholerick matter is either converted into Pus or else resolved if the lips of the wound be somewhat swoln as also all the face if the eyes be red and fiery if the neck and chaps be so stiffe that he can scarse bend the one or open the other if there be great excess of biting and pricking pain and heat and that far greater than in a Phlegmon Why an Erysipâ—las chiâ—fly assâ—ils the face For such an Erysipelous disposition generated of thin and hot bloud chiefly assails the face and that for two causes The first is by reason of the natural levity of the cholerick humor the other because of the rarity of the skin of these parts The cure of an Erysipelas on the â—â—ce The cure of such an affect must be performed by two means that is evacuation and cooling with humectation If choler alone cause this tumor we must easily be induced to let bloud but we must purge him with medicines evacuating choler If it be an Erysipelas Phlegmonodes you must draw bloud from the Cephalick-vein of that side which is most affected
of the fiercest of them broke the things wherein he was tyed and leaping amongst the company he with his paws threw to the ground a Girl of some twelve years old and taking her head in his mouth with his teeth wounded the musculous skin in many places yet hurt not the Skull She scarse at length delivered by the Master of the Lyons from the jaws of Death and the Lyon was committed to the cure of Rowland Claret Chirurgeon who was there present by chance at the same time some few days after I was called to visit her she was in a Feaver her head shoulders brest and all the places where the Lyon had set his teeth or nails were swoln all the edges of the wound were livid and did flow with a waterish acrid virulent cadaverous dark green and stinking matter so that I could scarse indure the smell thereof she was also opprest with pricking biting and very great pain which I observing that old saying came into my mind The bitings of man and beasts are venenate which is That all wounds made by the bitings of beasts or of men also do somewhat participate of poyson Wherefore there must principally great care be had of the venenate impression left in the wounds by the nails and teeth and therefore such things must be applyed as have power to overcome poyson Wherefore I scarified the lips of the wounds in divers places and applyed Leeches to suck out the venenate bloud and ease the inflammation of the parts then I made a Lotion of Aegyptiacum Treacle and Mithridate after the following manner Theriacal topick Medicines â„ž Mithrid â„¥ i theriac â„¥ ij aegyptiac â„¥ ss dissolvantur omnia cum aqua vitae Carduiben Let the wounds be fomented and washed with it warm besides also Treacle and Mithridate were put in all the medicines which were either applyed or put into the wound and also of the same with the conserves of Roses and Bugloss dissolved in the water of Sorrel and Carduus benedictus potions were made to strengthen the heart and vindicate it from malign vapours A Cordial Epithema For which purpose also this following Epithema was applyed to the region of her heart â„ž aquae rosar nenuphar an â„¥ iiij aceti scillitici â„¥ j corallorum santalorum alborum rubrorum rosar rub pulveris spodii an â„¥ j Mithridatii Theriacae an Ê’ ij flo cordial pulverifatorum p. ij crociÊ’ j dissolve them all together make an Epitheme and apply it to the heart with a scarlet cloth or spunge and let it be often renued Verily she drest after this manner and the former remedies but once used pain inflammation and all the malign symptoms were much lessened to conclude she recovered but lingred and was lean some two years after yet at length she was perfectly restored to her health and former nature By which you may understand that simple wounds must be handled after another manner than these which have any touch of poyson The cure of the hairy scalp when it is contused But now that we may prosecute the other affects of the hairy scalp say that it is contused with a blow without a wound that which must be first and alwayes done that so the affect may better appear and the remedies which are applyed may take more effect the hair must be shaven away and at the first dressing a repelling medicine applyed such as this following Oxyrhodinum â„ž ol ros â„¥ iij album ovorum nu ij pulveris nucum cypressi balaust alumin. rochae rosar rub anÊ’ j. Let them be all incorporated A repelling medicine and make a medicine for the former use or in stead thereof you may apply the catalpasm prescribed before consisting of Farina hordei fabarum aceto oleo rosaceo But such medicines must be often renued When the pain and defluxion are appeased we must use discussing medicines for dissipation of that humor which remains impacted in the part A discâ—ssing Fomentation â„ž Emplastri de mucilagin Ê’ ij oxicrocei emp. de meliloto an â„¥ i. olei chamaem anethi an â„¥ ss malaxentur simul fiat emplastrum ad usum dictum Such a fomentation will also be good â„ž vini rub lib. iiij lixivii com lib. ij nuces cupressi contus nu x. pul myrtillorum â„¥ i. rosar rub absinth fol. salviae majoranae staechados florum chamaem melil an M. ss aluminis rochae radicis cyperi calami aromatici an â„¥ ss bulliant omnia simul and make a decoction to foment the grieved part After somewhat a long fomenting it whereby it may the better discuss dry and exhaust the concrete humor the head must be dryed and more discussing things applyed such as the Cerate described by Vigo called de Minio Ceratum de Minio which hath an emollient and digestive faculty in this form â„ž Olei chamaem lilior an â„¥ x. olei mastich â„¥ ij pinguedinis vervecis lib. i. litharg auri â„¥ viij minii â„¥ ij vini boni cyathum unum bullianb omnia simul baculo agitando primum quidem lento igne mox verò luculentiore donec tota massa colorem nigrum vel subnigrum contrahat adde in fine cocturae Terebinth lib. s pulveris mastich â„¥ ij gum elemi â„¥ j. cerae quantum sufficit bulliant rursus una ebullitione fiat empl molle But if the humor be not thus discussed Detersive or cleansing medicines but only grow soft then the tumor must be quickly opened for when the flesh is inflamed and putrefied through occasion of the contained humor the bone under it putrefies also by the contagion of the inflammation and the acrimony of the matter falling upon the bone When you have opened it wash away the filth of the ulcer with this following deterâ—ive medicine â„ž syrupi ros absinth an â„¥ i. terebinth â„¥ ss pul ireos aloes mastichis myrrhae farinae hordei an Ê’ ss In stead hereof if there be great putrefaction Aegyptia either by it self or mixt with an equal quantity of Unguentum Apostolorum may be put into the Ulcer When the Ulcer is cleansed it will be time to use scarcotick and cicatrizing medicines CHAP. XVI Of the particular cure of a Fracture or broken Skull IF the Skull be broken so that it be needful to trepan it or to elevate and lift it up Why the Pericranium hath such exquisite sâ—nse or scrape it away the musculous skin being cut as we formerly noted the Pericranium shall be plucked from the Skull as we said before which because it can hardly be done without great pain by reason of its exquisite sense and connexion with the membranes of the brain we must labour to mitigate the pain for fear of inflammation and other accidents Therefore the first dressing ended and the corners of the wound drawn each from other at the second dressing put to the wound a digestive as they term it made of the yolk of an Egge and
Oyl of Roses but you must apply no humid thing to the bone because we desire to keep it sound and whole For Galen's opinion is Gal. 6 mâ—th The bones are offended with the application of humid thiâ—gs that bared bones must not be touched with unctuous things but rather on the contrary all dry things must be applyed to them which may consume the superfluous humidity Therefore we must lay some lint and the cephalick powders which we shall hereafter describe upon the bone we intend to preserve and must have diligent care that it be not offended either by the air or touch of humid medicines You must in Trepaning have a special care of the Crassa meninx For I have often observed a great quantity of bloud to have flowed from some broken vessel which adhered to the second Table neither must we presently and forthwith stay such bleeding but suffer it to flow according to the plenitude and strength of the Patient for thus the feaver and together therewith the rest of the symptoms are diminished For the opinion of Hippocrates Lib. de ulcer in every green wound it is good to cause often bleeding except in the bellies for thus the vehemency of pain inflammation and other accidents will be less troublesome also it is not amiss too for old Ulcers to bleed much for so they are freed from the burden of the impact humors When you think it hath bled sufficiently it may be stanched with this following medicine described by Galen â„ž pulveris AloesÊ’ ij thuris Mastiches Gal. 6. mith an Ê’i ss albumina ovorum nu ij agitentur simul cum pilis leporinis minutim incisis fiat medicamentum When the bleeding is stayed you shall for the asswageing of pain drop upon the Meninx some Pigeons bloud yet warm by opening a Vein under the wing then it shall be strewed over with this following powder â„ž Aloes Thuris Myrrhae sanguinis draconis an Ê’ i. Misce fiat pulvis subtilis Also you may make an irrigation with Rose Vinegar or some repelling medicine such as is a cataplasm ex farinis oleo rosaceo Which may be applyed until the fourth day to asswage and mitigate pain Vigo's Cerate will be of good use in this case Vigo's Ceraiâ— good for a broken Skull as that which in my opinion is most fit for fractures of the Skull because it draws powerfully resolves and dryes moderately and by reason of the smell refreshes the animal spirits and strengthens the Brain and Membranes thereof as you may easily perceive by things which enter into the composition thereof â„ž Olei ros Omph. resinae pini gummi Elemi an â„¥ ij Mastiches â„¥ i ss pinguedinis vervecis castrati â„¥ ij ss foliorum beton caprifol anthos an M j. ammoniaciÊ’ ss granorum tinctorumÊ’ x. liquata pinguedine terenda terantur ammoniacum simul cum aceto scillitico eliquetur deinde bulliant omnia simul in lib. ij vini boni lento igne usque ad consumptionem vini deinde exprimantur cum expressione addantur terebinth Ven. â„¥ iiij cerae albae quantum sufficit fiat cerotum molle ad usum praedictum Also let the neck and all the Spine of the Back be anointed with a liniment which hath force of mollifying the Nerves lest they should suffer Convulsion such is this â„ž Rutae marrubii rorismar ebulor salviae â—erb paralys an M. s rad Ireos cyperi baccarum lauri A liniment good against Convulsions an â„¥ i. florum chamae melil hyperici an M j. pistentur macerentur omnia in vino albo per noctem deinde coquantur in vase duplici cum oleo lumbricorum liliorum de terebinthina axungiae anseris hum an â„¥ ij usque ad consumptionem vini postea colentur in colatura adde terebrinth venet â„¥ iij aquae vitaeÊ’ ss cerae quantum sufficit Fiat linimentum secundum artem Gal. 4. meth But when the pain is asswaged we must abstain from all such unctuous things lest they make the wound become sordid and malign and putrefie the adjacent parts and consequently the Crassa meninx and Skull for the integrity of all parts may be preserved by their like and such are dry things in a fracture of the Skull Wherefore all humid and oyly things must be shunned in the cure thereof unless peradventure there shall be some need to mitigate pain and bring the humor to suppuration For according to Galen we are oft forced for a time to admit the proper cure of the disease so to resist the symptoms How farr humid things are good for a fractured skull furthermore Hippocrates would have us not to foment the Skull no not with Wine but if we do to let it be but with very little Vidius interprets that little to be when there is fear of inflammation for Wine if it be red tart and astringent hath a repressing refrigerating and drying faculty for otherwise all Wine although it heats and dryes by its faculty yet it actually humects and cools both which are very hurtful in wounds of the head or a fractured skul especially when the Bone is bare for from too much cooling of the Brain there is fear of a Convulsion or some other evil symptom Wherefore let this be ratified that is we must not use humid and unctuous medicines in wounds of the head except for curing of inflammation or the mitigation of pain caused thereby Why Cephalick or Catagmatick powders are good Therefore let the bared Skull be strewed with catagmatick and cephalick powders being so called by the Ancients for that they are convenient and good in fractures of the Skul and the rest of the Bones for by their dryness they consume the superfluous humidity and by that means help Nature in the separating of the broken Bones and the regenerating of flesh Such powders usually consist of such things as these ensuing Thus Radix Iridos florent farina hordci Ervi pulvis Aloes Hepaticae sanguis Draconis Mastiche Myrrha rad Aristolochiae Gentianae and generally all such Simples as have a drying and an abstergent faculty without biting but you must not use these things before the pain inflammation and apostumation be past that is then When to be used when the membranes must be cleansed the bones scaled and the flesh generated For the Skull by how much it is the dryer by so much it requires and more easily endures more powerful and dryer medicines than the Dura Mater How to be mixed when they are to be applyed to the Meninges or Pericranium as that which in quickness of sense comes far short of these two Wherefore when you would apply the fore-mentioned cephalick powders to the Meninges they must be associated and mixed with Hony Syrup of Roses or of Wormwood and such other like that so their too violently drying faculty may be allayed and tempered CHAP. XVII Why we use Trepaning in the Fractures of the Skull THere
as to equal the bigness of an Egg it must be tyed and strait twitched close to the root with a silken thred and when it shall fall away by reason of this binding the place must be strowed with the forementioned powders for so it will be more certainly cured than with more acrid Cathaereticks CHAP. XX. Of the corruption and Caries or rottenness of the Bones of the Head THere sometimes follows a corruption and Sphacel of the fractured bones of the skull upon wounds of the head which happens either because they are touched by the air Why when the skull is broken the bones sometimes become foul or rotten which they are not sensible of or for that the Sanies putrefying and detained under them hath infected them with like putrefaction or by the cure unskilfully handled they by the rash application of suppurating and oyly medicines becoming more moist and so undergoing an unnatural change of their proper complexion and native temper as we shall shew more at large when we shall treat of the reason of the Caries in the Lues venerea The signs of foulness of the bone We shal know this unnatural change and corruption partly by sight that is when from white they become to be yellowish livid and black partly also by putting down a Probe when as it meets with nothing smooth and slippery but feels rough in many places and besides also when it enters and easily penetrates with a small thrusting down into their substance as if it were fungous Yet this last sign may often deceive you Corrupt bones are sometimes hard for I have divers times observed rotten bones which being bare had long suffered the injury of the air to become so hard that a Trepan would scarse pierce them for it is putrid humidity which makes the bones soft and fungous but the air by drying them exhausts this humidity and lastly dryes it whence follows such contumacious hardness This sign will be far more certain if the flesh which is grown upon the bone be more soft than is fit loose and have little or no sense of feeling You may correct and amend this corruption of the bone with cauteries as well actual as potential or with the powders of Aloes Gentian Aristolochia Centaury Cortex pini as â„ž radic Ireos Flor. Aristolochiae an Ê’ j. centaur Ê’ ij corticis piniÊ’ ss Misce fiat pulvis subtilissimus ossi inspergendus But if it be much corrupted it must be scraped forth with your Scalpra And you must expect the falling or scaling of the corrupt bone from the sound and not forcibly procure it for otherwise the sound Bone which lies under it being as yet covered with no flesh growing over it would be corrupted by the appulse or touch of the air Yet you shall by little and little gently move and shake rotten Bones with your Probe that so they may more easily scale and with less trouble to Nature But note by the way that the scaling of the Bone which hath invironed the Trepan is commonly performed in the space of forty or fifty days So long also will that caused by the unusual appulse or touch of the air or application of a cautery or the aspersion of the Cephalick powders besides also in the same number of dayes broken bones may be united and joyned together by a Callus which is to them as a scar yet sometimes sooner somewhiles later according to the variety of the ages tempers habits of divers men But if the Caries or rottenness can neither by these fore-mentioned remedies be orecome amended neither the loosed continuity agglutinated nor united you must give the Patient a vulnerary potion for hence I have found happy success in many But sometimes not only a certain portion of the Bone is taken with a Caries The benefit of a vulnerary potion but also the whole is often seised upon with a sphacel and all falls out For in Hippocrates opinion Lib. de vulneribus capitis the Bone of the skull being broken falls from the sound more or less according to the violence of the blow which also is confirmed by experience For which purpose I think good in this place to recite a History whereof I was an eye-witness whilst I served as a Chirurgeon in Piemont under the Marshal de Montejan who was the King's Lieutenant there It happened that a Lackey of Monsieur de Coulains came to me to be cured he had the Bregma-bone of the left side broken with a Sword neither yet did the fracture come to the second Table a few days after his recovery the bone being agglutinated and united it came to pass that a company of Gascoine Souldiers his Countrymen came to Turin with whom one morning he eat plentifully Tripe fryed with Onions and Spices and drunk a great quantity of strong Wine Whereupon he presently fell into a continual Feaver and lost his speech and understanding his head swelled his eyes looked red and fiery and as though they would have started out of his head Which things being considered I let him bloud having first by the Physitian 's advice given him a Glyster and applyed to his head such things as were fit and also I laboured with Frictions and Ligatures of the extream parts to draw the humors downwards yet for all this the part of the head which was formerly affected begun to apostumate which being opened there came forth a great quantity of matter and at the length the musculous skin and Pâ—ricranium sinking down both the Tables of the Skull became putrefied and rotten as you might know by their blackness and stench Now to take away this corruption I applyed at certain times actual cauteries both to amend the corruption and separate that which was altered but mark after some months space a great number of worms came forth by the holes of the rotten bones from underneath the putrified skull which moved me to hasten the separation and falling away of the putrid bones Which being done upon the very Crassa Meninx A great falling away of a corrupt bone which is more strange in that place which nature had covered with flesh I observed 3. cavities of the largeness of one's thumb filled with worms about the bigness of a points tag with black heads diversly wrapped among themselves The bone which Nature separated was of the bigness of the palm of ones hand so that it was strange that so large a portion of the skull should be cast off by Nature and yet the Patient not dye thereof for he recovered yet beyond all mens expectation but after the agglutination of the wound the scar remained very hollow according to the decree of Hippocrates Aph. 45. sect â— For flesh doth not easily grow upon a Callus because it is a thing strange and suppositâ—tious by Nature besides as a scar is a thing more dense than the skin so is a Callus than the bone so that through the more
the present I will treat of the cure Therefore in this case for that there is fear that some vessel is broken under the skull it is fit presently to open the cephalick vein And let blood be plentifully taken according to the strength of the Patient as also respectively to the disease both which is present and like to ensue taking the advice of a Physitian Then when you have shaven away the hair you shall apply to the whole head and often renue the forementioned cataplasm Ex fâ—rinis oleo rosaceo oxymelite and other like cold and moist repelling medicines But you must eschew dry and too astringent medicins must be shunned such as are Unguentum de bolo and the like for they obstruct too vehemently and hinder the passage forth of the vapours both by the sutures and the hidden pores of the skull Wherefore they do not only not hinder the inflammation but fetch it when it is absent or encrease it when present The belly shall be loosed with a clyster and the acrid vapours drawn from the head for which purpose also it will be good to make frictions from above downwards to make straight ligatures on the extream parts to fasten large cupping-glasses with much flame to the shoulders and the original of the spinal marrow that so the revulsion of the blood running vioâ—ently upwards to the brain and ready to cause a phlegmon may be the greater The opening of the Vena Puppis The following day it will be convenient to open the Vena Puppis which is seated upon the Lambdall suture by reason of the community it hath with the veins of the brain and shutting the mouth and nose to strive powerfully to breathe For thus the membranes swell up and the blood gathered between them and the skull is thrust forth but not that which is shut up in the brain and membranes of which if there be any great quantity the case is almost desperate unless nature assisted with stronger force cast it forth turned into Pus But also after a few dayes the vena frontis or forehead-vein may be opened as also the Temporal Arteries and Veins under the tongue that the conjunct matter may be drawn forth by so many open passages In the mean space the Patient must keep a spare diet and abstain from wine especially until the 14th day for that until that time the fearful symptoms commonly reign But repelling medicins must be used untill the 14th day be past A discussing fomentation A caution in fomenting the head then we must come to discussing medicins beginning with the more milde such as is this following decoction â„ž rad Alth. â„¥ vj. ireos cypari calam arom an â„¥ ij fol. salviae majoran betonic flor chamaem melil ros rub stoechad an M. ss salis com â„¥ iij. bulliant omnia simul secundum artem cum vinâ— rub aqua fabrorum fiat decoctio Let the head be washt therewith twice a day with a spunge But yet when you do this see that the head be not too much heated by such a fomentation or any such like thing for fear of pain and inflammation A caution in fomenting the head Then you shall apply the cerate of Vigo which hath power to discuss indifferently to dry and draw forth the humors which are under the skull and by its Aromatick force and power to confirm and strengthen the Brain it thus described â„ž Furfuris bene triturati â„¥ iij. farin lentium â„¥ ij ros myrtillor foliorum granorum ejus an â„¥ j. calam A description of Vigo's Cerate aromat â„¥ i ss chamaemel melil M. ss nuces cupressi num vj. olei rosacei chamaem an Ê’ iij. cerae albae â„¥ ij ss thuris mastichis an Ê’ iij. myrrhaeÊ’ ij In pulverem quae redigi dâ—bent redactis liquefactis oleis cum cera omnia misceantur simul fiat mixtura quae erit inter formam emplastri ceroti Vigo saith that one of the Duke of Urbins Gentlemen found the Urine hereof to his great good A History He fell from his Horse with his head downwards upon hard Marble he lay as if he had been dead the bloud gusht out of his nose mouth and ears and all his face was swollen and of a livid colour he remained dumb twenty days taking no meat but dissolved Gellies and Chicken and Capon broths with Sugar yet he recovered but lost his memory and faultered in his speech all his life after To which purpose is that Aphorism in Hippocrates Aph. 58. sect 7. Those that have their Brain shaken by what cause soever mus of necessity become dumb yea also as Galen observes in his Commentary lose both their sense and motion That Cerot is not of small efficacy but of marvellous and admirable force which could hinder the generating of an abscess which was incident to the Brain by reason of the fall Yet there be many men so far from yielding to reason that they stifly deny That there may be an abcess in the brain Aph. 10. sect 6. that any impostumation can be in the Brain and augmenting this errour with another they deny that any who have a portion of the Brain cut off can recover or rise again but the authority of ancient Writers and Experience do abundantly refel the vanity of the reasons whereon they rely Now for the first in the opinion of Hippocrates If those which have great pain in their heads have either pus water or bloud flowing from their Nose Mouth or Ears it helps their disease But Galen Rhasis and Avicen Gal. lib. de inaequal intemp Rhas cap. 4. contineâ—t Avicen cap. de exit sen 3. lib. 4. cap. 20. A History affirm that Sanies generated in the Brain disburdens it self by the Nose Mouth or Ears and I my self have observed many who had the like happen to them I was told by Prothais Coulen Chirurgeon to Monsieur de Langey that he saw a certain young man in the Town of Mans who often used to ring a great Bell he once hanging in sport upon the rope was snatcht up therewith and fell with his head full upon the pavement he lay mâ—te was deprived of his senses and understanding and was besides hard bound in his Belly Wherefore presently a Feaver and Delirium with other horrid symptoms assayled him for he was not trepanned because there appeared no sign of fracture in the skull on the seventh day he fell into a great sweat with often sneesing by violence whereof a great quantity of matter and Pus flowed of forth his ears mouth and nose then he was eased of all his symptoms and recovered his health Now for the second Lib. 8. de usu part com ad Aph. 18. sect 6. Galen affirms that he saw a Boy in Smyrna of Ionia that recovered of a great wound of the brain but such an one as did not penetrate to any of the ventricles But Guido of Cauliac
with a cap stuffed with cotton on that side CHAP. XXIX Of the Wounds of the Neck and Throat THe Wounds of the Neck and Throat are somewhiles simple The differences of wounds of the neck and throat as those which only use the continuity of the muscles otherwhiles compound such as those which have conjoyned with them a fracture of the Bones as of the Vertebrae or hurt of the internal and external jugular Veins or sleepy Arteries sometimes the Trachea Arteria or Weazon and the oesophagus or gullet are wounded sometimes wholly cut off whence present death ensues Wherefore let not the Chirurgeon meddle with such wounds unless he first foretel the danger of death or the loss of some motion to those that are present The Palsie follows upon wounds of the neck For it often happens that some notable nerve or tendon is violated by a wound in the neck whence a Palsie ensues and that absolutely incurable if the wound shall penetrate to the spinal marrow also hurt therewith Wounds of the Gullet and Weazon are difficultly cured because they are in perpetual motion and chiefly of the latter by reason it is gristly and without bloud The wounds of the gullet are known by spitting of bloud Signs that the gullet is wounded by the breaking forth of meat and drink by the wound but if the Gullet be quite cut asunder the Patient cannot swallow at all For the cut parts are both contracted in themselves the one upwards and the other downwards But we know the weazon is hurt by casting up bloud at the mouth with a continual cough and by the coming forth of the breath or wind by the Wound The wounds of the jugular veins and sleepy Arteries are deadly by accident The Wounds of the jugular Veins and sleepy Arteries if they be great are usually deadly because they cannot be straitly bound up for you cannot bind the throat hard without danger of choaking or strangling the Patient But for defect of a strait ligature in this case the flux of bloud proves deadly If the recurrent Nerve of either side be cut it makes the voyce hoarse if cut on both sides it takes away the use of speech by hurting those instruments which impart motion to the muscles of the Larinx For the cure if the wound be small and not associated with the hurt of any notable vessel By hurting the recurrent Nerve the voyce is hurt nor of the Weazon and Gullet it is speedily and easily cured and if there shall be need you shall use a Suture then you shall put therein a sufficient quantity of Venice-Turpentine mixed with Bole-Armenick or else some of my Balsam of which this the Receipt â„ž Terebinth venetae lb ss gum elemi â„¥ iiij olei hypericonis â„¥ iij. boli armen sang draconis an â„¥ j. aqua vitae â„¥ ij The description of the Author's Balsom liquefiant simul omnia lento igne fiat Balsamum ut artis est ad dendo pulveris ireos florent aloes mastiches myrrhae an Ê’ j. I have done wonders with this Balsom in the agglutination of simple wounds wherein no strange body hath been Now when you have put it in The faculty of Diacalcitheos lay upon it a plaister of Diacalcitheos dissolved in Oyl of Roses and Vinegar as that which hath power to repress the flowing down of humors and hinder inflammation or in stead thereof you may apply Emp. de Gratia Dei or Emp. de Janua But if the jugular Veins and sleepy Arteries be cut let the bleeding be stayed as we have shewed in a chapter treating thereof When the Weazon or Gullet are wounded The cure of the wounded Weazon and Gullet the Chirurgeon shall sow them up as neatly as he can and the Patient shall not endeavour to swallow any hard thing but be content to be fed with gellies and broths When a gargarism is needful this following is very good â„ž hordei M. j. florum rosar p. j. passul mund juâ—ubarum an â„¥ ss glycyrhizae â„¥ j. bulliant omnia simul addendo mellis ros Julep ros an â„¥ ij fiat gargarisma ut artis est A Gargarism With which being warm the Patient shall moisten his mouth and throat for it will mitigate the harshness of the part asswage pain cleanse and agglutinate and make him breathe more freely But that the Chirurgeon may not despair of or leave any thing unattempted in such like wounds The manifold use thereof I have thought good to demonstrate by some examples how wonderful the works of Nature are if they be assisted by Art A certain servant of Monsieur de Champaigne a gentleman of Anjou was wounded in the throat with a sword whereby one of the Jugular-veins was cut together with his Weazon A History He bled much and could not speak and these symptoms remained until such time as the wound was sowed up and covered with medicines But if medicines at any time were more liquid he as it were sucked them by the wound and spaces between the stitches and presently put forth at his mouth that which he had sucked or drawn in Wherefore more exactly considering with my self the greatness of the wound the spermatick and therefore dry and bloudless nature unapt to agglutination of the affected part but chiefly of the Weazon and Jugular-vein as also for that the rough Artery is obnoxious to those motions which the gullet performs in swallowing by reason of the inner coat which is continued to the coat of the gullet by which means these parts mutually serve each other with a reciprocal motion even as the ropes which run to the wheel of a pulley furthermore weighing that the Artery was necessary for the breathing and tempering the heat of the heart as the Jugular-veins served for the nourishment of the upper parts and lastly weighing with my self the great quantity of bloud he had lost which is as it were the treasure of Nature I told those which were present that death was near and certainly at hand And yet beyond exceptation rather by divine favour then our Art he recovered his health A strange History Equally admirable is this History following Two Englishmen walked out of the City of Paris for their recreation to the wood of Vincenne but one of them lying in wait to rob the other of his money and a massie chain of gold which he wore set upon him at unawares cut his throat and robbed him and so left him amongst the Vines which were in the way supposing he had kill'd him having with his dagger câ—t the Weazon and Gullet This murderer came back to the City the other half-dead crawled with much ado to a certain Peasant's house and being dressed with such medicines as were present and at hand he was brought to the City and by his acquaintants committed to my care to be cured I at the first as diligently as I could sowed up the Weazon
which was cut quite asunder and put the lips of the wound as close together as I could I could not get hold of the Gullet because it was fallen down into the Stomach then I bound up the wound with medicines pledgets and fit ligatures After he was thus drest he begun to speak and tell the name of the villain the author of this fact so that he was taken and fastened to the wheel and having his limbs broken lost his wretched life for the life of the innocent wounded man who dyed the fourth day after he was hurt Another History The like hurt befel a certain German who lay at the house of one Perots in the street of Nuts he being frantick in the night cut his throat 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 recovered his speech which before could not utter one syllable freed from suspition of the crime 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 lived four days after the wound being nourished with Broths put into his Fundament like Clysters and with the grateful vapour of comfortable things as Bread newly drawn out of the Oven and soaked in strong Wine I having thus by Art of Chirurgery made the dumb speak for the space of four days CHAP. XXX Of the Wounds of the Chest The differences of wounds of the Chest SOme wounds of the Chest are on the fore-side some behind some penetrate more deep others enter not into the capacity thereof othersome pierce even to the parts contained therein as the Mediastinum Lungs Heart Midriffe hollow Vein and ascendent Artery Othersome pass quite through the body whereby it happens that some are deadly some not The signs 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 wind break through the wound with a noise so that it may dissipate or blow out a lighted candle being held near it If the Patient can scarse either draw or put forth his breath this also is a sign that there is some bloud fallen down upon the Diaphragma Signs that the heart is wounded By these signs you may know that the heart is wounded If a great quantity of bloud gush out if a trembling possess all the members of the body if the pulse be little and faint if the colour become pale if a cold sweat and frequent swooning assail him and the extream parts become cold then death 's at hand A History Yet when I was at Turin I saw a certain Gentleman who fighting a duel with another received a wound under his left brest which pierced into the substance of his heart yet for all that he struck some blows afterwards and followed his flying enemy some two hundred paces until he fell down dead upon the ground having opened his body I found a wound in the substance of the heart so large as would contain ones finger there was only much bloud poured forth upon the midriffe Signs that the Lungs are wounded These are the signs that the Lungs are wounded if the bloud comes foamy or froathy out of the wounds the Patient is troubled with a cough he is also troubled with a great difficulty of breathing and a pain in his side which he formerly had not he lies most at ease when he lies upon the wound and sometimes it comes so to pass that lying so he speaks more freely and easily but turned on the contrary side he presently cannot speak Signs that the midriffe is wounded When the Diaphragma or Midriffe is wounded the party affected is troubled with a weight or heaviness in that place he 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 sharp pain troubles the Patient the Guts are drawn upwards so that it sometimes happens by the vehemency of breathing that the Stomach and Guts are drawn through the wound into the capacity of the Chest which thing I observed in two The one of these was a Mason who was thrust through the midst of the Midriffe where it is nervous and dyed the third day following I opening his lower belly and not finding his stomach A History thought it a monstrous thing but at length searching diligently I found it was drawn into the Chest through the wound which was scarse an inch broad But the stomach was full of wind but little humidity in it The other was called captain Francis d' Alon a Native of Xantoigne Another History who before Rochell was shot with a Musket Bullet entring by the breast-bone near to the sword-like Gristle and passing through the fleshy part of the midriffe went out at the space between the fifth and sixth bastard ribs The wound was healed up on the outside yet for all that there remained a weakness of the stomach whereupon a pain of the guts like to the colick took 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 pain raging more violently in his belly then it was accustomed he dyed though for the mitigating of the vehemency thereof Simon Malmâ—dy and Anthony du Val both learned Physitians omitted no kind of Remedy The body of the diseased was opened by the skilful Chirurgeon James Guillemeau who found a great portion of the Colick-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 return 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 increasing feaver the stinking of the breath Signs that there is blood pouted into the capacity of the Chest the casting up of blood at the mouth and other symptoms which usually happen to those who have putrefied and clotted blood poured out of the vessels into the belly infecting with the filthy vapour of the corrupt substance the parts to which it shall come But also unless the Patient cannot lye upon his back he is troubled with a desire to vomit and covets now and then to rise whence he often falls into a swound the vitall faculty which sustains the body being broken and debilitated both by reason of the wound and concreat or clotted blood for so putting on the quality of poyson it greatly dissipates and dissolves the strength of the heart It is a sign the spinal marrow is hurt when a Convulsion or Palsie that is a sodain loss of sense and motion
in the parts thereunder an unvoluntary excretion of the Urine and other excrements Signs that the Spine is wounded or a totall suppression of them seises upon the Patient When the hollow vein and great Artery are wounded the Patient will dye in a short time by reason of the sodain and aboundant effusion of the blood and spirits which intercepts the motion of the Lungs and heart whence the party dies suffocated CHAP. XXX Of the cure of the Wounds of the Chest WE have read in John de Vigo that it is disputed amongst Chirurgeons concerning the consolidation of wounds of the Chest For some think that such wounds must be closed up Vigo tract de vuln thoraâ— cap. 10. and cicatrized with all possible speed lest the cold air come to the heart and the vitall spirits fly away and be dissipated Others on the contrary think that such wounds ought to be long kept open and also if they be not sufficiently large of themselves that then they must be inlarged by Chirurgery that so the blood poured forth into the capacity of the Chest may have passage forth which otherwise by delay would putrefie whence would ensue an increase of the feaver a fistulous ulcer and other pernicious accidents The first opinion is grounded upon reason and truth if so be that there is little or no blood poured forth into the capacity of the Chest But the latter takes place where there is much more blood contained in the empty spaces of the Chest Which lest I may seem rashly to determin I think it not amiss to ratifie each opinion with a history thereto agreeable Whilst I was at Turin Chirurgeon to the Marshall of Montejan the King of France his General A History I had in cure a Souldier of Paris whose name was Levesque he served under captain Renovart He had three wounds but one more grievous than the rest went under the right brest somewhat deep into the capacity of the Chest whence much blood was poured forth upon the midriff which caused such difficulty of breathing that it even took away the liberty of his speech besides through this occasion he had a vehement feaver coughed up blood and a sharp pain on the wounded side The Chirurgeon which first drest him had so bound up the wound with a strait and thick suture that nothing could flow out thereat But I being called the day after and weighing the present symptoms which threatned speedy death judged that the sowing of the wound must straight be loosed which being done there instantly appeared a clot of blood at the orifice thereof which made me to cause the Patient to lye half out of his bed with his head downwards and to stay his hands on a Settle which was lower than the bed and keeping himself in this posture to shut his mouth and nose that so his Lungs should swell the midriffe be stretched forth and the intercostal muscles and those of the Abdomen should be compressed that the blood poured into the Chest might be evacuated by the wound but also that this excretion might succeed more happily I thrust my finger somewhat deep into the wound that so I might open the orifice thereof being stopped up with the congealed blood and certainly I drew out some seven or eight ounces of putrefied and stinking blood by this means When he was laid in his bed I caused frequent injections to be made into the wound of a decoction of Barly with Honey of Roses and red Sugar which being injected I wisht him to turn first on the one and then on the other side and then again to lye out of his bed as before for thus he evacuated small but very many clots of blood together with the liquor lately injected which being done the symptomes were mitigated and left him by little and little The next day I made another more detergent injection adding thereto wormwood Why bitter things must not be cast into the Chest centaury and Aloes but such a bitterness did rise up to his mouth together with a desire to cast that he could no longer indure it Then it came into my mind that formerly I had observed the like effect of the like remedy in the Hospital of Paris in one who had a fistulous ulcer in his Chest Therefore when I had considered with my self that such bitter things may easily pass into the Lungs and so may from thence rise into the Weazon and mouth I determined that thenceforwards I would never use such bitter things to my Patients for the use of them is much more troublesome than any way good and advantagious But at the length this Patient by this and the like means recovered his health beyond my expectation Read the History of Maryllus in Galen lib. 7. de Anaâ—om administra But on the contrary I was called on a time to a certain Germain gentleman who was run with a sword into the capacity of his Chest the neighbouring Chirurgeon had put a great tent into the wound at the first dressing which I made to be taken forth for that I certainly understood there was no blood powred forth into the capacity of the Chest because the Patient had no feaver no weight upon the Diâ—phrâ—gma nor spitted forth any blood Wherefore I cured him in few dayes by only dropping in some of my balsome and laying a plaister of Diacalcitheos upon the wound What harm ensues the too long use of Tents The like cure I have happily performed in many others To conclude this I dare boldly affirm that wounds of the Chest by the too long use of tents degenerate into Fistula's Wherefore if you at any time shall undertake the cure of wounds which penetrate into the capacity of the Chest you shall not presently shut them up at the first dressing No liniments must be used in wounds of the Chest but keep them open for two or three dayes but when you shall find that the Patient is troubled with none or very little pain and that the midriffe is pressed down with no weight and that he breathes freely then let the tent be taken forth and the wound healed up as speedily as you can by covering it only with lint dipped in some balsome which hath a glutinative faculty and laid somewhat broader than the wound never apply liniments to wounds of this kind lest the Patient by breathing draw them into the capacity of the Chest Wherefore also you must have a care that the tent put into those kinds of wounds may be fastned to the pledgets and also have somewhat a large head lest they should be drawn as we said into the capacity of the Chest for if they fall in they will cause putrefaction and death Let Emplast Diacalcitheos or some such like be applyed to the wound But if on the contrary you know by proper and certain signs that there is much blood fallen into the spaces of the Chest then let the orifice of
the wound be kept open with larger tents untill all the Sanies or bloody matter wherein the blood hath degenerated shall be exhausted But if it happen at any time as assuredly it sometimes doth that notwithstanding the Art and care of the Physitian the wound degenerates into a Fistula then the former evil is become much worse For Fistula's of the Chest are scarse cured at any time and that for divers causes The first is for that the muscles of the Chest are in perpetual motion Wounds of the Chest easily degenerate into a Fistula Another is because they on the contrary inside are covered only with the membrane investing the ribs which is without blood The third is for that the wound hath no stay by means whereof it may be compressed sowed and bound whereby the lips being joined together the wound may at length be replenished with flesh and cicatrized Why there flows such plenty of matter out of wounds of the Chest But the reason why wounds of the Chest do every day heap up and pour forth so great a quantity of matter seems to be their vicinity to the heart which being the fountain of blood there is a perpetual efflux thereof from thence to the part affected For this is Natures care in preserving the affected parts that continually and aboundantly without measure or mean it sends all its supplyes that is blood and spirits to their aid Add hereto that the affected parts by pain heat and continual motion of the Lungs and midriffe draw and allure much blood to themselves Such like blood defiled by the malignity and filth of the wound is speedily corrupted whence it is that from the perpetual afflux of blood there is a continual efflux of matter or filth which at the last brings a man to a consumption because the ulcerated part like a ravenous wolf consumes more blood by the pain heat and motion than can be ministred thereto by the heart Yet if there be any hope to cure and heal the Fistula it shall be performed after the use of diet and phlebotomy according to the prescript of the Physitian by a vulnerary potion which you shall find described when we treat of the Caries or rottenness of the bones The cure of a Fistula in the Chest When Aegyptiacum must be put into the injections Wherefore you shall make frequent injections therewith into the Fistula adding and mixing with it syrup de rosis siccis and mel rosarum Neither do I if the putrefaction be great fear to mix therewith Aegyptiacum But you must have a care to remember observe the quantity of the injected liquor that you may know whether it all come forth again after it hath performed its detergent office For if any thereof remain behind in the corners and crooked passages it hurts the part as corrupted with the contagion thereof The form of a Syringe fit to make injection when a great quantity of liquor is to be injected into any part After the injected liquor is come forth a pipe of gold silver or lead shall be put into the fistulous ulcer and it must have many holes in it that so the filth may pass forth at them it must be fast tyed with strings that it may not fall into the capacity of the Chest A great Spunge steeped in Aqua-vitae and wrung forth again shall be laid hot to the end or orifice thereof both to hinder the entrance of the air into the Fistulous ulcer as also to draw forth the filth there by its gentle heat the which thing the Patient shall much further if often times both day and night he hold his breath stopping his mouth and nose and lying upon the diseased side that so the Sanies may be the more forcibly evacuated neither must we leave the putting in the pipe before that this fistulous ulcer shall be almost dry that is whole as when it yields little or no matter at all then it must be cicatrized But if the orifice of this fistulous ulcer being in the upper part hinder the healing thereof then by a chirurgical Section a passage shall be made in the bottom as we said before in an Empyema The delineation of the Pipes with their Strings and Spunges The Reader must note that the Pipes which are fit for this use need not have so many holes as these here exprest but only two or three in their ends for the flesh growing and getting into the rest makes them that they cannot be plucked forth without much pain A wound made in the Lungs admits cure What wounds of the Lungs are curable unless it be very large if it it be without inflammation if it be on the skirts of the Lungs and not on their upper parts if the Patient contain himself from coughing much and contentious speaking and great breathing for the wound is inlarged by coughing and thence also arises inflammation the Pus and Sanies whereof The harm that insues upon coughing in wounds of the Lungs whilst the lungs again endeavour to expel by coughing by which means they are only able to expel that which is hurtful and troublesome to them the ulcer is dilated the inflammation augmented the Patient wastes away and the disease becomes incurable There have been many Eclegma's described by Physitians for to clense the ulcer How Eclegma's must be swallowed which when the Patient useth he shall lye on his back to keep them long in his mouth so to relax the muscles of the Larinx for thus the medicin will fall by little and little alongst the coats of the Weazon for if it should fall down in great quantity it would be in danger to cause coughing Cows Asses or Goats-milk with a little Hony lest they should corrupt in the Stomach are very fit remedies for this purpose but Womans milk exceeds the rest But Sugar of Roses is to be preferred before all other medicins in the opinion of Avicen The utility of Sugar of Roses in ulcerated or wounded Lungs for that it hath a detergent and also an astrictive and strengthening faculty than which nothing is more to be desired in curing of ulcers When you shall think it time to agglutinate the clensed ulcer you must command the Patient to use emplastick austere and astringent medicins such as are Terra sigillata bolus armenus hypocystis Plantain Knot-grass Sumach Acacia and the like which the Patient shall use in his Broaths and Eclegma's mixing therewith Hony of Roses which serving for a vehicle to the rest may carry away the impacted filth which hinders agglutination But seeing an hective Feaver easily follows upon these kinds of wounds and also upon the affects of the Chest and Lungs it will not be amiss to set down somewhat concerning the cure thereof that so the Chirurgeon may know to administer some help to his Patient whilst a Physitian is sent for to overcome this disease with more powerful and certain remedies CHAP. XXXII
can for two or three hours in his bed when he wakes let him take some Ptisan or some such like thing and then repeat his bath after the foresaid manner Things strengthening the ventricle He shal use this bath thrice in ten days But if the Patient be subject to crudities of the stomach so that he cannot sit in the bath without fear of swooning and such symptoms his stomach must be strengthened with oyl of quinces wormwood and mastich or else with a crust of bread toasted and steeped in muskadine and strewed over with the powders of roses sanders and so laid to the stomach or behind neer to â—e 13. verteâ—ra of the back under which place Anatomy teaches that the mouth of the stomach lies Epithems shall be applyed to the liver and heart to temper the too acrid heat of these parts Epithems and correct the immoderate dryness by their moderate humidity Now they shal be made of refrigerating and humecting things but chiefly humecting for too great coldness would hinder the penetration of the humidity into the part lying within The waters of bugloss and violets of each a quartern with a little white wine is convenient for this purpose But that which is made of French barly the seeds of gourds pompious or cowcumbers of each three drams in the decoction mixed with much tempering with oyl of Violets or of sweet Almonds is most excellent of all other Let cloaths be dipped and steeped in such epithems and laid upon the part and renewed as oft as they become hot by the heat of the part And because in hectick bodies by reason of the weakness of the digestive faculty many excrements are usually heaped up and dryed in the guts it will be convenient all the time of the disease to use frequently clysters made of the decoction of cooling and humecting herbs flowers and seeds wherein you shall dissolve Cassia with Sugar and Oyl of Violets or Water-lillies What a flux happening in a hect ck feaver indicates But because there often happen very dangerous fluxes in a confirmed hectick Feaver which shew the decay of all the faculties of the body and wasting of the corporeal substance you shall resist them with refrigerating and assisting medicins and meats of grosser nourishment as Rice and Cicers and application of astringent and strengthening remedies and using the decoction of Oats or parched Barly for drink Let the Patient be kept quiet and sleeping as much as may be especially if he be a child For this Feaver frequently invades children by anger great and long fear or the too hot milk of the nurse over-heating in the Sun the use of wine and other such like causes they shall be kept in a hot and moist air have another Nurse and be anointed with oyl of violets to conclude you shal apply medicins which are contrary to the morbifick cause CHAP. XXXIII Of the Wounds of the Epigastrium and of the whole lower Belly How children be cured THe wounds of the lower Belly are sometimes before sometimes behind some only touch the surface thereof others enter in some pass quite through the body so that they often leave the weapon therein some happen without hurting the contained parts others grievously offend these parts the Liver Spleen Stomach Guts Kidneys Womb Bladder Ureters and great Vessels Their differences so that oft-times a great portion of the Kall falls forth We know the Liver is wounded when a great quantity of bloud comes forth of the wound when a pricking pain reaches even to the Sword-like gristle Signs of a wounded liver Signs that the stomach and smaller guts are wounded Signs to know when the greater Guts are wounded Signs that the Kidneys are hurt Signs that the Bladder is wounded Signs that the womb is wounded to which the Liver adheres Oft-times more choler is cast up by vomit and the Patient lyes on his Belly with more ease and content When the Stomach or any of the small Guts are wounded the meat and drink break out at the wound the Ilia or flanks swell and become hard the Hicket troubles the Patient and oft-times he casts up more choler and grievous pain wrings his Belly and he is taken with cold sweats and his extream parts wax cold If any of the greater Guts shall be hurt the excrements come forth at the wound When the Spleen is wounded there flows out thick and black bloud the Patient is oppressed with thirst and there are also the other signs which we said use to accompany the wounded Liver A difficulty of making water troubles the Patient whose reins are wounded bloud is pissed forth with the Urin and he hath a pain stretched to his groins and the regions of the Bladder and Testicles The Bladder or Ureters being wounded the flanks are pained and there is a Tension of the Pecten or Share Bloud is made instead of Urin or else the Urin is very bloudy which also divers times comes forth at the wound When the Womb is wounded the Bloud breaks forth by the Privities and the symptoms are like those of the Bladder The wounds of the Liver are deadly for this part is the work-house of the bloud wherefore necessary for life besides by wounds of the Liver the branches of the Gate or Hollow-veins are cut whence ensues a great flux of bloud not only inwardly but also outwardly and consequently a dissipation of the spirits and strength Prognosticks Lib. 6. cap. 88. But the bloud which is shed inwardly amongst the Bowels putrefies and corrupts whence follows pain a feaver inflammation and lastly death Yet Paulus Aegineta writes that the lobe of the Liver may be cut away without necessary consequence of death Also the wounds of the Ventricle and of the small Guts but chiefly of the Jejunum are deadly for many vessels run to the Jejunum or empty Gut and it is of a very nervous and slender substance and besides it receives the cholerick humor from the Bladder of the Gall. So also the wounds of the Spleen Kidneys Ureters Bladder Womb and Gall are commonly deadly but alwayes ill for that the actions of such parts are necessary for life besides divers of these are without bloud and nervous others of them receive the moist excrements of the whole body and lye in the innermost part of the body so that they do not easily admit of medicins Furthermore all wounds which penetrate into the capacity of the Belly are judged very dangerous though they do not touch the contained Bowels for the encompassing and new air entring in amongst the Bowels greatly hurts them as never used to the feeling thereof add hereto the dissipation of the spirits which much weakens the strength Neither can the filth of such wounds be wasted away according to the mind of the Chirurgeon whereby it happens they divers times turn into Fistula's as we said of wounds of the Chest and so at length by collection of matter cause death
Yet I have dressed many who by Gods assistance and favour have recovered of wounds passing quite through their bodies A History I can bring as a witness the Steward of the Portingal Embassadour whom I cured at Melun of a wound made with a Sword so running through the body that a great quantity of excrements came forth of the wounded Guts as he was a dressing yet he recovered Another History Not long ago Giles le Maistre a Gentleman of Paris was run quite through the body with a Rapier so that he voided much bloud at his mouth and fundament divers dayes together whereby you know the Guts were wounded and yet he was healed in twenty days In like sort the wounds of the greater vessels are mortal by reason of the great effusion of bloud and spirits which ensues thereupon CHAP. XXXIV The cure of wounds of the lower Belly THe first cogitation in curing of these wounds ought to be Whether they pierce into the capacity of the Belly for those which pass no further than the Peritonaeum shall be cured like simple wounds which only require union But those which enter into the capacity must be cured after another manner For oft-times the Kall or Guts or both fall forth at them A Gut which is wounded must be sowed up with such a seam as Furriers or Glovers use The cure of a wounded Gut as we formerly told you and then you must put upon it a powder made of Mastich Myrrh Aloes and Bole. Being sowed up it must not be put up boysterously together and at once into its place but by little and little the Patient lying on the side opposite to the wound As for example the right side of the Guts being wounded and falling out by the wound the Patient shall lye on his left side for the more easie restoring of the faln-down Gut and so on the contrary If the lower part of the Guts being wounded slide through the wound then the Patient shall lye with his head low down and his buttocks raised up by putting a pillow under them If the upper part be hurt then must he lye quite contrary that the Guts falling downwards by such a site may give way to those which are faln out through the wound But often in this case the Guts having taken cold by the encompassing air swell up and are distended with wind the which you must discuss before you put them into their place with a fomentation of the decoction of Camomil Mellilot Aniseeds and Fennel applyed with a Spunge or contained in a Bladder or else with Chickens or Whelps cut alive in the midst and laid upon the swelling for thus they do not only discuss the flatulency but also comfort the afflicted part But if the inflation cannot thus be discussed the wound shall be dilated that so the Guts may return the more freely to their place If the Kall shall fall out it must be speedily restored to its place for it is very subject to putrefie The cure when the Kal falls out for the fat whereof for the most part it consists being exposed to the air easily loses its native heat which is small and weak whence a mortification ensues Hence is that of Hippocrates If the Kall fall out it necessarily putrefies The Chirurgeon shall know whether it putrefie or not Hip. Aph. 58. sect 6. by the blackness and the coldness you may perceive by touching it neither must you when it putrefies presently restore it to its place for so the contagion of the putrefaction would spread to the rest of the parts but whatsoever thereof is putrefied shall be twitched and bound hard with a string and so cut off and the rest restored to his proper place but it 's good after cutting of it away to leave the string still hanging thereat that so you may pluck and draw forth whatsoever thereof may by being too strait bound fall away into the capacity of the belly Some think it to be better to let the Kall thus bound to hang forth until that portion thereof which is putrefied fall away of it self and not to cut it off But they are much deceived for it hanging thus would not cover the Guts which is the proper place The Guts and Kall being put up if the wound be great and worth speaking of it must be sowed with that suture which is termed Gastroraphia but this kind of suture is thus made The Needle at the first putting in must only take hold of the Peritonaum and then on the opposite side only of the flesh letting the Peritonaeum alone and so go along putting the Needle from without inwards and from within outwards but so that you only take the musculous flesh and skin over it and then only the Peritonaeum until you have sowed up all the wound He which doth otherwise shall undergo this danger that whereas the coat Peritonaeum is of it self without bloud it being divided or wounded cannot of it self be united to it self therefore it requires an intercourse of flesh otherwise unless it be thus united by the benefit of the flesh intermixed therewith there would remain an uncurable tumor after the wound is cicatrized on the outside But that which we said before according to Galen's mind that al the wounds must be sowed Lib. 6. Math. cap. 4. it is not so to be taken as if that the wound must be sowed up to the very end for in the lower part of the wound there must be left a certain small vent by which the quitture may pass forth which being wholly cleansed and exhausted the wound must be quite healed up But the wounds which shall penetrate into the substance of the liver spleen ventricles and other bowels the Chirurgeon shall not suffer them to be without medicines as if they were desperate but he shall spare neither labour nor care to dress them diligently For doubtful hope is better than certain despair The bladder womb and right gut being wounded detergent and agglutinative injections shall be put up by their proper passages I have read nothing as yet in any Author of the wounds of the fat for all of them refer the cure thereof to the wounds of the Muscles The cure of the wounded fat Yet I will say this by the way that wounds of the fat how deep soever they be if they be only simple may be dressed without putting in of any Tent but only dropping in some of my Balsam and then saying upon it a plaister of Gratia Dei or some such like for so they will heal in a short time CHAP. XXXV Of the Wounds of the Groins Yard and Testicles WHen the Groins and neighbouring parts are wounded we must first consider whether they pierce to within and if they do penetrate to what inward parts they come whether to the bladder the womb or right gut for these parts are such neer neighbours that oft-times they are all wounded with one blow
not yield to these means but that there is imminent danger of a convulsion it will be better to cut it in sunder whether Nerve Tendon or Membrane than to expose the Patient to the danger of a deadly convulsion for thus indeed the peculiar action of that part will be lost but the whole body preserved thereby for so we had determined by common consent that if the pain which afflicted the King would not yield to the prescribed remedies either to pour in scalding Oyl or else to cut the sinew quite asunder A History For the late and sad memory of Mistris Courtin dwelling in the street of Holy-Cross was in our minds who of a vein not well opened in her arm fell into a Gangrene and total mortification of that whole part of which she dyed because she was not dressed with the formerly mentioned medicines Yet we must abstain from these two powerful remedies when the pricked nerve shall lye bare for else the pain would be increased and more grievous symptoms follow Wherefore as I formerly wished more mild medicines must be applyed which may dry up the serous humor without biting or acrimony as â„ž Terebinth venet in aq ros lota â„¥ ij boli armeni subtiliter pulverisati Ê’ ij An Anodyne and Saicotick Balsom incorporentur simul Our Balsom also is excellent in this case and this of Vigo's which follows â„ž Olei rosar emphacini â„¥ j ss olei de terebinth Ê’ iij. succi plantag â„¥ ss semin hypericonis aliquantulum contritiâ—m ss tutiae praepar Ê’ iij. calcis decies lotae cum aqua plantagin Ê’ ij antimoniiÊ’ j. sâ—vi hircini vitulini an â„¥ v. vermium terrestrium cum vino lotorum â„¥ jss bulliant omnia simul dempta tutia in cyatho decoctionis hordei ad consumptionem aquae vini colentur rursumque igni admoveantur addendo tutiam fiat linimentum cum cera alba â„¥ ss croci This liniment asswages pains and covers the bared nerves with flesh This cure of punctured nerves may with choyce and judgement and observing the proportion of the parts be transferred to the pricked Tendons and membranes But take this as a general and common rule A general rule for all wounds of all Nervous parts that all nervous bodies howsoever hurt are to be comforted by anointing them with hot Oyls such as the Oyl of Bays Lillies of Worms Sage or some other such like remedy being applyed to their originals and more notable passages as to the original of the spinal marrow the armpits and groins Neither do I think it fit in this place to omit an affect which sometimes happens to the large Tendon of the heel of which we formerly made mention For it oft-times is rent or torn by a small occasion without any sign of injury or solution of continuity apparent on the outside as by a little jump the slipping aside of the foot the too nimble getting on Horse-back or the slipping of the foot out of the stirrop in mounting into the saddle When this chance happens it will give a crack like Coach-mans whip above the heel where the tendon is broken the depressed cavity may be felt with your finger there is great pain in the part and the party is not able to go This mischance may be amended by long lying and resting in bed and repelling medicines applyed to the part affected in the beginning of the disease for fear of more grievous symptoms and then applying the Black-plaister or Diacalcitheos or some other such as need shall require neither must we hereupon promise to our selves or the Patient certain or absolute health But on the contrary at the beginning of the disease we must foretel that it will never be so cured but that some reliques may remain as the depression of the part affected and depravation of the action and going for the ends of this broken or relaxed Tendon by reason of its thickness and contumacy cannot easily be adjoyned nor being adjoyned united CHAP. XXXIX Of the Wounds of the Joynts Why wounds of the joynts are malignant BEcause the wounds of the Joynts have something proper and peculiar to themselves besides the common nature of wounds of the Nerves therefore I intend to treat of them in particular Indeed they are alwayes very dangerous and for the most part deadly by reason of the nervous productions and membranous Tendons wherewith they are bound and ingirt and into which the Nerves are inserted whereby it comes to pass that the exquisite sense of such like parts will easily bring malign symptoms especially if the wound possess an internal or as they term it a domestique part of them as for example the arm-pits the bending of the arm the inner part of the wrist and ham by reason of the notable Veins Arteries and Nerves of these parts the loosed continuity of all which brings a great flux of bloud sharp pain and other malignant symptoms all which we must resist according to their nature and condition as a flux of bloud with things staying bleeding The cure pain with anodynes If the wound be large and wide the severed parts shall be joyned with a suture leaving an orifice in the lower part by which the quitture may pass forth This following powder of Vigo's description must be strewed upon the Suture â„ž thuris sang draconis boli armen terrae sigill an Ê’ ij aloes mastich an Ê’ j. fiat pulvis subtilis And then the joynt must be wrapped about with a repercussive medicine composed of the whites of Eggs a little oil of Roses Bole Mastich and Barly flowr If it be needful to use a Tent let it be short and according to the wound thick lest it cause pain and moreover let it be anointed with the yolk of an egg oil of Roses washed turpentine and a little saffron But if the wound be more short and narrow it shall be dilated if there be occasion that so the humor may pass away more freely You must rest the part and beware of using cold relaxing mollifying humecting and unctuous medicines unless peradventure the sharpness of the pain must be mitigated For on the contrary astringent and desiccant medicines are good as this following cataplasm â„ž furfur macri farin An astringent and drying cataplasm hordei fabarum an â„¥ iiij florum chamae melil an m. ss terebinth â„¥ iij. mellis communis â„¥ ij ol myrt â„¥ j. oxymelitis vel oxycrat vel lixivii com quantum sufficit fiat cataplasma ad formam pultis Or you may compose one of the Lees of wine Wheat bran the powder of Oaken bark cypress nuts galls and Turpentine and such like that have an astringent strengthening and drying quality and thereby asswaging pain and hindering the defluxion of humors This following medicine is astringent and agglutinative â„ž terebinth venet â„¥ ij aq vitae parum pulvâ—ris mastich aloes myrrhae bâ—li armen an ℈ ij And also our balsam
noble parts or ignoble the fleshy nervous or bony some whiles with rending and tearing asunder the larger vessels sometimes without harming them Now these wounds are only superficiary or else pierce deep and pass quite through the Body But there is also another division of these wounds taken from the variety of the Bullets wherewith they are made For some Bullets are bigger From the difference of Bullets Wounds made by Gunshot are usually round some less some between both they are usually made of Lead yet sometimes of Steel Iron Brass Tin scarse any of Silver much less of Gold There arises no difference from their figure for almost all kinds of wounds of this nature are round From these differences the Chirurgeon must take his Indications what to do and what medicins to apply The first care must be that he think not these horrid and malign symptoms which usually happen upon these kinds of wounds to arise from combustion or poyson carryed with the Bullet into the wounded part and that for those reasons we have formerly handled at large But rather let him judg they proceed from the vehemency of the contusion dilaceration and fracture caused by the Bullet's too violent entry into the nervous and bony Bodies For if at any time the Bullet shall only light upon the fleshy parts the wounds will be as easily cured as any other wound usually is which is made with a contusing and round kind of weapon as I have often found by frequent experience whilst I have followed the wars and performed the part of a Chirurgeon to many Noblemen and common Souldiers according to the counsel of such Physitians as were there overseers of the cure CHAP. II. Of the signs of Wounds made by Gunshot WOunds made by Gunshot are known by their figure which is usually round Signs of wounds from their figure by their colour as when the native colour of the part decays and in stead thereof a livid greenish violet or other colour succeeds by the feeling or sense of the stroke when in the very instant of the receiving thereof he feels a heavy sense as if some great stone From their colour or piece of timber or some such other weighty thing had faln upon it by the small quantity of bloud which issues out thereat for when the parts are contused From the feeling of the blow within some small while after the stroke they swell up so that they will scarse admit a Tent whence it is that the bloud is stopped which otherwise would flow forth of the orifice of the Wound by heat which happens eitner by the violentness of the motion or the vehement impulsion of the air From the bleeding or the attrition of the contused parts as the flesh and nerves Also you may conjecture that the wounds have been made by Gunshot if the Bones shall be broken From the heat of the wound and the splinters thereof by pricking the neighbouring bodies cause defluxion and inflammation But the cause that the Bullet makes so great a contusion is for that it enters the body without any points or corners Whence these wounds are so much contused but with its round and spherical body which cannot penetrate but with mighty force whence it cometh to pass that the wound looks black and the adjacent parts livid hence also proceed so many grievous symptoms as Pain Defluxion Inflammation Apostumation Convulsion Phrensie Palsie Gangrene and Mortification whence lastly Death ensues Now the Wounds do often cast forth virulent and very much stincking filth by reason of the great contusion and the rending and tearing of the neighbouring particles A great abundance of humors flow from the whole Body and fall down upon the affected parts which the native heat thereof being diminished forsakes and presently an unnatural heat seises upon it Hither also tend an universal or particular repletion of ill humors chiefly if the wounds possess the nervous parts as the joynts Verily neither a Stag with his horn nor a Flint out of a sling can give so great a blow or make so large a wound as a Leaden or Iron Bullet shot out of a Gun as that which going with mighty violence pierces the body like a Thunderbolt CHAP. III. How these Wounds must be ordered at the first dressing THe Wound must forthwith be inlarged unless the condition of the part resist Sâ—range bodies must first be pulled forth that so there may be free passage forth both for the Sanies or matter as also for such things as are farced or otherwise contained therein such as are pieces of their Cloaths Bombast Linnen Paper pieces of Mail or Armour Bullets Hail-shot splinters of Bones bruised flesh and the like all which must be plucked forth with as much celerity and gentleness as may be For presently after the receiving of the wound the pain and inflammation are not so great as they will be within a short time after This is the principal thing in performance of this work The manner how to draw them forth that you place the Patient just in such a posture as he was in at the receiving of the wound for otherwise the various motion and turning of the Muscles will either hinder or straiten the passage forth of the contained bodies You shall if it be possible search for these Bodies with your finger that so you may the more certainly and exactly perceive them Yet if the Bullet be entred somewhat deep in then you shall search for it with a round and blunt probe lest you put the Patient to pain yet oftentimes you shall scarce by this means find the Bullet As it happened to the Marshal of Brissac in the siege of Parpignan who was wounded in his right shoulder with a Bullet which the Chirurgeons thought to have entered into the capacity of his body But I wishing the Patient to stand just in the same manner as he did when he received the wound found at length the place where the Bullet lay by gently pressing with my fingers the parts near the wounds and the rest which I suspected as also by the swelling hardness pain and blackness of the part which was the lower part of the shoulder near unto the eighth or ninth spondil of the back Wherefore the Bullet being taken forth by making Incision in the place the wound was quickly healed and the Gentleman recovered You shall observe this and rather believe the judgment of your fingers than of your Probe CHAP. IV. A description of fit Instruments to draw forth Bullets and other strange Bodies BOth the magnitude and figure of Instruments fit for drawing forth of Bullets and other strange Bodies are various according to the diversity of the incident occasions For some are toothed others smooth others of another figure and bigness of all which sorts the Chirurgeon must have divers in a readiness that the may fit them to the Bodies and Wounds and not the Wounds and Bodies to
true manner of curing these kind of Wounds according to the rule of Hippocrates which wishes every contused wound to be presently brought to suppuration for so it will be lesse subject to a Phlegmon and besides all the rent and bruised flesh must putrefie dissolve and turn to quitture that new and good flesh may be generated in stead thereof Laurentius Iaubertus much commends this following medicine of whose efficacy as yet I have made no triall â„ž pulver mercur bis calcinati â„¥ j. adipis porci recentis vel butyri recentis â„¥ iiij Camphâ—rae in aqua vitae dissolutae Ê’ij misce omnia simul addendo tantillum olei liliâ—rum aut lini Experience taught him and reason also shewes that this kind of remedy is very commendable The faculties of the powder of Mercury for the powder of Mercury if mixed with a grosse and humecting matter doth in a short space turn the bruised flesh into Pus without causing any great pain For the Camphire whether it be hot or cold in temper it much conduces to that purpose by reason of the subtlety of the parts whereof it consists The force of calcined vitâ—iol How wounds made by Gun-shot may be combust For by means of this quality the medicines enter with more facility into the affected bodies and perform their parts besides also Camphire resists Putrefaction Some drop into the Wound aqua vitae wherein they have dissolved some calcined vitriol Which kind of remedy is not suppurative but yet much resists putrefaction so that we may use it with good success when the weather is hot moist and foggie But when the Wound is made very neer at hand it cannot but be burnt by the flame of the powder in which remedies used for Burns will be useful not omitting such as are fit for Contusions But for those parts which lye next the Wound you shall not unless at the first dressing apply refrigerating and astringent things but rather emollient and suppurative For those things which have a refrigerating faculty weaken the part and hinder suppuration For astringents constipate the skin which is the cause that the putrid vapours shut up and hindred from transpiration and passage forth a gangrene and mortification easily seise upon the part Scarification But if the contusion be great and diffuse it self more largely over the flesh the part must be much scarified that so the contused and concreat blood and therefore subject to putrefaction may be evacuated But for those parts which somewhat farther distant from the Wound encompass the contused flesh they require refrigerating and strengthening medicins An Astringent repelling medâ—cine so to hinder the falling down and setling of the humor in that part which is this ensuing medicine â„ž pul boli armen sanguin Dracon Myrrhae an â„¥ j. succi solan sempervivi perâ—uâ—c an â„¥ ss aâ—â—um iiij overum â—xyhodin quantum sufficit fiat linimentum ut dâ—cet You may use this and the like untill the suspected symptome be past fear Neither must you have less care The binding up of binding up and rolling the part than of your medicins for it doth not a little conduce to the care to bind it so fitly up as it may be without pain The Wound at the beginning of the cure How oft the wound must be drest in a day must be dressed but once in 24 houres that is untill the Wound come to suppuration but when the qâ—â—tture begins to flow from it and consequently the pain and feaver are encreased it shall be drest twice a day that is every twelve hours And when the quitture flowes more abundantly than usual so that the collection thereof is very troublesome to the Patient it will be requisite to dress it every 8 hours that is thrice a day Now when as this abundant efflux is somewhat sâ—â—ked and begins to decrease it will suffice to dress it twice a day But when the Ulcer is filled with flesh and consequently casts forth but little matter it will serve to dress it once a day as you did at the first CHAP. VI. How you shall order it at the second dressing AT the second and following dressings unless you suspect putrefaction Why wounds made by Gun-shot are so long before they come to suppuration and a Gangrene you shall only put into the Wound some of the oils formerly described adding to them the yolks of some eggs and a little saffron and use this medicin untill the Wound come to perfect suppuration Here you must note this that these kinds of Wounds are longer before they come to suppuration than other Wounds made by any other sort of weapon both for that the bullet as also the air which it violently carries before it by much bruising the flesh on every side dissipates the native heat and exhausts the spirits of the part Which things hinder digestion and often cause the matter to stink as also many other pernicious symptoms Yet most usually pus or quitture appears within three or four dayes sooner and later according to the various complexion and temperament of the Patients bodies and the condition of the ambient air in heat and cold Then by little and little you must come to detersives adding to the former medicin some Turpentine washed in Rose Barly or some other such like water which may wash away the biting thereof If the incompassing air be very cold you may to good purpose Why Turpentine must be washed Gal. lib. 3. Meth. add some aqua vitae for by Galens prescript we must not use hot medicins in winter and less hot in summer Then in the next place use detersives as â„ž aqua decoctionis hordei quantum sufficit succi plantaginis apii agrimon centaurei minoris an â„¥ j. bulliant omnia simul in fine decoctionis adde terebinthinae venetae â„¥ iij. mellis rosat â„¥ ij farin hordieÊ’iij creci ℈ j. Let them be all well mixed together and make a Mundificative of an indifferent consistence Or â„ž succi olymâ—ni plantag absinth apii an â„¥ ij tereb venet â„¥ iiij syrup absinth mellis ros an â„¥ iij. bulliant omnia secundum artem A detergent medicin postea câ—lentur in câ—â—utura adde pulver aloes mastiches Ireos Florent far hord an Ê’ j. fiat Mundificativum ad usum dictum Or â„ž teribinth venet lotae in aq ros â„¥ v. olei ros â„¥ j. mellis ros iij. myrrhae aloes mastich aristolech rotundae Why tents must be neither too long nor thick an Ê’ i ss far lâ—ord Ê’ iij. misce Make a Mundificative which you may put into the wound with Tents but such as are neither too long nor thick lest they hinder the evacuation of the quitture and vapours whence the wounded part will be troubled with erosion pain defluxion inflammation abscess putrefaction all which severally of themselves as also by infecting the noble parts are troublesome both to the part affected as also to the whole
incompassing air under which also is comprehended that which is taken from the season of the yeer region the state of the air and soil and the particular condition of the present and lately by-past time Hence it is we read in Guido Why wounds of the head at Paris and of the legs at Avignion are hard to be cured that Wounds of the head are cured with far more difficulty at Paris than at Avignion where notwithstanding on the contrary the Wounds of the legs are cured with more trouble than at Paris the cause is the air is cold and moist at Paris which constitution seeing it is hurtfull to the brain and head it cannot but must be offensive to the Wounds of these parts But the heat of the ambient air at Avignion attenuates and dissolves the humors and makes them flow from above downwards But if any object that experience contradicts this opinion of Guido and say that wounds of the head are more frequently deadly in hot countries let him understand that this must not be attributed to the manifest and natural heat of the air but to a certain malign and venenate humor or vapor dispersed through the air and raised out of the Seas as you may easily observe in those places of France and Italy which border upon the Mediterranean Sea An indication may also be drawn from the peculiar temper of the wounded parts for the musculous parts must be dressed after one and the bony parts after another manner The different sense of the parts indicates and requires the like variety of remedies for you shall not apply so acrid medicins to the Nerves and Tendons An indication to be drawn from the quick and dull sense of the wounded part as to the ligaments which are destitute of sense The like reason also for the dignity and function of the parts needfull for the preservation of life for oft-times wounds of the brain or of some other of the naturall and vitall parts for this very reason that they are defixed in these parts divert the whole manner of the cure which is usually and generally performed in wounds Neither that without good cause for oft-times from the condition of the parts we may certainly pronounce the whole success of the disease for wounds which penetrate into the ventricles of the brain into the heart the large vessels the chest the nervous parts of the midriffe the liver ventricles small guts bladder if somewhat large are deadly as also those which light upon a joynt in a body repleat with ill humors as we have formerly noted Neither must you neglect that indication which is drawn from the situation of the part and the commerce it hath with the adjacent parts or from the figure thereof seeing that Galen himself would not have it neglected Gal. lib. 7. Meth 2. ad Glauc But we must consider in taking these forementioned Indications whether there be a composition or complication of the diseases for as there is one and that a simple indication of one and that a simple disease so must the indication be various of a compound and complicate disease But there is observed to be a triple composition or complication of affects besides nature for either a disease is compounded with a disease as a wound or a plegmon with a fracture of a bone or a disease with a cause as an ulcer with a defluxion or a disease with a symptome as a wound with pain or bleeding It sometimes comes to pass that these three the disease cause and symptome concur in one case or affect In artificially handling of which we must follow Galens counsell Gal. lib. 7. Meth. who wishes in complicated and compounded affects that we resist the more urgent then let us withstand the cause of the disease and lastly that affect without which the rest cannot be cured Which counsell must well be observed for in this composure of affects which distracts the Emperick on the contrary the rational Physitian hath a way prescribed in a few and these excellent words which if he follow in his order of cure he can scarse miss to heal the Patient Symptomes truly as they are symptomes yeeld no indication of curing neither change the order of the cure for when the disease is healed the symptome vanishes as that which follows the disease as a shadow follows the body But symptomes do oftentimes so urge and press How and when we must take indication of curing from a symptome that perverting the whole order of the cure we are forced to resist them in the first place as those which would otherwise increase the disease Now all the formerly mentioned indications may be drawn to two heads the first is to restore the parts to its native temper the other is that the blood offend not either in quantity or quality for when those two are present there is nothing which may hinder the repletion or union of wounds nor ulcers CHAP. IX What remains for the Chirurgeon to do in this kind of Wounds THe Chirurgeon must first of all be skilfull and labour to asswage pain hinder defluxions prescribe a diet in those six things we call not-natural forbidding the use of hot and acrid things as also of Wine for such attenuate humors and make them more apt for defluxion Why such as are wounded must keep a slender diet Therefore at the first let his diet be slender that so the course of the humors may be diverted from the affected part for the stomach being empty and not well filled draws from the parts about it whereby it consequently follows that the utmost and remotest parts are at the length evacuated which is the cause that such as are wounded must keep so spare a diet for the next dayes following Venery is very pernicious for that it inflames the spirits and humors far beyond other motions whereby it happens that the humors waxing hot are too plentifully carried to the wounded and over heated part The bleeding must not be stanched presently upon receiving of the wound for by the more plentiful efflux thereof the part is freed from danger of inflammation and fulness Why we must open a vein in such as are wounded by Gunshot Wherefore if the wound bleed not sufficiently at the first you shall the next day open a vein and take blood according to the strength and plenitude of the Patient for there usually flows no great store of blood from wounds of this nature for that by the greatness of the contusion and vehemency of the moved air the spirits are forced in as also I have observed in those who have one of their limbs taken away with a Cannon bullet For in the time when the wound is received there flows no great quantity of blood although there be large veins and arteries torn in sunder thereby But on the 4 5 6. or some more dayes after the blood flows in greater abundance and with more violence the native
head and then take fast hold of the head with your Cranes-bill and so draw them forth all three together CHAP. XX. What to be done when an Arrow is left fastned or sticking in a Bone BUt if the weapon be so depart and fastned in a Bone that you cannot drive it forth on the other side neither get it forth by any other way than that it entred in by A Caution you must first gently move it up and down if it stick very fast in but have a special care that you do not break it and so leave some fragment thereof in the bone then take it forth with your Crows-bill or some other fit Instrument formerly described Then press forth the bloud The benefit of bleeding in wounds and suffer it to bleed somewhat largely yet according to the strength of the Patient and nature of the wounded part For thus the part shall be eased of the fulness and illness of humors and less molested with inflammation putrefaction and other symptoms which are customarily feared When the weapon is drawn forth and the wound once dressed handle it if simple as you do simple wounds if compound then according to the condition and manner of the complication of the effects Certainly the Oyl of Whelps formerly described is very good to asswage pain To conclude you shall cure the rest of the symptoms according to the method prescribed in our Treatise of wounds in general and to that we have formerly delivered concerning wounds made by Gunshot CHAP. XXI Of poysoned Wounds IF these Wounds at any time prove poysoned they have it from their Primitive cause to wit The signs of poysoned wounds the empoysoned Arrows or Darts of their enemies You may find it out both by the property of the pain if that it be great and pricking as if continually stung with Bees for such pain usually ensues in wounds poysoned with hot poyson as Arrows usually are Also you shall know it by the condition of the wounded flesh for it will become pale and grow livid with some signs of mortification To conclude there happen many and malign symptoms upon wounds which are empoysoned being such as happen not in the common nature of usual wounds Remedies in poysoned wounds Therefore presently after you have plucked forth the strange bodies encompass the wound with many and deep scarifications apply ventoses with much flame that so the poyson may be more powerfully drawn forth to which purpose the sucking of the wound performed by one whose mouth hath no soarness therein but is filled with Oyl that so the poyson which he sucks may not stick nor adhere to the part will much conduce Lastly it must be drawn forth by rubefying vesicatory and caustick medicines and assailed by Oyntments Cataplasms Emplaisters and all sorts of local medicines The End of the Eleventh Book The Twelfth BOOK Of CONTVSIONS and GANGRENES CHAP. I. Of Contusions A Contusion according to Galen is a solution of continuity in the flesh or bone Gal. Lib de artis c nstitut Sect. 2 lib. de fracturis caused by the stroak of some heavy and obtuse thing or a fall from on high The symptom of this disease is by Hippocrates called Peliosis and Melasma that is to say blackness and blewness the Latins term it Sugillatum There are divers sorts of these Sugillations or blacknesses Causes of Bruises and Sugillations according as the bloud is poured forth into the more inward or outward part of the body The bloud is poured forth into the body when any for example falls from an high or hath any heavy weight falls upon him as it often happens to such as work in Mines or are extreamly racked or tortured and sometimes by too loud and forcible exclamations Besides also by a Bullet shot through the body bloud is poured forth into the Belly and so often evacuated by the passages of the Guts and Bladder The same may happen by the more violent and obtuse blows of a hard Trunchion Club Stone and all things which may bruise and press the cloud out of the vessels either by extending or breaking them For which causes also the exteriour parts are contused or bruised sometimes with a wound sometimes without so that the skin being whole and as far as one can discern untoucht the bloud pours it self forth into the empty spaces of the muscles and between the skin and muscles which affect the Ancients have tearmed Ecchymosis Hippocrates calls it by a peculiar name Nausiosis Sect. 2. Lib. de fract for that in this affect the swoln veins seem as it were to vomit and verily do vomit or cast forth the superfluous blood which is contained in them From these differences of Contusions are drawn the indications of curing as shall appear by the ensuing discourse CHAP. II. Of the general cure of great and enormous Contusions THe blood poured forth into the body must be evacuated by visible and not-visible evacuation The visible evacuation may be performed by blood-letting Cupping-glasses horns scarrification horsleeches and fit purgative medicins if so be the patient have not a strong and continual feaver The not-visible evacuation is performed by resolving and sudorifick potions Ad sentent 62. sect 3. lib. de A ticulis baths and a slender diet Concerning Blood-letting Galens opinion is plain where he bids in a fall from an high place and generally for bruises upon what part soever they be to open a vein though the parties affected are not of a full constitution for that unless you draw blood by opening a vein there may inflammations arise from the concreat blood from whence without doubt evill accidents may ensue After you have drawn blood give him foure ounces of Oxycrate to drink for that by the tenuity of its substance hinders the coagulation of the blood in the belly A portion to disolve an evacuate clotted blood A hot sheeps skin or in stead thereof you may use this following Potion â„ž rad GentianaeÊ’iij bulliant in Oxycrato in cilaâ—ura dissolve rhei electiÊ’ j. fiat potio These medicins dissolve and cast forth by spitting and vomit the congealed blood if any thereof be contained in the ventricle or lungs it will be expedient to wrap the Patient presently in a sheeps skin being hot and newly taken from the sheep and sprinkled over with a little myrrhe cresses and salt and so to put him presently in his bed then cover him so that he may sweat plentifully The next day take away the sheeps-skin A discussing ointment and anoint the body with the following anodyne and resolving unguent â„ž unguent de althaea â„¥ vj. olei Lumbric chamaem anethi an â„¥ ij terebinth venetae â„¥ iiij farinae foenugrae rosar rub pulverisat pul myrtillorum an â„¥ j. fiat liâ—us ut dictum est Then give this potion which is sudorifick and dissolves the congealed blood A Sudorifick potion to dissolve congealed blood Syrups hindering putrefaction
and congealing of blood A drink for the same purpose â„ž Ligni guajaci â„¥ viij radicis enulae camp consolid majoris Ireos Florent polypod querni seminis coriandri anisi an â„¥ ss glycyrhiz â„¥ ij nepetae centaureae caryophyl cardui ben verbenae an m. s aquae fontanae lib. xij Let them be all beaten and infused for the space of twelve hours then let them boil over a gentle fire untill the one half be consumed let the Patient drink some halfe a pint of this drink in the morning and then sweat some hours upon it in his bed and do this for seven or eight dayes If any poor man light upon such a mischance who for want of means cannot be at such cost it will be good having wrapped him in a sheet to bury him up to the chin in Dung mixed with some hay or straw and there to keep him untill he have sweat sufficiently I have done thus to many with very good success You shall also give the Patient potions made with syrups which have power to hinder the coagulation and putrefaction of the blood such as syrup of Vinegar or Lemmons of the juice of Citrons and such others to the quantity of an ounce dissolved in scabius or Cardnus water You may also presently after the fall give this drink which hath power to hinder the coagulation of the blood and strengthen the bowells â„ž Rhei elect in pul redacti ℈ j aquae ruliae majoris plantagin an â„¥ j. theriacaÊ’ ss syrupide rosis siccis â„¥ ss fiat pâ—â—us Let him take it in the morning for four or five dayes In stead hereof you may make a potion of one dram of Sperma ceti d ssolved in bugloss or some other of the waters formerly mentioned and half an ounce of syrup of Maiden-hair if the disease yield not at all to these formerly prescribed medicins it will be good to give the Patient for nine dayes three or four hours before meat A powder for the same some of the following powder â„ž rhei torrefacti rad rub majoris centaurei gentianae aristoli rotundae an â„¥ ss give Ê’j hereof with syrup of Vinegar and Carduus water They say that the water of green Walnuts distilled by an Alembick is good to dissolve congealed and knotted blood Also you may use baths made of the decoction of the roots of Orris Elecampane Sorrel Fennel Marshmallows Water-fern or Osmund the waterman the greater Comfrey the seeds of Faenugreek the leaves of Sage Marjerum the flowres of Camomile Melilote and the like For a warm Bath hath power to rarifie the skin The distilled water of green Walnuts Baths to dissolve the clotted blood by cutting the tough and mitigating the acrid 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 Stomach or be contained in the Chest but by stool and urin if it lye in the lower parts by sweats and transpiration if it lye next under the skin Wherefore bathes are good for those who have a Peripneumonia or inflammation of their Lungs Lib 3 de vict aâ—ut lib. 3. de de meth or a Plurisie according to the mind of Hippocrates if so be that they be used when the feaver begins to be asswaged for so they mitigate pain help forwards suppuration and hasten the spitting up of the purulent matter But we would not have the Patient enter into the bath unless he have first used general remedies as blood-letting and purging for otherwise there will be no small danger lest the humors diffused by the heat of the bath cause a new defluxion into the parts affected Wherefore do not thou by any means attempt to use this or the like remedy having not first had the advice of a Physitian CHAP. III. How we must handle Contusions when they are joyned with a Wound EVery great Contusion forthwith requires Bloud-letting or purging or both and these either for evacuation or revulsion For thus Hippocrates in a contusion of the heel Sect. lib. fract gives a vomitory portion the same day or else the next day after the heel is broken And then if the Contusion have a wound associating it the defluxion must be strayed at the beginning with an Ointment made of Bole-Armenick the white of Eggs and Oyl of Roses and Myrtles with the powders of red-Roses Alome and Mastich At the second dressing apply a digestive made of the yolk of an Egg Oyl of Violets and Turpentine A suppurative Cataplasm This following Cataplasm shall be applyed to the near parts to help forwards suppuration â„ž rad althaeae lilii an â„¥ iiij sal malâ— violar senecionis an M. ss coquantur complete passentur per setaceum addendo butyri recentis olei viol an â„¥ iij. farinae volatilis quant sufficit fiat cataplasma ad formam pultis liquidae A caution to be observed Yet have a care in using of Cataplasms that you do not too much exceed for too frequent and immoderate use of them makes wounds phlegmonous sordid and putrid Wherefore the wound after it is come to suppuration must be clensed filled with flesh and cicatrized unless happily the contused flesh shall be very much torn so that the native heat forsake it for then it must be cut away But if there be any hope to agglutinate it let it be sowed How contused wounds must 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 skin CHAP. IV. Of these Contusions which are without a Wound IF the skin being whole and not hurt as far as can be discerned the flesh which lies under it be contused and the bloud poured forth under the skin make an Ecchymosis then the Patient must be governed according Art until the malign symptoms which commonly happen be no more to be feared Wherefore in the beginning draw bloud on the opposite side Phlebotomy both for evacuation and revulsion The contused part shall be scarified with equal scarifications Scarifying Cupping-glasses then shall you apply Cupping-glasses or horns both for evacuation of the bloud which causes the tumor and tension in the part as also to ventilate and refrigerate the heat of the part lest it turn into an Abscess Neither must we in the mean while omit gentle purging of the Belly Astrictives how good in Contusions The first Topick medicins ought to be astrictives which must lye some short while upon the part that so the Veins and Arteries may be as it were straitned and closed up and so the defluxion hindered as also that the part it self may be
an humor malign by its acrimony which frets asunder the roots of the hairs and depraves the natural construction of the pores of the skin whence it is Aph. 4. sect 6. that such as are troubled with Quartain agues the Leprosie or Lues venerea have their hair fall off A livid flesh is ill in Ulcers which cause a rottenness or corruption of the bones lying under the flesh for it is an argument of the dying heat and corruption of the bone whence the flesh hath its original and integrity Those Ulcers which happen by occasion of any disease as a Dropsie are hard to be cured Hip. Lib. de ult Gal. cap. 2. 5 lib. Meth. 4. as also those whereinto a varix or swoln vessell continually casts in matter which a present distemper foments which have swoln hard and callous lips and such as are circular or round An Hypersarcosis or fleshy excrescence usually happens to Ulcers not diligently mundified and if they possess the arms or Legs they cause a Phlegmon or some other tumor in the groins chiefly if the body be full of ill humors as Avicen hath noted For these parts by reason of their rarity and weakness are fit and subject to defluxions Albucrasis writes that for nine causes Ulcers are difficultly replenished with flesh and cicatrized The first for want of blood in a bloodlesse body For what causes Ulcers are hard to heal the second by reason of ill humors and the impurity of the blood the third by the unfit application of unconvenient medicins the fourth by reason of the sordidness of the Ulcer the fifth by the putrefaction of the soft and carion-like flesh encompassing the Ulcer the sixth when they take their original from a common cause which every where rages with fury such as are those which are left by the pestilence the seventh by reason of the callous hardness of the lips of the Ulcer The eighth when the heavens and air are of such condition as ministers fuell to the continuance of the Ulcer as at Sarogoza in Aragon the ninth when the bones which lye under it are wasted by rottenness An Ulcer that casts forth white smooth equall quitture What pus or matter is smooth is equallâ— and white Ad sement 32. sect 2. de fract Aph. 21. sect 7. Two sorts of excrements flow from a malign Ulcer and little or no stinking is easily healed for it argues the victory of the native heat and the integrity of the solid parts We term that smooth quitture which is absolutely concocted neither yeelds any asperity to the touch whereby we might suspect that as yet any portion of the humor remains crude we call that equall wherein you can note no diversity of parts and white not that which is perfectly so but that which is of an ash colour as Galen observes But it is ill if when the cure is indifferently forward a flux of blood suddainly break forth in those Ulcers which beat strongly by reason of the great inflammation adjoyned therewith For as Hippocrates observes an effusion of blood happening upon a strong pulsation in Ulcers is evill for the blood breaking out of an Artery cannot be stayed but by force and also this blood is so furious by reason of the heat and inflammation the nourishers of this Ulcer that it breaks its receptacles and hence ensues the extinction of the native heat whence the defect of suppuration and a Gangrene ensues Now for that there flowes two sorts of excrements from malign Ulcers the more thin is tearmed Ichor or saniâ—s but the more grosse is named sordes that is virulent and flowes from pricked nerves and the periostea when they are evill affected but the other usually flowes from the Ulcers of the joints and it is the worser if it be black reddish ash-coloured if muddy or unequall like wine Lees if it stink Sanies is like the water wherein flesh hath been washed it argues the preternatural heat of the part but when it is pale coloured it is said to shew the extinction of the heat CHAP. IV. Of the generall cure of Ulcers The curing of a simple Ulcer consists in exsiccation Gal 7 Meth. cap. 12. AN Ulcer is either simple or compound A simple Ulcer as an Ulcer hath one and that a simple indication that is exsiccation and that more than in a wound by how much an Ulcer is moister than a Wound There are many indications proposed for the cure of a compound Ulcer in respect of which Galen would have us to keep this order that we have the first regard of the most urgent then of the cause then of that which unless it be taken away the Ulcer cannot be healed By giving you an example you may easily understand the meaning hereof Imagin on the â—â—de of the Leg a little above the ancle an Ulcer very painful hollow putrid associated with the rottenness of the bone circular having hard and swoln Lips and engirt with the inflammatâ—on and varices of the neighbouring parts If you take this to cure before you do any thing about the Ulcer unlesse you be called upon by that which urges as by vehemency of pain you must first use general means by calling and advising with a Physitian For in Galens opinion Gal. lib. 4. de comp med secund gen if the whole body require a preparation then must that be done in the first place for in some Ulcers pâ—rgation onlâ— will be sufficient in some blood-letting others are better by using both meaâ—s which is as the cause of the Ulcer proceeds from a repletion or ilness of humors Now by t eâ—e means having taken away the cause of the Ulcer you must come to the particular cure thereoâ— begâ—nniâ—g with that which is most urgent Wherefore you must first asswage the pain by applicaâ— oâ— of things contrary to the cause thereof as if it proceed from a Phlegmonous distemper whic h t loâ—g possest distended and hardned the part it must be eased by evacuation First batâ—ng â— wi h warm water to mollifie and relax the skin that so you may the more easily evacuateâ—â—ec â—a eâ— hâ—mors then shall you draw away a portion of the matter cauâ—â—g the swelling and pa n by scar fication if the Patient shall be of sufficient courage or else by application of horse-leâ—câ—es if â—e be more faint-hearted and then you shall temper the heat thereof by applying Unguentum refrigerans Galeni To conclude you shall attempt all things which we have formerly delivered in our Treatise of Tumors to take away the swelling thereof When you have brought this to that pass you desire yoâ— shall come to those which are such that it cannot be taken away or healed without them which shall be done by orderly helping the defects against nature which were coâ—joâ—ned with the Ulcer to wit the rottenness of the bone which you shall help by actual cauter es and in the mean while you shaâ—l draw the Ulcer
palat must be quickly and carefully dressed for there is danger lest being the part is hot and moist the bone which lies under which is rare and humide may be corrupted by the contagion and fall away and the voice or speech be spoiled If the ulcer be pocky omitting the common remedies of ulcers you must speedily betake your self to the proper antidote of that disease to wit quick-silver Fistulous ulcers often take hold on the Gums whence the root of the next tooth becomes rotten and so far that the acrimony of the Sanies oft-times makes its self a passage forth on the outside under the chin which thing puts many into a false conceit of the scrophula or Kings-evil and consequently of an uncurable disease In such a case Aetius and Celsus counsel is to take out the rotten tooth Aetius Lib. 6. cap. 3. Celsus lib. 6. cap. 13. for so the Fistula will be taken away the Gum pressing and thrusting its self into the place of the tooth which was taken forth and so the cause nourishing the putrefaction being taken away that is the tooth the rest of the cure will be more easie The ulcers of the tongue may be cured by the same remedies by which the rest of the mouth yet those which breed on the side thereof endure very long and you must look whether or no there be not some sharp tooth over against it which will not suffer the ulcer in that place to heal which if there be then must you take it away with a file CHAP. XVI Of the Ulcers of the Ears ULcers are bred in the auditory passage both by an external cause as a stroak or fall as also by an internal as an abscess there generated They oft-times flow with much matter not there generated Their causes for such ulcers are usually but small and besides in a spermatick part but for that the brain doth that way disburden its self For the cure the chief regard must be had of the antecedent cause which feeds the ulcer and it must be diverted by purging medecins The cuure Masticatories and Errhines This is the form of a Masticatory â„ž Mastich Ê’j staphisagr pyreth an ℈ j. cinam caryoph an Ê’ ss fiant Masticatoria utatur mane vesperi A masticatory But this is the form of an Errhin â„ž succi betonic mercurial melissa an â„¥ ss An Errhin The composition of Andronius his trochisces vini alli â„¥ j. misce frequenter naribus attrahatur For topick medicins we must shun all fatty and oily things as Galen set down in Method medendi where he finds fault with a certain follower of Thessalus who by using Tetrapharmacum made the ulcer in the ear grow each day more filthy than other which Galen healed with the Trochisces of Andronius dissolved in Vinegar whose composure is as followeth â„ž baulast Ê’ij alumin. Ê’j atrament sutor Ê’ij myrrhaeÊ’j thur aristolâ—ch gallarum an Ê’ij salis Ammon Ê’j excipiantur omnia melicrato fiant trâ—chisci Galen in the same place witnesseth that The figure of a Pyoulcus or Matter-drawer he hath healed inveterate ulcers and of two years old of this kind Scales of Iron with the scales of Iron made into powder and then boiled in sharp Vinegar untill it acquired the consistence of Honey Moreover an Oxes gall dissolved in strong Vinegar and dropped in warm amends and dryes up the putrefaction wherewith these ulcers flow Also the scales of Iron made into powder boyled in sharp Vinegar dryed and strewed upon them But if the straitness of the passages should not give leave to the matter contained in the windings of the ears to pass forth Of the Pyoulcos Galen makes mention 2 ad Glauconem then must it be drawn out with an Instrument thereupon called a Pyoulcus or matter-drawer whereof this is the figure CHAP. XVII Of the Ulcers of the Wind-pipe Weazon Stomach and Guts THese parts are ulcerated either by an external cause as an acrid medicine The Causes or poyson swallowed down or by an internal cause as a malign fretting humor which may equal the force of poyson generated in the body and restrained in these parts Signs If the pain be encreased by swallowing or breathing it is the sign of an Ulcer in the Weazon or windpipe joining thereto But the pain is most sensibly felt when as that which is swallowed is either four or acrid or the air breathed in is more hot or cold than ordinary But if the cause of pain lye fastned in the stomach more grievous symptoms urge for sometimes they swound have a nauseous disposition and vomiting convulsions gnawings and pain almost intolerable and the coldness of the extream parts all which when present at once few scape unless such as are young and have very strong bodies The same affect may befall the whole stomach but because both for the bitterness of pain and greatness of danger that Ulcer is far more grievous which takes hold of the mouth of the Ventricle honoured by the Ancients with the name of the Heart therefore Physitians do not make so great a reckoning of that which happens in the lower part of the stomach Now we know that the Guts are ulcerated if Pus Gal. lib. 5. de loc affect cap. 5. or much purulent matter come forth by stool if blood come that way with much griping for by the Pus staying and as it were gathered together in that place there is as it were a certain continual Tenesmus or desire to goe to stool Now all such Ulcers are cured by meats and drinks Lib. 4. 5. Method The cure rather than by medicins according to Galen Therefore you must make choice of all such meats and drinks as are gentle and have a lenitive faculty shunning acrid things for Tutia Lytharge Ceruse Verdigreece and the like have no place here as they have in other Ulcers But when as the Ulcer shall be in the Gullet or Weazon you must have a care that such things may have some viscidity or toughness and be swallowed by little and little and at divers times otherwise they will not much avail because they cannot make any stay in these common wayes of breath and meat therefore they presently slip down and flow away How to take medicins for Ulcers of the throat wherefore all such things shall be used in form of an Eglegma to be taken lying on the back and swallowed down by little and little opening the muscles of the throat lest the medicin passing down suddainly and in great quantity cause a Cough a thing exceeding hurtfull to these kindes of Ulcers When they must be cleansed you shall have crude honey which hath a singular faculty above all other detergent things in these kinde of Ulcers But when they can conveniently swallow you shall mix Gum Tragaganth dissolved in some astringent decoction In Ulcers of the stomach Why acrid things
medicins as those of the reins are but these not only 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 Ulcers of the bladder cause greater and more sharp pain than those of the Kidnies therefore the Chirurgeon must be more diligent in using Anodynes For this purpose I have often by experience found that the oil of henbane made by expression gives certain help He shall do the same with Cataplasms and Liniments applyed to the parts about the Pecten and all the lower belly and perinaeum Aegyptiacum for the ulcers of the bladder as also by casting in of Clysters If that they stink it will not be amiss to make injection of a little Aegyptiacum dissolved in wine plantain or rose-water For I have often used this remedy in such a case with very prosperous success CHAP. XIX Of the Ulcers of the Womb. The causes ULcers are bred in the womb either by the conflux of an acrid or biting humour fretting the coats thereof or by a tumour against nature degenerating into an abscess or by a difficult and hard labour they are known by pain at the perinaeum and the efflux of Pus and Sanies by the privity Lib. 3. sect 12. tract 2. cap. 5. All of them in the opinion of Avicen are either putrid when as the Sâ—nies breaking forth is of a stinking smell and in colour resembles the water wherin flesh hath been washed Signs or else sordid when as they flow with many virulent and crude humours or else are eating or spreading Ulcers when as they cast forth black Sanies and have pâ—lsation joyned with much pain Besides they differ amongst themselves in site for either they possess the neck and are known by the sight by putting in a speculum or else are in the bottom and are manifested by the condition of the more liquid and serous excrements and the site of the pain The cure They are cured with the same remedies wherewith the Ulcers of the mouth to wit with aqua fortis the oil of Vitriol and Antimony and other things made somewhat more milde and corrected with that moderation that the ulcerated parts of the Womb may be safely touched with them it is requisite that the remedies which are applyed to the ulcers of the womb do in a moment that which is expected of them for they cannot long adhere or stick in the womb as neither to the mouth Galen saith Why strongly drying things are good for Ulcers of the womb that very drying medicins are exceeding fit for ulcers of the womb that so the putrefaction may be hindred or restrained whereto this part as being hot and moist is very subject besides that the whole body unto this part as unto a sink sends down its excrements If an ulcer take hold of the bottom of the womb it shall be cleansed and the part also strengthened by making this following injection â„ž hordei integri p. ij guajaci â„¥ j. An injection for an Ulcer in the bottom of the wombe rad Ireos â„¥ ss absinth plant centaur utriusque an M. j. fiat decoct in aqua fabrorum ad lb ij in quibus dissolve mellis rosati syrupi de absinthio an â„¥ iij. fiat injectio For amending the stinking smell I have often had certain experience of this ensuing remedy â„ž vini rab lb.j. unguent aegyptiaci â„¥ ij bulliant parum Thus the putrefaction may be corrected An injection hindering putrefaction and the painfull maliciousness of the humor abated Ulcers when they are cleansed must presently be cicatrized that may be done with Alum water the water of Plantain wherein a little Vitriol or Alum have been dissoved Lastly if remedies nothing availing the ulcer turn into a cancer it must be dressed with anodynes and remedies proper for a Cancer which you may finde set down in the proper treatise of Cancers The cure of Ulcers of the fundament was to be joined to the cure of these of the womb but I have thought good to referre it to the treatise of Fistulaes as I do the cure of these of the urinary passage to the Treatise of the Lues Venerea CHAP. XX. Of the Varices and their cure by cutting A Varix is the dilatation of a vein some whiles of one and that a simple branch What a Varix is and what be the differences thereof other whiles of many Every varix is either straight or crooked and as it were infolded into certain windings within its self Many parts are subject to Varices as the temples the region of the belly under the navil the testicles womb fundament but principally the thighs and legs The matter of them is usually melancholy blood The matter for Varices often grow in men of a melancholy temper and which usually feed on gross meats or such as breed gross and melancholy humours Also women with childe are commonly troubled with them by reason of the heaping together of their suppressed menstrual evacuation The causes The precedent causes are a vehement concussion of the body leaping running a painfull journey on foot a fall the carrying of a heavy burden torture or racking This kinde of disease gives manifest signs thereof by the largeness thickness Signs swelling and colour of the veins It is best not to meddle with such as are inveterate The cure for of such being cured there is to be feared a reflux of the melancholly blood to the noble parts whence there may be imminent danger of malign Ulcers a Cancer madness or suffocation When as many Varices and diversly implicit are in the legs they often swell with congealed and dryed blood and cause pain which is increased by going and compression The cutting of Varices Such like varices are to be opened by dividing the vein with a Lancet and then the blood must be pressed out and evacuated by pressing it upwards and downwards which I have oft-times done and that with happy success to the Patients whom I have made to rest for some few dayes and have applyed convenient medicins A varix is often cut in the inside of the leg a little below the knee in which place commonly the originall thereof is seen He which goes about to intercept a varix downwards from the first originall and as it were fountain thereof makes the cure far more difficult For hence it is divided as it were into many rivulets all which the Chirurgeon is forced to follow A varix is therefore cut or taken away so For what intention a Varix must be cut Paulus cap. 82. lib. 6. The manner how to cut it to intercept the passage of the blood and humours mixed together therewith flowing to an ulcer seated beneath or else lest that by the too great quantity of blood the vessel should be broken and death be occasioned by
a haemorrhagie proceeding from thence Now this is the manner of cutting it Let the Patient lye upon his back on a Bench or table then make a Ligature upon the leg in two places the distance of some four fingers each from other wherein the excision may be made for so the vein will swell up and come more in sight and besides you may also mark it with ink then taking the skin up between your fingers cut it long-wayes according as you have marked it then free the bared vein from the adjacent bodies and put thereunder a blunt-pointed needle lest you prick the vein thred with a long double thred and so bind it fast and then let it be opened with a Lancet in the middle under the ligature just as you open a vein and draw as much therehence as shall be fit Then straight make a ligature in the lower part of the forementioned vein and then cut away as much of the said vein as is convenient between the ligatures and so let the ends thereof withdraw themselves into the flesh above and below let these ligatures alone untill such time as they fall away of themselves The operation being performed let an astringent medicine be applyed to the wound and the neighbouring parts neither must you stir the wound any more for the space of three dayes Then do all other things as are fit to be done to other such affects CHAP. XXI Of Fistulaes A Fistula is a sinuous white narrow callous and not seldom unperceivable Ulcer What a Fistula is It took its denomination from the similitude of a reeden Fistula that is a pipe like whose hollowness it is A Fistula is bred in sundry parts of the body and commonly followes upon abscesses or Ulcers not well cured What a Callous is The differences of Fistulaes A Callous is a certain fleshy substance white solid or dense and hard dry and without pain generated by heaping up of dryed excrementitious phlegme or else adust melancholy encompassing the circuit of the Ulcer and substituting it self into the place of laudable flesh The Sinus or cavity of a Fistula is sometimes dry and other while drops with continual moisture sometimes the dropping of the matter sodainly ceases and the orifice thereof is shut up that so it may deceive both the Chirurgeon and the Patient with a false shew of an absolute cure for within a while after it will open again and run as formerly it did Some Fistulaes are bred by the corruption of a bone others of a nerve others of membranes and others of other parts of the body Some run straight in others and that the greater part have turnings and windings some have one others have more orifices and windings some are at the joints others penetrate into some capacity of the body as into the chest belly guts womb bladder some are easily others difficultly cured The signs and some wholly uncurable There are divers signs of Fistulaes according to the variety of the parts they possess for if that which you touch with the end of your probe make resistance and resound then you may know that it is come to the bone and then if the end of the probe slip up and down as on a smooth and polite superficies it is a sign that the bone is yet sound but if it stop and stay in any place as in a rough way The sign that the bone is bare from the condition of the matter which is cast forth Aetius tetr 4. sect 2. cap. 55. then know that the bone is eaten rough and perished sometimes the bone lies bare and then you need not use the probe Besides also it is a sign that the bone is affected if there be a purulent efflux of an unctuous or oily matter not much unlike that marrow wherewith the bone is nourished For every excrement shewes the condition of the nourishment of the part whence it is sent in a Fistula which penetrates to a nerve the Patient is troubled with a pricking pain especially when you come to search with a Probe especially if the matter which slowes down be more acrid Oft-times if it be cold the member is stupified the motion being weakened besides also the matter which flowes from thence is more subtle and somewhat like unto that which flowes from the bones yet not oily nor fat but sanious and viscous resembling the condition of the alimentary humour of the nerves The same usually appears and happens in Fistulaes which penetrate to the Tendons and those membranes which involve the muscles If the Fistula be within the flesh the matter flowing thence is more thick and plentifull smooth white and equal If it descend into the veins or arteries the same happens as in those of the nerves but that there is no such great pain in searching with your Probe nor no offence or impediment in the use of any member yet if the matter of the fistulous Ulcer be so acrid as that it corrode the vessels Old Fistulaes if closed prove mortall blood will flow forth and that more thick if it be from a vein but more subtle and with some murmuring if from an artery Old Fistulaes and such as have run for many years if suddainly shut up cause death especially in an ancient and weak body CHAP. XXII Of the cure of Fistulaes How to finde out the windings cavities of Fistulaes FOr the cure in the first place it will be expedient to search the Fistula and that either with a wax size a probe of lead gold or silver to finde out the depth and windings or corners thereof But if the Fistula be hollowed with two or more orifices and those cuniculous so that you cannot possibly and certainly search or find them all our with your probe then must you cast an injection into some one of these holes and so observe the places where it comes forth for so you may learn how many and how deep or superficiary cavities there be then by making incisions you must lay open and cut away the callous parts You must make incisions with an incision knife or razour or else apply actual or potential cauteries for nature cannot unless the callous substance be first taken away restore or generate flesh or agglutinate the distant bodies For hard things cannot grow together unless by the interposition of glue such as is laudable blood but a callous body on all sides possessing the surface of the ulcerated flesh hinders the flowing of the blood out of the capillary veins for the restoring of the lost substance and uniting of the disjointed parts If you at any time make caustick injections into the Fistula Caustick injections you must presently stop the orifice thereof that so they may have time to work the effect for which they are intended Which thing we may conjecture by the tumor of the part the digesture of the flowing matter and its lesser quantity Then you must hasten the falling
breasts groins testicles fundament hips thighs legs feet and toes For the parts of Bandages we tearm one part their body another their heads By the body we mean their due length and breadth Com. ad sect 22. sect 2. de offic chir but their ends whether they run long-wayes or a-cross we according to Galen tearm them their heads CHAP. II. Sheweth the Indications and general precepts of fitting of Bandages and Ligatures THere are in Hippocrates opinion two indications of fitting Bandages or Ligatures 1 2 sect lib. de fract the one whereof is taken from the part affected the other from the affect it self From the part affected so the leg if you at any time binde it up must be bound long-wayes for if you binde it over-thwart the binding will loosen as soon as the Patient begins to go and put forth his leg for then the muscles take upon them another figure On the contrary the Arm or Elbow must be bound up bending in and turned to the breast for otherwise at the first bending if it be bound when it is stretched forth the Ligature will be slacked for that as we formerly said the figure of the muscles is perverted Now for this indication let each one perswade himself thus much that the part must be bound up in that figure wherein we would have it remain Now for that Indication which is drawn from the disease if there be a hollow Ulcer sinuous and cuniculous We must alwayes begin our ligatures at the bottom of a sinus casting forth great store of Sanies then must you begin the ligature and binding from the bottom of the sinus and end at the orifice of the Ulcer and this Precept must you alwayes observe whether the sinus be sealed in the top bottom middle or sides of the Ulcer For thus the filth therein contained shall be emptied and cast forth and the lips of the Ulcer too far separated shall be joined together otherwise the contained filth will eat into all that lyes neer it increase the Ulcer and make it uncurable by rotting the bones which lye under it with this acrid sanies or filth But some Ligatures are remedies of themselves as those which perform their duties of themselves and whereto the cure is committed as are these which restore their native unity those parts which are disjoyned others are not used for their own sakes but only to serve to hold fast such medicins as have a curative faculty This kind of Ligature is either yet a doing Hip. cent 4. Sect. 2. offic Initio 2. sect off and is termed by Hippocrates Deligatio operans or else done and finished and is called Deligatio operata For the first that the Ligature may be well made it is fit that it be close rowled together and besides that the Surgeon hold it stiffe and strait in his hand and not carelesly for so he shall binde up the member the better Also he must in the binding observe that the ends of the Rowler and consequently their fastning may not fall to be on the affected or grieved part for it is better that they come above or below or else on the side Besides also he must have a special care that there be no knot tied upon the same place or upon the region of the back buttocks sides joints or back-part of the head or to conclude in any other part upon which the Patient uses to lean rest or lye Also on that part where we intend to sow or fasten the Rowlers you must double in their ends that so the fastning or suture may be the stronger otherwise how close soever they shall be wrapped or rowled about the member Ligatures must not be only lightly but also neatly performed yet will they not remain firm especially if they be of a great breadth For the second kind of Ligature to wit that which is already done and finished the Surgeon the performer thereof must consider to what end it was done and whether he hath performed it well and fitly as also neatly and elegantly to the satisfaction both of himself and the beholders For it is the part of a skilfull Workman every where handsomely and rightly to perform that which may so be done In fractures and luxations and all dislocations of bones as also in wounds and contusions you must begin your bandage with two or three windings or wraps about upon the place and that if you can more straitly than in other places that so the set bones may be the better kept in their places and that the humors if any be already fallen thither may by this strait compression be pressed forth as also to hinder and prevent the entrance in of any other which may be ready to fall down But in fractures as those which never happen without contusion the blood flowes and is pressed forth of its proper vessels as those which are violently battered and torn which causes sugillation in the neighbouring flesh which first looks red but afterwards black and blew by reason of the corruption of the blood poured forth under the skin Wherefore after these first windings which I formerly mentioned you must continue your rowling a great way from the broken or luxated part he which does otherwise will more and more draw the blood and humors into the affected part Gal. com ad sent 25. sect 1. lib. de fract and cause Impostumes and other malign accidents Now the blood which flowes goes but one way downwards but that which is pressed is carryed as it were in two paths to wit from above downwards and from below upwards Yet you must have a care that you rather drive it back into the body and bowels then towards the extremities thereof as being parts which are uncapable of so much matter and not furnished with sufficient strength to suffer that burden which threatens to fall upon it without danger and the increase of preternatural accidents But when this mass and burden of humors is thrust back into the body it is then ruled and kept from doing harm by the strength and benefit of the faculties remaining in the bowels and the native heat CHAP. III. Of the three kinds of Bandages necessary in Fractures Sent. 24. sect 2. offic TWo sorts of Ligatures are principally necessary for the Surgeon according to Hippocrates by which the bones as well broken as dislocated may be held firm when they are restored to their natural place Hypodesmides Of these some are called Hypodesmides that is Under-binders others Epidesmi that is Over-binders There are sometimes but two under-binders used but more commonly three The first must first of all be cast over the fracture and wrapped there some three or four times about then the Surgeon must mark and observe the figure of the fracture for as that shall be so must he vary the manner of his binding For the Ligature must be drawn strait upon the side opposite to that whereto the
conveniency as you can that it may be so large as to encompass and cover all the wound for these reasons which shall be delivered at large in our Treatise of Fractures But if the wound run long-wayes let the boulsters and splints be applyed to the sides of the wound that so the lips of the wound may be pressed together and the contained filth pressed forth Ad sent 12. sect de fract But if it be made overthwart we must abstain from boulsters and splints for that in Galens opinion they would dilate the wound and the purulent matter would be pressed out and cast back into the wound CHAP. V. Certain common precepts of the binding up of Fractures and Luxations IN every Fracture and Luxation the depressed hollow and extenuated parts such as are neer unto the joints ought to be filled up with boulsters or clothes put about them so to make the part equal that so they may be equally and on every side pressed by the splints and the bones more firmly contained in their seats So when the knee is bound up you must fill the ham or that cavity which is there that so the ligation may be the better and speedilier performed The same must be done under the arm-pits Hipp. sent 37. 38. sect 1. de fract above the heel in the arm neer the wrist and to conclude in all other parts which have a conspicuous inequality by reason of some manifest cavity When you have finished your binding then enquire of the Patient whether the member seem not to be bound too strait For if he say that he is unable to endure it so hard bound then must the binding be somewhat flackned The signs of too strait and loose binding up For too strait binding causes pain heat defluxion a gangrene and lastly a sphacel or mortification but too loose is unprofitable for that it doth not contain the parts in that state we desire It is a sign of a just ligation that is neither too strait nor too loose if the ensuing day the part be swoln with an oedematous tumor caused by the blood pressed forth of the broken place but of too strait ligation if the part be hard swoln and of too loose if it be no whit swoln as that which hath pressed no blood out of the affected part Now if a hard tumor caused by too strait binding trouble the Patient it must presently be loosed for fear of more grievous symptoms and the part must be fomented with warm Hydraeleum and another indifferent yea verily more loose ligature must be made instead thereof as long as the pain and inflammation shall continue in which time and for which cause you shall lay nothing upon the part which is any thing burdensome When the Patient begins to recover for three or four dayes space especially if you find him of a more compact habit and a strong man the ligature must be kept firm and not loosed If on the third day and so untill the seventh the spires or windings be found more loose and the part affected more slender then we must judge it to be for the better For hence you may gather that there is an expression and digestion of the humors causing the tumor made by force of the ligation Verily broken bones fitly bound up are better set and more firmly agglutinated which is the cause why in the place of the fracture the ligation must be made the straiter Why we must make more strait ligation on the broken part in other places more loosly If the fractured bone stand forth in any part it must there be more straitly pressed with boulsters and splints To conclude the seventh day being past we must bind the part more straitly then before for that then inflamation pain and the like accidents are not to be feared But these things which we have hitherto spoken of the three kinds of Ligatures cannot take place in each fractured part of the body as in the chaps collar-bones head nose ribs For seeing such parts are not round and long a Ligature cannot be wrapped about them as it may on the arms thighs and legs but only be put on their outsides CHAP. VI. The uses for which Ligatures serve The first benefit of Ligatures BY that which we have formerly delivered you may understand that Ligatures are of use to restore those things which are separated and moved forth of their places and joyn together those which gape as in fractures wounds contusions sinewous Ulcers and other like affects against nature in which the solution of continuity stands in need of the help of Bandages for the reparation thereof The second Besides also by the help of Bandages these things are kept asunder or separated which otherwise would grow together against nature as in Burns wherein the fingers and the hams would mutually grow together as also the Arm-pits to the Chest the Chin to the Breast The third unless they be hindred by due ligation Bandages do also conduce to refresh emaciated parts wherefore if the right leg waste for want of nourishment the left leg beginning at the foot may be conveniently rowled up even to the groin If the right arm consume binde the left with a strait Ligature beginning at the hand and ending at the arm-pit For thus a great portion of bloud from the bound-up part is sent back into the vena cava from whence it regurgitates into the almost empty vessels of the emaciated part But I would have the sound part to be so bound that thereby it become not painfull for a dolorifick ligation causes a greater attractation of blood and spirits as also exercise wherefore I would have it during that time to be at rest and keep holy-day The fourth Ligatures also conduce to the stopping of bleedings which you may perceive by this that when you open a vein with your lancet the blood is presently stayed laying on a boulster and making a Ligature The fifth Also Ligatures are usefull for women presently after their delivery for their womb being bound about with Ligatures the blood wherewith their womb was too much moistened is expelled the strength of the expulsive faculty being by this means stirred up to the expulsion thereof and it also hinders the empty womb from being swoln up with wind which otherwise would presently enter thereinto The sixth This same Ligature is a help to such as are with childe for the more easie carrying of their burden especially those whose Childe lyes so far downwards that lying as it were in the den of the hips it hangs between the thighs and so hinders the free going of the mother Therefore the woman with childe is not only eased by this binding of her womb with this Ligature which is commonly tearmed the Navil-ligature but also her childe being held up higher in her womb she hath freer and more liberty to walk The seventh Ligatures are in like sort good for
ribs for that they are bony may be broken in any part of them In what place the short ribs may be broken But the bastard ribs cannot be truly broken unless at the back-bone because they are only bony in that part but gristly on the foreside toward the breast-bone wherefore there they can only be folded or crooked in These which are subject to fractures may be broken inwards and outwards But oft-times it comes to pass that they are not absolutely broken but cleft into splinters and that sometimes inwards but not outwards Thus the fissure doth oft-times not exceed the middle substance of the rib but sometimes it so breaks through it all that the fragments and splinters doe prick and wound the membrane which invests and lines them on the inside and then there is great danger But when the fracture is simple without a wound compression puncture of the membrane and lastly without any other symptome then the danger is less Therefore Hippocrates wisheth that those who are thus affected Sent. 56. sect 3. de art fill themselves more freely with meat for that moderate repletion of the belly is as it were a certain prop or stay for the ribs keeping them well in their place and state which rule chiefly takes place in fractures of the bastard ribs For such as have them broken usually feel themselves better after than before meat For emptiness of meat or of the stomach makes a suspension of the ribs as not underpropped by the meat Now that fracture which is outwardly is far more easie to heal Why an internal fracture of the ribs is deadly than that which is inwardly for that this pricketh the membrane or Pleura and causeth inflammation which may easily end in an Empyema Adde hereunto that this is not so easily to be handled or dealt withall as the other whereby it cometh to pass that it cannot be so easily restored for that these things cannot be so fully and freely performed in this kinde of fracture which are necessary to the setting of the bone as to draw it out hold it and join it together It is therefore healed within twenty dayes if nothing else hinder The signs of fractured ribs are not obscure The signs for by feeling the grieved part with your fingers you may easily perceive the fracture by the inequality of the bones and their noise or crackling especially if they be quite broke asunder The cause of spitting blood when the ribs are broken But if a rib be broken on the inside a pricking pain far more grievous than in a plurisie troubles the Patient because the sharp splinters prick the Costall membrane whence great difficulty in breathing a cough and spitting of bloud ensue For bloud flowing from the vessels broken by the violenee of the thing causing the fracture is as it were sucked up by the lungs and so by a dry cough carryed into the Weazond and at length spit out of the mouth Some to pull up the bone that is quite broken and deprest apply a Cupping-glass and that is ill done for there is caused greater attraction of humours and excess of pain by the pressure and contraction of the adjacent parts by the Cupping-glass wherefore Hippocrates also forbids it Sent. 15. sect 3. de art Paulus lib. 6. cap. 96. Avicen 4. The cure Therefore it is better to endeavour to restore it after this following manner Let the Patient lye upon his sound side and let there be laid upon the fractured side an emplaister made of Turpentine Rosin black Pitch Wheat flour Mastick and Aloes and spread upon a strong and new cloth When it hath stuck there some time then pluck it suddenly with great violence from below upwards for so the rib will follow together therewith and be plucked and drawn upwards It is not sufficient to have done this once but you must do it often untill such time as the Patient shall finde himself better and to breath more easily There will be much more hope of restitution if whilest the Surgeon do this diligently the Patient forbear coughing and hold his breath Otherwise if necessity urge as if sharp splinters with most bitter tormenting pain prick the Costall membrane overspread with many nerves veins and arteries which run under the ribs whence difficulty of breathing spitting of bloud a cough and feaver ensue then the only way to deliver the Patient from danger of imminent death is to make incision on the part where the rib is broken that so laying it bare you may discern the pricking fragments and take them out with your instrument or else cut them off And if you make a great wound by incision then shall you sew it up and cure it according to the common rules of curing wounds Now diet phlebotomy and purgation A simple fracture may be cured only by Surgery which as Hippocrates saith are not very needfull in a simple fracture for that there are no symptomes which may require such remedies yet they by reason of the complicated symptoms as a convulsion feaver Empyema and the like must here be prescribed by the advice of the Physician which oversees the cure A Cerate and other remedies fitting the occasion shall be applyed to the grieved part no other ligatures can be used than such as are fit to hold fast and stay the local medicins There is no other Rule of site and lying than such as is taken from the will and content of the Patient CHAP. XII Of certain preternatural affects which ensue upon broken Ribs MAny symptoms ensue upon fractured and contused ribs but amongst the rest there are two which are not common whereof we will treat in this place The first is the inflation or rising up of the contused flesh which also ensues upon light affects of the bone which have been neglected at the beginning But the flesh is not meerly puffed up of it self but also within a certain phlegmatick glutinous and viscous humour gathering thereinto The cause hereof is The cause the weakness of the digestive faculty of the part occasioned by the stroak and distemper which therefore cannot affimilate the nourishment flowing more plentifully than it was wont either drawn thither by means of the pain or sent thither by a blinde violence of nature stirred thereto by a desire of its own preservation Wherefore this half crude humor remaining there raiseth much flatuling from its self or else wrought upon by the weaker heat it is resolved into cloudy vapours whence it cometh to pass that the flesh is swoln up in that place The signs and the skin on the contrary grows soft as if it were blown up with a quill Therefore laying your hand thereon you may hear the noise of the winde going forth thereof and see a cavity left in the part as it is usually seen in oedematous tumors Unless you remedy this inflation there will ensue an inflammation feaver abscess difficulty of breathing and lastly that
to the side opposite to that towards which the bone fell that so also in some measure it may be more and more forced into its place In the mean time you must have a care that you do not too straitly press the great and large tendon which is at the heel This kinde of dislocation is restored in forty days unless some accident happen which may hinder it CHAP. LIII Of the dislocation of the Heel Causes and differences WHosoever leaping from an high place have fallen very heavy upon their heel have their heel dislocated and divided from the pastern-bone This dislocation happens more frequently inwardly then outwardly because the prominencie of the lesser Focile embraces the pastern-bone whence it is that there it is more straitly and firmly knit It is restored by extension and forcing it in which will be no very difficult matter The Cure unless some great defluxion or inflammation hinder it For the binding up it most be straitest in the part affected that so the blood may be pressed from thence into the neighbouring parts yet using such a moderation that it may not be painful not press more straitly than is fit the nerves and gross tendons which runs to the heel 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 vehemencie of the contusion Wherefore it will not be amiss to handle them in a particular chapter CHAP. LIV. Of the Symptoms which follow upon the contusion of the Heel Why blood-letting necessary in the fracture of a heel IT happeneth by the vehemencie of this contusion that the veins and arteries do as it were vomit up blood both through the secret passages of their coats as also by their ends or orifices whence an Ecchymosis or blackness over all the heel pain swelling and other the like ensue which implore remedies and the Surgeons help to wit convenient diet Hip. sect 3. de fracturis and drawing of bloud by opening a vein 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 local medicines chiefly such as may soften and rarifie the skin under the heel otherwise usually hard and thick such as are fomentations of warm water and oil so that divers times wee are forced to scarifie it with a lancet shunning the quick 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 inflamtion seiz upon the part otherwise there will bee danger of a convulsion For the blood Why the heel is subject to inflammation when it fall's out of the vessels readily putrifie's by reason the densitie of this part hinder's it from ventilation dispersing to the adjacent parts Hereto may bee added that the large and great tendon wich cover's the heel is endued with exquisite sens and also the part it self is on every side spred over with many nervs Besides also there is further danger of inflammation by lying upon the back and heel as wee before admonished you in the Fracture of a leg Therefore I would have the Surgeon to bee here most attentive and diligent to perform these things which wee have mentioned left by inflammation a Gangrene and Mortification for here the sanious flesh presently fall's uppon the bone happen together with a continued and sharp Fever with trembling hicketting and raving For the corruption of this part first by contagion assail's the next and thence a Fever assail's the heart by the arteries pressed and growing hot by the putrid heat and by the nervs and that great and notable tendon made by the concours of the three muscles of the calf of the leg Gal. ad sent 23. sect 2. lib. de fract the muscles brain and stomach are evilly affected and drawn into consent and so caus convulsions raving and a deadly hicketting CHAP. LV. Of the dislocated Pastern or Ancle-bone THe Astragalus or pastern bone may bee dislocated and fall out of its place to every side Wherefore when it fall's out towards the inner part Sign the sole of the foot is turned outwards when it flie's out to the contrarie the sign is also contrarie if it bee dislocated to the foreside on the hinde side the broad tendon coming under the heel is hardned and distended but if it bee luxated backards the whole heel is as it were hid in the foot neither doth this kinde of dislocation happen withou much violence It is restored by extending it with the hands and forcing it into the contrary part to that from whence it fell Beeing restored it is kept so by application of medicins and fit ligation The patient must keep his bed long in this case Cure lest that bone which sustain's and bear's up the whole bodie may again sink under the burden and break out the sinews beeing not well knit and strengthned CHAP. LVI Of the dislocation of the In-step and back of the foot THe bones also of the In-step and back of the foot may bee luxated and that either upwards or downwards or to one side though seldom sidewise for the reason formerly rendred speaking of the dislocation of the like bones of the hand Cure If that they stand upwards then must the patient tread hard upon som plain or even place and then the Surgeon by pressing them with his hand shal force them into their places on the contrary if they stand out of the sole of the foot then must you press them thence upwards and restore each bone to its place They may bee restored after the same manner if they bee flown out to either side But you must note that although the Ligatures consist but of one head in other dislocations yet here Hippocrates would have such used as have two heads for that the dislocation happen's more from below upwards Sent. 14. sect 2. lib. de fract or from above downwards then sidewise CHAP. LVII Of the dislocation of the Toes NOw the Toes may bee four wais dislocated even as the fingers of the hand The differences The and they may bee restored just after the same manner that is extend them directly forth and then force eath joint into its place and lastly binde them up as is fitting The restitution of all them is easie for that they cannot far transgress their bounds To conclude Cure the bones of the feet are dislocated and restored by the same means as those of the hands but that when as any thing is dislocated in the foot the patient must keep his bed but when any thing is amiss in the hand hee must carrie it in a scarf The patient must rest twenty daies that is until hee
can firmly stand upon his feet CHAP. LVIII Of the symptoms and other accidents which may befal a broken or dislocated member MAnie things may befal broken or dislocated members by the means of the fracture or dislocation such as are bruises great pain inflammation a fever impostume Remedies for a contusion grangrene mortification ulcer fistula and atrophia all which require a skilfull and diligent Surgeon for their cure A contusion happen's by the fall of som heavie thing upon the part or by a fall from high whence follow 's the effusion of blood poured out under the skin wich if it bee poured forth in great plentie must bee speedily evacuated by scarification and the part eased of that burden lest it should thence gangrenate And by how much the blood shall appear more thick and the skin more dens by so much the scarification shall be made more deep You may also for the same purpose apply Leeches What may happen by pain Concerning pain wee formerly said that it usually happen's by reason that the bones are mooved out of their places whence it happeneth that they becom troublesom to the muscles and nervs by pricking and pressing them Hence ensue inflammations as also impostumation and a fever oft times a gangrene and in conclusion a mortification corrupting and rotting the bones otherwhiles a sinuous ulcer or fistula But an atrophia and leanness ariseth by the sloth and idelness of the member decaying all the strength thereof and by too straight ligation intercepting the passages of the blood otherwise readie to fall and flow thither Remedies for the leanness or Atrophia of any member Now the leanness which is occasioned by too straight ligation receive's cure by the flackning of the ligatures wherewith the member was bound That which proceed's from idleness is helped by moderate exercise by extending bending lifting up and depressing the member if so bee that hee can away with exercise Otherwise hee shall use frictions and fomentations with warm water The frictions must be moderate in hardness and gentleness in length and shortness The same moderation shall be observed in the warmness of the water What measure to bee used in fomenting and in the time of fomenting For too long fomenting resolv's the blood that is drawn But that which is too little or short a space draw's little or nothing at all after the fomentation hot and emplastick medicins made of pitch turpentine euphorbium pellitorie of Spain sulphur and the like shall bee applied They shall bee renued every day more often or seldom as the thing it selfe shall seem to require A dropax These medicines are termed Dropaces whose form is thus ℞ picis nigriae ammoniaci bdelii gummi elemi in aquâ vitae dissolutorum an ℥ ii olei laurini ℥ i. pulveris piperis zinziberis granorum paradisi Binding of the sound part opposite to the emaciated baccarum lauri juniperi anʒii fiat emplastrum secundùm artem extendatur super alutam It is also good to binde about the opposite sound part with a ligature yet without pain as if the right arm shall decay for want of nourishment the left shall bee bound beginning your ligation at the hand and continuing it up to the arm-pit If this mischance shall seiz upon the right leg then the left shall bee swathed up from the sole of the foot to the groin For thus a great portion of the blood is forced back into the vena cava or hollow vein and from this being distended and over full into the part affected and gapeing with the vessels almost empty beside also it is convenient to keep the sound part in rest that so it may draw the less nourishment and by that means there will bee more store to refresh the weak part How to binde up the emaciated part Som wish also to binde up the decaying member with moderate ligation for thus say they the blood is drawn thither for when as wee intend to let blood by opening a vein with a lancet wee bind the arm Also it is good to dip it into water somwhat more than warm and hold it there util it grow red and swell for thus blood is drawn into the veins as they finde which use to draw blood of the saphena and salvatella Now if when as these things and the like bee don the lame part grow's hot red and swollen then know that health is to bee hoped for but if the contrary happen the case is desperate wherefore you need attempt nothing further Signs that an Atrophia is curable Furthermore there is somtimes hardness lest in the joints after fractures and dislocations are restored It is fit to soften this by resolving the contained humor by fomentations liniments cataplasms emplasters made of the roots of marsh-mallows brionie lillies line seed fenugreek seed and the like and also of gums dissolved in strong vineger as ammoniacum bdelium opopanax labdanum sagapenum styrax liquida and adeps anserinus gallinaceus humanus oleum liliorum and the like Also you must wish the patient to moov the part ever now and then every day yet so that it bee not painfull to him that so the pent up humor may grow hot bee attenuated and at length discussed and lastly the part it self restored as far as art can performe it for oft-times it cannot bee helped any thing at all For if the member bee weak and lame by reason that the fracture happend neer the joint for the residue of his life the motion thereof useth to bee painful and difficult and oft-times none at all especially if the callus which grow's there bee somwhat thick and great and lastly if the joint it self shall bee contused and broken by the stroke as it oft-times happen's in wounds made by gun-shot Of divers other PRETER-NATURAL AFFECTS Whose cure is commonly performed by Surgerie THE SEVENTEENTH BOOK CHAP. I. Of an Alopecia or the falling away of the hairs of the head AN Alopecia is the falling away of the hair of the head and somtimes also of the eie-brows chin and other parts the French commonly call it the Pelade Physicians term it the Alopecia for old Foxes subject Gal. c. 2. lib. 1. de comp med secun locos by reason of their age to have the scab are troubled oft-times with this diseas This affect is caused either through defect of nourishment fit to nourish the hairs as in old age through want of the radical humiditie The caus or by the corruption of the alimentarie matter of the same as after long Fevers in the Lues venerea Leprosie the corruption of the whole bodie and all the humors whence follow 's a corruption of the vapors and fuliginous excrements or els by the vitious constitution of pores in the skin in raritie and constriction or densitie as by too much use of hot ointments made for coloring the hair or such as are used to take off hair
troubled with this grievous Megrim were Chaplain the King 's and Castellane the Queen's chief Physicians A History and Lewes Duret who notwithstanding could help him nothing by blood-letting cupping bathes frictions diet or any other kinde of remedy either taken inwardly or applyed outwardly I being called said that there was onely hope one way to recover his health which was to open the artery of the temple in the same side that the pain was for I thought it probable that the cause of his pain was not contained in the veins but in the arteries in which case by the testimony of the ancients there was nothing better than the opening or bleeding of an artery whereof I have made trial upon my self to my great good When as the Physicians had approved of this my advice I presently betake my self to the work and choose out the artery in the pained temple which was both the more swoln and beat more vehemently than the rest I open this as we use to do in the bleeding of a vein with one incision and take more than two sawcers of blood flying out with great violence and leaping the pain presently ceased neither did it ever molest him again Yet this opening of an Artery is suspected by many for that it is troublesom to stay the gushing forth blood and cicatrize the place by reason of the density hardness and continual pulsation of the artery and lastly for that when it is cicatrized there may be danger of an Aneurisma Wherefore they think it better first to divide the skin then to separate the artery from all the adjacent particles and then to binde it in two places and lastly divide it as we have formerly told you must be done in Varices No danger in opening an artery But this is the opinion of men who fear all things where there is no cause for I have learn'd by frequent experience that the apertion of an attery which is performed with a Lancet as we do in opening a vein is not at all dangerous and the consolidation or healing is somewhat flower than in a vein but yet will be done at length but that no flux of blood will happen if so be that the ligation be fitly performed and remain so for four dayes with fitting pledgets CHAP. V. Of certain affects of the Eyes and first of staying up the upper Eye-lid when it is too lax OF the diseases which befall the eyes some possess the whole substance thereof as the Ophthalmia a Phlegmon thereof others are proper and peculiar to some parts thereof Differences as that which is termed Gutta serena to the optick nerve Whence Galen made a threefold difference of the diseases of the eyes as that some happened to the eye by hurting or offending the chief organ thereof that is the crystalline humor others by hindering the animal faculty the chief causer of sight from entring into them and lastly other some by offending the parts subservient to the prime organ or instrument Now of all these diseases the eye hath some of them common with the other parts of the body such as are an ulcer wound Phlegmon contusion and the like other some are peculiar and proper to the eye Paul Aegin lib. 8. cap. 6. such as are the Egilops Cataracta Glaucoma and divers others of this kinde Some have their upper eye-lid fall down by reason that the upper skin thereof is relaxed more than is sufficient to cover the eye the gristle in the mean while not relaxing it self together therewith Hence proceeds a double trouble the first for that the eye cannot be easily opened the other because the hairs of the relaxed eye-lid run in towards the eye The cause and become troublesom thereto by pricking it The cause of such relaxation is either a particular palsie of that part which is frequent in old people or the defluxion or falling down of a waterish humor and that not acrid or biting which appears by this that those who are thus affected have a rank of hairs growing under the natural rank by reason of abundance of heaped-up humor as it is most probable For thus a wet and marish ground hath the greatest plenty of grass Now if this same humor were acrid it would cause an itching and consequently become troublesom to the patient and it would also fret in sunder and destroy the roots of the other hairs so far it is from yielding matter for the preternatural generation of new The cure It is fit before you do any thing for the cure that you mark with ink the portion thereof which is superfluous and therefore to be cut away left if you should cut off more than is requisite the eye-lid should remain turned up and so cause another kinde of affect which the ancients have called Ectropion Then the eye being covered take and lift up with your fingers the middle part of the skin of the eye-lid not taking hold of the gristle beneath it and then cut it athwart taking away just so much as shall be necessary to make it as it were natural lastly join the lips of the wound together with a simple future of three or four stitches that so it may be cicatrized for the cicatrization restrains the eye-lid from falling down so loosly at least some part thereof being taken away There ought to be some measure and heed taken in the amputation otherwise you must necessarily run into the one or other inconvenience as if too much be cut a way then the eye will not be covered if too little then you have done nothing and the patient is troubled to no purpose If there shall be many hairs grown preternaturally you shall pluck them away with an instrument made for the same purpose then their roots shall be burned with a gentle cautery the eye being left untoucht for a scar presently arising will hinder them from growing again CHAP. VI. Of Lagophthalmus or the Hare-eye SUch as have their eye-lids too short sleep with their eyes open for that they cannot be covered by the too short skin of the eye-lids The Greeks term this affect 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 The cause is either internal or external internal as by a Carbuncle Paulus Aegi◠lib. 6. cap. 10. Impostume or Ulcer external as by a wound made by a sword burn fall and the like If this mishap proceed by reason of a cicatrization it is curable if so that the short eye-lid be of an indifferent thickness But if it have been from the first conformation or by some other means whereby much of the substance is lost as that which happens by burning and a carbuncle then it is uncurable For the cure The cure you shall use relaxing and amollient fomentations then the skin shall be divided above the whole scar in figure of an half-Moon with the horns looking downwards Then the edges of the incision shall be opened and lint put into the middle thereof that
horny coat being relaxed or thrust forth by the violence of the pustule generated beneath It in shape resembleth a grape whence the Greeks stile it Staphyloma This tumor is sometimes blackish otherwhiles whitish For if the horny coat be ulcerated and fretted in sunder so that the grapy coat shew it self fall through the ulcer then the Staphyloma will look black like a ripe grape for the utter part of the Vvea is blackish But if the Cornea be only relaxed not broken then the swelling appears of a whitish colour like an unripe grape Paulus and Aetius The Antients have made many kinds or differences thereof For if it be but a smal hole of the broken Cornea by which the Vvea sheweth or thrusteth forth it self then they termed it Myccephalon that is like the head of a flie But if the hole were large and also callous they called it Clavus Every Slaphiloma infers incurable blindness or a nail if it were yet larger then they termed it Acinus or a grape But in what shape or figure soever this disease shall happen it bringeth two discommodities the one of blindness the other of deformitie Wherefore here is no place for Surgerie to restore the sight which is already lost but onely to amend the deformitie of the eye which is by cutting off that which is prominent But you must take heed that you cut away no more then is fit for so there would be danger of pouring out the humours of the eye CHAP. XVII Of the Hypopyon that is the suppurate or putrified eye PVS or Quitture is sometimes gathered between the hornie and grapie coat from an internal or external cause From an internal as by a great defluxion The cause and oft-times after an inflamation but externally by a stroke through which occasion a vein being opened hath poured forth bloud thither which may presently be turned into Quitture For the cure universal remedies being premised cupping glasses shall be applied with scarifications and frictions used Anodine and digestive collyria shall be poured from above downwards Galen writes that he hath sometimes evacuated this matter Lib. 14. method cap. ult the Cornea being opened at the Iris in which all the coats meet concur and are terminated I have done the like and that with good success James Guillemeau the Kings Surgeon being present the Quitture being expressed and evacuated after the apertion The Ulcer shall be cleansed with Hydromel or some other such like medicine CHAP. XVIII Of the Mydriasis or dilatation of the Pupil of the Eye MYdriasis is the dilatation of the pupil of the eye The Cause and this happeneth either by nature or chance the former proceedeth from the default of the first conformation neither is it cureable but the other is of sorts for it is either from an internal cause the off-spring of an humour flowing down from the brain wherefore Physical means must be used for the cure thereof The cure Now that which cometh by any external occasion as a blow fall or contusion upon the eye must be cured by presently applying repercussive and anodine medicines the defluxion must be hindered by diet skilfully appointed phlebotomie cupping scarification frictions and other remedies which may seem convenient Then must you come to resolving medicines as the bloud of a Turtle-dove Pigeon or chicken reeking-hot out of the vein being poured upon the eye and the neighbouring parts Then this following cataplasm shall be applied thereto A digesting Cataplasm â„ž farinae fabar hordei an â„¥ iij. ol rosar myrtillor an â„¥ j. ss pul ireos flor Ê’ij cum sapa fiat cataplasm You may also use the following fomentation â„ž rosar rub myrtyl an m.j florum melil chamaem an p.j. nucum cupress â„¥ j. vini ansteri lb ss aq rosar plantag an â„¥ iij. make a decoction of them all for a fomentation to be used with a sponge CHAP. XIX Of a Cataract A Cataract is called also by the Greeks Hypochima by the Latines suffusio A Cataract Howsoever you term it it is nothing else but the concretion of an humour into a certain thin skin under the hornie coat just against the apple or pupil and as it were swimming upon the waterie humour and whereas the place ought to be emptie opposing it self to the internal faculty of seeing whereby it differeth from spots and scars growing upon the hornie coat and Adnata It sometimes covereth the whole pupil The differences otherwhiles but the one half thereof and somewhiles but a small portion thereof According to this varietie the sight is either quite lost weak or somewhat depraved because the animal visive spirit cannot in its entire substance pass through the densitie thereof Causes The defluxion of the humour whence it proceeds is either caused by an external occasion as a stroke fall or by the heat or coldness of the encompassing air troublesome both to the head and eyes or else it is by an internal means as the multitude or else the acrid hot and thin quality of the humours This disease also sometimes taketh its original from gross and fumid humours sent from a crude stomach or from vaporous meats or drinks up to the brain and so it falleth into the eyes where by the coldness straitness and tarrying in the place they turn into moisture and at length into that concretion or film which we see The signs may be easily drawn from that we have already delivered Signs For when the cataract is formed and ripe it resembleth a certain thin membrane spred over the pupil and appeareth of a different colour accorcing to the variety of the humor whereof it consisteth one while white another while black blue ash-coloured livid citrine green It sometimes resembleth quick-silver which is very trembling and fugitive more than the rest At the first when it beginneth to breed they seem to see many things as flyes flying up and down hares nets and the like as if they were carelesly tossed up and down before their eyes sometimes every thing appeareth two and somewhiles less than they are because the visive spirit is hindred from passing to the objects by the density of the skin like as a cloud shadowing the light of the Sun Whence it is that the patients are duller fighted about noon and surer and quicker sighted in the morning and evening for that the little visive spirit diffused through the air is dispersed by the greater light but contracted by the less Now if this film cover half the pupil then all things shew but by halfs but if the midst thereof be covered and as it were the centre of the chrystalline humor then they seem as if they had holes or windows but if it cover at all then can he see nothing it all but only the shadows of visible bodies and of the Sun Moon Stars lighted cancles and the like luminous things and that but confusedly and as
thrust this hot iron thorow a pipe or cane made for the same purpose lest it should harm any sound part by the touch thereof and thus the putrefaction the cause of the arosion may be staid But if the hole be 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 wier without doing any harm The forms of Files made for filing the teeth Worms breeding by putrefaction in the roots of the teeth Causes of worms in the teeth shall be killed by the use of causticks by gargles or lotions made of vineger wherein either pellitory of Spain hath been steeped or treacle dissolved also aloes and garlick are good to be used for this purpose Setting the teeth on edge happens to them by the immoderate eating of acrid or tart things or by the continual ascent of vapours endued with the same quality Causes of setting the teeth on edge from the orifice of the ventricle to the mouth or by a cold defluxion especially of acrid phlegm falling from the brain upon the teeth or else by the too excessive use of cold or stupifying liquors This affect is taken away if after general medicines and shunning those things that cherish the disease the teeth be often washed with aqua vitae or good wine wherein sage rosemarie cloves nutmegs and other things of the like nature have been boiled CHAP. XXVII Of drawing of teeth TEeth are drawn either for that they cause intolerable pains which will not yield 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 pain A caveat in drawing of teeth 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 brain 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 do this until 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 Lib. 7. cap. 18. whence follows a fever and a great flux of blood not easily to be staid for blood or pus flowing out in great plenty is in Celsus's opinion the sign of a broken bone and many other malign and deadly symptomes Some have had their mouths drawn so awry during the rest of their lives that they could scarce gape Besides if the tooth be much eaten the hole thereof must be filled either with lint or a cork or a piece of lead well fitted thereto lest it be broken under your forceps when it is twitched more straitly to be plucked out and the root remain ready in a short time to cause more grievous pain But judgment must be used and you must take special care lest you take a sound tooth for a pained one for oft-times the Patient cannot tell for that the bitterness of pain by neighbourhood is equally diffused over all the jaw The manner of drawing teeth 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 therefrom with the instruments marked with this letter A. and then if spoiled 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 stick in too fast and will not stir 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 greatness figure and site shall seem to require I would have a tooth-drawer expert and diligent in the use of such toothed mullets for unless one know readily and cunningly how to use them he can scarce so carrie himself but that he will force out three teeth at once oft-times leaving that untoucht which caused the pain Instruments for scraping the teeth and a three-pointed levatorie The effigies of Forcipes or Mullets for the drawing of teeth The form of another Instrument for drawing of teeth What to be done when the tooth is pluckt out 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 press the flesh of the gums on both sides with his fingers whereas he took out the tooth that so the socket that was too much dilated and oft-times torn by the violence of the pluck may be closed again Lastly the mouth shall be washed with oxycrate and if the weather be cold the Patient shall take heed of going much in the open air lest it cause a new defluxion upon his teeth CHAP. XXVIII Of cleansing the Teeth PIeces of meat in eating sometimes stick between the teeth Causes of foul or rusty teeth and becoming corrupt by long staying there do also hurt the teeth themselves and spoil the sweetness of the breath He that would eschew this ought presently after meat to wash his mouth with wine mixed with water or oxycrate and well to cleanse his teeth that no slimie matter adhere to them Many folks teeth by their own default gather an earthy filth of a yellowish colour which eats into them by little and little as rust eats into iron This rustie filthiness or as it were mouldiness of the teeth doth also oft-times grow by the omitting of their proper duty that is of chawing Whence soever this slimie filth proceeds we must get Dentifrices to fetch it off withall The cure and then the teeth must be presently rubbed with aqua fortis and aqua vitae mixed together that if there be any thing that hath scaped the Dentifrices it may be all fetched off A caution in the use of acrid things yet such acrid washings are hurtful to the sound teeth for that they by little and little consume and waste the flesh of the gums Dentifrices shall be made of the root of marsh-mallows boiled in white wine and allom and as when the teeth are loose we must abstain from such things as are hard to be eaten and chawed but much more from
so could that bee don without the infection and corruption of the whole mass of blood whil'st it flow's through the veins therefore to bee more probable that this quantitie of filth mixed with excrements urine flowed out by the default of the liver or of som other bowel rather than from the wounded arm I was of a contrarie opinion for these following reasons How the pus may flow from the wounded arm by the urine and excrements First for that which was apparently seen in the patient for as long as the excrement and urine were free from this purulent matter so long his arm plentifully flowed therewith this on the contrary being dry much purulent matter was voided both by stool urine Another was that as our whole bodie is perspirable so it is also if I may so term it confluxible The third was an example taken from the glasses with the French term Monte-vins that is Mount-wines for if a glass that is full of wine be set under another that is fill'd with water you may see the wine raise it self out of the lower vessel to the upper through the mid'st of the water and so the water descends through the mid'st of the wine yet so that they do not mix themselvs but the one take and possess the place of the other If this may bee don by art by things onely naturall and to bee discerned by our eies what may bee don in our bodies in which by reason of the presence of a more noble soul all the works of nature are far more perfect What is it which wee may dispair to bee don in the like case For doth not the laudable blood flow to the guts kidnies spleen bladder of the gall by the impuls of nature together with the excrements which presently the parts themselvs separate from their nutriment Doth not milk from the brests flow somtimes forth of the wombs of women lately dilivered Yet that cannot bee carried down thither unless by the passages of the mammillary veins and arteries which meet with the mouths of the vessels of the womb in the middle of the straight muscles of the Epigastrium Therefore no marvel if according to Galen Lib. de loc affec 6. cap. 4. the pus unmix't with the blood flowing from the whole body by the veins arteries into the kidnies and bladder bee cast forth together with the urine These and the like things are don by nature not taught by anie counsel or reason but onely assisted by the strength of the segregateing and expulsive facultie and certainly wee presently dissecting the dead bodie observed that it all as also all the bowels thereof were free from inflammation and ulceration neither was there anie sign of impression of anie purulent matter in anie part thereof CHAP. L. By what external causes the urine is supprest and prognosticks concerning the suppression thereof THere are also manie external causes through whose occasion the urine may bee supprest Such are batheing and swimmeing in cold water the too long continued application of Narcotick medicines upon the reins perinaeum and share the use of cold meats and drinks and such other like Moreover Why the dislocation of a vertebra of the loins may caus a suppression of urine the dislocation of som Vertebra of the loins to the inside for that it presseth the nerves disseminated thence into the bladder therefore it causeth a stupiditie or numness of the bladder Whence it is that it cannot perceiv it self to bee vellicated by the acrimonie of the urine and consequently it is not stirred up to the expulsion thereof But from whatsoever caus the oppression of the urine proceed's if it persevere for som daies death is to bee feared Why the suppression of the urine becom's deadly unless either a fever which may consume the matter of the urine or a scouring or flux which may divert it shall happen thereupon For thus by stay it acquireth an acrid and venenate qualitie which flowing by the veins readily infecteth the mass of blood and caried to the brain much molest's it by reason of that similitude and sympathie of condition which the bladder hath with the Meninges A fever following thereon help 's the suppression of urine But nature if prevalent easily free'th it self from this danger by a manifest evacuation by stool otherwise it must necessarily call as it were to its aid a feverish heat which may send the abounding matter of this serous humiditie out through the skin either by a sensible evacuation as by sweat becaus sweat and urine have one common matter or els dispers and breath it out by transpiration which is an insensible excretion CHAP. LI. Of bloodie Vrine SOm piss pure blood others mixt and that either with urine and then that which is expelled resembl's the washing of flesh newly killed The differences or els with pus or matter and that either alone or mixed with the urine There may bee divers causes of this symptom Causes as the too great quantitie of blood gathered in the body which by the suppression of the accustomed and period cal evacuation by the courses or hemorrhoids now turn's its cours to the reins and bladder the fretting asunder of som vessel by an acrid humor or the breaking thereof by carrying or lifting of som heavie burden by leaping falling from high a great blow the falling of som weight upon the loins rideing post too violently the too immoderate use of venerie and lastly from anie kinde of painfull and more violent exercise by a rough and sharp stone in the kidnies by the weaknes of the retentive facultie of the kidnies by a wound of som of the parts belonging to the urine by the too frequent use of diuretick and hot meats and medicines or els of things in their whole nature contrarie to the urinarie parts for by these and the like causes the reins are oft-times so inflamed that they necessarily impostumate and at length the impostume beeing broken it turn's into an ulcer casting forth quitture by the urine In so great varietie of the causes of blodie urine wee may gather whence the causes of this symptom may arise Signs of what causes they proceed by the depraved action of this or that part by the condition of the flowing blood to wit pure or mixt and that either with the urine alone or with pus For example if this bloodie matter flow from the lungs liver kidnies dislocated Vertebrae the straight gut or other the like part you may discern it by the seat of the pain and symptoms as a fever and the propriety of the pain and other things which have preceded or are yet present And wee may gather the same by the plentie and qualitie for if for example the pus flow from an ulcer of the arm the purulent matter will flow by turns one while by the urine so that little is cast forth by the ulcer then presently on the
luc lb. ii aq vitae â„¥ vi agitentur omnia simul diligentissime Lutetur alembicum luto sapientiae fiat distillatio lento ignae in balneo mariae Use it after the following manner â„ž aq stillatitiae prescriptae â„¥ ii aut iii. According to the operation which it shall perform let the patient take it four hours before meat Also radish-water distilled in balneo mariae is given in the quantity of â„¥ iiii with sugar and that with good success Baths and sem cupia or halt baths are artificially made Why the use of diureticks is better after bathing To cleanse the ulcers of the kidnies and bladder relax soften dilate and open all the body therefore the prescribed diureticks mixed wtih half a dram of treacle may be fitly given at the going forth of the bath These medicines following are judged fit to cleanse the ulcers of the kidnies and bladder Syrup of maiden-hair of â—oses taken in quantity of â„¥ i. with hydromel or barlie-water Asses or Goats-milk are also much commended in this affect because they cleanse the ulcers by their serous or whayish portion and agglutinate by their chees-life They must be taken warm from the dug with hony of roses or a little salt least they corrupt in the stomach and that to the quantity of four ounces drinking or eating nothing presently upon it The following Trochises are also good for the same purpose Trochisces to heal the ulcers of the kidnies â„ž quatuor sem frigid major seminis papaveris albi portulâ—cae-plantag cydon myrtil gum tragacanth arab pinear. glycyrrhi mund hordei mund mucilag psilii amygdal dulcium an â„¥ i. bâ—â— armen sanguin dracon spodii rosar mastich terrae sigil myrrhae an â„¥ ii cum oxymelite conficiantur secundum artem trochisci Let the patient take Ê’ ss dissolved in whay ptisan barlie-water and the like they may also be profitably dissolved in plantain-water and injected into the bladder Let the patient abstain from wine and instead thereof let him use barlie-water or hydromel or a ptisan made of an ounce of raisins of the Sun Drink instead of wine stoned and boiled in five pints of fair water in an earthen pipkin well leaded or in a glass untill one pint be consumed adding thereto of liquorice scraped and beaten â„¥ i. of the cold seeds likewise beaten two drams Let it after it hath boiled a little more be strained through an hypocras bag with a quartern of sugar and two drams of choice cinnamon added thereto and so let it be kept for usual drink CHAP. LVI Of the Diabete or inabilitie to hold the Vrine THe Diabete is a disease wherein presently after one hath drunk the urine is presently made in great plentie What Diabete is by the dissolution of the retentive faculty of the reins and the depravation or immoderation of the attractive faculty The external causes are the unseasonable and immoderate use of hot and diuretick things and all more violent and vehement exercises The causes The internal causes are the inflammation of the liver lungs spleen but especially of the kidnies and bladder This affect must be diligently distinguished from the excretion of the morbifick causes by urine Signs The loins in this disease are molested with a pricking and biteing pain and there is a continual and unquenchable thirst and although this disease proceed from a hot distemper Why the urines are watrish yet the urine is not coloured red troubled or thick but thin and white or waterish by reason the matter thereof makes very small stay in the stomach liver and hollow vein being presently drawn away by the heat of the kidnies or bladder If the affect long endure the patient for want of nourishment falleth away whence certain death ensues For the cure of so great a disease the matter must be purged which causes or feeds the inflammation or phlegmon and consequently blood must be let We must abstain from the four cold seeds for although they may profit by their first qualitie The cure yet will they hurt by their diuretick faculty Refrigerating and astringent nourishments must be used and such as generate gross humors as rice thick and astringent wine mixed with much water Narcotick things to be applied to the loins Exceeding cold yea narcotick things shall be applied to the loins for otherwise by reason of the thickness of the muscles of those parts the force unless of exceeding refrigerating things will not be able to arrive at the reins of this kinde are oil of white poppie henbane opium purslain and lettuce-seed mandrage vinegar and the like of which cataplasms plasters and ointments may be made fit to corroborate the parts and correct and heat CHAP. LVII Of the Strangurie What the Strangurie is THe Strangurie is an affect haveing some affinitie with the Diabete as that wherein the water is involuntarily made but not together at once but by drops continually and with pain The causes The external causes of a strangurie are the too abundant drinking of cold water and all too long stay in a cold place The internal causes are the defluxion of cold humors into the urinarie parts for hence they are resolved by a certain palsie and the sphincter of the bladder is relaxed so that he cannot hold his water according to his desire inflammation also and all distemper causeth this affect and whatsoever in some sort obstructs the passage of the urine as clotted blood thick phlegm gravel and the like And because according to Galens opinion all sorts of distemper may cause this disease diverse medicines shall be appointed according to the difference of the distemper Therefore against a cold distemper fomentations shall be provided of a decoction of mallows Com. ad aphor 15. sect 3. roses origanum calamint and the like and so applied to the privities then presently after let them be anointed with oil of bays and of Castoreum and the like Strong and pure wine shall be prescribed for his drink and that not only in this cause but also when the strangurie happens by the occasion of obstruction caused by a gross and cold humor if so be that the body be not plethorick But if inflammation together with a Plethora oâ— fulness hath caused this affect we may according to Galens advice Ad aphor 48. sect 7. heal it by blood-letting But if obstruction be in fault that shall be taken away by diureticks either hot or cold according to the condition of the matter obstructing We here omit to speak of the Dysuria or difficultie of making water because the remedies are in general the same with those which are used in the Ischuriae or suppression of urine CHAP. LVIII Of the Cholick WHensoever the guts being obstructed or otherwise affected the excrements are hindred from passing forth and if the fault be in the small guts the affect is termed Volvulus Ileos and Miserere mei but if it be in
come forth at the mouth Marianus Sanctuâ— wisheth by the counsel of many who have so freed themselves from this deadly symptome to drink three pounds of quick-silver with water only For the doubled The force of quick-siâ—ver in the unfolding of the guts An historie and as it were twined up-gut is unfolded by the weight of the quick-silver and the excrements are deprest and thrust forth and the worms are killed which gave occasion to this affect John of S Germans that most worthie Apothecary hath told me that he saw a Gentleman who when as he could not be fâ—eed from the pain of the colick by any means prescribed by learned Physicians at length by the counsel of a certain German his friend drank three ounces of oil of sweet almonds drawn without fiâ—e and mixed with some white wine and pellitorie-water and swallowed a leaden bullet besmeaâ—ed with quick-silver and that bullet coming presently out by his fundament he was wholly freed from his colick CHAP. LIX Of Phlebotomie or Blood-letting PHlebotomie is the opening of a vein evacuating the blood with the rest of the humors What Phlebotomie is thus Atteritomie is the opening of an arterie The first scope of phlebotomie is the evacuation of the blood offending in quantity The use although oft-times the Physician 's intention is to draw forth the blood which offends in qualitie or either way by opening a vein Repletion which is caused by the quantity is two-fold the one ad vires that is to the strength Repletion two-fold the veins being otherwise not very much swelled this makes men infirm and weak nature not able to bear his humor of what kinde soever it be The other is termed ad vasa that is to the vessells the which is so called comparatively to the plentie of blood although the strength may very well away therewith The vessels are oft-times broke by this kinde of repletion so that the patient casts and spits up blood or else evacuates it by the nose womb hemorhoids or varices The repletion which is ad vires The signs is known by the heaviness and wearisomness of the whole body but that which is ad vasa is perceived by their distension and fulness both of them stand in need of evacuation But blood is only to be let by opening a vein Five scopes in letting blood for five respects the first is to lessen the abundance of blood as in plethorick bodies and those who are troubled with inflammation without any plenitude The second is for diversion or revulsion as when a vein of the right is opened to stay the bleeding of the left nostril The third is to allure or draw down as when the saphena is opened in the ankle to draw down the courses in women The fourth is for alteration or introduction of another quality as when in sharp fevers we open a vein to breath out that blood which is heated in the vessels and cooling the residue which remains behinde The fifth is to prevent imminent diseases as when in the Spring and Autumn we draw blood by opening a vein in such as are subject to spitting of blood the squinancie plurifie falling-sicknesse apoplexie madnesse gout or in such as are wounded for to prevent the inflammation which is to be feared Before blood-letting if there be any old excrements in the guts they shall be evacuated by a gentle glyster or suppositorie least the mesaraick veins should thence draw unto them any impuritie Bloud must not be drawn from ancâ—ent people From whence we must not draw blood â—â—less some present necesitie require it least the native heat which is but languid in them should be brought to extreme debilitie and their substance decay neither must any in like sort be taken from children for fear of resolving their powers by reason of the tenderness of thei substance and â—areness of their habit The quantity of blood which is to be let must be considered by the strength of the patient and greatness of the disease therefore if the patient be weake and the disease require large evacuation it will be convenient to part the letting of blood When and foâ— what it is necessarie yea by the interposition of some daies The vein of the forehead being opened is good for the pain of the hind part of the head yet first we foment the part with warm water that so the skin may be softer and the blood drawn into the veins in greater plenty In the squinancie the veins which are under the tongue must be opened aslant without putting any ligatures about the neck for fear of strangling Phlebotomie is necessary in all diseases which stop or hinder the breathing or take away the voice or speech as likewise in all contusions by a heavy stroke or fall from high in an apoplexie sqâ—inancie and burning feaver though the strength be not great nor the blood faultie in quantity or quality blood must not be let in the height of a feaver Most judge it fit to draw blood from the veins most remote from the affected and inflamed part for that thus the course of the humors may be diverted the next veins on the contrary being opened the humors may be the more drawn into the affected part and so increase the burden and pain But this opinion of theirs is very erroneous for an opened vein alwaies evacuates and burdens the next part For I have sundry times opened the veins and arteries of the affected part as of the hands and feet in the Gout of 〈◊〉 parts of the temples in the Megrim whereupon the pain alwaies was somewhat asswaged for that together with the evacuated blood the malignitie of the Gout and the hot spirits the causers of the Head-ach or Megrim were evacuated For thus Galen wisheth to open the arteries of the temples in a great and contumacious defluxion falling upon the eies 13. meth cap. 〈◊〉 or in the Megrim or Head-ach CHAP. LX. How to open a vein or draw blood from thence How to pâ—ace the patient THe first thing is to seat or place the patient in as good a posture as you can to wit in his bed if he be weak but in a chair if strong yet so that the light may fall directly upon the vein which you intend to open Then the Surgeon shall rub the arm with his hand Rubbing the arm Binding it before we open the vein or a warm linnen cloth that the blood may flow the more plentifully into the vein Then he shall binde the vein with a ligature a little above the place appointed to be opened and he shall draw back the blood upwards towards the ligature from the lower part and if it be the right arm he shall take hold thereof with his left hand but if the left then with his right hand pressing the vein in the mean time with his thumb a little below the place where you mean to open it least it should
tendons What and how the matter of the gout come down from the brain ligaments and other bodies wherein the joint consists CHAP. IV. Out of what part the matter of the Gout may flow down upon the joynts THe matter of the Gout comes for the most part from the liver or brain that which descends from the brain is phlegmatick serous thin and clear such as usually drops out of the nose endued with a malign and venenate quality Now it passeth out by the musculous skin and pericranium as also through that large hole by which the spinal marrow the brains substitute is propagated into the spine by the coats and tendons of the nervs into the spices of the joynts and it is commonly cold That which proceedes from the liver is diffused by the great vein and arteries filled and puffed up and participates of the nature of the four humors of which the mass of the blood consist's more frequently accompanyed with an hot distemper together with a gouty malignity Besides this manner of the Gout Gut by congestion which is caused by defluxion there is another which is by congestion as when the too weak digestive faculty of the joynts cannot assimilate the juices sent to them CHAP. V. The signs of the Arthritick humor flowing from the brain WHen the defluxion is at hand there is an heaviness of the head a desire to rest and a dulness with the pain of the outer parts then chiefly perceptible when the hairs are turned up or backwards moreover the musculous skin of the head is puffed up as swoln with a certain oedematous tumor the patients seem to be much different from themselves by reason of the functions of the mind hurt by the malignity of the humor from whence the natural faculties are not free as the crudities of the stomach and the frequent and acrid belchings may testifie CHAP. VI. The signs of a gouty humor proceeding from the liver THe right Hypocondrie is hot in such gouty persons When the Gout which proceeds from the default of the liver assimiates the nature of an oedema Why the Gout seldom proceedâ— from melancholy yea the inner parts are much heated by the bowelâ— blood and choler carrie the sway the veins are large and swoln a defluxion suddenly falls down especially if there be a greater quantity of choler then of other humors in the mass of the blood But if as it often falls out the whole bloud by means of crudites degenerate into phlegm and a whayish humor then will it come to pass that the Gout also which proceeds from the liver may be pituitous or phlegmatick and participate of the nature of an oedema like that which proceeds from the brain As if the same mass of bloud decline towards melancholy the Gout which thence ariseth resembles the nature of a scirrhus yet that can scarce hâ—ppen that melancholy by reason of the thickness and slowness to motion may fall upon the joynts Yet notwithstanding because we speak of that which may be of these it will not be unprofitable briefly to distinguish the signs of each humor and the differences of Gouts to be deduced from thence CHAP. VII By what signs we may understand this or that humor to accompany the gouty malignity YOu may give a guess hereat by the patients age temper season of the year condition of the country where he lives his diet and condition of life the increase of the pain in the morning noon evening or night by the propriety of the beating pricking sharp or dull pain by numness as in a melancholy gout or itching as in that which is caused by tough phlegm by the sensible appearance of the part in shape and colour as for example sake in a phlegmatick Gout the colour of the affected part is very little changed from its sef and the neighbouring well parts in a sanguine Gout it look's red in a cholerick it is fiery or pale in a melancholy livid or blackish by the heat and bigness which is greater in a sanguine and phlegmatiâ—k then in the rest by the change and lastly by things helping and hurting And there be some who for the knowledge of these differences wish us to view the patients urine and feel their pulse and consider these excrements which in each particular nature are accustomed to abound or flow and are now suddenly and unaccustomarily supprest Foâ— hence may bee taken the signs of the dominion of this or that humor But a more ample knowledg of these things may be drawn from the humors predominant in each person and the signs of tumors formerly delivered Onely this is to be noted by the way that the gout which is caused by melancholy is rare to be found CHAP. VIII Prognosticks in the Gout BY the writeings of Physicians the pains of the Gout are accounted amongst the most grievous and acute so that through vehemency of pain many are almost mad and wish themselves dead They have certain periods and fits according to the matter and condition of the humor wherein this malign and inexplicable gouty virulency resides Yet they more frequently invade in the Spring and Autumn The Gout frequent in the Spring Fall What Gout uncureable such as have it hereditary are scarce ever throughly freâ— therefrom as neither such as have it knotty for in the former it was born with them and implanted and as it were fixed in the original of life but in the other the matter is become plaster-like so that it can neither be resolved nor ripened That which proceeds from a cold and pituitous matter causeth not such cruel tormenting pain as that which is of an hot sanguine or cholerick cause neither is it so speedily healed for that the hot and thin matter is more readily dissolved therefore commonly it ceaseth not until forty dayes be past Besides also by howmuch the substance of the affected part is more dense and the expulsive faculty more weak by so much the pain is more tedious Hence it is that those Gouty pains which molest the knee hee l ad huckle-bone Gal. ad aphor 49. sect 5. are more contumacious The Gout which proceeds of an hot matter rests not before the fourteenth or twentieth day That which is occasioned by acriâ—e choler by the bitterness of the inflamation of the pain causeth a difficulty of breathing raveing and sundry times a gangrene of the affected part and lastly death and healed it often leaves a palsie behinde it Why the Sciatica causeth lameness Amongst all the gouty pains the Sciatica challengeth the prime place by the greatness of the pain and multitude of symptoms it brings unquietness and watching a fever dislocation perpetual lameness and the decay of the whole leg yea and often-times of the whole body Now lameness and leanness or decay of the part are thus occasioned for that the decurrent humor forceth the head of the thigh-bone out of the cavity of the huckle-bone
pains he knew no greater nor surer remedy then to let blood even to the fainting of the patient If thoâ—e which are in this case shall not become better by purging and phlebotomy conveniently prescribed then it happens by the means of drunkenness gluttony and the like distemper For hence abundance of crude humors are heaped up which by their contumacy yield themselves less obedient to medicines Therefore such gouty persons as are intemperate and given to gluttony and venery may hope for no health by use of medicines CHAP. XV. Of local medicines which may be used to a cold Gout LIttle do topick medicines avail It is not safe to use repercussives in the Gout before purging unless the body of the gouty patient shall be purged from excrementitious humors besides also there is danger least by the use of repelling medicines the virulency of the humor may be driven into the entrails which thing hath been the cause of sudden death to many Now in the first place we will speak of locall medicines which are thought meet for a phlegmatick juice because this is more frequent then that which is from a hot cause At the beginning in every Gout the Sciatica excepted we must use astringent things which have a faculty to binde or strengthen the joints and to drie and waste the excrementitious humor An astringent Cataplasm As â„ž fol. sabimae m. ss nucum cupressi â„¥ iii. aluminis rech â„¥ i. gum tragacnathae â„¥ iiii mucilaginis psilii cydon quantum sufficit fiat cataplasma Or â„ž sterceris bubuâ—i recentis lb. i. mellis ros â„¥ iiii olei ros aceti an â„¥ ii bulliant simul parum fiat cataplasma Or else â„ž olei rosar myrtill an â„¥ ii pulveris myrrhae alves an â„¥ i. acaciae â„¥ ii ss incâ—rporentur cum aquâ gallarum câ—ctarum fiat unguentum Some boil sage camomile and melilote flowers wormwood and dane-wort A discussing fomentation of each a handful in a sufficient quantity of vinegar then they put the grieved part into this decoction being warm and by frequent useing this medicine it hath been found to repel and consume the noxious humor not only cold but also cholerick and also to stâ—enthen the part The fresh faces of Olives laid to the part asswage pain dried Oranges boiled in vinegar One partly astâ—ingent and partly discussing beaten and applied do the same Or â„ž medii corticis ulmi lb. ss caudae equin stoechad consolid majoris an m. ss aluminis roch thuris an Ê’ iii farin hordeiÊ’ v. lixivii com quantum sufficit fiat cataplasma ad formam pultis satis liquidae Commonly then when as the part swelleth up the pain is lessened for that the expulsive faculty driveth the humor from the center into the circumference of the part that is from within outward for in like sort such as have the tooth-ache have less pain when their cheeks begin to sweel After repercussives we must come to those which evacuate the conteined humor by evacuating or resolving it For every defluxion of humors remaining in any part requires evacuation Neither must we marvell thereat if the digested humor doth not vanish at the first time for we must have regard to the cold phlegm which is thick and viscid as also of the part which is ligamentous Why the gouty humor doth not presently vanish upon the use of repercussives Greater discusses membranous and nervous and consequently more dense then fleshie parts â„ž rad Bryon sigilli beat Mariae an â„¥ iv bulliant in lixivio postea terantur colentur per setaceum addâ—ndâ— fâ—rin hordei fabarum an â„¥ i. olei chamaem â„¥ iii. fiat cataplasma Or â„ž hordei lupin an â„¥ iii. sulphuris vivi salis com an â„¥ i. mellis com â„¥ v. pul aloes myrrhae an â„¥ ss aq vit â„¥ i cum lixivis fiat cataplasma Or â„ž succi calium rub aceti bâ—ni an â„¥ iiii farin hordei â„¥ iss pul Hermodactyl Ê’ ss vitellos â—â—â—rum nu iii. olei chamam â„¥ ii creci ℈ ii some burn the roots and stalks of Coleworts and mix the ashes with hogs grease and the powder of Orris and so make a pultis Or â„ž Lactis vaccini lb. ii micae panis albi quantum sufficit A cataplasm good for any Gâ—ut at any time bulliant simul addend pulveris subtilis florum chamam melilâ—ti an m. ss cr ci ℈ i. vitellos ovorum nu iiii ol ros â„¥ iii. butyri recentis â„¥ i. terebinth â„¥ ii fiat cataplasma ad formam pultis satis liquidae This Cataplasm may be applyed with good success not only to phlegmatick and cold but also to any gout at any time to mitigate the extremity of the pain in men of any temper and it must be changed twice or thrice a day Also Triacle dissolved in wine and anointed on the part is said to asswage this pain You may for the same purpose make and apply emplaisters unguents cerats and liniments This may be the form of an emplaster â„ž gummi ammoniaci Discussing emplaisters bdelii styracis an â„¥ ii cum aceto aquâ vit dissolve adde farin faenugr â„¥ ss olei chamaem aneth an â„¥ ii cerae quantum sufficit fiat emplasitum molle Or â„ž rad bryon sigill bâ—at Mariae an â„¥ v. bulliant in lixivio complete colentur per setaceum addendo olei cham â„¥ iiii seviâ—ircini â„¥ iiii cerae nov quantum sufficit fiat emplastrum mâ—lle Or â„ž gum ammon opopanacis galbani an Ê’ ii dissolvantur in aceto postea colentur adde olei liliorum terebinth venet an â„¥ i. picis navalis cer nâ—v quantam sufficit fiat emplastrum molle Or else â„ž succi rad â—nul camp ebuli an â„¥ iii. rad alâ—b lb. ss coquantur colentur per petaceum addendo flâ—rum cham meliâ— samâ—â—ci rerisâ—ar hyperici an p. ii nucum cupressi nu iiii ol cham aneth hyper liliorum de spicà an Ê’ ii pinguedinis anatis gallin anseris aâ— Ê’ ss raâ—as viridas vivas nu vi catellos duos nuper natos bulliant omnia simul in lb. ii ss viâ—i odoriferi unâ aquae vit ad consumptionem succorum vini â—ssium catellorum dissolutionem fortiter exprimantur expressionis adde terebinth â„¥ iii. cer quantum sufficit fiat emplastrum molle Also Emp. de vigo Oxicroceum de mucilaginibus de meliloto and the like mixed together and softned with a little oil or axungia are of the like faculty and good for the same purpose Ointments Let this be the form of an ointment â„ž anserem pinguâ—m imple catellis duobus de quibus deâ—â— cutem viscera caput pedes item accipe ranas nu x. colubros detracta cutâ— in frusta dissectos nu iv mithridat theriac an â„¥ ss fol salvia rorismar thymi rutae an m ss baccarum lauri
sweat runs a quite contrary course and this is the opinion of many and great Physcians Hip aph ult sect 6. This first decoction being boiled out and strained the like quantity of water shall be put to the stuff or mass that so being boiled again without any further inâ—usion and strained with the addition of a little cinnamon for the strengthening of the stomach the patient may use it at his meals and between his meals if he be drie for his ordinary drink How and in what quantity the decoction must taken The quantity of the first decoction to be taken at once ought to be some five or six ounces and it shall be drunk warm that so it may be the sooner brought into action and least the actual coldness should offend the stomach and then the patient being well covered shall keep himself in bed and there expect sweat which if it come slowly on it shall be helped forwards with stone-bottles filled full of water and put to the sores of the feet If any parts in the interim shall be much pained they shall be comforted by applying of swines-bladders half filled with the same decoction heated Neither will it be unprofitable before the decoction be drunk to rub over all the body with warm linnen clothes that by this means the humors may be attenuated and the pores of the skin opened When he shall have sweat some two hours the parts opposite to the grieved places How to drie the sweat of the body shall first be wiped then presently but more gently the grieved parts themselves least a greater conflux of humors flow thereto These things being done he shall keep himself in bed shunning the cold air untill he be cooled and come to himself again some two hours after he shall so dine as the disease and his former custome shall seem to require six hours after betakeing himself to his bed he shall drink the like quantity of the decoction and order himself as before But if he be either weak or weary of his bed it shall be sufficient to keep the house without lying down for although he shall not sweat yet there will be a great dissipation of the vapors and venenate spirits by insensible transpiration for the Lues venerea by the only communication of these often times catcheth hold and propagates it self in lying with a bedfellow tainted therewith But as it is requisite to have let blood and purged the body by the advice of a Physician before the taking of the decoction of Guaicum so whilst he doth take it it much conduceth to keep the belly soluble which is much bound by the heat and driness of such a drink and to preserve the purity of the first veins by a glyster How long this decoct on must be used or laxative medicine taken every fifth or sixth day But for the use of it we muâ—â— warily observe taking indication not only from the malignity and contumacy of the disease but also from the particular nature of the patient for such as have their body wasted by heat and leanness and their skin drie and scaly whence you may gather a great adustion of the humors as it were a certain incineration of the habit of the body must more sparingly make use of these things but rather temper the body by humecting things taken inwardly and applyed outwardly as bathes ointments without Quick-silver and other such like things And then a very weak decoction of Guaicum shall be used for a few dâ—ies before your unction with Quick-silver A more plentiful diet The manner of diet as it draws forth the disease which of its own nature is long so a more sparing and slender diet makes the ulcers more rebellious and contumacious by a hectick dryness Therefore a middle course must be kept and meats made choice of which are fit and naturally engender good and laudable juice in the body For it is not only great ignorance but much mo e cruelty to go about to contain all patients without any difference within the strait allowance of four ounces of Ship-bisket and twelve damask prunes for I judg it far better to diet the patient with Lamb Veal Kid Pullets fat Larks and black-birds as those which have a greater familiarity with our bodies then Prunes and the like Junkets Let his bread be made of white wheat To whom and what manner of wine may be allowed well leavened neither too new or tough neither too old or hard Let his drink be made of the mass or strainings of the first decoction of Guaicum boiled with more water as was formerly mentioned yet if there arise any great weakness of the faculties you may permit the use of some little wine drinking especially before each a cup of the last mentioned decoction Let him avoid sleep presently after meat for so the head is filled with gross vapors Passions or perturbations of the minde must also be avoided for that by these the spirits are inflamed and dissipated all the delights of honest pleasure are to be desired but venery wholly avoided as that which weakens all the nervous parts The description of China Many instead of a decoction of Guaicum use a decoction of China Now this China is the root of a certain Rush knotty rare and heavy when it is fresh but light when it is waxed old it is also without smell whence many judge it void of any effectual quality it is brought into use out of India it is thus prepared it is cut into thin round slices boiled in fountain or river water and is given to patients to drink morning and evening after this manner â„ž rad chin in taleol The preparation sect â„¥ ii aquae font lbxii infundantur per hor. xii coquantur ad consumption tertiae partis Let him take â„¥ vi in the morning and so much at night let him expect a sweat in his bed a second decoction may be made of the mass remaining of the first but with a less quantity of water put thereto which also by longer boiling may draw forth the strength remaining in the mass and be used at meals for ordinary drink There are some who make a third decoction thereof but that is wholly unprofitable and unuseful Of Sarsaparilla Sarsaparilla is prepared also just after the same manner CHAP. IX Of the second manner of cureing the Lues Venerea which is performed by friction or unction THe cure of the Lues Venerea which is performed by unction and friction is more certain yet not in every kinde condition and season thereof For if the disease be inveterate from an humor tough gross viscous and more tenaciously fixed in the solid parts as you may gather by the knotty tumors of the bones for then we are so far from doing any good with a friction used at the first that on the contrary we bring the patient in danger of his life When the body
languisheth and becommeth dull By this we have delivered it may be perceived that the running of virulent strangury is not the running of a seminal humor fit for generation of issue but rather of a viscous and acrid filth which hath acquired a venenate malignity by the corruption of the whole substance CHAP. XVII Of the causes and differences of the scalding or sharpness of the urine The cause of a particular repletition of the privy parts THe heat or scalding of the water which is one kinde of the virulent strangury ariseth from some one of these three causes to wit repletition inanition and contagion That which proceeds from repletion proceeds either from too great abundance of blood or by a painful and tedious journy in the hot sun or by feeding upon hot acrid diuretick and flatulent meats causing tension and heat in the urinary parts whence proceeds the inflamation of them and the genital parts whence it happens that not only a seminal but also much other moisture may flow unto those parts but principally to the prostata which are glandules situate at the roots or beginning of the neck of the bladder in which place the spermatick vessels end also abstinence from venery causeth this plentitude in some who have usually had to do with women especially the expulsive faculty of the seminal and urinary parts being weak so that they are not of themselves able to free themselves from this burden For then the suppressed matter is corrupted and by its acrimony contracted by an adventitious and putredinous heat it causeth heat and pain in the passage forth The prostata swelling with such inflamed matter in process oftime become ulcerated the abscess being broken The purulent sanies dropping and flowing hence alongst the urinary passage causes the ulcers by acrimony which the urine falling upon exasperates whence sharp pain which also continueth for some short time after making of water and together therewith by reason of the inflamation the pains attraction and the vaporous spirits distension the yard stands and is contracted with pain as we noted in the former Chapter But that which happens through inanition The causes of the inanition of the genital parts is acquired by the moderate and unfit use of venery for hereby the oily and radical moisture of the fore-mentioned glandules is exhausted which wasted and spent the urine cannot but be troublesome and sharp by the way to the whole Vrethra From which sense of sharpe pain the scalding of the urine hath its denomination That which comes by contagion is caused by impure copulation with an unclean person or with a woman which some short while before hath received the tainted seed of a virulent person or else hath the whites or her privities troubled with hidden and secret ulcers or carrieth a virulent spirit shut up or hidden there which heated and resuscitated by copulation presently infects the whole body with the like contagion no otherwise then the sting of a Scorpion or Phalangium by casting a little poison into the skin presently infects the whole body the force of the poison spreading further then one would believe so that the party falls down dead in a short while after Thus therefore the seminal humor contained in the prostatae is corrupted by the tainture of the ill The reason of a contagious Strangury drawn thence by the yard and the contagion infects the part it self whence follows an abscess which â—asting forth the virulency by the urinary passage causeth a virulent strangury and the malign vapor carried up with some portion of the humor unto the entrials and principal parts cause the Lues Venerea CHAP. XVIII Prognosticks in a virulent Strangury WEe ought not to be negligent or careless in cureing this affect for of it proceed pernicious accidents as we have formerly told you and neglected A virulent Strangury continues with some during their lives it becoms uncurable so that some have it run out of their urinary passage during their lives oftimes to their former misery is added a suppression of the urine the prostatae and neck of the bladder being inflamed and unmeasurably swelled Copulation and the use of acrid or flatulent meats increase this inflamation and also together therewith cause an Ischuria or stoppage of the urine they are worse at the change of the Moon certain death follows upon such a stoppage An History as I observed in a certain man who troubled for ten years space with a virulent strangury at length died by the stoppage of his water He used to be taken with a stopping of his urine as often as he used any violent exercise and then he helped himself by putting up a silver Catheter which for that purpose he still carried about him it happened on a certain time that he could not thrust it up into his bladder wherefore he sent for me that I might help him to make water for which purpose when I had used all my skill it proved in vain when he was dead and his body opened his bladder was found full and very much distended with urine but the prostatae preternaturally swelled ulcerated and full of matter resembling that which formerly used to run out of his yard From what part the matter of a virulent strangury flows whereby you may gather that this virulency flows from the prostatae which runs forth of the yard in a virulent strangury and not from the reins as many have imagined Certainly a virulent strangury if it be of any long continuance is to be judged a certain particular Lues Venerea so that it cannot be cured unless by frictions with Hydragyrum But the ulcers which possess the neck of the bladder are easily discerned from these which are in the body or capacity thereof For in the latter the filth comes away as the patient makes water and is found mixed with the urine with certain strings or membranous bodies coming forth in the urine to these may be added the far greater stench of this filth which issueth out of the capacity of the bladder Now must we treat of the cure of both these diseases that is the Gonorrhoea and virulent Strangury but first of the former CHAP. XIX The chief heads of curing a Gonorrhoea LEt a Physician be called who may give direction for purging bleeding and diet if the affect proceed from a fulness and abundance of blood and seminal matter Diet. all things shall be shunned which breed more blood in the body which increase seed and stir to venery Wherefore he must abstain from wine unless it be weak and astringent and he must not onely eschew familiarity with women but their very pictures and all things which may call them to his remembrance especially if he love them dearly strong exercises do good For a Strangury occasioned by repletion as the carrying of heavy burdens even until they sweat swimming in cold water little sleep refrigerations of the loins and genital
appetite whereby they require many and several things without reason a great part of the nourishment being consumed by the worms lying there they are also subject to often fainting by reason of the sympathy which the stomach being a part of most exquisite sense hath with the heart the nose itches the breath stinks by reason of the exhalations sent up from the meat corrupting in the stomach through which occasion they are also given to sleep but are now and then waked there-from by sudden startings and fears they are held with a continued and slow fever a dry cough a winking with their eye-lids and often changeing of the colour of their faces But long and broad worms being the innates of the greater guts Signs of worms in the great guts Signs of Ascarides shew themselves by stools replenished with many sloughs here and there resembling the seeds of a Musk-melon or Cucumber Ascarides are known by the itching they cause in the fundament causing a sense as if it were Ants running up and down causing also a tenasmus and falling down of the fundament This is the cause of all these symptoms their sleep is turbulent and often clamorous when as hot acrid and subtill vapors raised by the worms from the like humor and their food are sent up to the head but sound sleep by the contrary as when a misty vapor is sent up from a gross and cold matter They dream they eat in their sleep for that while the worms do more greedily consume the chylous matter in the guts they stir up the sense of the like action in the phantasie They grate or gnash their teeth by reason of a certain colvulsifick repletion the muscles of the temples and jaws being distended by plenty of vapors A dry cough comes by the consent of the vitall parts serving for respiration which the natural to wit the Diaphragma or midriffe smit upon by acrid vapors and irritated as though there were some humor to be expelled by coughing These same acrid sumes assailing the orifice of the ventricle cause either an hicketting or else a fainting according to the condition of their consistence gross or thin these carried up to the parts of the face cause an itching of the nose a darkness of the sight and a sudden changeing of the colour in the cheeks Great worms are worse then little ones red then white living then dead many then few variegated then those of one colour as those which are signs of a greater corruption Why worms of divers colors are more dangerous Such as are cast forth bloody and sprinkled with blood are deadly for they shew that the substance of the guts is eaten asunder for oftimes they corrode and perforate the body of the gut wherein they are contained and thence penetrate into divers parts of the belly so that they have come forth sometimes at the navel having eaten themselves a passage forth as Hollerius affirmeth When as children troubled with the worms draw their breath with difficulty and wax moist over all their bodies it is a sign that death is at hand If at the beginning of sharp fevers round worms come forth alive it is a sign of a pestilent fever the malignity of whose matter they could not endure but were forced to come forth But if they be cast forth dead they are signs of greater corruption in the humors and of a more venenate malignity CHAP. V. What cure to be used for the Worms The general indications of cureing the worms IN this disease there is but one indication that is the exclusion or casting out of the worms either alive or dead forth of the body as being such that in their whole kind are against nature all things must be shunned which are apt to heap up putrefaction in the body by their corruption such as are crude fruits cheese milk-meats fishes and lastly such things as are of a difficult and hard digestion but prone to corruption Pap is fit for children for that they require moist things but these ought to answer in a certain similitude to the consistence and thickness of milk that so they may be the more easily concocted and assimilated and such only is that pap which is made with wheat flower not crude but baked in an oven that the pap made therewith may not be too viscid nor thick if it should only be boiled in a pan as much as the milk would require or else the milk would be too terrestrial or too waterish all the fatty portion thereof being resolved the cheesie and wayish portion remaining if it should boil so much as were necessary for the full boiling of the crude meat they which use meal otherwise in pap yield matter for the generating of gross and viscid humors in the stomach whence happens obstruction in the first veins and substance of the liver by obstruction worms breed in the guts and the stone in the kidnies and bladder The patient must be fed often and with meats of good juice lest the worms through want of nourishment should gnaw the substance of the guts Now when as such things breed of a putrid matter the patient shall be purged and the putrefaction represt by medicines mentioned in our Treatise of the Plague Wherefore and wherewith such as have the worms must be purged For the quick killing and casting of them forth syrup of succory or of Lemmons with rubarb a little treacle or methridate is a singular medicine if there be no fever you may also for the same purpose use this following medicine â„ž cornu cervi pul rasur ebâ—ris an Ê’i ss sem tanacet contra verm an Ê’i fiat decoctio pro parvâ dosi in colaturâ infunde rhei optimi Ê’i cinam ℈ i. dissolve syrupi de absinthio â„¥ ss make a potion give it in the morning three hours before any broth Oil of Olives drunk kills worms as also water of knot-grass drunk with milk and in like manner all bitter things Yet I could first wish them to give a glyster made of milk hony and sugar without oils and bitter things lest shunning thereof they leave the lower guts and come upwards for this is natural to worms to shun bitter things and follow sweet things Whence you may learn that to the bitter things which you give by the mouth you must alwaies mix sweet things that allured by the sweetness they may devour them more greedily that so they may kill them Harâ—s horn good against the worms Therefore I would with milk and suger mix the seeds of centaury Rue wormwood aloes and the like harts-horn is very effectual against worms wherefore you may infuse the shaveings thereof in the water or drink that the patient drinks as also to boil some thereof in his broths So also treacle drunk or taken in broth killeth the worms purslain boiled in broths and distilled and drunk is also good against the worms as also succory and mints also a
they have small store of spirits and native heat both which are dissipated by venery The nineteenth is the so great thickness of their gross and livid blood that if you wash it you may finde a sandy matter therein as some have found by experience by reason of the great adustion and assation thereof The twentieth is the languidness and weakness of the pulse by reason of the oppression of the vitall and pulsifick faculty by a cloud of gross vapors Herewith also their mine sometimes is thick and troubled like the urine of carriage-beasts if the urinary vessels be permeable and free otherwise it is thin if there be obstruction which only suffers that which is thin to flow forth by the urinary passages now the urine is oftentimes of a pale ash-colour and oftimes it smells like as the other excrements do in this disease Verily there are many other signs of the Leprosie as the slowness of the belly by reason of the heat of the liver often belchings by reason that the stomach is troubled by the reflux of a melancholick humor frequent sneezing by reason of the fulness of the brain to these this may be added most frequently Why their faces seem to be greasie that the face and all the skin is unctuous or greasie so that water poured thereon will not in any place adhere thereto I conceive it is by the internal heat dissolving the fat that lies under the skin which therefore alwaies looks as if it were greased or anointed therewith in leprous persons Now of these forementioned signs some are univocal that is which truly and necessarily shew the Leprosie other-some are equivocal or common that is which conduce as well to the knowledge of other diseases as this To conclude that assuredly is a Leprosie which is accompanied with all or certainly the most part of these fore-mentioned signs CHAP. VIII Of Prognostick in the Leprosie and how to provide for such as stand in fear thereof Why the Leprosie is incurable THe leprosie is a disease which passeth to the issue as contagious almost as the Plague scarce cureable at the beginning incureable when as it is confirmed because it is a Cancer of the whole body now if some one Cancer of some one part shall take deep root therein it is judged incureable Furthermore the remedies which to this day have been found out against this disease are judged inferiour and unequal in strength thereto Besides the signs of this disease do not outwardly shew themselves before that the bowels be seized upon possessed and corrupted by the malignity of the humor especially in such as have the white Leprosie sundry of which you may see about Burdeaux and in little Brittain who notwithstanding inwardly burn with so great heat that it will suddenly wrinkle and wither an apple held a short while in their hand as if it had laid for many daies in the sun There is another thing that increaseth the difficulty of this disease which is an equall pravity of the three principal faculties whereby life is preserved The deceitful and terrible visions in the sleep and numness in feeling argue the depravation of the animal faculty now the weakness of the vitall faculty is shewed by the weakness of the puls the obscurity of the hoarse and jarring voice the difficulty of breathing and stinking breath the decay of the natural is manifested by the depravation of the work of the liver in sanguification whence the first and principal cause of this harm ariseth The cure Now because we cannot promise cure to such as have a confirmed Leprosie and that we dare not do it to such as have been troubled therewith but for a short space it remains that we briefly shew how to free such as are ready to fall into so fearful a disease Such therefore must first of all shun all things in diet and course of life whereby the blood and humors may be too vehemently heated The Diet. whereof we have formerly made some mention Let them make choice of meats of good or indifferent juice such as we shall describe in treating of the diet of such as are sick of the plague purging bleeding bathing cupping to evacuate the impurity of the blood and mitigate the heat of the Liver shall be prescribed by some learned Physician Gelding good against the leprosie Valesius de Tarenta much commends gelding in this case neither do I think it can be disliked For men subject to this disease may be effeminated by the amputation of their testicles and so degenerate into a womanish nature and the heat of the liver boiling the blood being extinguished they become cold and moist which temper is directly contrary to the hot and dry distemper of leprous persons besides the leprous being thus deprived of the faculty of generation that contagion of this disease is taken away which spreadeth and is diffused amongst mankind by the propagation of their issue The end of the twentieth Book The ONE and TVVENTIETH BOOK Of Poysons and of the Biting of a mad Dog and the Bitings and Stingings of other venomous Creatures CHAP. I. The cause of writing this treatise of Poysons FIve reasons have principally moved me to undertake to write this Treatise of poysons ac-according to the opinion of the antients The first is that I might instruct the Surgeon what remedies must presently be used to such as are hurt by poysons in the interim whilst greater means may be expected from a Physician The second is that he may know by certain signs and notes such as are Poysoned or hurt by poysonous meats and so make report thereof to the judges or to such as it may concern The third is that those Gentlemen and others who live in the country and far from Cities and store of greater means may learn somthing by my labour by which they may help their friends bitten by an Adder mad Dog or other poysonous creature in so dangerous sudden and unusual a case The fourth is that every one may beware of poysons and know their symptoms when present that being known they may speedily seek for a remedy The fifth is that by this my labour all men may know what my good will is and now well minded I am towards the common-wealth in general and each man in particular to the glory of God I do not here so much arm malicious and wicked persons to hurt as Surgeons to provide to help and defend each mans life against poyson which they did not understand or at least seemed not so to do which taking this my labour in evil part have maliciously interpreted my meaning But now at length that we may come to the matter I will begin at the general division of poysons and then handle each species thereof severally but first let us give this Rule What is to be accounted poyson That poyson is that which either outwardly applied or struck in or inwardly taken into the body hath
into the bowels All things that resist poison must be given any way whatsoever as lemons oranges angelica-roots gentian tormentil burnet vervain cardus benedictus borage bugloss and the like Let all things that are afterwards set before the patient be meats of good juice such as ate veal kid mutton patridg pullets capons and the like CHAP. XVI Of the biting of a Viper or Adder and the symptoms and cure thereof THe remedies that were formerly mentioned against the bitings of mad dogs the same may be used against all venomous bites and stings yet nevertheless each poison hath his peculiar antidote Vipers or Adders as we vulgarly term them have in their gums The bites of vipers how virulent or the spaces between their teeth little bladders filled with a virulent sanies which is pressed out into the part that they bite with their teeth There forthwith ariseth a pricking pain The symptoâ— the part at the first is much swollen and then the whole body unless it be hindred gross and bloody filth sweats out of the wound little blisters rise round about it as if it were burnt the wound gnaws and as it were feeds upon the flesh great inflammation possesseth the liver and the guts and the whole body becomes very dry becoming of a pale or yellowish colour with thirst unquenchable the belly is griped by fits a cholerick vomiting molesteth them the stomach is troubled with a hicketting the patients are taken with often swoundings with cold sweat the fore-runner of death unless you provide by fit medicines for the noble parts before the poison shall invade them Matthiolus tells that he saw a country-man who as he was mowing a meadow An history by chance cut an Adder in two with his sithe which when he thought it was dead he took the one half whereon the head remained without any fear in his hand but the enraged creature turning about her head cruelly bit him by one of his fingers which finger as men usually do especially when as they think of no such thing he put into his mouth and sucked out the blood and poison and presently fell down dead When as Charls the ninth was at Montpelier An history I went into the shop of one Farges an Apothecary who then made a solemn dispensation of Treacle where not satisfying my self with the looking upon the Vipers which were there in a glass ready for the composition I thought to take one of them in my hands but whilst that I too curiously and securely handled her teeth which were in her upper jaw covered with a skin as it were a case to keep the poison in the beast catched hold of the very end of my fore-finger and bit me in the space which is between the nail and the flesh whence presently there arose great pain both by reason of the part endued with most exquisite sense as also by the malignity of the poison forthwith I exceeding straitly bound my finger above the wound that so I might press forth the blood and poison lest they should diffuse themselves further over the body Remedies for the bite of a viper I dissolved old Treacle in aqua vitae wherein I dipped and moistned cotton and so put it to the wound and within a few daies I throwly recovered by this only medicine You may use in stead of Treacle Mithridate and sundry other things which by reason of their heat are powerful drawers as a quill rosted in hot embers garlick and leeks beaten and applied barly-flowr tempered with vinegar hony and goats-dung and so applied like a pult is Some think it sufficient forthwith to wash and foment the wound with vinegar salt and a little honey Galen writes that the poison inflicted by the bite of a viper Lib. de theriac may be drawn forth by applying to the wound the head of a viper but othersome apply the whole viper beaten to mash CHAP. XVII Of the Serpent called Haemorrhous The Haemorrhous why so called THe Serpent Haemorrhous is so called because by biting he causeth blood to drop out of all the passages of the wounded body he is of a small body of the bigness of a viper with eies burning with a certain fiery brightness and a most beautiful skin The back of him as Avicen writes is spotted with many black spots his neck little and his tail very small the part which he bites forthwith grows blackish by reason of the extinction of the native heat which is extinguished by such poison which is contrary thereto in its whole substance Then follows a pain of the stomach and heart these parts being touched with the pestiferous quality of the poison These pains are seconded by vomiting the orifice of the ventricle being relaxed by a Diarrhaea the retentive faculty of all the parts of the belly being weakned and the veins which aâ—e spread through the guts Wonderful bleedings not being able to retain the blood contained in them For the blood is seen to slow out as in streams from the nose mouth ears fundament privities corners of the eies roots of the nails and gums which putrefie the teeth falling out of them Moreover there happens a difficulty of breathing and stoppage of the urine with a deadly convulsion The cure is forthwith to scarisie and burn the bitten part or else to cut it quite off if that it may be done without danger of life and then to use powerfully drawing Antidotes The figure of the Serpent Haemorrhous CHAP. XVIIII Of the Serpent called Seps The reason of the name and description of the Seps THe Serpent Seps is so called because it causeth the part which it bites forthwith to putrefie by reason of the cruel malignity of its poison It is not much unlike the Haemorrhous but that it curls or twines up the tail in divers circles Pausanias writes that this serpent is of an ash colour a broad head small neck big belly writhen tail and as he goes he runs aside like a crab But his skin is variegated and spotted with several colours like to Tapistry By the cruelty of his caustick and putrefying venom he burns the part which he hath bit with most bitter pain he causeth the shedding of the hairs and as Aetius addeth the wound at the first casteth forth manifest blood The symptoms but within a little while after stinking filth The putrefied affected parts wax white and the body all over becomes of the colour of that scurf which is termed Alphos so that by the wickedness of this putrefactive poison not only the spirits are resolved but also the whole body consumed as by fire a pestilent carbuncle and other putrid tumors arising from an hot and humid or suffocating constitution of the air Now for the remedies they must be such as are formerly prescribed against the bitings of a viper The figure of the Serpent Seps CHAP. XIX Of the Basiliske or Cockatrice THe Basilisk far exceeds all kinds
they let him feed on veal kid and pork boiled with lettuce purslain barly and violet leaves the which by their humidity might relax the belly and by their toughnesse lenifie the roughness of asperity they applied also refrigerating things to the loins share and perinoeum to asswage the heat of the urine At length they put him into a warm bath and to conclude they left nothing unattempted to draw forth or weaken the poison But all their endeavors were in vain for the Abbot died not being destitute of remedies conveniently prescribed but overcome by the contumacious malignity of the poison An history The Physicians pains had far better success in a certain Gentlewoman against this kind of affect her whole face was deformed with red fiery and filthy pullies so that all shunned her company as if she had been troubled with a Leprosie and were ready to forbid her the society of men she came to Paris and calling Hollerius and Grealmus Physicians me and Caballus being Surgeons she made a grievous complaint and besought us earnestly for some remedy against so great a deformity of her face having diligently considered her case we pronounced her free from a Leprosie but we judged it fit to apply to her whole face a veficatory of Cantharides Cantharides applied to the head ulcerate the bladder three or four hours after the application whereof the medicine being come to work its effect her bladder began to burn exceedingly and the neck of her womb to swell with gripings continual vomitings making of water and scowring a troublesome agitation of the body and members a burning and absolutely fiery fever I forthwith called the Phisicians it was decreed that she should drink wine plentifully and that it should be injected by the fundament into the guts and by the urinary passage into the bladder and the neck of the womb and that she should keep her self untill the pain were mitigated in a warm bath made of the decoction of Line-seeds the roots and leavs of mallows marsh-mallows violets heâ—bane purslain and lettuce and her loins and genitals should be anointed with unguentum rosatum and populeon stirred and incorporated with oxyorate By these means all the symptoms were mitigated A remedy against Leprous pustles Her face in the interim rose all in a blister and much purulent matter came out thereof and so the deformity wherewith she was formerly troubled vanished away for ever so that within a while after she was married and had many children and is yet living in perfect health Buprestes also are of the kind of Cantharides being like unto them in shape and faculty If an Ox or sheep or any other creature shall in feeding devour one of them he will presently swell up like a Tun The reason of the name whence also they take their name if a man take them inwardly he shall endure the like symptoms as in taking Cantharides and over and besides both his stomach and his whole belly shall be wonderfully puffed up as if he had a Dropsie It is probable that this inflation like a tympany happeneth by humors diffused and resolved into vapors by the fiery acrimony of the venom They are to be cured after the same manner as such as have drunk Cantharides Lastly as in all other poisons which are taken into the body so also here if the poison taken by the mouth be thought as yet to be in the stomach you must then procure vomit If it be gotten into the guts then must it be drawn away by glisters if diffused over all the body then must you make use of such things as may drive the poison forth from the center to the circumference such as are baths and stoves CHAP. XXIX Of Hors-leeches HOrs-leeches are also venomous especially such as live in muddy stinking ditches What hors-leeches mosâ— virulent for these are less hurtful which reside in clear and pure waters Wherefore before they are to be used in cases of physick they must be kept for some daies space in clean water that so they may purge themselves otherwise they may chance to leave ulcers hard to cure in the places whereto they shall be applied and the rather if they be violently plucked off because they by that means leave their teeth fastned in the part Now he which by chance hath swallowed a Hors-leech must be asked in what part he feeleth her that is the sense of her sucking Divers remedies according to the diversity of the parts For if she stick in the top of the throat or gullet or in the midst thereof the part shall be often washed with mustard dissolved in vinegar If she be near the orifice of the ventricle it is fit that the patient by little and little swallow down oil with a little vinegar But if she fasten to the stomach or the bottom of the ventricle the patient by the plucking oft the part shall perceive a certain sense of sucking the patient will spit blood and will for fear become melancholik To force her thence he shall drink warm water with oil but if she cannot so be loosed then shall you mix aloes therewith or some thing endued with the like bitterness for she will by that means leave her hold and so be cast forth by vomit You may perceive this by such as are applied to the skin on the external parts for by the aspersion of bitter things whether they be full or empty they will forsake their hold Then shall the patient take astringent things which may stop the blood flowing forth of the bitten part such is Conserve of Roses with terra sigillata Bole-Armenick and other more astringent things if need so require For if they shall adhere to some greater branch of some vein or artery it will be more difficult to stop the flowing blood But for that not the earth only but the sea also produceth venomous creatures we will in like fort treat of them as we have already done of the other beginning with the Lampron CHAP. XXX Of the Lampron THe Lampron called in Latine Muraena is a sea-fish something in shape The description of the Lampron resembling a Lamprey but she is bigger and thicker and hath a larger mouth with teeth long sharp and bending inwards she is of a dusky colour distinguished with whitish spots and some two cubits length the Antients had them in great esteem because they yield good nourishment and may be kept long alive in pools or ponds and so taken as the owners please to serve their table as it is sufficiently known by the history of the Roman Crassus She by her biting induceth the same symptoms as the viper and it may be helped by the same means The natural friendship of the Lampron and Viper Verily the Lampron hath such familiarity with the Viper that leaving her natural element the sea she leapeth ashoar and seeketh out the Viper in her den to join with her in copulation as
is delivered by Galen Colchicum or Medow-Saffron Ephemerum which some call Colchicum or Bulbus sylvestris that is medow saffron being taken inwardly causeth an itching over all the body no otherwise then those that are nettled or rubbed with the juice of a Squill Inwardly they feel gnawings their stomach is troubled with a great heaviness and in the disease encreasing there are strakes of blood mixed with the excrements The Antidote The Antidote thereof is womans milk Asses or Cows-milke drunken warm and in a large quantity Mandrag Mandrag taken in great quantity either the root or fruit causeth great sleepines sadness resolution and languishing of the body so that after many scritches and gripings that patient falls asleep in the same posture as he was in just as if he was in a Lethargy Wherefore in times past they gave Mandrag to such as were to be dismembred The apples when as they are ripe and their seeds taken forth may be safely eaten for being green and with their seeds in them they are deadly For there ariseth an intolerable heat which burns the whole surface of the body the tongue and mouth wax dry by reason whereof they gape continually so take it in the cold air and in which case unless they be presently helped they die with convulsions But they may easily be helped if they shall presently drink such things as are convenient therefore The cure Amongst which in Conciliatorâ— opinion excell raddishseeds eaten with salt and bread for the space of three dayes Sreesing shall be procured if the former remedy do not quickly refresh them and a decoction of Coriander or Pennie-roy all in fair water shall be given them to drink warm Opium Why not used in poysonings The ungrateful taste of the juice of black poppy which is termed Opium as also of Mandrag easily hinders them from being put into meat or drink but that they may be discerned and chiefly for that neither of them can kill unless they be taken in a good quantity But because there is danger lest they be given in greater quantity then is fitting by the ignorance of Physicians or Apothecaries you may by these signs finde the error Thesâ—mâ— to 〈◊〉 There ensues heavy sleep with a vehement itching so that the patient oft-times is forced thereby to cast off his dull sleep wherein he lay yet he keeps his eie-lids shut being unable to open them By this agitation there flows out sweat which smells of â—riâ—m the body waxeth pale the lips burn the jawbone is relaxed they breath little and seldom When as their eies wax livid unless they be drawn aside and that they are depressed from their orb we must know that death is at hand The remedy against this is two drams of the powder of Castoreum given in wine Hemlock drunken causeth Vertigos troubleth the minde Hemlock The symptom so that the patients may be taken for mad men it darkneth the sight causeth hicketting and benums the extreme parts lastly strangles with convulsions by suppressing or stopping the breath of the Artery Whereof at the first as in other poysons you must endeavor to expell it by vomit then inject glysters to expell that which is got into the guts then use wine without mixture which is very powerful in this case Peter Aponensis thinks the Bezoar or Antidote thereof to be a potion of two drams of Treacle The Antidote with a decoction of Dictamnus or Gentian in wine He which further desires to inform himself of the effects of Hemlock let him read Matthiolus his commentary upon Dioscorides In lib. 6. diosc where he treats of the same subject Aconitum called of Aconis a town of the Periendines whereas it plentifully grows Aconitum According to Matthiolus it kills Wolves Foxes Dogs Cats Swine Panthers Leopards and all wilde beasts mixed with flesh and so devoured by them but it kills mice by onely smelling thereto Scorpions if touched by the root of Aconite grow numme and torpid and so die thereof arrows or darts dipped therein make incureable wounds Those who have drunk Aconite their tongue forthwith waxeth sweet with a certain astriction which within a while turneth to bitterness it causeth a Vertigo and shedding of tears and a heaviness or straitness of the chest and parts about the heart it makes them break wind downwards and makes aâ—l the body to tremble Lib. 27. cap. 2. Pliny attributes so great celerity and violence to this poyson that if the genitals of female creatures bee touched therewith it will kill the same day there is no presenter remedy then speedy vomiting after the poyson is taken But Conciliator thinks Aristolochia to be the Antidote thereof Yet some have made it useful for man by experimenting it against the stinging of Scorpions Aconite good against the poison of Scorpions being given warm in wine For it is of such a nature that it killeth the party unless it finde something in him to kill for then it strives therewith as if it had found an adversary But this fight is onely when as it finds poyson in the body and this is marvelous that both the poysons being of their own nature deadly should die together that man may by that means live There are divers sorts thereof one whereof hath a flower like an helmet as if it were armed to mans destruction The differences but the other here delineated hath leavs like to sows-bread or a cucumber and a root like the tail of a Scorpion The figure of a Certain kind of Aconite Trees also are not without poyson The Yew as the Yew and Walnut tree may witness Cattle if they feed on the leaves of Yew are killed therewith * This is true in some countries as in provence Italy Greece c. but it is not so here with us in England as both Lobeâ— and daily experience can testifie But men if they sleep under it or sit under the shadow thereof are hurt therewith and oft-times die thereof But if they eat it they are taken with a bloody flux and a coldness over all their bodies and a kind of strangling or stoppage of their breath All which things the Yew causeth not so much by an elementary and cold quality as by a certain occult malignity whereby it corrupteth the humors and shaveth the guts The same things are good against this The Antidote as we have set down against Hemlock Nicander affirms that good wine being drunken is a remedy thereto There is also malignity in a Wall-nut-tree The Wall-nut tree which Grevinus affirms that he found by experience whilst he unawares sate under one and slept there in the midst of Summer For waking he had a sence of cold over all his body a heaviness of his head and pain that lasted six dayes The remedies are the same as against the Yew CHAP. XXXVI Of Bezoar and Bezoartick medicines What poyson is FOR that we
emplasters and so applied it asswageth pain by stupefaction hindering the acrimony of pustles and cholerick inflammations But by its humidity it softneth scirrhous tumors dissolveth and dissipateth knots and tophous knobs besides it causeth the breath of such as are annointed therewith to stink by no other reason then that it putrefies the obvious humor by its great humidity Avicens experiment confirms this opinion who affirmeth that the blood of an Ape that drunk Quick-silver was found concrete about the heart the carcass being opened In l. 6 Dios c. 28 Matthiolus moved by these reasons writes that Quick-silver killeth men by the excessive cold and humid quality if taken in a large quantity because it congeals the blood and vital spirits and at length the very substance of the heart as may be understood by the history of a certain Apothecary An history set down by Conciliator who for to quench his severish heat in stead of water drunk of a glass of Quick-silver for that came first to his hands he died within a few hours after but first he evacuated a good quantity of the Quick-silver by stool the residue was found in his stomach being opened and that to the weight of one pound besides the blood was found concrete about his heart Others use another argument to prove it cold and that is drawn from the composition thereof because it consists of Lead and other cold metals But this argument is very weak For unquencht Lime is made of flints and stony matter which is cold yet nevertheless it exceeds in heat Lib. 4. de nat rerum Paracelsus affirmeth that Quick-silver is hot in the interior substance but cold in the exterior that is cold as it comes forth of the Mine But that coldness to be lost as it is prepared by art and heat only to appear and be left therein so that it may serve instead of a tincture in the trans-mutation of metals And verily it is taken for a Rule amongst Chymists that all metals are outwardly cold by reason of the watery substance that is predominant in them but that inwardly they are very hot which then appears when as the coldness together with the moisture is segregated for by calcination they become caustick Moreover many account quick-silver poison Tract de casu offen yet experience denies it For Marianus Sanctus Boralitanus tells that he saw a woman who for certain causes and effects would at several times drink one pound and a half of quicksilver which came from her again by stool without any harm Moreover he affirmeth that he hath known sundry who in a desperate Colick which they commonly call miserere mei have been freed from imminent death by drinking three pounds of quick-silver with water only For by the weight it opens and unfolds the twined or bound up gut nnd thrusts forth the hard and stopping excrements he addeth that others have found this medicine effectual against the colick drunk in the quantity of three ounces Antonius Musa writes that he usually giueth Quick-silver to children ready to die of the worms Avicen confirmeth this averring that many have drunk Quick-silver without any harm wherefore he mixeth it in his ointments against scales and scabs in little children whence came that common medicine amongst country people to kill lice by annointing the head with Quick-silver mixed with butter or axungia Quick-silver good for women in travel Matthiolus affirmeth that many think it the last and chiefest remedy to give to women in travel that cannot be delivered I protest to satisfie my self concerning this matter I gave to a whelp a pound of Quick-silver which being drunk down it voided without any harm by the belly Whereby you may understand that it is wholly without any venomous quality Verily it is the only and true Antidote of the Lues Venerea and also a very fit medicine for all malign ulcers as that which more powerfully impugns their malignity then any other medicines that work only by their first qualities For the disease called Malum sancti manis Besides against that contumacious scab which is vulgarly called Malum sancti manis there is not any more speedy or certain remedy Moreover Guido writes that if a plate of lead be besmeared or rubbed there with and then for some space laid upon an ulcer and conveniently fastned that it will soften the callous hardness of the lips thereof and bring it to cicatrization which thing I my self have often times found true by experience Lib. de comp med socurd loc Against malign ulcers Certainly before Guido Galen much commended Quick-silver against malign ulcers and cancers Neither doth Galen affirm that lead is poisonous which many affirm poisonous becaus it consists of much Quick-silver but he only saith thus much that water too long kept in leaden pipes cisterns by reason of the drossiness that it useth to gather in lead causeth bloody fluxes which also is familiar to brass and copper Otherwise many could not without danger bear in their bodies leaden bullets during the space of so many years as usually they do It is reported It is declared by Theodoret Herey in the following histories how powerful Quick-silver is to resolve and asswage pain and inflamations Not long since Against the Parotides saith he a certain Doctor of Physick his boy was troubled with parotides with great swelling heat pain and beating to him by the common consent of the Physicians there present I applied an Anodine medicine whose force was so great that the tumor manifestly subsided at the first dressing and the pain was much asswaged At the second dressing all the symptoms were more mitigated At the third dressing I wondring at the so great effect of an Anodine Cataplasm observed that there was Quick-silver mixed therewith and this happened through the negligence of the Apothecary who mixed the simple Anodine medicine prescribed by us in a mortar wherein but a while before he had mixed an ointment whereinto Quick-silver entred whose reliques and some part thereof yet remained therein This which once by chance succeeded well I afterwards wittingly and willingly used to a certain Gentlewoman troubled with the like disease possessing all the region behind the ears much of the throat and a great part of the cheek when as nature helped by common remedies could not evacuate neither by resolution nor suppuration the contained matter greatly vexing her with pain and pulsation I to the medicine formerly used by the consent of the Physicians put some Quick-silver so within a few daies the tumor was digested and resolved But some will say it resolves the strength of the nerves and limbs as you may see by such as have been anointed therewith for the Lues Venerea who tremble in all their limbs during the rest of their lives This is true if any use it too intemperately without measure and a disease that may require so great a remedy for thus we see the Gilders
hinder natures diligence and care of concoction For as in the Dog-Dayes the lees of wine subsiding to the bottom are by the strength and efficacie of heat drawn up to the top and mixed with the whole substance of the wine as it were by a certain ebullition or working so melancholick humors being the dregs or lees of the blood stirred by the passions of the minde defile or taint all the blood with their seculent impurity We found that some years agon by experience at the battle of S. Dennis For all wounds by what weapon soever they were made degenerated into great and filthy putrefactions and corruptions with severs of the like nature and were commonly determined by death what medicines and how diligently soever they were applied which caused many to have a false suspicion that the weapons on both sides were poysoned But there were manifest signs of corruption and putrefaction in the blood let the same day that any were hurt and in the principal parts disected afterwards that it was from no other cause then an evil constitution of the air and the mindes of the Souldiers perverted by hate anger and fear CHAP. V. What signs in the Air and Earth prognosticate a Plague WEe may know a plague to be at hand and hang over us if at any time the air and seasons of the year swerve from their natural constitution after those waies I have mentioned before if frequent and long continuing Meteors or sulphureous Thunders infect the air Why abortions are frequent in a pestilent season if fruits seeds and pulie be worm-eaten If birds forsake their nests eggs or young without any manifest cause if we perceive women commonly to abort by continual breathing in the vaporous air being corrupted and hurtful both to the Embryon and original of life and by which it being suffocated is presently cast forth and expelled Yet notwithstanding those airy impressions do not solely courrupt the air but there may be also others raised by the Sun from the filthy exhalations and poysonous vapors of the earth and waters or of dead carkasses which by their unnatural mixture easily corrupt the air subject to alteration as that which is thin and moist from whence divers Epidemial diseases and such as are every-where seize upon the common sort according to the several kinds of corruptions A Catarrh with difficulty of breathing killing many such as that famous Catarrh with difficulty of breathing which in the year 1510 went almost all over the world and raged over all the Cities and Towns of France with great heaviness of the head whereupon the French named it Cuculla with a straitness of the heart and lungs and a cough a continual fever and sometimes raving This although it seized upon many more then it killed yet because they commonly died who were either let blood or purged it shewed it self pestilent by that violent and peculiar and unheard of kinde of malignity The English Sweating-sickness Such also was the English Sweating-sickness or Sweating-fever which unusual with a great deal of terror invaded all the lower parts of Germany and the Low-Countries from the year 1525 unto the year 1530 and that chiefly in Autumn As soon as this pestilent disease entred into any City suddenly two or three hundred fell sick on one day then it departed thence to some other place The people strucken with it languishing fel down in a swound and lying in their beds sweat continually having a fever a frequent quick and unequal pulse neither did they leave sweating till the disease left them which was in one or two daies at the most yet freed of it they languished long after they all had a beating or palpitation of the heart which held some two or three years and others all their life after At the first beginning it killed many before the force of it was known but afterwards very few when it was found out by practice and use that those who furthered and continued their sweats and strengthened themselves with cordials were all restored But at certain times many other popular diseases sprung up as putrid fevers fluxes bloody-fluxes catarrhs coughs phrenzies squinances plurisies inflamations of the lungs inflamations of the eies apoplexies lithargies The Plague is not the definite name of one disease small pox and meazles scabs carbuncles and malign pustles Wherefore the Plague is not alwaies nor every-where of one and the same kinde but of divers which is the cause that divers names are imposed upon it according to the variety of the effects it brings and symptoms which accompany it and kinds of putrefaction and hidden qualities of the air What signs in the earth foreteâ—l a plague They affirm when the Plague is at hand that Mushroms grow in greater abundance out of the Earth and upon the surface thereof many kinds of poysonous insecta creep in great numbers as Spiders Catterpillers Butter-flies Grass-hoppers Beetles Hornets Wasps Flies Scorpions Snails Locusts Toads Worms and such things as are the off-spring of putrefaction And also wilde beasts tired with the voporous malignity of their dens and caves in the Earth forsake them and Moles Toads Vipers Snakes Lizards Asps and Crocodiles are seen to flie away and remove their habitations in great troops For these as also some other creatures have a manifest power by the gift of God and the instinct of Nature to presage changes of weather as rains showrs and fair weather and seasons of the year as the Spring Summer Autumn Winter which they testifie by their singing chirping crying flying playing and bearing with their wings and such like signs so also they have a perception of a Plague at hand And moreover the carkasses of some of them which took less heed of themselves suffocated by the pestiferous poyson of the ill air contained in the earth may be every-where found not onely in their dens but also in the plain fields These vapors corrupted not by a simple putrefaction but an occult malignity How pestilent vapors may kill plants and trees are drawn out of the bowels of the earth into the air by the force of the Sun and Stars and thence condensed into clouds which by their falling upon corn trees and grass infect and corrupt all things which the earth produceth and also kills those creatures which feed upon them yet brute beasts sooner then men as which stoop and hold their heads down towards the ground the maintainer and breeder of this poyson that they may get their food from thence Therefore at such times skilful husbandmen taught by long experience never drive their Cattle or Sheep to pasture before that the Sun by the force of his beams hath wasted and dissipated into air this pestiferous dew hanging and abiding upon the boughs and leaves of trees herbs corn and fruits But on the contrary that pestilence which proceeds from some malign quality from above by reason of evil and certain conjunction of the Stars is
his belly and make him to sweat Truly those that are wounded or bit with venomous beasts If they bind broom above the wound it will prohibit or hinder the venom from dispersing it self or going any further therefore a drink made thereof will prohibit the venom from going any nearer the heart Some take of the root of Elecampane Gentian Tormentil Kermes-berries and broom of the powder of Ivory and Harts-horn of each half a dram they do bruise and beat all these and infuse them for the space of four and twenty hours in white wine and aqua vitae on the warm embers and then strain it and give the patient three or four ounces thereof to drink this provokes sweat and infringeth the power of the poysons and the potion following hath the same virtue Take good Mustard half an ounce of Treacle or Mithridate the weight of a bean A Potion dissolve them in white wine and a little aqua vitae and let the patient drink it and sweat thereon with walking You may also roast a great Onion made hollow and filled with half a dram of Treacle and vinegar under the embers and then strain it and mix the juice that is pressed out of it with the water of Sorrel Carduus Benedictus or any other cordial thing and with strong wine and give the paticet to drink thereof to provoke sweat to repel the malignity Or else take as much Garlick as the quantity of a Nut of Rue and celandine of each twenty leaves bruise them all in white wine and a little aqua vitae then strain it and give the patient thereofto drink There besome that do drink the juice that is pressed out of Celandine and Mallows with three ounces of Vinegar and half an ounce of the oil of Wall-nuts and then by much walking do unburthen their stomach and belly upwards end downwards and so are helped When the venomous air hath already crept into and infected the humors one dram of the dried leaves of the Bay-tree macerated for the space of two dayes in Vinegar and drunk is thought to be a most soveraign medicine to provoke sweat loosnes of the belly and vomiting Matthiolus in his Treatise de Morbo gallico writeth that the powder of Mercury ministred unto the patient with the juice of Carduus Benedictus or with the Electuary de Gemmis will drive away the pestilence before it be confirmed in the body by provoking vomit loosness of the belly and seat one dram of Calcauchum of white Copperas dissolved in Rose-water performeth the like effect in the same disease Some do give the patient a little quantity of the oil of Scorpions with white wine to expel the the poyson by vomit and therewithall they annoint the region of the heart the breast and the wrists of the hands I think these very meet to be used often in bodies that are strong and well exercised because weaker medicines do evacuate little or nothing at all but only move the humors whereby cometh a Fever When a sufficient quantity of the malignity is evacuated then you must minister things that may strengthen the belly and stomach and with-hold the agitation or working of the humors and such is the confection of Alkermes CHAP. XXVI Of many Symptoms which happen together with the Plague and first of the pain of the head The cause of phrensie in the Plague IF the malignity be carried into the brain and nature be not able to expel it it inflames not only it but also the menbranes that cover it which inflamation doth one while hurt trouble or abolish the imagination another while the judgment and sometimes the memory according to the situation of the inflamation whether it be in the former or hinder or middle part of the head but hereof cometh alwaies a Phrensie with fiery redness of the eies and face and heaviness and burning of the whole head If this will not be amended with Clysters and with opening the Cephalick vein in the arm the arteries of the Temples must be opened taking so much blood out of them The benefit of opening an artery as the greatness of the Symptoms and the strength of the patient shall require and permit Truly the incision that is made in opening an arterie will close and joyn together as readily and with as little difficulty as the incision of the vein And of such an incision of an artery cometh present help by reason that tensive and sharp vapours do plentifully breath out together with the arterious blood It were also very good to provoke a flux of blood at the nose Aph. 10. sect 6. if nature be apt to exonerate her self that way For as Hippocrates saith when the head is grieved or generally aketh if matter water or blood flow out at the nostrils mouth or ears it presently cures the disease Such bleeding is to be provoked by strong blowing or striving to cleanse the nose by scratching or pricking of the inner side of the nostrils by pricking with an hors hair and long holding down of the head An history The Lord of Fontains a Knight of the Order when we were at Bayon had a bleeding at the nose which came naturally for the space of two dayes and thereby be was freed of a pestilent Fever which he had before a great sweat arising there-withall and shortly after his Carbuncles came to suppuration To stay bleeding and by Gods grace he recovered his health being under my cure If the blood do flow out and cannot be stopped when it ought the hands arms and legs must be tied with hands and sponges wet in Oxycrate must be put under the arm-holes cupping glasses must be applied unto the dugs the region of the Liver and Spleen and you must put into the nostrils the doun of the willow-tree or any other astringent medicine incorporated with the hairs plucks from he flank belly or throat of an Hare Bole-Armenick Terra Sigillata the juice of Plantaine and Knot-grass mixed together and furthermore the patient must be placed or laied in a cool place But if the patient be nothing mitigated notwithstanding all these fluxes of blood we must come to medicines that procure sleep whose forms are these Medicines to procure sleep Take of green Lettuce one handful flowers of water-Lillies and Violets of each two pugils one head of white-Poppy bruised of the four cold seeds of each two drams of Liquorice and Raisins of each one dram make thereof a decoction and in the straining dissolve one ounce and a half of Diacodium make thereof a large potion to be given when they go to rest Also Barly-cream may be prepared in the water of water-Lillies and of Sorrel of each two ounces adding thereto six or eight grains of Opium of the four cold seeds and of white-Poppy seeds of each half an ounce and let the same be boiled in broth with Lettuce and Purslain also the pils de Cynoglesso i. e. Hounds-tongue
four ounces of Basilicon two ounces three yelks of egs oil of Lillies two ounces Treacle one dram let it be received on stupes and applied in like manner Or take of Diachylon and Basilicon of each two ounces oil of Lillies one ounce and an half let them be melted and mixed tegether and let it be applyed as is abovesaid When you see feel and know according to reason that the Bubo is come to perfect suppuration it must be opened with an incision-knife Why it is best to open a plague sore with a potential cautery or an actual or potential Cautery but it is best to be done with a potential Cautery unless that happily there be great inflammation because it doth draw the venom from beneath unto the superficial parts and maketh a larger orifice for the matter that is contained therein neither must it be looked for that nature should open it of her self for then there were danger that lest while nature doth work slowly a venomous vapour should be stirred up which striking the heart by the arteries the brain by the nerves and the liver by the veins should cause a new increase of the venomous infection For fear whereof there be some that will not expect the perfect maturation and suppuration but as it were in the midst of the crudity and maturity will make an orifice for it to pass forth at yet if it be done before the tumour be at his perfect maturity pain a Fever and all accidents are stirred up and enraged whereof cometh a malign ulcer that often degenerates into a Gangrene For the most part about the tenth or eleventh day the work of suppuration seemeth perfected and finished but it may be sooner or later by reason of the application of medicines the condition of the matter and state of the part when the matter cometh forth you must yet use suppurative and mollifying medicines to maturate the remains thereof in the mean while clensing the ulcer by putting mundificatives into it as we shall declare in the cure of Carbuncles But if the tumor seem to sink in How to draw forth a sore that sâ—ems to go in again or hide it self again it must be revoked and procured to come forth again by applying of Cupping glasses with scarification and with sharp medicines yea and with Cauteries both actual and potential When the Cauteries are applied it shall be very good to apply a vesicatory a little below it that there might be some passage open for the venom while the Eschar is in falling away For so they that are troubled with the French-Pox so long as they have open and flowing ulcers so long are they void of any pain that is worth the speaking of which ulcers being closed and cicatrized they do presently complain of great pain If you suspect that the Bubo is more malign by reason that it is of a green or black and inflamed colour as are those that come of a melancholick humour by adustion turned into a gross and rebellious melancholick humour so that by the more copious influx thereof into the part there is a danger of a gangrene and mortification then the places about the abscess must be armed with repercussives When repercussives may be applyed but not the abscess it self and this may be the form of the repercussives Take of the juice of Hous-leek Purslain Sorâ—el Night-shade or each two ounces of Vinegar one ounce the whites of three eggs of oil of Roses and water-Lillies of each two ounces and a half stir them together apply it about the Bubo and renew it often or boil a Pomgranat in vinegar beaâ— it with Vnguentum Rosatum or Populeon newly made and apply it as is aforesaid If these things do not stop the influx of other humors the abscess it self and the places about it must be scarified round about if the part will permit it that the part exorerated of portion of the venom may not stand in danger of the extinction of the proper and natural heat by the greater quantity and malignity of the humors that flow unto it In scaâ—ifying you must haâ—e care of great vessels for fear of an irrepugnable flux of blood which in this case Why too much bleeding is to be feared is very hard to be stayed or resisted both because the part it self is greatly inflamed and the humor very fierce for the expulsion whereof nature careful for the preservation of the part and all the body besides seemeth to labour and worke But yet you must suffer so much of the blood and humor to flow out as the patient is able to abide without the loss of his strength Moreover you may spend forth the superfluous portion of the malignity with relaxing mollifying and resolving fomentations as Take the roots of Marsh-Mallows Lillies and Elecampane of each one pound of Line-seeds and Fenugreek of each one ounce of Fennel-seeds and Anise-seeds of each half an ounce of the leaves oâ— Rue Sage Rosemary of each one handful of Camomile and Melilot-flowers of each three handfuls boil them all together and make thereof a decoction for a fomentation use it with a sponge according to Art Also after the aforesaid scarification we may put Hens or Turkies that lay egs which therefore have their fundaments more wide and open and for the same purpose put a little salt into their fundaments upon the sharp top of the Bubo that by shutting their bills at several times they may draw and suck the venom into their bodies far more strongly and better then cupping-glasses because they are endued with a natural property against poyson for they eat and concoct Toads Efts and such like virulent beasts when one Hen is killed with the poyson that shee hath drawn into her body you must apply another and then the third fourth fifth and sixt within the space of half an hour There be some that will rather cut them or else use whelps cut asunder in the midst and applyed warm to the place that by the heat of the creature that is yet scarce dead portion of the venom may be dissipated and exhaled But if nevertheless there be any fear of a Gangrene at hand you must cut the flesh with a deeper scarification not only avoiding the great vessels but also the nerves for fear of convulsion and after the scarification and a sufficient flux of blood you must wash it with Aegyptiacum Treacle and Mithridate dissolved in sea-water aqua vitae and Vinegar For such a lotion hath virtue to stay putrefaction repel the venom and prohibit the blood from concretion but if the Gangrene cannot be avoided so cauteries may be applyed to the part especially actual because they do more effectually repel the force of the poyson and strengthen the part Presently after the impression of the hot Iron Liniments to hasten the falling away of the Eschar the Eschar must be cut away even unto the quick-flesh that the venomous vapours and
the humors may have a free passage forth for it is not to be looked for that they will come forth oâ— themselves With these inunctions they are wont to hasten the falling away of the Eschar Take of the mucilâ—ge of marsh-mallows and Line-seeds of each two ounces fresh butter or Hogs-grease one ounce the yelks of three eggs incorporate them together and make thereof an ointment butter Swines-grease oyl of Roses with the yelks of eggs performe the self same thing When the Eschar is fallen away we must use digestives As take of the juice of Plantaine Water-Betony and Smallage of each three ounces hony of Roses four ounces Venice-Turpentine five ounces Against eating Uâ—cers Barly-flower three drams Aloes two drams oyl of Roses four ounces Treacle half a dram make a mundificative according to Art Or Take of Venice-Turpentine four ounces syrup of dried Roses and Wormwood of each an ounce of the powder of Aloes Mastich Myrrh Barly-flower of each one dram of Mithridate half an ounce incorporate them together The unguent that followeth is very meet for putrefied and corroding ulcers Take red Orpiment one ounce of unquenched Lime burnt Alum Pomgranat-pills of each six drams of Olibanum Galls of each two drams of Wax and Oyl as much as shall suffice make thereof an unguent This doth mundifie strongly consume putrefied flesh and drie up virulent humidities that engender Gangrenes But there is not a more excellent unguent them Egyptiacum increased in strength The praise of Agyptiacum for besides many other vertues that it hath it doth doth consume and waste the proud flesh for there is neither oyl nor wax that goeth into the composition thereof with which things the vertue of sharp medicines convenient for such ulcers is delayed and as it were dulled and hindred from their perfect operation so long as the ulcer is kept open There have been many that being diseased with this disease have had much matter and venomous filth come out at their abscess so that it seemed sufficient and they have been thought well recovered yet have they died suddenly In the mean while when these things are in doing cordial medicines are not to be omitted to strengthen the heart And purgations must be renewed at certain seasons that nature may be every way unloaded of the burthen of the venenate humours CHAP. XXXII Of the Nature Causes and Signes of a Pestilent Carbuncle A Pestilent Carbuncle is a small tumor or rather a malign pustle hot and raging What a Carbuncle is consisting of blood vitiated by the corruption of the proper substance It often cometh to pass through the occasion of this untamable malignity that the Carbuncle cannot be governed or contained within the dominion of nature In the beginning it is scarce so big as a seed or grain of Millet or Pease sticking firmly unto the part and immovable The signs of a Carbuncle so that the skin cannot be pulled from the flesh but shortly after it increaseth like to a Bubo unto a round and sharp head with great heat pricking paid as if it were with needles burning and intolerable especially a little before night and while the meat is in concocting more then when it is perfectly concocted In the midst thereof appeareth a bladder puffed up and filled with sanious matter If you cut this bladder you shall finde the flesh under it parched burned and black as if there had bin a Burning cole laid there When so called whereby it seemeth that it took the name of Carbuncle but the flesh that is about the place is like a Rain-Bow of divers colours as red dark-green purple livid and black but yet alwaies with a shining blackness like unto stone-Pitch or like unto the true precious stone which they call a Carbuncle whence some also say it took the name Some call it a Nail because it inâ—erreth like pain as a nail driven into the flesh There are many carbuncles which take their beginning with a crusty ulcer without a pustle Symptoms of Caâ—buncles like to the burning of an hot Iron and these are of a black colour they increase quickly according to the condition of the matter whereof they are made All pestilent Carbuncles have a Fever joyned with them and the grieved part seemeth to be so heavy as if it were covered or pressed with lead tied hard with a ligature There cometh mortal swoundings faintings tossing turning idle talking raging gangrenes and mortifications not only to the part but also to the whole body by reason as I think of the oppression of the spirits of the part and the suffocation of the natural heat as we see also in many that have a pestilent Bubo For a Bubo and Carbuncle are tumors of a near affinity so that the one doth scarce come without the other How the Matter of a Bâ—bo and Carbuncle differ consisting of one kinde of matter unless that which maketh the Bubo is more gross and clammy and that which causeth the Carbuncle more sharp burning and raging by reason of its greater subtility so that it maketh an Eschar on the place where it is as we noted before CHAP. XXXIII What Prognosticks may be made in pestilent Buboes and Carbuncle Why it is deadly to have a sore come after the Fever 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 Fever which giveth better hope of health if there be no other malign accident therewith for it is a sign that nature is the victor and hath gotten the upper-hand which excluded the pestilent venom before it could come to assault the heart But if a Carbuncle Bubo come after the Fever it is mortal for it is a token that the heart is affected moved and incensed with the furious rage of the venom whereof presently cometh a feverish heat or burning and corruption of the humors sent as it were from the center unto the superficies of the body It is a good sign when the patients minde is not troubled from the beginning until the seventh day but when the Bubo or Carbuncle sinketh down again shortly after that it is risen it is a mortal sign especially if ill accidents follow it If after they are brought to suppuration they presently wax drie without any reason thereof it is an ill sign Those Carbuncles that are generated of blood have a greater Eschar then those that are made of choler because that blood is of a gross consistence and thereof occupieth a greater room in the flesh contrariwise a cholerick humor is more small in quantity and thin and it taketh little room in the upper part of the flesh only as you may see in an Erysipelas And I have seen Carbuncles whose Eschars were as broad and as large as half the back also I have seen others which going up by the shoulders to the throat did so eat
of an Onion rosted under the embers and incorporated with Treacle and a little oil of Rue after the hoemorrhoid veins by these means come to shew themselves they shall be rubbed with rough linnen cloths or Fig-leaves or a raw Onion or an Ox-gall mixt with some powder of Collequintida Lastly you may apply Horse-leeches or you may open them with â— lancet if they hang much forth of the fundament and be swoln with much blood But if they flow too immoderately they may be staid by the same means as the courses CHAP. XXXIX Of procuring evacuation by stâ—ol or a flax of the belly NAture oftentimes both by it self of its own accord as also helped by laxative and purging medicines casts into the belly and guts as into the sink of the body the whole matter of a pestilâ—nt disease whence are caused Diarrhaeas Lienteries and Dysenteries you may distinguish these kinds of fluxes of the belly by the evacuated excrements For if they be thin and sincere that is retain the nature of one and that a simple humor as of choler melancholy or phlegm and if they be cast forth in a great quantity without the ulceration or excoriation of the guts vehement or freâ—ting pain then it is a Diarrhaea What a Diarrhaea is which some also call fluxus humoralis It is called a Lienteria when as by the resolved retentive faculty of tâ—e stomach and guts caused by ill humors either there collected or flowing from some other 〈◊〉 or by a cold and moist distemper the meat is cast forth crude and almost as it was taken A Dysenteria is when as many and different things and oft-times mixt with blood What a Disenteria is are cast forth with pâ—iâ—â—g gâ—ipings and an ulcer of the guts caused by acrid choler fretting in sunder the coats of the vessels But 〈…〉 â—ny kind of disease certainly in a pestilent one fluxes of the belly happen immoderate in quantity and horrible in the quality of their contents as liquid viscous frothy as from melted grease yellow red purple green ash-coloured black and exceeding stinking The cause of various and stinking excrements in the Plague The cause is various and many sorts of ill humors which taken hold of by the pestilent malignity turn into divers species differing in their whole kind both from their particulâ—r as also from nature in general by reason of the corruption of their proper substance whose inseparable sign is stench which is oft-times accompanied by worms In the camp at Amiens a pestilent Dysentery was over all the Camp An history in this the strongest souldiers purged forth meer blood I dissecting some of their dead bodies observed the mouths of the Mesaraick veins and arteries opened and much swollen and whereas they entered into the guts were just like little Catyledones out of which as I pressed them there flowed blood For both by the excessive heat of the Summers sun and the minds of the enraged souldiers great quantity of acrid and cholerick humor was generated and so flowed into the belly but you shall know whether the greater or lesser guts be ulcerated better by the mixture of the blood with the excrements then by the site of the pain therefore in the one you must rather work by clysters but in the other by medicines taken by the mouth Therefore if by gripings a tenesmus the murmuring and working of the guts you suspect in a pestilent disease that nature endeavors to disburden it self by the lower parts neither in the mean while doth it succeed to your desire then must it be helped forward by art as by taking a potion of â„¥ ss of hiera simplex and a dram of Diaphaenicon dissolved in Worm-wood wateâ— A person Also Clysters are good in this case not only for that they asswage the gripings and pains and draw by continuation or succession from the whole body but also because they free the mesaraick veins and guts from obstruction and stuffing so that by opening and as it were unlocking of the passages nature may afterwards more freely free it self from the noxious humors In such Clysters they also sometimes mix two or three drams of Treacle that by one and the same labour they may retund the venenate malignity of the matter There may also be made for the same purpose Suppositories of boiled hony â„¥ i of hiera picra and common salt of each Ê’ ss or that they may be the stronger of hony â„¥ iii. of Ox-gall â„¥ i. of Scammony Euphorbium and Coloquintida powdred of each Ê’ ss Suppositories The want of these may be supplyed by Nodulas made in this form â„ž vitell ovor nu iii. fellis bubuli mellis an â„¥ ss salis tom Ê’ss let them be stirred together and well incorporated and so parted into linnen rags and then bound up into Noduleas of the bigness of a Fil-berd and so put up into the fundament you may make them more acrid by adding some powder of Eupporbium or Coloquintida CHAP. XL. Of stopping the flux of the belly VIolent and immoderate scourings for that they resolve the faculty and lead the patient into a consumption and death if they shall appear to be such A hasty pudding to stay the lask they must be staied in time by things taken and injected by the mouth and fundament To this purpose may a pudding be made of wheat-flower boiled in the water of the decoction of one Pomegranat Berberies Bole-Armenick Terra sigillata white Poppy-seeds of each Ê’i The following Almond-milk strengthens the stomach and mitigates the acrimony of the cholerick humor provoking the guts to excretion Take sweet Almonds boiled in the water of Barly wherein steel or non hath been quenched â—eat them in a marble-mortar and so with some of the same water make them into an Almond-mâ—lk whereto adding Ê’i of Diarhâ—den Abbatis you may give it to the patient to drink This following medicine I learnt of Dr. Chappelain the Kings chief Physician who received it of his father and held it as a great secret and was wont to prescribe it with happy success to his patients D. Chappâ—lains medecine to stay a scouring It is 〈◊〉 â„ž beâ—â—â—rmen terrae sigil l. pid hamat an Ê’i picis nâ—valis Ê’ i ss coral rub marg 〈◊〉 câ—râ— câ—vi â—st 〈◊〉 in aq p. aâ—t an ℈ succar r. s â„¥ ii fiat pu vis Of this let the patient take a 〈◊〉 before meat or with the yâ—lk of an egg Chrisâ—â—pher Anarâ—â— in his 〈◊〉 much commendeth dogs-dung when as the dog hath for three dries before â—een fed only with bones Qâ—â—ces rosted in members or boâ—led in a pot the Conserve of Cornelian-cherries Preserved Berberies and Myrabolans rosted nutmeg taken before meat strengthen the stomach and stay the lask the patient must feed upon good meats Drink and these rather rosted then boiled His drink shall be caliâ—â—â—ate-water of the decoctâ—on of sower Pomegranats beaten or of the
miseries of mans life as it were by the enticements of that pleasure also the great store of hot blood that is about the heart wherewith men abound maketh greatly to this purpose which by impulsion of imagination which ruleth the humors being driven by the proper passages down from the heart and entrails into the genital parts doth stir up in them a new lust The males of brute beasts being provoked or moved by the stimulations of lust rage and are almost burst with a Tentigo or extension of the genital parts and sometimes wax mad but after that they have satisfied their lust with the female of their kinde they presently become gentle and leave off such fierceness CHAP. IV. What things are to be observed as necessary unto generation in the time of copulation How women may be moved to Venery conception WHen the husband commeth into his wives chamber he must entertain her with all kinde of dalliance wanton behaviour and allurements to Venery but if he perceive her to be slow and more cold he must cherish embrace and tickle her and shall not abruptly the nerves being suddenly distended break into the field of nature but rather shall creep in by little and and little intermixing more wanton kisses with wanton words and speeches handling her secret parts and dugs that she may take fire and be enflamed to Venery for so at length the womb will strive and wax servent with a desire of casting forth it own seed and receive the mans seed to be mixed together therewith But if all these things will not suffice to enflame the woman for women for the most part are more slow and slack unto the expulsion or yeelding forth of their seed it shall be necessary first to foment her secret parts with the decoction of hot herbs made with Muscadine or boiled in any other good wine and to put a little Musk or Civet into the neck or mouth of the womb and when she shall perceive the efflux of her seed to approach by reason of the tickling pleasure she must advertise her husband thereof that at the very instant time or moment The meeting of the seeds most necessary for generation he may also yeeld forth his seed that by the concourse or meeting of the seeds conception may be made and so at length a child formed and born And that it may have the better success the husband must not presently separate himself from his wives embraces lest the air strike into the open womb and so corrupt the seeds before they are perfectly mixed together When the man departs let the woman lye still in quiet laying her legs or her thighs across one upon another and raising them up a little lest that by motion or downward situation the seed should be shed or spilt which is the cause why she ought at that time not to talk especially chiding nor to cough nor snees but give her self to rest and quietness if it be possible CHAP. V. By what signs it may be known whether the woman have conceived or not IF the seed in the time of copulation or presently after be not spilt if in the meeting of the seeds the whole body do somewhat shake that is to say the womb drawing it self together for the compression and entertainment thereof if a little feeling of pain doth run up and down the lower belly and about the navel if she be sleepy if she loath the embracings of a man and if her face be pale it is a token that she hath conceived In some after conception spots or freckles arise in their face Spots or specks in the faces of those that are with child their eies are depressed and sunk in the white of their eyes waxeth pale they wax giddy in the head by reason that the vapors are raised up from the menstrual blood that is stopped sadness and heaviness grieve their minds with loathing and waywardness by reason that the spirits are covered with the smoaky darkness of the vapors pains in teeth and gums and swounding often-times commeth the appetite is depraved or overthrown with aptness to vomit and longing whereby it happeneth that they loath meats of good juice and long for and desire illaudable meats Why many women being great with childe refuse laudable meats and desire those that are illaudable and contrary to nature The suppressed terms divided into three parts and those that are contrary to nature as coles dirt ashes stinking salt-fish sowr austere and tart fruits pepper vinegar and such like acrid things and other altogether contrary to nature and use by reason of the condition of the suppressed humor abounding and falling into the orifice of the stomach This appetite so depraved or over-thrown endureth in some untill the time of child-birth in others it cometh in the third month after their conception when hairs do grow on the child and lastly it leaveth them a little before the fourth month because that the child being now greater and stronger consumes a great part of the excremental and superfluous humor The suppressed or stopped terms in women that are great with childe are divided into three parts the more pure portion maketh the nutriment for the child the second ascendeth by little and little into the dugs and the impurest of all remaineth in the womb about the infant and maketh the secondine or after-birth wherein the infant lieth as in a soft bed Those women are great with child whose urine is more sharp fervent and somewhat bloody the bladder not only waxing warm by the compression of the womb fervent by reason of the blood contained in it but also the thinner portion of the same blood being expressed and sweating out into the bladder Hip. 1. de morb mul. A swelling and hardness of the dugs and veins that are under the dugs in the breasts and about them and milk comming out when they are pressed with a certain stirring motion in the belly are certain infallible signs of greatness with child Neither in this greatness of child-bearing the veins of the dugs only but of all the whole body appear full and swelled up especially the veins of the thighs and legs so that by their manifold folding and knitting together they do appear varicous Aph. 41. sect 5. whereof commeth sluggishness of the whole body heaviness and impotency or difficulty of going especially when the time of deliverance is at hand Lastly if you would know whether the woman have conceived or not give unto her when she goeth to sleep some mead or honied water to drink and if she have a griping in her guts or belly she hath conceived if not she hath not conceived CHAP. VI. That the womb so soon as it hath received the seed is presently contracted or drawn together AFter that the seeds of the male and female have both met and are mixed together in the capacity of the womb then the orifice thereof doth draw it self close together lest
the seeds should fall out There the females seed goeth and turneth into nutriment Why the female seed is nutriment for the male seed and the increase of the males seed because all things are nourished and do increase by those things that are most familiar and like unto them But the similitude and familiarity of seed with seed is far greater then with blood so that when they are perfectly mixed and co-agulated together and so wax warm by the straight and narrow inclosure of the womb a certain thin skin doth grow about it like unto that that will be over unsâ—immed milk Moreover this concretion or congealing of the seed is like unto an egg laied before the time that it should that is to say whose membrane or tunicle that compasseth it about hath not as yet increased or grown into a shelly hardness about it in folding-wise are seen many small threds dividing themselves over-spread with a certain clammy whitish or red substance as it were with black blood In the middest under it appeareth the navel from whence that small skin is produced A compendious way to understand humane conception But a man may understand many things that appertain unto the conception of mankind by the observation of twenty eggs setting them to be hatched under an Hen and taking one every day and breaking it and diligently considering it for in so doing on the twentieth day you shall find the Chick perfectly formed with the navel That little skin that so compasseth the infant in the womb is called the secundine or Chorion but commonly the after-birth Lib. de nat puer This little skin is perfectly made within six daies according to the judgment of Hippocrates as profitable and necessary not only to contain the seeds so mixed together but also to sâ—â—k nutriment through the oâ—ifices of the vessels ending in the womb What the Câ—tyledones are Those orifices the Greeks do call Câ—tyledones and the Latines Acetabula for they are as it were hollowed eminences like unto those which may be seen in the feet or snout of a Cuttle-fish many times in a double order both for the working and holding of their meat Those eminences called Acetabula do not so greatly appear in women as in many brute beasts Therefore by these the secundiâ—e cleaveth on every side unto the womb for the conservation nutrition and increase of the conceived â—eed CHAP. VII Of the generation of the navel AFter the woman hath conceived to every one of the aforesaid eminences groweth presently another vessel that is to say a vein to the vein and an aâ—tery to the aâ—tery these soft and yet thin vessels are framed with a little thin membrane which being spread under sucketh to them for to them it is in stead of a membrane and a ligament and a tunicle oâ— a defence and it is doubled with the others and made of the vein and artery of the navel These new small vessels of the infant with their orifices do answer directly one to one to the Cotyledones or eminencies of the womb they are very small and little as it were the hairy fibres that grow upon roots that are in the earth and when they have continued so a longer time they are combined together that of two they are made one vessel untill that by continual connexion all those vessels go and degenerate into two other great vessels called the umbilical vessels or the vessels of the navel because they do make the navel and do enter into the childs body by the hole of the navel The vein never joyneth it selfe with the artery Here Galen doth admire the singular providence of God and Nature because that in such a multitude of vessels and in so long a passage or length that they go or are produced the vein doth never confound it self nor stick to the artery nor the artery to the vein but every vessel joineth it self to the vessel of its own kind But the umbilical vein or navel-vein entering into the body of the child doth join it self presently to the hollow part of the liver but the artery is divided into two which join themselvs to the two Iliack arteries along the sides of the bladder and are presently covered with the peritonaeum and by the benefit thereof annexed unto the parts which it goes unto Those small veins and arteries are as it were the roots of the childe but the vein and artery of the navel are as it were the body of the tree Hippocrates calleth all the membranes that compass the infa t in the womb according to the judgment of Galen in his book de usu pâ—rtium by the name of the secandines to bring down the nutriment to nourish the child For first we live in the womb the life of a plant and then next the life of a sensitive creature and as the first tunicle of the child is called Châ—riâ—ns or Allantâ—ides so the other is called Amnios or Aguiâ—a which doth compass the seed or child about on every side These membranes are most thin yea for their thinness like unto the Spiders web woven one upon another and also connexed in many places by the extremeties of certain small and hairy substances which at length by the adjunction of their like do get strength whereby you may understand what is the cause why by divers and violent motions of the mother in going and dancing or leaping and also of the infant in the womb those membranes are not almost broken For they are so conjoined by the knots of those hairy substances that between them nothing neither the urine nor the sweat can come as you may plainly and evidently perceive in the dissection of a womans body that is great with child not depending on any other mans opinion be it never so old or inveterate yet the strength of those membranes is not so great but that they may be soon broken in the birth by the kicking of the child GHAP. VIII An old opinion confuted Of the Vmbilical vessels or the vessels belonging to the navel MAny of the antient Writers have written that there are five vessels found in the navel But yet in many nay all the bodies I sought in for them I could never find but three that is to say one vein which is very large so that in the passage thereof it will receive the tag of a point and two arteries but not so large but much narrower because the child wanteth oâ— standeth in need of much more blood for his conformation and the nutriment or increase of his parts then of vital spirit These vessels making the body of the navel which as it is thought To what use the knots of the childes navel in the womb serve is formed within nine or ten dayes by their doubling and folding make knots like unto the knots of a Franciscan Friers girdle that staying the running blood in those their knotty windings they might more perfectly
concoct the same as may be seen in the ejaculatory spermatick vessels for which use also the length of the navel is half an ell so that in many infants that are somewhat grown it is found three or four times doubled about their neck or thigh As long as the child is in his mothers womb he taketh his nutriment only by the navel The childe in the womb taketh his nutriment by his navel not by his mouth and not by his mouth neither doth he enjoy the use of eyes ears nostrils or fundament neither needeth he the functions of the heart For spirituous blood goeth unto it by the artertes of the navel and into the Iliack arteries and from the Iliack arteries unto all the other arteries of the whole body for by the motion of these only the infant doth breath Therefore it is not to be supposed that the air is carried or drawn in by the lungs unto the heart in the body of the child How the childe breatheth but contrariwise from the heart to the lungs For neither the heart doth perform the generation or working of blood or of the vital spirits For the issue or infant is contented with them as they are made and wrought by his mother Which untill it hath obtained a full perfect and whole description of his parts and members cannot be called a child but rather an embryon or an imperfect substance CHAP. IX Of the ebullition or swelling of the seed in the womb and of the concretion of the bubbles or bladders or the three principal entrails IN the six first dayes of conception the new vessels are thought to be made and brought forth of the eminences or cotyledons of the mothers vessels and dispersed into all the whole seed as they were fibres or hairy strings Those as they pierce the womb so do they equally and in like manner penetrate the tunicle Chorion And it is carried this way being a passage not only necessary for the nutriment and conformation of the parts but also into the veins diversly woven and dispersed into the skin Chorion For thereby it cometh to pass that the seed it self boileth and as it were fermenteth or swelleth not only through occasion of the place but also of the blood and vital spirits that flow unto it and then it riseth into three bubbles or bladders like unto the bubbles which are occasioned by the rain falling into a river or channel full of water These three bubbles or bladders are certain rude or new forms The three bladders or concretions of the three principal entrails that is to say of the liver heart and brain All this former time it is called seed and by no other name but when those bubbles arise it is called an embryon or the rude form of a body untill the perfect conformation of all the members When the seed is called an embryon on the fourth day after that the vein of the navel is formed it sucketh grosser blood that is of a more full nutriment out of the Cotyledons And this blood because it is more gross easily congeals and curdles in that place where it ought to prepare the liver fully and absolutely made For then it is of a notable great bigness above all the other parts and therefore it is called Parenchyma Why the liver is called Parenchyma because it is but only a certain congealing or concretion of blood brought together thither or in that place From the gibbous part thereof springeth the greater part or trunk of the hollow vein called commonly vena cava which doth disperse his small branches which are like unto hairs into all the substance thereof and then it is divided into two branches whereof the one groweth upwards the other downwards unto all the particular parts of the body In the mean season the arteries of the navel suck spirituous blood out of the eminences or Cotyledons of the mothers arteries whereof that is to say of the more fervent and spirituous blood the heart is formed in the second bladder or bubble being endued with a more fleshie sound and thick substance as it behooveth that vessel to be which is the fountain from whence the heat floweth and hath a continual motion In this the virtue formative hath made two hollow places one on the right side another on the left In the right the root of the hollow vein is infixed or ingraffed carrying thither necessary nutriment for the heart in the left is formed the stamp or root of an artery which presently doth divide it self into two branches the greater whereof goeth upwards to the upper parts and the wider unto the lower parts carrying unto all the parts of the body life and vital heat CHAP. X. Of the third Bubble or Bladder wherein the head and the brain is formed THe far greater portion of the seed goeth into this third bubble that is to say Why the greater portion of seed goeth into generation of the head and brain yeelding matter for the conformation of the brain and all the head For a greater quantity of seed ought to go unto the conformation of the head and brain because these parts are not sanguine or bloody as the heart and liver but in a manner without blood bony marrow cartilaginous nervous and membranous whose parts as the veins arteries nerves ligaments panicles and skin are called spermatick parts because they obtain their first conformation almost of seed only although that afterwards they are nourished with blood as the other fleshie and musculous parts are But yet the blood when it come unto those parts degenerateth and turneth into a thing somewhat spermatick by virtue of the assimulative faculty of those parts All the other parts of the head form and fashion themselves unto the form of the brain when it is formed and those parts which are situated and placed about it for defence especially are hardened into bones Why the head is placed on the top of the body The head as the seat of the senses and mansion of the minde and reason is situated in the highest place that from thence as it were from a lofty tower or turret it might rule and govern all the other members and their functions and actions that are under it for there the soul or life which is the rectress or governess is situated and from thence it floweth and is dispersed into all the whole body Nature hath framed these three principal entrals as props and sustentations for the weight of all the rest of the body for which matter also she hath framed the bones The first bones that appear to be formed or are supposed to be conformed are the bones called ossa Ilium conneâ—ed or united by spondyls that are between them then all the other members are framed and proportioned by their concavites and hollownesses which generally are seven that is to say two of the ears two of the nose one of the mouth and in the parts beneath the
reduceth all the simple and divided formes or images or things into one heap that by dividing collecting and reasoning it might discern and trie truth from falshood The functions of Reason This faculty of Understanding or Reason is subject to no faculty or instrument of the body but is free and penetrateth into every secret intricate and hidden thing with an incredible celerity by which a man seeth what will follow perceiveth the originals and causes of things is not ignorant of the proceedings of things he compareth things that are past with those that are present and to come decreeing what to follow and what to avoid This bridleth and with-holdeth the furions motions of the minde bridleth the over-hasty motions of the tongue and admonisheth the speaker that before the words pass out of his mouth he ought with diligence and discretion to ponder and consider the thing whereof he is about to speak What memory is After Reason and Judgment followeth Memory which keeping and conserving all forms and images that it receiveth of the senses and which Reason shall appoint and as a faithfull keeper and conserver receiveth all things and imprinteth and sealeth them as well by their own virtue and power as by the impulsion and adherence of those things in the body of the brain without any impression of the matter that when occasion serveth we may bring them forth there-hence as out of a treasury or store-house For otherwise to what purpose were it to read hear and note so many things unless we were able to keep and retain them in minde by the care and custody of the Memory or Brain Therefore assuredly God hath given us this only remedy and preservative against the oblivion and ignorance of things which although of it self and of its own nature it be of greater efficacy yet by dayly and often meditation it is trimmed and made more exquisite and perfect Wisdome the daughter of memory and experience And hence it was that the Antients termed wisedome the daughter of memory and experience Many have supposed that the mansion or seat of the Memory is in the hinder part or in the ventricle of the Cerebellum by reason that it is apt to receive the forms of things because of the engrafted driness and hardness thereof CHAP. XII Of the natural excrements in general and especially of those that the childe or infant being in the womb excludeth What an excrement is BEfore I declare what excrements the infant excludeth in the womb and by what passages I think it good to speak of the excrements which all men do naturally void All that is called an excrement which nature is accustomed to separate and cast out from the laudable and nourishing juice The excrement of the first concoction There are many kindes of those excrements The first is of the first concoction which is performed in the stomach which being driven down into the intestines or guts is voided by the fundament The second commeth from the Liver and it usually is three-fold or of three kindes one cholerick whereof a great portion is sent into the bladder of the gall that by sweating out there-hence The excrement of the second concoction is triple it might stir up the expulsive faculty of the guts to expel and exclude the excrements The other is like unto whay which goeth with the blood into the veins and is as it were a vehicile thereto to bring it unto all the parts of the body and into every capillar vein for to nourish the whole body and after it hath performed that function it is partly expelled by sweat and partly sent into the bladder and so excluded with the urine The third is the melancholick excrement which being drawn by the milt the purer and thinner part thereof goeth into nourishment of the milt and after the remnant is partly purged our downwards by the Hemorrhoidal veins and partly sent to the orifice of the stomach to instimulate and provoke the appetite The excrement of the third concoction is triple The last cometh of the last concoction which is dissolved in the habit of the body and breathed out partly by insensible transpiration is partly consumed by sweating and partly floweth out by the evident and manifest passages that are proper to every part as it happeneth in the brain before all other parts for it doth unload it self of this kinde of excrements by the passages of the nose mouth ears eyes palat-bone and futures of the scul Therefore if any of these excrements be staied altogether or any longer then it is meet they should the default is to be amended by diet and medicine Furthermore there are other sorts of excrements not natural of which we have entreated at large in our book of the Pestilence When the infant is in the mothers womb The use of the navel-stâ—ing until be is fully and absolutely formed in all the lineaments of his body he sends forth his urine by the passage of the navel or urachus But a little before the time of childe-birth the urachus is closed and then the man-childe voideth his urine by the conduit of the yard and the woman-childe by the neck of the womb This urine is gathered together contained in the coat Chorion or Allantcides together with the other excrements that is to say sweat and such whaysh superfluities of the menstrual matter for the more easie bearing up of the floating or swimming childe But in the time of childe-birth The signs of speedy and easie deliverance when the infant by kicking breaketh the membranes those humors run out which when the midwives perceive they take it as a certain sign that the childe is at hand For if the infant come forth together with those waters the birth is like to be more easie and with better success for the neck of the womb and all the genitals are so by their moisture relaxed and made slippery that by the endeavour and stirâ—ing of the infant the birth will be more easie and with the better success contrariwise if the infant be not excluâ—ed before all these humors be wholly flowen out and gone but remaineth as it were in a drie place presently through driness the neck of the womb and all the genitals will be contracted and drawn together so that the birth of the childe will be very difficult and hard unless the neck of the womb to amend that default be annointed with oil or some other relaxing liquor Moreover when the childe is in the womb he voideth no excrements by the fundament unless it be when at the time of the birth the proper membranes and receptacles are burst by the striving of the infant for he doth not take his meat at the mouth wherefore the stomach is idle then and doth not execute the office of turning the meats into chylus nor of any other concoction wherefore nothing can go down from it into the guts Children born
or in swallowing the milke What is to be observed in the milk We may judg of or know the nature and condition of milk by the quantity quality colour savor and taste when the quantity of the milk is so little that it wil not suffice to nourish the infant it cannot be good and laudable for it aâ—gueth some distemperature either of the whole body or at least of the dugs especially a hot and dry distemperature But when it superaboundeth and is more then the infant can spend it exhausteth the juice of the nurses body and when it cannot all be drawn out by the infant it clutteâ—eth and congealeth or corrupteth in the dugs Yet I would rather wish it to abound then to be defective for the superabounding quantity may be pressed out before the childe be set to the breast The laudable consistence of milk That milk that is of a mean consistence between thick and thin is esteemed to be the best For it betokeneth the strength and vigor of the faculty that ingendreth it in the breasts Therefore if one drop of the milk be laid on the nail of ones thumb being first made very clean and fair if the thumb be not moved and it run off the nail it signifieth that it is watery milk but if it sâ—â—ck to the nail although the end of the thumb be bowed downwards it sheweth that it is too gross and thick but if it remain on the nail so long as you hold it upright and fall from it when you hold it a little aside or downwards by little and little it sheweth it is very good milk And that which is exquisitely white is best of all For the milk is no other thing then blood made white Therefore if it be of any other colour it argueth a default in the blood so that if it be brown Why the milk ougâ—t to be very white it betokeneth melancholick blood if it be yellow it signifieth cholerick blood if it be wan and pale it betokeneth phlegmatick blood if it be somewhat red it argueth the weakness of the faculty that engendreth the milk It ought to be sweet fragrant and pleasant in smell for if it strike into the nostrils with a certain sharpness as for the most part the milke of women that have red hair and little freckles on their faces doth it prognosticates a hot and cholerick nature Why a woman that hath red hair or frecles on her face cannot be a good Nurse if with a certain sowerness it portendeth a cold and melancholick nature In taste it ought to be sweet and as it were sugered for the bitter saltish sharp and stiptick is nought And here I cannot but admire the providence of nature which hath caused the blood wherewith the childe should be nourished to be turned into milk which unless it were so who is he that would not turn his face from and abhor so grievous and terrible a spectacle of the childes mouth so imbrued and besmeared with blood what mother or Nurse would not be amazed at every moment with the fear of the blood so often shed out or sucked by the infant for his nourishment Moreover we should want two helps of sustentation that is to say Butter and Cheese Neither ought the childe to be permitted to suck within five or six daies after it is born both for the reason before alledged and also because he hath need of so much time to rest quiet and ease himself after the pains he hath sustained in his birth in the mean season the mother must have her breasts drawn by some maid that drinketh no wine or else she may suck or draw them her self with an artificiall instrument which I will describe hereafter That Nurse that hath born a man childe is to be preferred before another What that Nurse that hath born a man-childe is to be p eferred before another because her milk is the better concocted the heat of the male-childe doubling the mothers heat And moreover the women that are great with childe of a male-childe are better colored and in better strength and better able to do any thing all the time of their greatness which proveth the same and moreover the blood is more laudable and the milk better Furthermore it behoveth the Nurse to be brought on bed or to travail at her just and prefixed or natural time Why she cannot be a good Nurse whoâ—e childe was born befoâ—e the time for when the childe is born before his time of some inward cause it argueth that there is some default lurking and hidden in the body and humors thereof CHAP. XXII What diet the Nurse ought to use and in what situation she ought to place the infant in the Cradle BOth in eating drinking sleeping watching exercising and resting the Nurses diet must be divers according as the nature of the childe both in habit and temperature shall be as for example if the childe be altogether of a more hot blood the Nurse both in feeding and ordering herself ought to follow a cooling diet In general let her eat meats of good juice moderate in quantity and quality let her live in a pure and clear air let her abstain from all spices and all salted and spiced meats and all sharp things wine especially that which is not allayed or mixed with water and carnal copulation with a man let her avoid all perturbations of the minde but anger especially let her use moderate exercise Anger â—reatly hu teth the Nurse The exercise of the arms is best for the Nurse How the childe should be placed in the Cradâ—e unless it be the exercise of her armes and upper parts rather then the leggs and lower parts whereby the greater attraction of the blood that must be turned into milk may be made towards the dugs Let her place her childe so in the Cradle that his head may be higher then all the body that so the excremental humors may be the better sent from the brain unto the passages that are beneath it Let her swathe it so as the neck and all the back-bone may be strait and equal As long as the childe sucketh and is not fed with stronger meat it is better to lay him alway on his back then any other way for the back is as it were the keel in a ship the ground-work and foundation of all the whole body whereon the infant may safely and easily rest But if he lie oâ— the side it were danger left that the bones of the ribs being soft and tender not strong enough and united with stack bands should bow under the weight of the rest and so wax crooked whereby the infant might become crook-backed But when he beginneth to breed teeth and to be fed with more strong meat and also the bones and connexions of them begin to wax more firm and hard he must be laved one while on this side another while on that and now and then also on his
womb There are women that bear the childe in their womb ten or eleven whole moneths and such children have their conformation of much quantity of seed wherefore they will be more big great and strong and therefore they require more time to come to their perfection and maturity for those fruits that are great will not be so soon ripe as those that are small But children that are small and little of body do often come to their perfection and maturity in seven or nine moneths if all other things are correspondent in greatness and bigness of body it happeneth for the most part that the woman with childe is not delivered before the ninth moneth be done A male will be born soonner then a female or at the leastwise in the same moneth But a male childe will be commonly born at the beginnâ—ng or a little before the begining of the same moneth by reason of his engrafted heat which causeth maturity and ripeness Furthermore the infant is sooner come to maturity and perfection in a hot woman then in a cold for it is the property of heat to ripen CHAP. XXXI How to preserve the infant in the womb when the mother is dead IF all the signes of death appear in the woman that lieth in travel and cannot be delivered there must then be a Surgeon ready and at hand which may open her body so soon as she is dead whereby the infant may be preserved in safety neither can it be supposed sufficient if the mothers mouth and privie parts be held open for the infant being inclosed in his mothers womb Why it is not sufficient to preserve life in the childe to hold open the mouth and privie parts of the mother so soon as she is dead and the childe alive in her body and compassed with the membranes cannot take his breath but by contractions and dilatations of the artery of the navel But when the mother is dead the lungs do not execute their office function therefore they cannot gather in the air that compasseth the body by the mouth or aspera arteria into their own substance or into the arteries that are dispersed throughout the body thereof by reason whereof it cannot send it unto the heart by the veiny artery which is called arteria venalis for if the heart want air there cannot be any in the great artery which is called arteria aorta whose function it is to draw it from the heart as also by reason thereof it is wanting in the arteries of the womb which are as it were the little conduits of the great artery whereinto the air that is brought from the heart is derived and floweth in unto these little ones of all the body and likewise of the womb Wherefore it must of necessity follow that the air is wanting to the cotyledons of the secundines to the artery of the infants navel the iliack arteries also and therefore unto his heart and so unto his body for the air being drawn by the mothers lungs is accustomed to come to the infant by this continuation of passages How the bellie of the woman that dieth in travel must be cut open to save the childe Therefore because death maketh all the motions of the mothers body to cease it is far better to open her body so soon as she is dead beginning the incision at the cartilage Xiphoides or blade and making it in a form semicircular cutting the skin muscles and peritonaeum not touching the guts then the womb being lifted up must first be cut lest that otherwise he infant might perchance be touched or hurt with the knife You shall oftentimes finde the childe unmoveable as though he were dead but not because he is dead indeed but by reason that he being destitute of the accesse of the spirits by the death of the mother hath contracted a great weakness yet you may know whether he be dead indeed or not by handling the artery of the navel for it will beat and pant if he be alive otherwise not but if there be any life yet remaining in him How it may be known whether the infant be aâ—ive or not shortly after he hath taken in the air and is recreated with the access thereof he will move all his members and also all his whole body In so great a weakness or debility of the strength of the childe by cutting the navel string it must rather be laid close to the region of the belly thereof that thereby the heat if there be any jot remaining may be stirred up again But I cannot sufficiently marvel at the insolency of those that affirm that they have seen women whose bellies and womb have been more then once cut and the infant taken out when it could no otherwise be gotten forth and yet notwithstanding alive which thing there is no man can perswade me can be done without the death of the mother by reason of the necessary greatness of the wound that must be made in the muscles of the belly and substance of the womb for the womb of a woman that is great with childe by reason that it swelleth and is distended with much blood must needs yield a gread flux of blood which of necessity must be mortal And to conclude when that the wound or incision of the womb is cicatrized it will not peâ—mit or suffer the womb to be dilated or extended to receive or bear a new birth For these and such like other causes this kinde of cure as desperate and dangerous is not in mine opinion to be used CHAP. XXXII Of superfetation SUperfetation is when a woman doth bear two or more children at one time in her womb What superfetation is and they be enclosed each in his several secundine but those that are included in the same secundine are supposed to be conceived at one and the same time of copulation by reason of the great and copious abundance of seed and these have no number of daies between their conception and birth but all at once For as presently after meat the stomach which is naturally of a good temper is contracted or drawn together about the meat to comprehend it on every side though small in quantity as it were by both hands so that it cannot rowl neither unto this or that side so the womb is drawn together into the conception about the seeds assoon as they are brought into the capacity thereof and is so drawn in unto it on every side that it may come together into one body not permitting any portion thereof to go into any other region or side so that by one time of copulation the seed that is mixed together cannot engender more children then one which are divided by their secundines A womans womb is not distinguished into diverse cells And moreover because there are no such cells in the wombs of women as are supposed or rather known to be in the wombs of beasts which therefore bâ—ing forth many
to be a mola The dropsie comming of a tumor of thâ— Mesenterium others thought that it came by reason of the dropsie Assuredly this disease caused the dropsie to ensue neither was the cause thereof obscure for the function of the Liver was frustrated by reason that the concoction or the alteration of the Chylus was intercepted by occasion of the tumor and mâ—reoveâ— the Liver it self had a proper disease for it was hard and scirrhous and had many abscesses both within and without it and all over it The milt was scarce free from putrefaction the guts and Kill were somewhat blew and spotted and to be brief there was nothing found in the lower belly There is the like history to be read written by Philip Ingrassias in his book of tumors Tom. 1. tra â— cap. 1. of a certain Moor that was hanged for theft for saith he when his body was publickly dissected in the Mesenterium were found seventy scrophulous tumors and so many abscesses were containeâ— or enclosed in their several cists or skins and sticking to the external tunicle especially of the greater guts the matter contained in them was divers for it was hard knotty clammy glutinous liquid and waterish but the entrails especially the Liver and the Milt were found free from all manner of a tainture because as the same Author alledgeth nature being strong had sent all the evill juice and the corruption of the entrails into the Mesenterie and verily this Moor so long as he lived was in good and perfect health Without doubt the corruption of superflous humors for the most part is so great as is noted by Fernelius that it cannot be received in the receptacles that nature hath appointed for it Lib 6. part mor. cap 7. The Mesenterium is the â—inâ— or the body therefore then no small portion thereof falleth into the parts adjoyning and especially into the Mesentery and Pancreas which are as it were the sink of the whole body In those bodies which through continual and daily gluttony abound with choler melancholy and phlegm if it be not purged in time nature being strong and lusty doth depel and drive it down into the Pancreas and the Mesentery which are as places of no great â—epute and that especially out of the Liver and Milt by those veins or branches of the â—â—â—a pâ—rta which end or go not into the guts but are terminated in the Mesentery and Pancreas In these places diverse humors are heaped together which in process of time turn into a loose and soâ—t tumor and then if they grow bigger into a stiff hard and very scirrhous tumor Whereof Fernelius affirmeth that in those places he hath found the causes of choler melancholy fluxes cyâ—enteries cachexia's atrophia's consumptions tedious and uncertain fevers and lastly of many hidden diseases The Scrophulaes in the Mesenterium by the â—â—king whereof some have received their health that have been thought past cure Moreover Ingrassias affirmeth out of Julius Pollux that Scrophulas may be engendred in the Mesenterie which nothing differs from the mind and opinion of Galen who saith that Scrophulas are nothing else but indurate and scirrhous kernels But the Mesenterium with his glanduls being great and many making the Pancreas doth establish strengthen and confirm the divisions of the vessels A scirrhus of the womb Also the scirrhus of the proper substance of the womb is to be distinguished from the mola for in the bodies of some women that I have opened I have found the womb annoyed with a scirrhous tumor as big as a mans head in the curing whereof Physicians nothing prevailed because they supposed it to be a mola contained in the capacity of the womb and not a scirrhous tumor in the body thereof CHAP. XXXVII Of the cause of barrenness in men THere are many causes of barrenness in men that is to say the too hot cold dry or moist distemper of the seed the more liquid and flexible consistence thereof so that it cannot stay in the womb How the seed in unfertil but will presently flow out again for such is the seed of old men and striplings and of such as use the act of generation too often and immoderately for thereby the seed becommeth crude and waterish because it doth not remain his due and lawful time in the testicles wherein it should be perfectly wrought and concocted but is evacuated by wanton copulation Furthermore that the seed may be fertile it must of necessity be copious in quantity but in quality well concocted moderately thick clammy and puffed with abundance of spirits both these conditions are wanting in the seed of them that use copulation too often and moreover because the wives of those men never gather a just quantity of seed laudable both in quality and consistence in their testicles whereby it commeth to pass that they are the less provoked or delighted with Venereous actions and perform the act with less alacrity so that they yeeld themselves less prone to conception Therefore let those that would be parents of many children use a mediocrity in the use of Venery How the cutting of the veines behinde the ears maketh men barren The woman may perceive that the mans seed hath some distemperature in it if when she hath received it into her womb she feeleth it sharp hot or cold if the man be more quick or slow in the act Many become barren after they have been cut for the stone and likewise when they have had a wound behind the ears whereby certain branches of the jugular veins and arteries have been cut that are there so that after those vessels have been cicatrized there followed an interception of the seminal matter downwards and also of the community which ought of necessity to be between the brain and the testicles so that when the conduits or passages are stopped the stones or testicles cannot any more receive neither matter nor lively spirits from the brain in so great quantity as it was wont whereof it must of necessity follow that the seed must be lesser in quantity and weaker in quality Those that have their testicles cut off or else compressed or contused by violence cannot beget children because that either they want that help the testicles should minister in the act of generation or else because the passage of the seminal matter is intercepted or stopped with a Callus by reason whereof they cannot yield forth seed but a certain clammy humor contained in the glanduls called prostatae yet with some feeling of delight The defaâ—lts of the yard Moreover the deâ—ects or imperfections of the yard may cause barrenness as if it be too short or if it be so unreasonable great that it renteth the privy parts of the woman and so causeth a flux of blood for then it is so painful to the woman that she cannot void her seed for that cannot be excluded without pleasure and delight also if
at all it this necessary humor were wanting in the womb yet it may be some women may conceive without the flux of the courses but that is in such as have so much or the â—â—mor gathered together as is wont to remain in those which are purged although it be not so great a quantity that it may flow out as it is recorded by Aristotle But as it is in some very great and in some very little so it is in some seldom and in some very often What womeâ— have this mâ—nstrual flux often abundantly and for a lo ger space then others There are some that are purged twice and some thrice in a moneth but it is altogether in those who have a great liver large veins and are filled and fed with many and greatly nourishing meats which sit idlely at home all day which having slept all night do notwithstanding lie in bed sleeping a great part of the day also which live in a hot moist rainy and southerly air which use warm baths of sweet waters and gentle frictions which use and are greatly delighted with carnal copulation in these and such like women the courses flow more frequently and abundantly What women hâ—ve this flâ—x mâ—re 〈◊〉 leâ— and a far more short time then others But contrariwise those that have small and obscure veins and those that have their bodies more furnished and big either with flesh or with fat are more seldom purged and also more sparingly because that the sâ—perfluous quantity of blood useth to go into the habit of the body Also tender delicate and fair women are less purged than those that are brown and endued with a more compact flesh because that by the rarity of their bodies they suffer a greater wasting or dissipation of their substance by transpiration Moreover they are not so greatly purged with this kind of purgation which have some other solemn or accustomed evacuation in any other place of their body as by the nose or hemorrhoids Why young women are purged in the new of the Moon And as concerning their age old women are purged when the Moon is old and young women when the Moon is new as it is thought I think the cause thereof is for that the Moon ruleth moist bodies for by the variable motion thereof the Sea floweth and ebbeth and bones marrow and plants abound with their genital humor Therefore young people which have much blood and more fluxible and their bodies more fluxible are soon moved unto a flux although it be even in the first quarter of the Moons rising or increasing Why old women are purged in the wane of the Moon but the humors of old women because they wax stiff as it were with cold and are not so abundant and have more dense bodies and straighter vessels are not so apt to a flux nor do they so easily flow except it be in the full of the Moon or else in the decrease that is to say because the blood that is gathered in the full of the Moon falls from the body even of its own weight for that by reason of the decreasing or wane of the Moon this time of the moneth is more cold and moist CHAP. L. The causes of the Monethly Flux or Courses The material cause of the Monethtly flux BEcause a woman is more cold and therefore hath the digestive faculty more weak it cometh to pass that she requireth and desireth more meat or food than she can digest or concoct And because that superfluous humour that remaineth is not digested by exercise nor by the efficacy of strong and lively heat therefore by the providence or benefit of nature it floweth out by the veins of the womb by the power of the expulsive faculty at its own certain and prefixed season or time But then especially it beginneth to flow and a certain rude portion of blood to be expelled being hurtful and malign otherwise in no quality When the monthly flux begins to flow when nature hath laid her principal foundations of the increase of the body so that in greatness of the body she hath come as it were in a manner to the highest top that is to say from the thirteenth to the fiftieth year of her age Moreover the childe cannot be formed in the womb nor have his nutriment or encrease without this flux therefore this is another finall cause of the monethly flux The final cause Many are perswaded that women do far more abound with blood than men considering how great an abundance of blood they cast forth of their secret parts every month A woman exceeds a man in quantity of blood from the thirteenth to the fiftieth year of their age how much women great with child of whom also many are menstrual yeeld unto the nutriment and encrease of the childe in their wombs and how much Physicians take from women that are with childe by opening of a vein which otherwise would be delivered before their natural and prefixed time how great a quantity thereof they avoid in the birth of their children and for ten or twelve daies after and how great a quantity of milk they spend for the nourishment of the child when they give suck which milk is none other thing than blood made white by the power of the kernels that are in the dugs which doth suffice to nourish the child be he great or little yet notwithstanding many nurses in the mean while are menstrual A man exceedeth a women in the quality of his blood and as that may be true so certainly this is true that one dram that I may so speak of a mans blood is of more efficacy to nourish and encrease than two pounds of womans blood because it is far more perfect more concocted wrought and better replenished with abundance of spirits whereby it commeth to pass that a man endued with a more strong heat A man is more hot than a woman and therefore not menstrual doth more easily convert what meat soever he eateth unto the nourishment and substance of his body and if that any superfluity remains he doth easily digest and scatter it by insensible transpiration But a woman being more cold than a man because she taketh more than she can concoct doth gather together more humors which because she cannot disperse by reason of the unperfectness and weakness of her heat it is necessary that she should suffer and have her monthly purgation especially when she groweth unto some bigness but there is no such need in a man CHAP. LI. The causes of the suppression of the courses or menstrual flux THe courses are suppressed or stopped by many causes as by sharp vehement and long diseases by fear sorrow hunger immoderate labors watchings fluxes of the belly great bleeding haemorrhoids fluxes of blood at the mouth and evacuations in any other part of the body whatsoever often opening of a vein great sweats ulcers flowing much and long scabbiness
immoderately the blood is sharp and burning and also stinking the sick woman is also troubled with a continual fever and her tongue will be dry ulcers arise in the gums and all the whole mouth In women the flowers do flow by the veins and arteries which rise out of the spermatick vessels and end in the bottom and sides of the womb but in virgins and in women great with child whose children are sound and healthful by the branches of the hypogastrick vein and artery which are spred and dispersed over the neck of the womb 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 greatness and the dissolution of the retentive faculty of the vessels The criticâ—l flux of the flowers The signs of blood flowing from the womb or neck of the womb oftentimes also the flowers flow immoderately by reason of a painful and a difficult birth of the childe or the after-birth being pulled by violence from the cotyledons of the womb or by reason that the veins and arteries of the neck of the womb are torn by the comming forth of the infant with great travel and many times by the use of sharp medicines and exulcerating pessaries Oft-times also nature avoids all the juice of the whole body critically by the womb after a great disease which flux is not rashly or suddenly to be stopped That menstrual blood that floweth from the womb is more gross black and clotty but that which commeth from the neck of the womb is more clear liquid and red CHAP. LVI Of stopping the immoderate flowing of the flowers or courses YOu must make choce of such meats and drinks as have power to incrassate the blood for as the flowers are provoked with meats that are hot and of subtil parts so they are stopped by such meats as are cooling thickning a stringent and sliptick as are barly-waters sodden rice the extreme parts of beasts as of oxen calves sheep either fried or sodden with sorrel purslain plantain shepherd's-purse sumach the buds of brambles berberries and such like It is supposed that a Harts-horn burned washed and taken in astringent water will stop all immoderate fluxes likewise sanguis draconis terra sigillata bolus armenus lapis haematites coral beaten into most subtil powder and drunk in steeled water also pap made with milk wherein steel hath oftentimes been quenched and the flowr of wheat barly beans or rice is very effectual for the same Quinces cervices medlars cornelian-berries or cherries may likewise be eaten at the second course Julips are to be used of steeled waters with the syrup of dry roses pomegranats sorrel myrtles quinces or old conserves of red roses but wine is to be avoided but if the strength be so extenuated that they require it you must chuse gross and astringent wine tempered with steeled water exercises are to be shunned especially Venerous exercises anger is to be avoided a cold air is to be chosen The institution or order of life which if it be not so naturally must be made so by sprinkling cold things on the ground especially if the summer or heat be then in his full strength sound sleeping stayes all evacuations except sweating The opening of a vein in the arm cupping-glasses fastened on the breasts bands and painful frictions of the upper parts are greatly commended in this malady But if you perceive that the cause of this accident lieth in a cholerick ill juice mixed with the blood Purging the body must be purged with medicines that purge choler and water as Rubarb Myrobalanes Tamarinds Sebestens and the purging syrup of Roses CHAP. LVII Of local medicines to be used against the immoderate flowing of the Courses ALso unguents are made to stay the immoderate flux of the terms and likewise injections and pessaries This or such like may be the form of an unguent â„ž ol mastich myrt an Ê’ii nucum cupres olibani An unguent myrtil an Ê’ii succi rosar rubr â„¥ i. pulv mastichin â„¥ ii boli armen terrae sigillat anÊ’ ss cerae quantum sufficit fiat unguentum An injection may be thus made â„ž aq plantag An astringent injection rosar rubr bursae pastor centinodii an lb ss corticis querni nucum cupressiâ— gallar non maturar an Ê’ ii berberis sumach balaust alumin. roch an Ê’i make thereof a decoction and inject it in a syringe blunt-pointed into the womb lest if it should be sharp it might hurt the sides of the neck of the womb also Snails beaten with their shells and applied to the navel are very profitable Quinces roasted under the coales and incorporated with the powder of Myrtles and Bole-Armenick and put into the neck of the womb are marvellous effectual for this matter The form of a pessarie may be thus A stringent pessaries â„ž gallar immaturar combust in aceto extinctar Ê’ii ammo Ê’ ss sang dracoâ— pulv rad symphyt sumach mastich fucci acaciae cornu cerust colophon myrrhae scoriae ferri an Ê’i caphur ℈ ii mix them and incorporate them all together with the juice of knot-grass syngreen night-shade hen-bane water-lillies plantain of each as much as is sufficient and make thereof a pessary Cooling things as Oxycrate unguentum rosatum and such like are with great profit used to the region of the loins thighs and genital parts but if this immoderate flux do come by erosion so that the matter thereof continually exulcerateth the neck of the womb let the place be annointed with the milk of a shee-Ass with barly-water or binding and astringent mucelages as of Psilium Quinces Gum Tragacanth Arabick and such like CHAP. LVIII Of Womens Fluxâ—s or the Whites The reason of the name BEsides the fore-named Flux which by the law of nature happeneth to women monthly there is also another called a Womans Flux because it is only proper and peculiar to them this sometimes wearieth the woman with a long and continual distillation from the womb The differences or through the womb comming from the whole body without pain no otherwise then when the whole superfluous filth of the body is purged by the reins or urine sometimes it returneth at uncertain seasons and sometimes with pain and exulcerating the places of the womb it differeth from the menstrual Flux because that this for the space of a few daies as it shall seem convenient to nature casteth forth laudable blood but this Womans Flux yeeldeth impure ill juice somtimes sanious sometimes serous and livid otherwhiles white and thick like unto barly-cream proceeding from flegmatick blood this last kind thereof is most frequent Therefore we see women that are phlegmatick and of a soft and loose habit of body to be often troubled with this disease and therefore they will say among themselves that they have the whites What women are apt to
this flux And as the matter is divers so it will stain their smocks with a different color Truly if it be perfectly red and sanguine it is to be thought it commeth by erosion or the exsolution of the substance of the vessels of the womb or of the neck thereof therefore it commeth very seldome of blood and not at all except the woman be either great with childe or cease to be menstrual for some other cause Womens flâ—x commeth veâ—y seldom of blood for then in stead of the monthly flux there floweth a certain whayish excrement which staineth her cloaths with the color of water wherein flesh is washed Also it very seldome proceeds of a melancholick humor and then for the most part it causeth a cancer in the womb But often-times the purulent and bloody matter of an ulcer lying hidden in the womb deceiveth the unskilful Chirurgian or Physician but it is not so hard to know these diseases one from the other for the matter that floweth from an ulcer By what signs an ulcer in the womb may be known from the white flowers because as it is said it is purulent it is also lesser grosser stinking and more white But those that have ulcers in those places especially in the neck of the womb cannot have copulation with a man without pain CHAP. LIX Of the causes of the Whites SOmetimes the cause of the Whites consisteth in the proper weakness of the womb or else in the uncleanness thereof and sometimes by the default of the principal parts For if the brain or the stomach be cooled or the liver stopped or schirrous many crudities are engendred which if they run or fall down into the womb that is weak by nature they cause the flux of the womb or Whites but if this Flux be moderate and not sharp How a womans flux is who eâ—â—me How it causeth diseases it keepeth the body from malign diseases otherwise it useth to infer a consumption leanness paleness and an oedematus swelling of the legs the falling down of the womb the dejection of the appetite and all the faculties and continual sadness and sorrowfulness from which it is very hard to perswade the sick woman because that her minde and heart will be almost broken by reason of the shame that she taketh How it leâ—teâ—h the concepâ—ion because such filth floweth continually it hindereth conception because it either corrupteth or driveth out the seed when it is conceived Often-times if it stoppeth for a few months the matter that stayeth there causeth an abscess about the wound in the body or neck thereof and by the breaking of the abscess there followeth rotten and cancerous ulcers sometimes in the womb sometimes in the groin and often in the hips This disease is hard to be cured not only by reason of it self Why it is hard to be cured as because all the whole filth and superfluous excrements of a womans body floweth down into the womb as it were into a sinke because it is naturally weak hath an inferior situation many vessels ending therein and last of all because the courses are wont to come through it as also by reason of the sick woman who oftentimes had rather die then to have that place seen the disease known or permit local medicines to be applied thereto for so saith Montanus An history that on a time he was called to a noble woman of Italy who was troubled with this disease unto whom he gave counsel to have cleansing decoctions injected into her womb which when she heard she fell into a swound and desired her husband never thereafter to use his counsel in any thing CHAP. LX. The cure of the Whites IF the matter that floweth out in this disease be of a red color it differeth from the natural monthly flux in this only because it keeps no order or certain time in its returning If the flux of a woman be red wherein it d ffereth from the menstrual flux Therefore phlebotomy and other remedies which we have spoken of as requisite for the menstrual flux when it floweth immoderately is here necessary to be used But if it be white or doth testifie or argue the ill juice of this or that humor by any other colour a purgation must be prescribed of such things as are proper to the humor that offends for it is not good to stop such a flux suddenly for it is necessary A womans flux is not suddenly to be stopped that so the body should be purged of such filth or abundance of humors for they that do hasten to stop it cause the dropsie by reason that this sink of humors is turned back into the liver or else a cancer in the womb because it is stayed there or a fever or other diseases according to the condition of the part that receiveth it Therefore we must not come to local detersives desiccatives restrictives unless we have first used universal remedies according to art Alum-baths baths of brimstone and of bitumen or iron are convenient for the whites that come of a phlegmatick humor What baths are profitable instead whereof baths may be made of the decoction of herbs that are hot dry and indued with an aromatick power with alom and pebbles or flint-stones red hot thrown into the same Let this be the form of a cleansing decoction and injection â„ž fol. absynth agrimon centinod burs-past an m. ss boil them together and make thereof a decoction in which dissolve mellis rosar â„¥ .ii aloes myrrhae salis uitri an Ê’i make thereof an injection the woman being so placed on a pillow under her buttocks that the neck of the womb being more high An astringent injection may be wide open when the injection is received let the woman set her legs across and draw them up to her buttocks and so she may keep that which is injected They that endeavor to dry and binde more strongly add the juice of acatia green galls the findes of pomegranats roch-alome Romane vitriol and they boil them in Smiths water and red-wine pessaries may be made of the like faculty The signs of a putrified ulcer in the womb If the matter that commeth forth be of an ill color or smell it is like that there is a rotten ulcer therefore we ought to inject those things that have power to correct the putrefaction among which Aegyptiacum dissolved in lie or red wine excelleth There are women which when they are troubled with a virulent Gonorrhaea The vâ—rulent Gonorrhaea is like unto the flux of women or an involuntary flux of the seed cloaking the fault with an honest name do untruly say that they have the whites because that in both these diseases a great abundance of filth is avoided But the Chyrurgian may easily perceive that malady by the rottenness of the matter that floweth out and he shall perswade himself that it will not be cured without salivation or fluxing
heare by his so many ears yet hath he but one mouth and one belly to contain his meat but his round body is encompassed with many feet by whose help he can go any way he please without turning of his body his tail is something long and very hairy at the end Blood as good as balsom The inhabitants affirm that his blood is more effectuall in healing of wounds then any balsom It is strange that the Rhinoceros should be a born enemy to the Elephant wherefore he whets his horn which grows upon his nose upon the rocks and so prepares himself for fight wherein he chiefly assails the belly as that which he knows to be the softest he is as long as an Elephant but his legs are much shorter he is of the colour of box yet somewhat spotted Pompy was the first Plin. 18. c. 29. that shewed one at Rome The figure of the Rhinoceros The figure of the Chameleon Plim lib. 8. c. 33. Affrica produceth the Cameleon yet is it more frequent in India he is in shape and greatness like a Lizard but that his legs are strait and higher Arist lib. 2. hist anim cap. 12. his sides are joyned to the belly as in fish and his back stands up after the same manner his nose stands out not much unlike a swines his tail is long and endeth sharp and he foulds it up in a round like a serpent his nails are crooked his pace slow like as the Tortoise his body rough be never shuts his eyes neither doth he look about by the moving of the apple but by the turning of the whole eye The strange nature of the colour of the Chameleon The nature of his colour is very wonderful for he changeth it now and then in his eye and tail and whole body beside and he alwayes assimilates that which he is next to unless it be red or white His skin is very thin and his body clear therefore the one of these two either the colour of the neighbouring things in so great subtility of his clear skin easily shines as in a glass or else various humors diversly stirred up in him according to the variety of his affections represent divers colours in his skin as a turky-cock doth in those fleshy excrescences under his throat and under his head he is pale when he is dead Mathiolus writes that the right eye taken from a living Chameleon takes away the white spots which are about the thorny coat of the eye his body being beaten and mixed with Goats milk and rubbed upon any part fetcheth off hairs his gall discusseth the Cataracts of the eye CHAP. XIII Of Celestial Monsters PEradventure it hath not been strange that monsters have been generated upon the earth and in the Sea but for monsters to appear in heaven and in the upper region of the air exceeds all admiration Yet have we often read it written by the antients that the face of heaven hath been deformed by bearded tailed and haired Comets by meteors representing burning torches and lamps pillars darts shields troups of clouds hostilly assayling each other Dragons two Moons Suns and the like monsters and prodigies The figure of a fearfull Comet Also there have been seen great and thick bars of Iron to have faln from heaven which have presently been turned into swords and rapiers At Sugoliah in the borders of Hungaria a stone fell from Heaven wich a great noise the seventh day of September Anno Dom. 1514 it weighed two hundred and fifty pound the Citizens hangâ—â—â— up with a great iron-chain put through it in the midst of the Church of their City and used to shew it as a miracle to travellers of better note that pass that way * L. 2. c. 57. Pliny reports that clashing of armour and the sound of a trumpet were heard from Heaven often before and after the Cimbrian war The same author writes that in the third Consul-ship of Marius the Amarines and Tudortines saw the heavenly armies comming from East and West and so joyning those being vanquished which came from the East Which same thing was seen in Lusalia at a town called Jubea too hours after midnight Anno Dom. 1535. But in Anno Dom. 1550. upon the 19. day of Julie in Saxony not far from Wittenburg there appeared in the air a great Stag incompassed with two armed Hosts making a great noise in their conflict and at the same instant it rained blood in great abundance the Sun seemed to be cloven in two pieces and the one of them to fall upon the earth A little before the taking of Constantinople from the Christians Presages of the taking of Constantinople Monstrous rains there appeard a great army in the air appointed to fight attended on with a great company of dogs and other wilde beasts Julius Obsequius reports that in Anno Dom. 458. it rained flesh in Italy in great and lesser pieces part of which were devoured by the birds before they fell upon the earth that which fell upon the earth kept long unputrified and unchanged in colour and smell A. Dom. 989. Otho the third being Emperor it rained corn in Italy A. Dom. 180. it rained milk and oyl in great abundance and fruit-bearing trees brought forth corn Lycosthenes tells that in the time of Charles the fifth whilst Maidenburg was besieged three suns first appeared about 7. a clock in the morning and then were seen for a whole day whereof the middlemost was the brightest the two others were reddish and of a bloody colour but in the night time there appeared three Moons The same appeared in Bavaria Anna Dom. 1554 But if so prodigious and strange things happen in the Heavens besides the common order of nature shall we think it incredible that the like may happen in the earth Earthquakes Anno Dom. 542. the whole earth quaked mount Aetna cast forth flames and sparks of fire with which many houses of the neighbouring villages were burn'd Anno Dom. 1531. in Portugal there was an earthquake for eight dayes and it quaked seven or eight times each day so that in Lisbone alone it cast down a thousand and fifty houses and more then six hundred were spoyled Ferrara lately was almost wholly demolished by a fearful earthquake Above all which ever have been heard is that prodigie which happened in the time of Pliny at the death of Nero the Emperor in the Marucine field the whole Olive-field of Vectius Marcellus a Roman Knight going over the high way Lib. 2 cap. 73. and the fields which were against it comming into the place thereof Why should I mention the miracles of waters from whose depth and streams fires and great flames have oft broke forth They tell out of St. Angustine that the fire of the sacrifice which for those seventy years of the Babylonian captivity endured under the water was extinguished Antiochus selling the priest-hood to Jason What miracle is this that the fire
separate your desired oyl now there will ten or twelve ounces of oyl flow from a pound of Turpentine This kinde of oyl is effectual against the Palsie Convulsions punctures of the nerves and wounds of all the nervous parts How to make oyl of wax But you shall thus extract oyl our of wax Take one pound of wax melt it and put it into a glass Retort set it in sand or ashes as we mentioned a little before in drawing oyl of Turpentine then distil it by increasing the fire by degrees There distils nothing forth of wax besides an oily substance and a little Phlegma yet portion of this oyly substance presently concretes into a certain butter-like matter which therefore would be distilled over again you may draw â„¥ vi or viii of oyl from one pound of wax The faculties thereof This oyl is effectual against Contusions and also very good against cold affects CHAP. XV. Of extracting of Oyls out of the harder sorts of Gums as myrrh mastich Frankincense and the like SOme there be who extract these kindes of oyls with the Retort set in ashes or sand as we mentioned in the former Chapter of Oyls of More liquid Gums adding for every pound of Gum two pintes of Aqua Vitae and two or three ounces of oyl of Turpentine then let them infuse for eight or ten daies in Balneo mariae How to make oyl or myrrh or else in hors-dung then set it to distil in a Retort Now this is the true manner of making oyls of Myrrh take Myrrh made into fire powder and therewith fill hard Eggs in stead of their yelks being taken out then place the Eggs upon a gridiron or such like grate in some moist place as a cellar and set under them a leaden-earthen-pan the Myrrh will dissolve into an oily-water which being presently put into a glass and well stopped with an equal quantity of rectified Aqua vitae and so set for three or four months in hot hors-dung which past the vessel shall be taken forth and so stopped that the contained liquor may be poured into an Alembick for there will certain gross settling by this means remain in the bottom then set your Alembick in Balneo and so draw off the Aqua vitae and phlegmatick liquor and there will remain in the bottom a pure and clear oyl whereto you may give a curious color by mixing therewith some Alkanet How to give it a pleasing color and smell and a smell by dropping thereinto a little oyl of Sage Cinnamon or Cloves Now let us shew the composition and manner of making of balsams by giving you one or two examples the first of which is taken out of Vesalius his Surgery and is this â„ž terebinth opt lbi ol laurini â„¥ iv gum elem â„¥ iv ss thuris myrrhae gum beredae centaur majoris Vesalius his Balsam ligni aloes an â„¥ iii. galangae caryopholl consolidae majoris Cinnamomi nucis moschat zedoariae zin zib dictamni albi an â„¥ i olei vermium terrestrium â„¥ ii aqua vitae lbvi. The manner of making it is thus Let all these things be beaten and made small and so infused for three dayes space in Aqua vitae then distilled in a Retort just as we said you must distill oyl of Turpentine and Wax There will flow hence three sorts of liquors the first watrish and clear the other thin and of pure golden color the third of the color of a Carbuncle which is the true Balsam The first liquor is effectual against the weakness of the stomach comming of a cold cause for that it cuts phlegm and discusses flatulencies the second helps fresh and hot bleeding wounds as also the palsie The third is chiefly effectual against these same effects The composition of the following Balsamum is out of Fallopius and is this â„ž terebinth clarae lbii. olei de semine lini lbi resinae pini â„¥ vii thuris myrrhae aloes mastiches sarcocollae an â„¥ iii. macis ligni Aloes an â„¥ ii croci â„¥ ss Let them all be put into a glass Retort Fallopius hic Balsam set it ashes and so distilled First there will come forth a clear water then presently after a reddish oyl most profitable for wounds Now you must know that by this means we may easily distil all Axungias fats parts of creatures woods all kindes of barks and seeds if so be that they be first macerated as they ought to be yet so that there will come forth more watry then oily humidity Now for that we formerly frequently mentioned Thus or Frankincense What Frankincense is I have here thought good out of Thevets Cosmography to give you the description of the tree from which it flows The Frankincense-tree saith he grows naturally in Arabia resembles a Pine yeelding a moisture that is presently hardened and it concretes into whitish clear grains fatty within which cast into the fire take flame Now Frankincense is adulterated with Pine-rosin and Gum which is the cause that you shall seldome finde that with us as it is here described you may finde out the deceit thus for that neither Rosin nor any other Gum takes flame for Rosin goes away in smoke but Frankinsence presently burns The smell also bewraies the counterfeit for it yeelds no graceful smell as Frankinsence doth The Arabians wound the tree that so the liquor may the more readily flow forth The faculties thereof whereof they make great gain It fills up hollow ulcers and cicatrizes them wherefore it enters as a chief ingredient into artificial balsom Frankinsence alone made into ponder and applied stanches the blood that flows out of the wounds Matthiolus saith that it being mixed with Fullers-earth and oyl of Roses is a singular remedy against the inflammation of the breasts of women lately delivered of childe CHAP. XVI The making of oyl of Vitriol TAke ten pounds of Vitriol which being made into powder put it into an earthen pot The sign of perfectly calcined vitriol and set it upon hot coals until it be calcined which is when as it become reddish after some five or six hours when as it shall be throughly cold break the pot and let the Vitriol be again made into powder that so it may be calcined again and you shall do thus so often and long until it shall be perfectly calcined which is when as it shall be exactly red then let it be made into powder and put it into an earthen-Retort like that wherein aqua fortis is usually drawn adding for every pound of your calcined Vitriol of tile-shreds or powdered-brick one quarter then put the Retort furnished with its receiver into a Fornace of Reverberation alwaies keeping a strong fire and that for the space of 48. hours more or less according to the manner and plenty of distilling liquor You shall know the distillation is finished when as the Receiver shall begin to recover his native perspicuity being not now filled
Christ and love toward his neighbors with hope of life everlasting left that he being carried away by favor or corrupted with money or rewards should affirm or testifie those wounds to be small that are great and those great that are small for the report of the wound is received of the Surgeon according to the Civil Law Wounds termes great for three respects It is recorded in the works of antient Physicians that wounds may be called great for three respect The first is by reason of the greatness of the dissolved Unity or resolution of Continuity and such are these wounds which made by a violent stroke with a back-sword have cut off the arm or leg or overthwart the breast The second is by reason of the dignity or worthiness of the paâ—t now this dignity dependeth on the excellency of the action therefore thus any little wound made with a bodkin knife in any part whose substance is noble as in the brai Heart Liver or any other part whose action and function is necessary to preserve life as in the Weasant Lungs or Bladder is iudged great The third is by reason of the greatness and ill habit or the abundance of ill humors or debility of all the wounded body so those wounds that are made in the nervous parts and old decayed people are said to be great But in seaching of wounds let the surgeon take heed that he be not deceived by his probe For many times it cannot go into the bottom 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 stroke being made down right slipt aside to the right or left hand or else from below upwards or from above downwards and then he may expect that the wound is but little and will be cured in a short time How long a Surgeon must suspend his judgment in some cases when it is like to be long in curing or else mortal Therefore from the first day it behooveth him to suspend his judgment of the wound until the ninth for in time the accidents will shew themselves manifestly whether they he small or great according to the condition of the wound or wounded bodies and the state of the air according to his prinitive qualities or venemous corruption General signs whereby we judg of diseases But generally the signs whereby we may judg of diseases whether they be great or small of long or short continuance mortal or not mortal are four For they are drawn 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 we are called to the cure of a green 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 soon be cured But if it have an Ulcer annexed unto it that is if it be fanious then we may say it will be more difficult and long in curing and so we may pronounce of all diseases taking a sign of their essence and nature But of the signs that are taken of the causes let this be an example A wound that is made with a sharp-pointed and heavy weapon as with an halberd being stricken with great violence must be accounted great yea and also mortal if the accidents be correspondent But if the patient fall to the ground through the violence of the stroke if a cholerick vomiting following thereon if his sight fail him together with a giddiness if blood come forth at his eyes and nostrils if distraction follow with loss of memory and sense of feeling we may say that all the hope of life remaineth in one small sign which is to be deduced from the affects of the wound But by comparing it unto the season that then is and diseases that then assault mans body Wounds deadly by the fault of the air we may say that all those that are wounded with Gun-shot are in danger of death as it happened in the skirmishes at the siege of Rean and at the battle of Saint Denis For at that time whether it were by reason of the sault of the heavens or air through the evil humors of mans body and the disturbance of them all wounds that were made by Gun-shot were for the most part mortal So likewise at certain seasons of the year we see the small-pocks and meazles break forth in children as it were by a certain pestilent contagion to the destruction of children only inferring a most cruel vomit and lask and in such a season the judgment of those diseases is not difficult Signs of a fractured scull But you by the following signs may know what parts are wounded If the patient fall down with the stroke if he lye â—ensless as it were asleep if he avoid his excrements unwittingly if he be taken with giddiness if blood come out at his ears mouth and nose and if he vomit choler you may understand that the scull is fractured or pierced through by the defect in his understanding and discourse You also may know when the scull is fractured by the judgment of your external senses as if by feeling it with your finger you finde it elevated or depressed beyond the natural limits if by striking it with the end of a probe when the Perictanium or nervous film that investeth the scull is cut cross-wise and so divided there from it it yield a base and unperfect sound like unto a pot-sheard that is broken or rather like to an earthen-pitcher that hath a cleft or rent therein But we may say that death is at hand if his reason and understanding fail him Signs of death by a wound on the head if he be speechless if his sight forsake him if he would tumble head-long out of his bed being not at all able to remove the other parts of his body if he have a continual fever if his tongue be black with driness if the edges of the wound be black or drye and cast forth no sanions matter if they resemble the colour of salted-flesh if he have an apoplexy phrensie convulsion or palsie with an involuntary excretion or absolute suppression of the urine and excrements Signs that the throat is cut You may know that a man hath his throat 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 speak nor swallow any meat or drink and the parts that are cut asunder divide themselves by retraction upwards or downwards one from another whereof cometh sudden or present death You may know that a wound hath pierced into the brest or
concavity of the body Signs that a wound hath pierced in the concavity of the chest if the air come forth at the wound making a certain whizzing noise if the patient breathe with great difficulty if he feel a great heaviness or weight on or about the midriff whereby it may be gathered that a great quantity of blood lieth upon the place or midriff and so causeth him to feel a weight or heaviness which by little and little will be cast up by vomiting But a little after a fever commeth and the breath is unsavory and stinking by reason that the putrifying blood is turned into sanies the patient cannot lye but on his back and he hath an often desire to vomit but if he 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 Signs that the Lungs are wounded That the Heart is wounded he is vexed with a grievous shortness of breath and with pain in his sides We may perceive the heart to be wounded by the abundance of blood that commeth out at the wound by the trembling of all the whole body by the faint and small pulse paleness of the face cold sweat with often swooning coldness of the extreme parts and sudden death When the midriff which the Latins call Diaphragma is wounded The Midriff the patient feeleth a great weight in that place he raveth and talketh idlely he is troubled with shortness of winde a cough and fit of grievous pain and drawing of the intrals upwards Wherefore when all these accidents appear we may certainly pronounce that death is at hand Death appeareth suddenly by a wound of the hollow Vein or the great Artery The Vena Cava and great Artery by reason of the great and violent evacuation of blood and spirits whereby the functions of the Heart and Lungs are stopped and hindered The marrow of the back bone being pierced The spinal marrow the patient is assaulted with a palsie or convulsion very suddenly 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 cometh out at the wound The Liver and pricking-pain disperseth it self even unto the sword-like gristle which hath its situation at the lower end of the breast-bone called Sternon the blood that followeth from thence down into the intestines doth oft-times infer most malign accidents yea and sometimes death When the stomach is wounded the meat and drink come out at the wound The Stomach there followeth a vomiting of pure choler then commeth swearing and coldness of the extreme parts and therefore we ought to prognosticate death to follow such a wound When the Milt or Splene is wounded black and gross blood cometh out at the wound The spleen the patient will be very thirsty with pain on the left side and the blood breaks forth into the belly and there purrifying causeth most malign and grievous accidents and often-times death to follow When the guts are wounded the whole body is griped and pained The Guts the excrements come out at the wound whereat also oft-times the guts break forth with great violence When the reins of Kidnies are wounded the patient will have great pain in making his urine The Kidnies and the blood commeth out together therewith the pain commeth down even unto the groin and yard and testicles When the Bladder and Ureters are wounded the pain goeth even unto the entrails The Bladder the parts all about and belonging to the groin are d stended the urine is bloody that is made and the same also commeth oftentimes out of the wound When the womb is wounded the blood commeth out at the privities The womb and all other accidents appear like as when the bladder is wounded The nerves When the sinews are pricked or cut half asunder there is great pain in the affected place and there followeth a sudden inflammation flux abscess fever convulsion and oftentimes a gangrene or mortification of the part whereof commeth death unless it be speedily prevented Having declared the signs and tokens of wounded parts it now remaineth that we set down other signs of certain kindes of death that are not common or natural whereabout when there is great strife and contention made it oftentimes is determined and ended by the judgment of the descreet Physician or Surgeon Signs that an infant is smothered or over-laid Therefore if it chance that a nurse either through drunkenness or negligence lies upon the infant lying in bed with her and so stifles or smothers it to death If your judgment be required whether the infant died through the default or negligence of the nurse or through some violent or sudden disease that lay hidden and lurking in the body thereof you shall finde out the truth of the matter by these signs following For if the infant were in good health before if he were not froward or crying if his mouth and nostrils now being dead be moistened or bedewed with a certain foam if his face be not pale but of a Violet or Purple colour if when the body is opened the Lungs be found swoln and puffed up as it were with a certain vaporous foam and all other intrails sound it is a token that the infant was stifled smothered or strangled by some outward violence If the body or dead corps 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 slain by lightning or some other violent death you may by the following signs finde out the certainty hereof Signs of such as are slain by lightning For every body that is blasted or stricken with lightning doth cast forth or breathe out an unwholsome stinking or sulphureous smell so that the birds and sowls of the air or dogs will not once touch it much less prey or feed upon it the part that was stricken oftentimes sound and without a wound but if you search it well you shall finde the bones under the skin to be bruised broken or shivered in pieces Lib. 2. cap. 54. But if the lightning hath pierced into the body with making a wound therein according to the judgment of Pliny the wounded part is far colder then all the rest of the body For lightning driveth the most thin and fiery air before it and striketh it into the body with great violence by the force whereof the heat that was in the part is soon dispersed wasted and consumed Lightning doth alwaies leave some impression or sign of some fire either by ustion or blackness for no Lightning is without fire Moreover whereas all other living creatures when they are
was forced to forego it he was so infamous amongst all men during the rest of his life as one banished or forlorn and losing his freedom he shall become a servant yea scorned and reviled of all men he should be accounted unworthy to enjoy the light and society of men And certainly the Egyptians understanding the life which we here lead to be of short continuance comparison being made with that which we are to live after separation of the soul from the body they were more negligent in building their houses they dwelt in but in rearing the Pyramids which should serve them in stead of sepulchres The reason of building of the Egyptians Pyramids they were so beyond reason sumptuous and magnificent that for the building of one of these edifices so renowned over all the world which King Cheopes begun a hundred thousand men were every three months for twenty years space there kept at work It was five furlongs and being square each side was 800. foot long and so much in height Almost all the pieces of marble went to the building thereof were thirty foot long engraven and carved with various workmanship as Heredotus reports Lib. 2. But before the bodies were committed to these magnificent Sepulchres they were carrried to the Salters and Embalmers who for that purpose had allowance out of the publick stock These besmeared them with Aromatick and Balsamick ointments and sewed up the incisions they made then strewed them over with salt and then covered them with brine for 70. dayes which being expired they washed them being taken thence and all the filth being taken off they wrapped then in Cotton-Cloths glued together with a certain gum then their kinsmen placed them thus ordered in a wooden Coffin carved like to a man This was the sacred and accustomed rite of Embalming and Burying dead bodies amongst the Egyptians which were of the richer sort Our country-men the French stirred up with the like desire embalm the bodyes of their Kings and Nobles with spices and sweet ointments Which custom they may seem piously and Christianly to have taken from the Old and and New Testament and the antient and laudable custome of the Jews for you may read in the Nest Testament that Joseph bought a fine linnen cloth John 19.39 and Nicodemus brought a mixture of myrrh and Aloes about 100. pound weight that they might embalm and bury the body of Jesus Christ our Saviour for a sign and argument of the renovation and future integrity which they hoped for by the resurrection of the dead Which thing the Jews had received by tradition from their ancestors For Joseph in the old Testament commanded his Physicians Gen. 50.2 The manner of embalming for a long continuance that they should enbalm the dead body of his father with spices But the body which is to be Embalmed with spices for very long continuance must first of all be embowelled keeping the heart apart that it may be embalmed and kept as the kinsfolks shall thing fit Also the brain the scull being divided with a saw shall be taken out Then shall you make deep incisions along the arm thighs legs back loins and buttocks especially where the greater veins and arteries run first that by this means the blood may be pressed forth which otherwise would putrifie and give occasion and beginning to putrefaction to the rest of the body and then that there may be space to put in the aromatick powders the whole body shall be washed over with a spunge dipped in aqua vitae and strong vinegar wherein shall be boyled wormwood aloes coloquintida common salt and alum Then these incisions and all the passages and open places of the body and the three bellies shall be stuffed with the following spices grosly powdered â„ž pul rosar chamaem melil balsami menthae anethi salviae lavend. rorismar marjoran thymi absâ—nthii cyperi calami aromat gentianae ireos florent assae odoratae caryophyll nucis moschat cinnamomi styracis calamitae benjoini myrrhae aloes santal omnium quod sufficit Let the incisions be sowed up and the open spaces that nothing fall out then forthwith let the whole body be annointed with Turpentine dissolved with oyl of Roses and Camomil adding if you shall think it fit some Chymical oyls of spices and then let it be again strewed over with the fore-mentioned powder then wrap it in a linnen-cloth and then in sear-cloths How to embalm bodies when as we want spices Lastly let it be put in a Coffin of Lead sure sondered and filled up with dâ—ye sweet herbs But if there be no plenty of the fore-mentioned spices as it usually happens in besieged towns the Surgeon shall be contented with the powder of quenched lime common ashes made of oke-wood For thus the body being over and above washed in strong vinegar or Lye Why the bodies of our Princes how well soever embalmed corrupt in a few daies shull be kept a long time if so be that a great dissolving heat do not bear sway or if it be not put in a hot and moist place And this condition of time and place is the cause why the dead bodies of Princes and Kings though enbalmed with Art and cost within the space of six or seven dayes in which they are kept to be shewed to the people after their embalming do cast forth so greivous a sent that none can indure it so that they are forced to be put in a leaden Coffin For the air which incompasseth them groweth so hot by reason of the multitude of people flowing to the spectacle and the burning of lights night and day that the small portion of the native heat which remaineth being dissipated they easily putrifie especially when as they are not first moistened and macerated in the liquor of aromatick things as the Aegyptians antiently used to do steeping them in brine for 70 dayes as I formerly told you out of Herodotus I put in minde hereby use that so the embalming may become the more durable to steep the bodies being embowelled and pricked all over with sharp bodkins that so the liquor hindering putrefaction may penetrate the deeper into them in a wooden tub filled with strong vineger of the decoction of aromatick and bitter things as Aloes Rue Wormwood and Coloquintida and there keep them for twenty dayes pouring thereinto eleven or twelve pintes of Aqua vitae Then takâ—ng it forth and setting it on the feet I keep it in a clear and drye place I have at home the body of one that was hanged which I begged of the Sheriff embalmed after this manner which remains sound for more then 25 years so that you may tell all the muscles of the right side which I have cut up even to their heads and plucked them from those that are next them for distinctions sake that so I may view them with mine eyes and handle them with my hands as often as I please that by renewing my
the space of three years with extreme pain by reason of a great Caries which was in the bone Asiragal Cyboides great â—nd little â—â—cil and through all the nervous parts through which she felt extreme and intolerable pains night and day she is called Mary of Hostel aged 28 years or thereabouts wife of Peter Heâ—ve Esquire of the Kitchin to the Lady Ducheâ—s of Vzez dwelling in the meet of Verbois on the other side S. Martin in the fields dwelling at the sign of the S. John's-head where the said Charbâ—nel cut off the said leg The operation of Charbonel the bredth of 4 large fingers below the knee and after that he had inâ—â—ed the flesh and â—awed the bone he griped the vein with the Crow-bill then the Artery then tied them fâ—om whence I protest to God which the company that were there can witness that in all the operation that was suddenly done there was not spilt one porrenger of blood and I bid the said Charbonel to let it bleed more following the precept of Hippâ—crates that it is good in all wounds and also in inveterate ulcers to let the blood run by this means the part is less subject to inflammation In the â— Cent. of â—e bâ—ok of Ulcers The said Charbonel continued the dressing of her who was cured in two months without any flux of blood happening unto her or other ill accident and she went to see you at your lodging being perfectly cured Another History Another history of late memory of a singing-man of our Ladies Church named M. Colt who broke both the bones of his leg which were crusht in divers pieces insomuch that there was no hope of cure to withstand a gangrene and mortification and by consequence death Monsieur Helin Doctor Regent in the faculty of Physick a man of honor and good knowledge Claud. Viard and Simon Peter sworn Surgeons of Paris men well exercised in Surgery and Balthazar of Lestre and Leonard de Leschenal Operation done by Viaâ—d M. Barber-Surgeons weâ—l experimented in the operations of Surgery were all of opinion to withstand the accidents aforesaid to make entire amputation of the whole leg a little above the broken and shivered bones and the torn nerves veins arteries the operation was nimbly done by the said Viard and the blood stancht by the ligature of the vessels in the presence of the said Helin and M. Tousard great vicar of our Ladies Church and was continually drest by the said Leschenal and I went to see him otherwhiles he was happily cured without the applâ—cation of hot irons and walketh lustily on a woodden leg Another History In the year 1583. the 10. day of December Toussiant Posson born at Ronieville at this present dwelling at Beauvais near Dâ—urdan having his leg all ulcered and all the bones cariez'd and rotten prayed me for the honor of God to cut off his leg by reason of the great pain which he could no longer endure After his body was prepared I caused his leg to be cut off four fingers below the retula of the knee by Daniel Powlet one of my servants to teach him and to imbolden him in such works and there be readily tied the vessels to stay the bleeding without application of hot irons in the presence of James Guillemau ordinary Surgeon to the King and John Châ—â—bâ—nel Master-Surgeon of Paris and during the cure was visited by M. Laffile and M. Couâ—tin Doctor Regents in the faculty of medicine at Paris The said operation was made in the house of John â—â—hel Inn-keeper dwelling at the sign of the white-Horse in the Greve I will not heâ—e forget to say that the Lady Princess of Montpensier knowing that he was poor and in my hands gâ—ve him mony to pay for his chamber and diet He was well cured God be praised and is returned home to his house with a woodden-leg Another History A Gangreen happening by an Antecedent cause A Gangreen happened to half of the leg to one named Nicolas Mesnager aged 76. years dwelling in S. Honores street at the sign of the Basket which happened to him through an inward cause so that we were constrained to cut off his leg to save his life and it was taken off by Antony Renaud Master Barber-Surgeon of Paris the 16. day of December 1583. in the presence of M. Le Fort and M. La Nave sworn Surgeons of Paris and the blood was stanched by the Ligature of the Vessels and he is at this present cured and in health walking with a wooden-leg A water-man at the Port of Nesle dwelling near Monsieur de Mas Post-master Another History nâ—â—ed John Boussereau in whose hands a Musket brake asunder which broke the bones of his hâ—â—d 〈◊〉 â—ent â—nd tore the other parts in such sort that it was needful and necessary to make aâ—p◠〈…〉 the â—â—nd two fingers above the wrist Operation d nâ— by Gullâ—mâ—r which was done by James Guillemau then Surgâ—on 〈…〉 the King who dwelt at that time with me The operation likewise beiâ—â—â—ly â—one and the blood stanched by the Ligature of the vessels without burning â—ons he is 〈◊〉 this present living A Merchant Grocer dwelling in S. Denis-street at the sign of the 〈…〉 named the Judg who fell upon his head where was made a wound 〈…〉 â—poral muscle Another History Operation â— done by the Author where he had an artery opened from whence issued forth blood wâ—◠〈…〉 impeâ—â—oâ—â—y insomuch that common remedies would not serve the turn I was called tâ—â—â—her wâ—â—re I found Mr. Russe Mr. Câ—interet Mr. Viard sworn Surgeons of Paris to stay â— ood where presently I took a needle and thred and tied the artery and it bled no more after that and was quickly cured Mr. Rowssellet can witness it not long since Deacon of your Faculty who was in the cure with us A Sergaant of the Chastlet dwelling near S. Andrew des Aâ—ts Another History Another operation who had a stroak of a sword upon the throat in the Clacks medow which cut asunder the jugular vein extern as soon as he was hurt he put his hankeâ—â—her upon the wound and came to look me at my house and when he took away his hankercheâ— the blood leaped out with great impetuosity I suddenly tied the vein toward the root he by this this means was stanched and cured thanks be to God And if one had followed your manner of stanching blood by cauteries I leave it to be supposed whether he had been cured I think he had been dead in the hands of the operator If I would recite all those whose vessels were tied to stay the blood which have been cured I should not have ended this long time so that me thinks there are Histories enough recited to make you believe the blood of veins and arteries is surely stanched without applying any outward cauteries He that doth strive against experience Daigns not to talk of any learned science NOw my
else make them lye for all together Also there was order given to the women to unpave the streets and to cast out at their windows billets tables tresses forms and stools which would have troubled their brains moreover there was a little further a strong Court of Guard filld with carts und pallisados pipes and hogsheads filld with earth for barricados to serve to interlay with faulcons faulconets field-pieâ—es harquibuzes muskets and pistols and wilde-fire which would have brokenlegs and thighs insomuch that they had been beaten in head in flank and in tail and where they had forced this Court of Guard there was others at the crossing of the streets each distant an hundred spaces who had been as bad companions as the first and would not have been without making a great many Widdows and Orphans And if fortune would have been so much against us as to have broken our Courts of Guard there was seven great Bastallions ordered in square and triangle to combate altogether each one accompanied with a Prince to give them boldness and encourage them to fight even till the last gasp and to dye all together Moreover it was resolved that each one should carry his treasure rings and jewels and their houshold-stuff of the best to burn them in the great place and to put them into ashes rather then the enemy should prevail and make Trophies of their spoils likewise there was people appointed to put fire to the munition and to beat out the heads of the Wine-casks others to put the fire in each house to burn our enemies and us together the Citizens had accorded it thus rather then to see the bloody knife upon their throat and their Wives and Daughters violated and to be taken by force by the cruel inhumane Spaniards Now we had certain prisoners which Monsieur de Guise sent away upon their faith to whom was secretly imparted our last resolution will and desperate mindes who being arrived in their Camp do not defer the publishing which bridled the great impetuosity and will of the souldiers to enter any more into the City to cut our throats and to enrich themselves of our pillages The Emperor having understood this deliberation of the great Warriour the Duke of Guise put water in his wine and restrained his great choler and fury saying He could not enter into the City without making a great slaughter and butchery and spill much blood as well of the defendants as of the assaylants and that they should be dead together and in the end could have nothing else but a few ashes and that afterward it might be spoken of that as of the destruction of Jerusalem already made by Titus and Vespatian The Emperor then having understood our last resolution and seeing their little prevailing by their battery and undermining and the great plague which was in his whole army and the indisposition of the time and the want of victuals and mony and that his souldiers forsook him and went away in great companies concluded in the end to retire themselves accompanied with the Cavallery of his Vantguard with the greatest part of his Artillery and the Battalia The Marquess of Brandeburg was the last which uncampt maintained by certain bands of Spaniards Bohemians and his German companies and there remained one day and a half after to the great grief of Monsieur de Guise who caused four pieces of Artillery to be brought out of the City which he caused to be discharged at him on one side and the other to hasten them to be gon which he did full quickly with all his Troops He being a quarter of a league from Mets was taken with a fear lest our Cavallery should fall upon him in the Rere which caused him to put fire to his munition-powder and leave certain pieces of Artillery and much baggage which he could not carry because the Vantguard and the Battalia and great Cannons had too much broken the way Our hors-men would by all means have gone out of the city to have falln upon their breech But Monsieur de Guise would never permit them but on the contrary we should rather make plain their way and make them bridges of gold and silver and let them go being like to a good shepherd who will not lose one of his sheep See now how our well-beloved Imperialists went away from before the City of Mets which was the day after Christmas day to the great contentment of the besieged and honor of Princes Captains and Souldiers who had endured the travels of this siege the space of two moneths Notwithstanding they did not all go there wanted twenty thousand who were dead as well by Artillery as by the sword as also by the plague cold and hunger and for spite they could not enter into the City to cut our throats and have the pillage and also a great number of their horses died of which they had eaten a great part in stead of Beef and Bacon They went where they had been encamped where they found divers dead-bodies not yet buried and earth all digged like S. Innocents Church-yard in the time of the Plague They did likewise leave in their lodgings pavillions and tents divers sick people also bullets arms carts wagons and other baggage with a great many of munition loaves spoiled and rotten by the rain and snow yet the souldiers had it but by weight and measure and likewise they left great provision of wood of the remainders of the houses of the Villages which they had pluckt down two or three miles compass likewise divers other houses of pleasure belonging to the Citizens accompanied with fair gardens and grass-plats fild with fruit-trees for without that they had been starved with cold and had been constrained to have raised the siege sooner The said Monsieur de Guise caused the dead to be buried and dress their sick people likewise the enemies left in the Abby of S. Arnoul divers of their hurt souldiers which they could not lead with them the Said Monsieur de Guise sent them all victuals enough and commanded me and other Surgeons to go dress them and give them medicines which we willingly did and think they would not have done the like toward others because the Spaniard is most cruel perfidious and inhumane and therefore enemy to all Nations which is proved by Lopez a Spaniard and Benzo of Milan and others who have written the history of America and the West Indies who have been constrained to confess that the cruelty avarice blasphemy and wickedness of the Spaniards have altogether alienated the poor Indians from the Religion which the said Spaniards are said to hold And all write they are less worth then the Idolatrous Indians by the cruel usage done to the said Indians And after a few dayes we sent a Trumpet to Thionville toward the enemy that they should send back for their wounded men in safety which they did with Carts and Waggons but not enough Monsieur de Guise caused
Savoy with six other Surgeons following the Army to see the hurt of the said Lord of Martigues and to know of me how I had dressed him and with what medicines The Emperors Physician bid me declare the essence of the wound and how I had drest it Now all the assistants had a very attentive ear to know if the wound were mortal 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 Arquebus quite through the body presently I was called to dress him I saw he cast out blood out of his mouth and his wounds Moreover he had a great difficulty 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 sharp pricking pain at the entrance of the bullet I do beleive and think it might be some little pieces 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 out-going of it had likewise broken the fifth Rib with pieces of bones which had been driven from within outward I drew out some but not all because they were very deep and adherent I put in each wound a Tent having the head very large tied with a thred lest by the inspiration it might be drawn into the capacity of the Thorax which hath been known by experience to the detriment of the poor wounded for being faln in it cannot be taken out which is the cause that engenders putrefaction a thing contrary to nature The said Tents were annointed with a medicine composed of yelks of eggs Venice-turpentine with a little oyl of Roses My intention for putting the Tents was to stay the flux of blood and to hinder that the outward air did not enter into the brest which might have cooled the Lungs and by consequent the heart The said Tents were also put to the end that issue might be given for the blood that was spilt within the Thorax I put upon the wound great Emplasters of Di acolcitheos in which I had relented oyl of Roses and Vineger to the avoiding of the inflammation then I put great stupes of Oxycrate and bound him up but not too hard to the end he might have easie respiration that done I drew from him five porrengers of blood from the Basilisk vein of the right arm 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 chiefly his forces considering his youth and sanguine temper He presently after went to stool and by his urine and sieg cast great quantity of blood And as for the pâ—â—n which he said he felt at the entrance of the bullet which was as if he had been pricked with a bodkinâ— that was because the Lungs by their motion beat against the splinters of the Broken Rib. Now the Lungs are covered with a coat comming from the membrane called Pleura interweâ—ved with nerves of the sixt Conjugation from the brain which was cause of the extreme pain â—e self likewise he had great difficulty of breathing which proceededd from the blood which was spilt in the capacity of the Thorax and upon the Diaphragm the principal instrument of respiration and from the dilaceration of the muscles which are between each Rib which help also to make the expiration and the inspiration and likewise because the Lungs were torn and wounded by the bâ—llet which hath caused him ever since to spit black and putrid blood in coughing The fever seised him soon after he was hurt with faintings and swoonings It seemed to me that the said fever proceeded from the putredinous vapors arising from the blood which is out of his proper vessels which hath falln down and will yet flow down The wound of the Lungs is grown great and will grow more great because it is in perpetual motion both sleeping and waking and is dilated and comprest to let the air to the heart and cast fuliginous vapors out by the unnatural heat is made inflammation then the expulsive vertue is constrained to cast out by cough whatsoever is obnoxious unto it for the Lungs cannot be purged but by coughing and by coughing the wound is dilated and grows greater from whence the blood issues out with great abundance which blood is drawn from the heart by the vein arterial to give them nourishment and to the heart by the vena cava his meat was barly broath stued prunes somtimes Panado his drink was Ptisan He could not lye but upon his baâ—k which shewed he had a great quantity of blood spilt within the capacity of the Thorax and being spread or spilled along the spondyls doth not so much press the Lungs as it doth being lain on the sides or â—itting What shall I say more but that the said Lord Martigues since the time he was hurt hath not reposed one hour only and hath alwaies cast out bloody urines and stools These things then Messieres considered one can make no other prognostick but that he will dye in a few dayes which is to my great grief Having ended my discourse I â—rest him as I was wont having discovered his wounds the Physicians and other assistants presently knew the truth of what I had said The said Physiciâ—ns having felt his pulse and known his forces to be almost spent and abolished they concluded with me that in a few dayes he would dye and at the same instant went all toward the Lord of Savoy where they all said that the said Lord Martigues would dye in a short time he answered it were possible if he were well drest he might escape Then they all with with one voice said he had been very well drest and sollicited with all things necessary for the curing of his wounds and could not be better and that it was impossible to cure him and that his wound was mortal of necessity The Monsieur de Savoy shewed himself to be very much discontented and wept and asked them again if for certain they all held him deplored and remediless they answered yes Then a certain Spanish impostor offered himself who promised on his life that he would cure him and if he failed to cure him they should cut him in an hundred pieces but he would not have any Physicians Surgeons or Apoâ—hecaries with him And at the same instant the said Lord of Savoy told the Physicians and Surgeons they should not in any wise go any more to see the said Lord of Martigues And he sent a Genâ—leman to me to forbiâ— me upon pain of life not to touch any more the said Lord of Martigues which I promised not to do wherefore I was very glad seeing he
should not dye in my hands and commanded the said Impostor to dress the said Lord of Martigues And that he should have no other Physicians nor Surgeons but him he came presently to the said Lord of Martigues who told him Senor Cavallero el senor Duge me ha mandadâ— que veniasse a curar vastra herida yo os juro a Dios que antes de achio dias yo os haga subir a Cavello con la lansa en puno contasque no ago que yo quos tâ—gâ—e Comeris y biberis to dis comidas que sueren de vastro gusto y yo hare la dieta pro V. M. y desto os de veu aâ—eguirar sobre de mi yo he sanaâ—o mun hos que tenian magores heridas que la vastra That is to say Lord Cavallere Monsieur the Duke of Savoy hath commanded me to come dress thy wound I swear to thee by God that before eight dayes I will make thee mount on hors-back with thy Lance in thy hand provided that no man may touch thee but my self thou shalt eat and drink any thing that thou hast a minde to I will perform thy diet for thee and of this thou mayest be assured upon my promise I have cured divers who have had greater wounds then thine and the Lord replied God give you grace to do it He demanded of the said Lord a shirt and tore it in little rags which he put across muttering and murmuring certain words over the wounds and having dress him permitted him to eat and drink what he would telling him he would observe a diet for him which he did eating but six prunes and six bits of breatd at a meal and drinking but beer Notwithstanding two dayes after the said Lord of Martigues died and my Spaniard seeing of him in the Agony eclipst himself and got away without bidding farewell to any body and I beleive if he had been taken he had been hangd for his false promises which he had made to monsieur the Duke of Savoy and to divers other Gentlemen He died about ten of the clock in the morning and after dinner the said Lord of Savoy sent Physicians and Surgeons and his Apothecary with a great quantity of Drogues to embalm him they came accompanied with divers Gentlemen and Captains of the Army The Emperors Surgeon came near tome and prayed me kindely to open the body which I refused telling him I was not worthy to carry his plaster-box after him he prayed me again which then I did for his sake if it so liked him I would yet again have excused my self that seeing he was not willing to embalm him that he would give this charge to another Surgeon of the company he made me yet answer that he would it should be I and if I would not do it I might here after repent it knowing this his affection for fear he should not do me any displeasure I took the razor and presented it to all in particular telling them I was not well practised to do such operations which they all refused The body being placed upon a Table truly I purposed to shew them that I was an Anatomist declaring to them divers things should be here too long to recite I began to tell all the company that I was sure the bullet had broken two ribs and that it had pass'd through the Lungs and that they should find the wound much enlarged became they are in perpetual motion sleeping or waking and by this motion the wound was the more dilacerated Also that there was great quantity of blood spilt in the capacity of the brest and upon the midriff and splinters of the broken ribs which were beaten in at the entrance of the bullet and the issuing forth of it had carried out Indeed all which I had told them was found true in the dead body One of the Physicians asked me which way the blood might pass to be cast out by urine being contained in the Thorax I answered him that there was a manifest conduit which is the Vena Azygos which having nourish'd the ribs the rest of the blood descends under the Diaphragm and on the left side is conjoined to the emulgent vein which is the way by which the matter in Pleurisies and in Empuema do manifestly empty themselves by urine and stool As it is likewise seen the pure milk of the brests of women newly brought to bed to descend by the Mammillarie veins and to be evacuated downwards by the neck of the womb without being mixt with the blood And such a thing is done as it were by a miracle of nature by her expulsive and sequestring virtue which is seen by experience of two glass-vessels called Mount-wine let the one be filled with water and the other with Claret-wine and let them be put the one upon the other that is to say that which shall be filled with water upon that which shall be filled with wine and you shall apparently see the wine mount up to the top of the vessel quite through the water and the water descend atraverse the wine and go to the bottom of the vessel without mixture of both and if such a thing be done so exteriorly and openly to the sence of our eye by things without life you must believe the same in our understanding That nature can make matter and blood to pass having been out of their vessels yea through the bones without being mingled with the good blood Our discourse ended I embalmed the body and put it into a coffin after that the Emperors Surgeon took me apart and told me if I would remain with him that he would use me very well and that he would cloath we anew also that I should ride on hors-back I thank'd him very kindly for the honor he did me and told him that I had no desire to do service to strangers and enemies to my country then he told me I was a fool and if he were Prisoner as I he would serve the devil to get his liberty In the end I told him flat that I would not dwell at all with him The Emperors Physician returned towards the said Lord of Savoy where he declared the cause of the death of the said Lord of Martigues and told him that it was impossible for all the men in the world to have cured him and confirmed again that I had done what was necessary to be done and prayed him to win me to his service and spake better of me then I deserved Having been perswaded to take me to his service he gave charge to one of his stewards named Monsieur dn Bouches to tell me if I would dwel in his service that he would use me kindly I answered him that I thanked him most humbly and that I had resolved not to dwell with any stranger This my answer being heard by the Duke of Savoy he was some what in choler and said he would send me to the Gallies Monsieur de
Vandeville Governor of Gravelin and Colonel of the seventeen Ensigns of foot prayed him to give me to him to dress him of an ulcer which he had in his leg this six or seven years Monsieur de Savoy told him because I was of worth that he was content and if I rankled his leg it would be well done He answered that if he perceived any thing he would cause my throat to be cut Soon after the said Lord of Vandeville sent for me by four Germane Halberdiers which affrighted me much not knowing whether they led me they spake no more French then I heigh Dutch being arrived at his lodging he told me I was welcom and that I was his and as soon as I should have cured him of that ulcer in his leg that he would give me leave to be gon without taking any ransome of me I told him that I was not able to pay any ransome Then he made his Physician and Surgeon in ordinary to shew me his ulcerated leg having seen and considered it we went apart into a chamber where I began to tell them that the said ulcer was annual not being simple but complicated that is of a round figure and scaly having the lips hard and callous hollow and sordid accompanied with a great varicous vein which did perpetually feed it besides a great tumor and a phlegmonous distemper very painful through the whole leg in a body of cholerick complexion as the hair of his face and beard demonstrated The method to cure it if cured it could be was to begin with universal things that is with purgation and bleeding and with this order of diet that he should not use any wine at all nor any salt meats or of great nourishment chiefly those which did heat the blood afterward the cure must begin with divers scarifications about the ulcer and totally cutting away the callous edges or lips and giving a long or a triangular figure for the round will very hardly cure as the Antients have left it in writing which is seen by experience That done the filth must be mundified as also the corrupt flesh which should be done with Vnguentum Aegyptiacum and upon it a bolster dipt in juice of plantain and Nightshade and Oxycrate and rowl the leg beginning at the foot and finishing at the knee not forgetting a little bolster upon the Varicous vein to the end no superfluities should flow to the ulcer Moreover that he should take rest in his bed which is commanded by Hippocrates who saith that those who have sore legs should not use much standing or sitting but lying along And after those things be done and the ulcer well mundified a plate of lead rubded with quicksilver should be applied See then the means by which the said lord Vandeville might be cured the said ulcer all which they found good Then the Physician left me with the Surgeon and went to the Lord Vandeville to tell him that he did assure him I would cure him and told him that I had resolved to do for the cure of his ulcer wherefore he was very joyfull He made me to be called to him and asked me if I was of the opinion that this ulcer could be cured and I told him yes provided he would be obedient to what he ought He made me a promise he would perform all things which I would appoint and as soon as his ulcer should be cured he would give me liberty to return without paying any ransom Then I beseech'c him to come to a bettet composition with me telling him that the time would be too long to be out of liberty if I stayed till he was perfectly well and that I hoped within fifteen dayes the ulcer should be diminished more then one half and it should be without pain and that his Physicians and Surgeons would finish the rest of the cure very easily To which he agreed and then I took a peice of paper and cut it the largeness of the ulcer which I gave him and kept as much my self I prayed him to keep promise when he should finde his business done He swore by the faith of a Gentleman he would do it then I resolved to dress him well according to the method of Galen which was that after all strange things were taken out of the ulcer and that there wanted nothing but filling up with flesh I drest him but once a day and he found that very strange And likewise his Physician which was but a fresh man in those affairs who would perswade me with the patient to dress him two or three times a day I prayed him to let me do what I thought good and that it was not to prolong the cure but on the contrary to hasten it for the great desire I had to be in liberty And that he would look in Galen in the fourth book of the composition of medicaments secundum genera who saith that if a medicine do not remain long upon the part it profits not so much as when it doth continue long a thing which many Physicians have been ignorant of and have thought it hath been better to change the plaster often And this ill custom is so inveterate and rooted that the Patients themselves accuse often-times the Surgeons of negligence because they do not oftner remove their emplasters But they are deceived For as you have read in my works in divers places The qualities of all bodyes which mutually touch operate one against another and both of them suffer something where one of them is much stronger then the other by means whereof the said qualities are united they familiarise with the time although they are much differing from the manner that the qualitie of the medicament doth unite and sometimes becomes like to that of the body which is a very profitable thing Therefore they say he is to be praised much who first invented not to change the plaster so often because it is known by experience this is a good invention Moreover it is said great fault is committed to dress ulcers often in wiping of them hard for one takes not away only the unprofitable excrement which is the pus or Sanies of the ulcer but the matter whereof the flesh is engendered wherefore for the reasons aforesaid it is not needful to dress ulcers so often The said Lord Vandeville would see whether that which I alledged out of Galen were true and commanded the said Physician to look there for that he would know it he caused the book to be brought upon the table where my saying was found true and then the Physician was ashamed and I very joyful So that the said Lord of Vandeville desired not to be dressed but once a day insomuch that within fifteen dayes the ulcer was almost cicatrized the composition being made between us I began to be merry He made me eat and drink at his Table when there were not men of more great rank with him He gave me a great red scarf which
Haemorrhoidalis interna the inner emroid vein to distinguish it from the outer which is derived from the Hollow-vein It is truly and properly called the Emroid vein I say properly and truly because sometimes they call by that name the veins of the nostrils gums and mouth that cast forth blood and without pain In this large sence the Philosopher took it 3. de part animal where he makes menstrous purgation also a species of the emroids But the Emroids properly so called by Physitians are dilatations of this vein in the fundament caused as well by black and yellow choler as also by a salt phlegm as by the melancholick humor And these are of two kinds Caecae blind piles which cast out no blood but swell out like the stone of a grape into the fundament or out of it Others apertae open which cast out the blood which they contain The learned Hippocrates hath left us a peculiar book a golden one indeed concerning the cure of these The remaining part of the Spleen-branch is spent upon the whole Spleen and therein is scattered into divers and very small propagations entring the very flesh of it about the hollow and middle line And these are the sprigs which gâ—ow out of the Spleen-branch The Mesenterick vein or right branch of the Gate-vein is joyned to the Mesentery as soon as it comes from the back and is divided into two chief branches which passing through the Mesentery betwixt its two coats are each of them cleft into an infinite number of small branches and they again into less twigs which going to the Guts make up those veins so famous among Physitians that are called the Mesaraick-veins The first of these branches is called the right Mesenterick vein from the right side The right Mesenterick branch wherein it is placed and is likewise twofold whence it came to pass that Vesalius and almost all others who follow him reckon three Mesenterick veins This branch is inserted into the Jejunum or empty Gut the Ileum or circle Gut the caecum or blinde Gut and the right side of the Colique Gut where it lies next to the reins and Liver and although both its branches shoot forth many propagations from themselves so that it is very hard to express any number of them as well because they vary much by reason of their subjects as also because they do not observe the very same order and course yet it hath been observed that for the most part there are fourteen which afterwards are scattered into an infinite company of other twigs These when they are come to the Guts only gape with their little mouths into their Coat and enter not the cavity it self that being compassed about within with a certain crust But as in most parts of our body the divarications or divisions of the vessels are attended with certain glandules partly that they may make the safer progress partly lest they should sink down and withall the flow and ebb of the blood so very necessary be hindered so here also the divisions of the vessels which are scattered through the Mesentery are bolstered up with certain glandules which with their propagations observe such an exact propagation that the greater glandules do sustain the greater branches and the less the lesser When these glandules swell with a Scirrhus the vessels being prest close together and the distribution of the chylus through the veins and consequently of the blood through the body being hindered there follows a Consumption and pining of the whole body The left Mesenterick vein is distributed into the middle part of the Mesentery and also that part of the Colique Gut The left Mesenterick which runs from the left region of the Stomach as far as to the strait Gut The haemorrhaidalis interna or inner Emroid vein of which we spake a little before sometimes arises from this vein as Vesalius hath observed which affording some sprigs to the Colique Gut at last running forward through the whole length of the strait Gut determines in the fundament But before the Mesenterick Trunk be divided into these two branches Propagations that arise before the division of the Mesenterick Gastro-epiplois it first sends forth two propagations one of which is called Gastro-epiplois dextra or the Right Stomach and Kall-vein which creeps through the right bottom of the Stomach before and behinde as also through the upper membrane of the Kall the other called by others Intestinalis or the Gut-vein by us the Duodena reaches to the middle of the Gut Duodenum and the beginning of the Empty Gut or Jejunum and descends all along through them The chief use of the Gate-vein is to nourish those parts Dextra Intestinalis The first use of the Gate-vein which are seated in the lowest belly and need a thicker and more faeculent blood such as are all those parts which serve for nutrition For their blood ought to be thicker that it might be hotter when heat is alwaies more powerful in a thicker body so then the Roots of the Gate-vein nourish the Liver the Trunk nourishes the Pancreas or Sweet-bread of the Twigs the Cysticus or Gall-twig nourishes the bladder of the Gall the Spleen-branch all the entrails which serve for nutrition except the Mesentery and the Guts the Twig Pyloricus or of the lower mouth of the Stomach the Gastricus or Stomach-branch both the Stomach and Kall-veins and the short vessel nourish the stomach For I do not think that the short vessel was made by nature for the carrying back of melancholick humors to the Stomach but chiefly fot its nourishments sake when that blood which is generated in the Spleen is not a melancholy and excrementitious humor but rathet the best although somewhat thicker then other blood and that because the parts that are to be nourished by the Spleen branch needed a thicker blood then they which are to be nourished by the Mesenterick Both the Stomach and Kall-veins nourish the upper membrane of the Kall the right and the hinder Epiplois or the Kall-veins the lower The Spleen is nourished by those two branches into which the Spleen-vein is cleft and which enter its parenchyma or flesh through its middle line the Mesentery and almost all the Guts by the two Mesenterick branches the Gut Duodenum by the propagation called Duodena but the empty Gut the Ileum or circle Gut the blind Gut and the right side of the Colique or Colon by the right Mesenterick-branch The left side of the Colique and all the strait-Gut by the haemorrhoidal vein but the middle part which lies under the Stomach by the hinder Kall-vein The second use is to attract the Chylus and carry it to the Liver The second use whose veins are most famous for the making of blood But the same veins which nourish the Mesentery branch do also attract the Chylus as we shall shew you hereafter when we shall insist upon the History of it The third use
if the humor go back to the Breast or Lungs it breaks through or eats out their vessels and hence follows a spitting first of blood then of corrupt matter and from thence at last a Consumption as Hippocrates teaches in his Aphorism But in this place it is first of all to be observed that there are two sorts of propagations of veins which make the Emroids for there are some propagations of the Gate-vein of which we have already treated but there are others of the Hollow-vein which arise from the Iliacal branches of which we are to speak hereafter Now if the forementioned humors whether melancholick or cholerick or phlegmatick and salt flow through the propagations of the Gate-vein the internal Emroids are caused which being cured the matters flow back into the branches of the Gate-vein that are scattered through the lower Belly into which the veins being loaden with these humors unburden themselves make a species of the Dropsie called Ascites But if they flow through the branches of the Hollow-vein they cause the external Emroids and these being cured against the Precept of Hippocrates there is danger of a Consumption to ensue because from hence there is an easie passage of the peccant matter through the Hollow-vein to the Lungs nigh to the Heart And this is that which we have of a good while observed that many who have been long troubled with Fistula's of the Fundament and afterwards cured through the ignorance of Physitians have faln into a spitting of blood and then into a Consumption Nay we remember that a Maid was once cured by us in Germany which had a Fistula in the middle of her Hip and for three years had sought help from many in vain but being cured she fell at length after three or four month into a spitting of much blood Although she was scarce ten years old I let her blood presently in the foot of that side on which she had been troubled with the Fistula and purging her body and laying on a cautery near the place in which the Fistula had been I easily freed her in this manner from imminent danger of a Consumption This spitting of blood happened from no other cause but that sharp and cholerick matter which when it could no longer finde a way out by the Fistula got up afterwards to the Lungs through the branches of the Hollow-vein But Hippocrates sayes expresly that there is danger of a Dropsie or Consumption to follow because it sometimes falls out that neither of these happen but rather some other disease insues as it happened to Alcippus who fell in to a madness and from that into an acute Feaver sometimes also the bloody flux follows and other mischiefs Sometimes also it happens that they who are so cured are preserved still in health by abundance of urine sweatings remedies and a good rule of diet CHAP. II. Treats of the superior or ascendent Trunk of the Vena Cava or Hollow-vein and the branches which it scatters through the Head WEE are now to consider the other vein which as we told you is called Cava the Hollow one a which spreads it self much wider then the Gate-vein The use of the Hollow-vein as being distributed throughout the whole body For its office is to nourish all those pars of our body which conduce not to the concoction of the food those parts being spread far and wide it is necessary that the Hollow-vein also be very large and extended to a great length and because they ought to be nourisht with a thinner and more elaborate blood and not so thick and faeculent as that wherewith the Stomach Spleen and Gall are nourisht therefore the blood which the Hollow-vein makes and carries is also more pure thin and sincere In delivering the History of this vein although we are not of their opinion The method to be observed in the History of this Vein who derive its beginning either from the liver or heart yet because we must begin our Treatise of it somewhere we thought fit to follow the received custome of Anatomists and so for perspicuities sake we shall alwayes speak of it as if it took its birth from the Liver It may be added that it spreads certain roots as it were in the Liver just like the Gate-vein in the History of which when for that reason we took our rise from those roots we may not without cause begin thence also with the Hollow one But this vein although it run directly through the whole Trunk of the body and make one very notable stock D that is drawn out through the middle and lowest belly like one straight line continued or rather in manner of a channel or conduit pipe is notwithstanding wont to be divided into two by reason of the Liver and so one to be called the Ascendent Trunk the other the Descendent For indeed that is not true to which many perswade themselves that the Hollow-vein in its going forth from the Liver like the great Artery when it comes out of the heart is cleft into two trunks but if hereafter they be called Trunks by me you must beleive that I do it only for orders sake in teaching The Ascendent thetefore of upper Trunk A.D. is that which stands about the Liver and is terminated about the Jugulum or Hollow of the Neck but that is called the Descendent one T.V. which is beneath the Liver and reaches down as far as the Legs For both of them are afterwards divided into two branches of which they of the Ascendent m and q â—re carried upwards to the head as the Jugular or Neck-branches or to the Arms as the Brachiales G and I or Arm-veins these of the Descendent Trunk to the Legs and are called the Crural b anches T We will speak therefore of all these in order so that we first deliver the History of the Ascendent Trunk then of its branches that grows up partly to the Head partly to the Arms after that we will come to the Descendent Trunk and its branches that are digested into the Legs The Ascendent Trunk As therefore we have said that many little Veins like roots grow out of the Hollow side of the Liver which alwayes by degrees inserted into the greater veins and all of them at length meeting together about the middle of it did make a Trunk so in the same manner out of the circuit of the Convex side of the Liver a numerous propagation of veins issues forth which afterwards meet together in one Trunk This Trunk makes its way through the nervous part of the midriff on its right side and passing through it goes undivided to the Jugulum or Hollow of the Neck and because it climbs upwards it is commonly called the Ascendent Trunk by them who conceive that the Hollow-vein rises out of the Liver It is much lesser then the Descendent because the upper parts are nourished by it alone but almost all the inferior parts that are contained
in the lowest Belly by the Gate-vein But although it be not parted into any branches until it come to the Jugulum Propagations of the Ascendent Trunk Phrenica yet before that it spreads some propagations at its sides and of those three notable ones The first ee is that which is called Phrenica or the vein of the Midriff on either side one and is distributed throughout the whole Midriff which is called 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 with a numerous issue sending little branches to the neighbouring Pericardium or purse of the Heart and the mediastinum or partition of the Chest which when it has now got above and entred the Chest it inclines a little to the left hand and enters the Pericardium and being hidden very close over against the eight Rack-bone of the Chest is very strongly infixt into the right ventricle C of the heart that Aristotle did not without cause guess that it sprung from hence But before it be so infixed it sends out another propagation bb which is a notable one and extends it self by the hinder part of the Heart and the left side of it towards the forepart compassing the basis of the Heart like a Crown Coronâ—ria from whence it is called Coronaria or the Crown-vein of the Heart This scatters many branches through all the outer surface of the Heart but especially through the left side as that which needed a more copious aliment then the right side because of the continual and greater motion there But because the flesh of the Heart is hard and solid it ought therefore to be nourisht with a thicker blood from whence it is that this branch grows out of the vein before it enters the Heart to wit when the blood is somewhat thicker and not yet attenuated in the cavities of the Heatt Near to the original of this there is a little valve or flood-gate which hinders the blood from flowing back to the Hollow-vein as it might easily do by reason of the continual motion of the Heart When the Hollow vein has now gotten above the Heart it becomes lesser and perforates again the Pericardium and for sakes the Rack-bones of the Back and being got above the Gullet the rough Artery and the Aorta or great Artery which lean so upon one another that the Gullet takes hold of the bodies of the Rack-bones the rough Artery lies upon that and the aorta again upon this it climbs upwards through the midst of the division of the Lungs where the right part is separated from the left But because by this means it could not get to the back and the little branches if it should have sent forth any such had been very liable to danger of breaking being so hanged up therefore it sends forth a third propagation cc as soon as it is got out of the Pericardium or purse of the Heart 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 The Greeks call this vein 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 the Latins sine pari or carens conjuge without a companion or wanting a mate because in a man there is but one and it has no companion or mate on the left side as other veins have though in creatures that chew the cud it is double and plainly to be perceived of both sides But it issues forth about the fifth Rack-bone of the Chest out of the hinder part of the Hollow-vein and the right side and goes downwards not directly but inclining a little toward the right hand is as it were reflected backwards to the Back-bone but as soon as it reaches the eight or ninth rib it is cleft above the Spine of the Back into two branches which running downwards pass through the division of the midriff which is betwixt its two productions and so are spread abroad into the lowest Belly Of these the left which is sometimes the greater hiding it self about the transverse Processes of the Rack-bones and under the left production of the midriff and the original of the first bending Muscle of the thigh is inserted into the left Emulgent either near to its beginning or as it oft happens into the middle of it But the right running on likewise under the membranes about the transverse processes of the right side and the right production of the Septum or Midriff and the beginning of the same first bender of the thigh which keeps the right side is implanted sometimes into the very Trunk of the Hollow-vein sometimes into the first vein of the Loins And we are indebted for this observation to the learned Fallopius who would have the matter that is gathered together in the Chest whether it be watery or purulent and corrupt or sanguinous to be evacuated by the benefit of the left branch of this vein of which notwithstanding we will say something briefly in the following Book But this vein in its journey downwards shoots forth twigs of both sides as well right as left of which the right are more notable and larger of which there are numbred almost alwayes ten which run out to as many distances of the lower ribs and make the inferior Intercostal veins But I say they are almost alwayes ten because it happens very seldome that all the distances of the ribs receive branches from this vein the two uppermost to wit the first and second distance getting their surcles or twigs from the fourth branch that is presently to be mentioned But these twigs run straight forwards near to to the lower side of the ribs where there are cavities cut out for them as we have taught in the second Book And truly this place is diligently to be taken notice of by Students in Chirurgery because of the opening of the Chest in the disease called Empyema that they may know that incision is to be made in the uppermost place of the rib because in the lower the vessels would be harmed to the great indangering of life But these veins do not run through the whole length of the true ribs but are terminated together with the bony part But the propagations of the Mammary vein nourish the six distances between the gristles of the seven true ribs as we shall tell you by and by Yet in the bastard ribs they run even beyond the Gristles towards the Abdomen or Paunch into whose Muscles they insinuate themselves But there are certain other little branches propagated from the same vein by which nourishment is derived to the marrow of the Rack-bones and the Muscles to wit those about which they are carried some also are implanted into the Mediastinum near to the back This vein sine pari without a companion being thus constituted the Hollow-vein ascends to the Jugulum or Hollow of the Neck D being supported by the Mediastinum and a certain soft and glandulous body which the Greeks call 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 and is placed in the highest part of the Chest to defend the divarications of the veins there hanging up from all danger of breaking And here
joyned by Anastomosis or ineculation 10. 10. The second called Pudenda 11. spent upon the privy parts 11. The third Coxalis 12 upon the Muscles of the Hip. 12. Here the outer Iliacal vein having past through the Peritoneum or rim of the Belly enters the Crus and begins to be called the Crural Trunk Γ Γ. that is undivided as far as to the two lower heads of the Thigh But it reaches forth four propagations before its division The first 13 13. is called Saphena which creeps through the inside of the Leg under the skin as far as to the ends of the Toes 14. Another 14 called Ichia is spread out into the skin upon the Hip-bone The third 15 named Muscula is sent to the Muscles 15. which extend the Leg. 16. The fourth 16 named Poplitea is distributed into the Calf of the Leg. 13. The vein Saphena also scatters from it self four surcles 17 the first 17 into the upper part of the skin of the inside of the Thigh 18. the second 18 about the middle of the Thigh 19. the third 19 into the Knee the fourth 20 is carried forward and backward to the middle of the Leg. 20. Δ. The division of the Crural Trunk near to the two lower heads of the Thigh into an inner branch Θ Θ. and an outer one Λ. Λ. Θ. The inner distributes little branches to the Muscles of the Calf 21 12. and then runs down under the inner ankle to the great Toe 22. 22. Λ. The outer presently is cleft into two branches an inner one Ξ Ξ. and an outer Π. That is spent wholly upon the Muscles of the Calf Π. this passes on near to the Fibula or lesser bone of the Leg through the outer and back-side of the Leg. The second Treatise Concerning The ARTERIES CHAP. I. Shews the upper or ascendent Trunk of the great Artery with its propagations that are distributed through the Head THere is no controversie among writers of Anatomy concerning the number and original of the Arteries The Original of the great Artery but an unanimous consent that all the propagations which are scattered throughout the body take their rise from one which they call Aorta and that this is derived out of the Heart But the Heart consisting of two sinus or cavities a right and a left one this great Artery grows out of the left sinus or ventricle A where it is largest and more hard and griestly then elswhere But as soon as it is grown out and before it fall out of the Pericardium or purse of the Heart Arteriae Coronariae the Crown-Arteries it presently propagates two small sprigs a a one of each side which they call Arteriae Coronariae the Crown-Arteries because together with the vena Coronalis or Crown-vein they compass the basis of the Heart in manner of a Crown and from these many propagations are scattered downward all along the Heart But they are more and greater about the left then the right ventricle as we have also formerly said concerning the vein because the Heart needs a greater plenty of blood on that side as which beats with a perpetual and more violent motion wherein more blood is digested then the right sinus or ventricle does yet that propagation is bigger and longer which arises on t of the right side of the Artery sometimes also there is only one at whose orifice a little valve is found Those propagations being thus disseminated the Artery ascends somewhat under the Trunk of the vena Arteriosa The divisions of the great Artery into two Trunks or Arterial vein and pierces through the Pericardium and having got above it is cleft B into two branches which because of their natural greatness we will call Trunks and because one ascends C and the other runs downward Q that shall be the Ascendent Trunk this the Descendent Yet the Descendent and lower one is bigger by much then the upper What parts both the Trunks nourish The order of that which is to be said because that serves more parts then this For the Ascendent one goes only to some parts of the Chest to the Head and Arms but the lower to very many parts of the Chest to all the lowest belly and the Legs That therefore we may treat of the great Artery with more perspicuity we will first shew the Ascendent Trunk and its progress through the Chest and Head and after that its branches distributed through the Arms. Then we will fall upon the Descendent one add explain the manner of its distribution through the Chest and lowest belly and lastly through the Legs The Ascendent therefore or upper Trunk of the Aorta C being fastened to the Oe sophagus or Gullet climbs upward betwixt the rough Artery and Hollow-vein and the mediastinum or partition of the Chest Which situation of it they ought diligently to observe who desire to know the reason of that Aphorism which is the four and twentieth of the fifth Section in Hippocrates For sayes he cold things as snow and ice are enemies to the Breast provoke coughs and cause eruptions of blood and distillations Truly they are enemies to the Breast because whilest they are swallowed down through the Gullet they cool the rough Artery that lyes next to it together with the Gullet which part being of it self cold does easily take harm from so violent a cold hence the cough and other diseases of the Brest follow one another in a long row But issues of blood happen in like manner the great Artery being cooled whereby the vital Spirits and the blood are driven back to the Heart and from thence are sent up forcibly to the Head which being stuft eruptions of blood are caused by its dropping forth at the Nostrils as also catarrhs and distillations it being driven down undigested to the inferiour parts And hence also a reason may be rendered why some upon drinking of cold water after vehement motions and exercise of body have presently been suffocated the passion of the heart and grievous swoundings following thereupon For the Artery being vehemently coold the blood is congealed as well that which was in the Aorta or Great artery as that which abides in the heart from whence happen at first fearful symptoms and then suddain death But we have seen in these men that a vein being opened the blood hath come out thick and cold and with very great difficulty whence also we have not found a more present remedy for them then such things as by reason of the thinness of their parts have a power of dissolving the clots of blood Hence also a reason may be given why in burning fevers the tongue becomes black the diseased can hardly swallow For although it be true which is the cause commonly assign'd that many vapors are sent up from the whole body to the head yet we may ascribe a main
midriff the Coeliacal one then the upper Mesenterick the two emulgents as many spermatical ones at last the lower Mesenterick and the Lumbares or arteries of the loins Of these the Intercostals are scattered whilst the trunk is yet in the chest the rest whilst it passes on through the lowest belly But some of them accompany the branches of the gate-vein as the Coelicacal and both the Mesenterical arteries others those of the hollow vein as the rest Now we will treat of these in order beginning from the Intercostals or arteries between the ribs which are placed uppermost Presently therefore after the Descendent trunk Q is issued forth from its back-side it sends over little branches on both sides to the distances of the eight lower ribs which they call Intercostales inferiores Intercostales inferiores the arteries between the lower ribs the lower arteries between the ribs uuu in respect of the upper Intercostal of which we have spoken above These associating themselves with the veins and nerves of the same name go straight on by the lower side of the ribs where peculiar sinus or channels are cut out for them But as the Intercostal veins reach in the true ribs only to the gristles but in the bastard ones somewhat farther to wit to the sides of the abdomen so also the arteries end in them together with the bony parts of the ribs but in these run out a little farther And these arteries send over some propagations through the holes of the nerves to the spinal marrow and to the muscles that lye upon the rack-bones of the back just as we have said the Intercostal veins were propagated Their use But the use of them is to diffuse the vital spirit and the blood to the muscles betwixt the ribs besides which they have also another notable office to wit of carrying down the water and purulent matter that is gathered together in the chest into the great artery and from thence by the Emulgent branches to the bladder Although I am not ignorant that the most learned Fallopius and others who have read before me in this most famous University of Padua have shewn another way to their Auditors by which either purulent matter or water might be conveyed forth by help of the kidneys to wit the vein sine pari or without a companion a little branch whereof in the left side goes into the Emulgent of the left kidney But this way which we shew through the Intercostal arteries is by much the shorter that I pass by this that any matter heaped together may be more easily dispatcht away through the arteries then the veins Nor needs any one here to be afraid lest the vital spirits should be infected from these excrementitious and ill humurs whereby the heart may incurre fearful symptoms when we willingly grant which experience also hath often taught us that whilst the corrupt matter is emptied out by the urine the sick parties have often faln into fits of swounding and other diseases sometimes also have died suddenly when the peccant humor has been of too great a quantity or too bad a quality and has offered so much violence to nature that the heat and spirits have been over come therewith The explanation of a place in Hippocrates But here a certain place in Hippocrates calls upon me to explain it which has long and often troubled my minde The place is in Coacis praenotionibus where he says They who together with the heart have their whole lungs inflamed so that it falls to the side are deprived of motion all over and the parties so diseased lye cold senseless and dye the second or third day But if this happen to the lungs without the heart they live not so long Yet some also are preserved I have often thought with my self what should be that sympathy of the heart lungs with the brain and nerves that from the inflammation of those parts the patient should be so deprived of sense and motion all over when the same Hippocrates teacheth in the same place that the diseased suffer such deprivation in that part livid spots appear on the outside about the rib where-about the Aortae so he seems to call the lobes or division of the lungs being inflamed fall to the sides But if they be not much inflamed so that they fall not down to the side he sayes that there is a pain indeed all over but no deprivation of sense or motion nor any spots appear Having deliberated often with my self at length I came to be of this opinion that there was no other cause but the sympathy betwixt these Intercostal arteries and the marrow in the back-bone This sympathy arises from those propagations which we told you past through the holes of the rack-bones of the chest into the back-bone Wherefore if the lungs and heart be so mightily inflamed that great plenty of blood rush into the great artery whereupon it swels as also these vessels betwixt the ribs and consequently those surcles which go to the marrow of the back-bone truly it cannot be but that both the marrow and the nerves which issue out of it be comprest from whence what else can follow but the resolution of those parts into which those nerves are implanted to which they impart the faculty of motion This opinion seems to me to be wonderfully confirmed by a certain pretty observation which the learned Cornelius Gemma has in his book de hemititraeo pestilenti A certain studious young man sayes he through the whole course of his disease had his left eye less then the other He was paind in the left side especially all the time the fit raged but about the crisis or judication thereof the artery of his left leg being swoln up was moved according to its length that being to be seen by us it seemed to be turned upward and downward like a rope pull'd back Who will not here willingly confess that this matter was in the arteries when the crisis was made by them But from this that hath been said a reason may be also given of another observation of Galen which is l. 4 de locis affect c. 4. where he sayes thus In a certain man who was troubled with a vehement inflammation of the lungs as wel the outer as the inner parts of his arm from the cubit to the very ends of his fingers labour'd with difficulty of sense and their motion also was somewhat empair'd In the same man also the nerves which are in the first and second distances betwixt the ribs sustained harm And a little after This man was quickly restored to his health to wit a medicine being applyed to the place from whence the nerves issue forth near to the first and second spaces betwixt the ribs By reason of the same branches betwixt the ribs John Valeriola the son of that Physitian whose observations we have being yet a boy suffered Convulsion-fits in a grievous Pleurisie The arteries
into it self store of choler carries it directly over to the Colon or Collique-Cut In like manner the use of the left branch or Spleen Artery besides the common one is to throw down choler melancholy and wheay humors if at any time the Spleen abound with them to the Guts Moreover by this same way the waterish humors in such as have the Dropsie are sometimes committed either to the Guts or to the Kidneys and Bladder This same branch is that by which the drink passes so suddainly through the whole body and by which ill hâ—mors are cast out by vomit This same is the cause that upon a full Stomach we make little water but more when the concoction therein is finished For the Stomach being much distended presses it but that once empty it can perform its office This same branch teaches us that a slender diet is to be prescribed to them who are to take purges that the way may be open for the medicines as well that by which the excrements are sent over the Stomach as that by which they are conveyed to the Guts This same branch also if you adde the two Mesentericks is the seat of the hypochondriacal Melancholy For this disease arising from the obstruction of the entrails which are contained in the lowest belly it is necessary that the arteries here should suffer very much which the very sumptoms that happen in this disease may sufficiently inform us Mesenterica superior 4. Mesenterica superior the upper artery of the Mesentery y arises a little below the Coeliacal being distributed like the Meseraick vein which is its companion with numerous propagations in the Guts called Ilium and Jejunum as also that region of the Colon which reaches from the Hollow of the Liver as far as the right Kidney An observation and so for the most part into the upper part of the Mesentery In which place it is to be observed that the Artery sometimes lies upon the vein sometimes on the contrary the vein upon the Artery and so is carried betwixt the Membranes of the Mesentery But these Arteries in many places in the Mesentery have Glandules which were made for the free perspiration of the vessels and especially of the Arteries whereby is comes to pass that these Glandules labouring with a hard tumor or Scirrhus the vessels are comprest and a pining away of the whole body follows thereupon The Emulgent arteries z are two one the right and another the left one 5. Emulgenets Both issue out under the forementioned Artey where the first and second Rack-bones of the loins are coupled together by the Ligament But they arise out of either side of the Trunk although not directly over against one another as also it is in the Emulgent veins the right one being lower then the left These Arteries when they come to the Kidney are cleft into two branches with which they are inserted into the sinus or channels of the cavity of the Kidneys and like the veins are consumed in an infinite number of little sprigs upon their substance Their use besides the common one is to purge out the whey Their use which is found in great plenty in the Arteries The spermatical or seed-arteries α are likewise two 6. Spermatica which arise out of the forepart of the Trunk of the great Artery their originals touching each other for the left Artery issues not from the Emulgent as the left spermatical vein does Afterward in their descent they are made fast to the veins of their own side and in men are carried through the processes of the Peritoneum or Rim of the Belly to the Testicles but in women when they come somewhat near to the Testicles they are divided into two parts one of which is carried to the Testicles the other to the bottom of the Womb. But the arteries do so come to the womb that they only water it at the sides and pierce not at all into the inner parts of it Which truly came to pass by the great providence of wisest nature since it had not been so safe to have brought them down to the inner surface of the womb by reason that in the coming forth of the childe very great issuings of blood would be caused to the no small danger of the Woman in Child-bed if the Arteries had been annexed to the Womb on the inside Hence also it is that in the time of delivery they flow by little and little not rushing down with violence Mesenterica inferior the lower Artery of the Mesentery β arises near to the Os sacrum 7. Mesenterica inferior or great bone a little above the division of the Trunk into the Iliacal branches and goes into the left side of the Colon and into the strait Gut descending with the haemorrhoidal veins to the very end of the Fundament and making the haemorrhoidal Arteries It is questioned concerning the use of both the Mesentericks whether besides the common they have any peculiar one For Galen in his 4. of the use of the parts seems to make mention of some other when he would have some part of the Chylus to be attracted by them It s use And in the book whether blood be contained in the Arteries in the fifth Chapter he sayes If we divide the lowest belly and the inner membrane we shall plainly see the Arteries in the Mesentery filled with milk in Kids newly yeaned but in living creatures that are grown full of something else In which words Anatomical experience teaches us that not only the Meseraick veins but Arteries also do manifestly draw the Chylus to them Which being so indeed it is altogether to be believed that the Chylus is either afterward transported by them into the veins or else turned into blood by the Arteries themselves Nor will this seem wonderful to any one who shal consider also that the mothers blood is conveyed through the Umbilical Arteries to the child whilest it is yet shut up in the Womb. But if the blood which is received up by the veins ought yet to be better worked as any diligent inquirer into nature will conclude it ought truly that which is received by the Arteries will require to be so much the more exactly laboured by how much the better it is then that of the veins But it is so laboured in the Arteries themselves and in the Spleen being haled into the Coeliacal Artery and carried to the Spleen And this is an excellent use of the Mesenterick Arteries whilest a man enjoys perfect health besides which we will adde another also as often as he leaves to be in health For these Arteries take to them the excrements of the whole body that they may carry them down to the Guts in like manner as the veins do by which nature doth both attract the Chylus and likewise expell the noisom humors out of the body as choler phelgm and melancholy Choler is thus expelled oftentimes in continual and
intermitting cholerick feavers a solution whereof follows by a loosness Phlegm is so expell'd as often as bloody fluxes happen to such as have the gout in the feet which ease them of their pain if the intent of nature be advanced by the help of a wise Physitian Lastly melancholy is conveyed out by both the Mesentericks but especially by the Haemorrhoidal branch whence Hippocrates sayes 6. Epidem He which has the Emroids naturally shall neither be troubled with the pain of the side or inflammation of the lungs nor with felons or black pustles called Terminthi nor with the Leprosie canker or other diseases For there is a very great sympathy betwixt the brest and the haemorrhoidal artery because the trunk out of which it arises An observation descending from the heart presently after it first issues from thence propagates the intercostal branches Moreover all black cholerick humors are purg'd by this means out of the whole body that cankers and leprosie cannot be caused by them From these voluntary purgings which nature it self has found out we may now judg of such as are caused by the help of a Physitian and may be termed artificial For an opinion of some men hath prevailed much in our age that the body cannot be purged by clyster but only by those medicines which are taken at the mouth But I will not only believe but also being taught it by experience can witness that if the clysters contain in them purging medicines the whole body is very commodiously cleansed For the whole colick gut receiving the matter of the clyster the vertue it self of the medicine draws down the noisome humors by the arteries out of the Aorta or great artery Which being granted we may give a reason what we have seen very often why Suppositories made of white helebore produce the same symptoms as are wont to be caused in them who have taken in white hellebore at the mouth Why anointing of the navel with such things as purge loosens the belly How the colick is changed into the gout on the contrary In like manner from hence we may fetch the reason why the belly is strongly purged the region about the navel being anointed with purging medicines For the vertue of the medicine is attracted by the arteries and by them afterward it purges These arteries are they by which the disease of the colick is changed into the gout and on the contrary the gout into the colick as we have it in Hippocrates 6. Epidem Sect. 4. where he sayes One that was vexed with the pain of the colick on the right side had some ease whilest the Gout held him but this disease being cured he was pained more The reason whereof was this because that humor which caused the gout was carried out of the joints to the colick gut whereby the colick disease was increased Laurentius inquiring into the cause of this refers us to hidden and unknown passages to which it seems to me that we need not fly if we say that the humors are brought out of the crural arteries into the trunk and out of this into the Mesenterick branches and lastly out of these into the guts for this is the shortest and most convenient way Nor is there any reason that we should be afraid of that pollution of the vital spirits which they will object to us if the excremenitious humors pass through the arteries for this betrayes their great ignorance as well in Anatomy as in solid Physick and it would be very easie if I would digress to prove in this place that a great part of the humors in our body flow down through the arteries For in them the strength of nature exceeds and is more vigorous that whensoever it is provoked it is most apt to expel and the blood being stirred by their continual beating as also by its own nature makes all that is therein more fit to flow And who will not beleive that excrements are carried through the arteries who considers the flowings down from the spleen in which there being five times more arteries then there are veins truly it is necessary that that ballast of the spleen be carried out through the Arteries Lumbares The four Lumbares or loin-arteries γ γ γ arise out of the backside of the trunk of the great artery all along as it passes through the region of the loins They run through the common holes in the rack-bones of the loins and to their marrow and also into the neighbouring muscles And at the side of the marrow after they have entred the rackbones they climb upon both sides to the brain together with the veins of the loins But they are all equally big if you excep those two which issue out near to the Os sacrum or holy-bone which are not only derived into the rackbones to the marrow and to the muscles thereabout but are also sent overthwart through the Peritoneum and muscle of the Abdomen The two last are by some called Musculae superiores the upper muscle-arteries and are distinguisht from the Lumbares And these are the arteries which if we observe we shall easily give the reasons of many things of which Physitians do still dispute very hotly but especially of that most difficult question which is controverted among Physitians by what wayes and in what manner the colick ends in a palsie or in the falling sickness How the colick disease ends in a palsie or Epilepsie For we have the observation in Paulus Aegineta lib. 3. c. 43. where he sayes the colick as it were by a certain pestilent contagion ended with many in the falling sickness with others in a resolution of the joints or palsie their sence remaining and they who fell into the falling sickness for the most part dyed but they who fel into the palsie were most of them preserved the cause of the disease being carried to another place in the solution For the humor that caused the disease came back out of the colick gut through the mesenterical arteries from whence being afterward transported into the trunk of the great Artery it came also to the lumbares or arteries of the loins which swelling with blood prest together the neighbouring nerves from which came the palsie in the feet And this we have often observed as well in our selves as in others especially in former years when these diseases at Padua were Epidemical Yet the Palsie is not alwayes a perfect one but often as I am wont to call it imperfect because the power to walk is not wholly taken away but the diseased stand upon their feet with a great deal of difficulty Many at that time being deceived in the knowledg of the disease mistaking this for a great weakness of body contracted by their sickness endeavoured to take it away by eating and drinking largely but in vain This also is the cause why the Falling-sickness and Lethargies too as we have oft-times seen follow after the Colick because the matter
the marrow of the brain drawn out in length whilest it is yet contained within the limits of the skull that offers it self in the first place The first pair of the brain which makes the Optick Nerves that are so famous among all the Masters of Anatomy For these are not only the biggest if thou look upon their thickness but also without doubt the softest of all the nerves of the body But they arise out of the middle of the basis of the brain It s original on the forepart according to the opinion of the Antients but indeed if the head be turned upside down in the dissection wich is the proper way out of the beginning of the former trunks of the spinal marrow that their original is as it were in the back part of the head Progress and presently each of them by little and little making towards its mate they are united not only joyned as some would have it over the saddle of the wedg-bone and making one common square body the marrow within them being mixed together After that presently separating again each of them is carried obliquely into the eye of its own side Insertion entring the orb thereof through the first hole of the wedg-bone and entring at the very centre of the eye In this pair we may easily shew those two membranes which are derived to the nerves from the two Meninges of the brain as also the very inner marrowy substance which comes from the body of the brain Yet the nerve it self is not cleft into more branches as the other are but lying hid makes the coats of the eye and out of the thick membrane it forms that coat which is called Cornea the horney one out of the thin membrane that is called Vvea the grapy one but out of the substance of the marrow the Retina or coat like a net For as soon as it is arrived at the centre of the eye these membranes are displayed and making a sphere contain the humors in them Use These nerves convey the faculty of seeing to the eyes wherefore they being obstructed or comprest a blindeness ensues The holes of the optick nerves Galen hath ascribed holes to them and Herophilus for the same reason called them 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 the passages of the sight teaching that there is a sensible hollowness plainly to be seen in them whom for all that almost all Anatomists do contradict But I have heretofore shewen in the University of Padua and in a great assembly of them that there are certain passages continuing from the beginning of these Nerves as far as to the place where they meet together and presently after that vanish away toward the eye And therefore I shewed that the Ancients may not only be excused but also that they writ the truth especially when none of them have said that these passages were great but only such as did not altogether escape the sight if one would make tryal thereof in a great living creature and by a cleer light and presently after it is killed For Galen himself requires these three conditions 7. placit 4 and lib. de oculis that one may see them But before we depart hence I will bring in some problemes that besides the history it self Problemes I may also shew the use of that which I say especially when in our time they only for the most part follow the study of Anatomy who imploy their industry in the behalf of Physick The first therefore shall be what is the cause that many upon sneesing often especially when they have povoked it for the nonce have of a sodain faln blind This happens either because the branches of the sleepy arteries which are so near to the optick nerves that they touch are filled and bring so press together those nerves or else because a copious and that a phlegmatick humor has faln out of the brain into the optick nerves and obstructed them I have seen those that have been bling through the first cause sometimes cured by a Seton but I never remember that any in whom this arose from phlegmatick humors have recovered except one having the French Pox who being annointed with quick-silver all the humors melting away was restored to health But it is not the part of a good and pious Physitian to make use of those things which being full of danger may do more harm if they prove hurtful then they can procure good if they be profitable And truly it is better not to cure blindeness then to cause death although oftentimes rashness helps them whom reason helps not as the most elegant of Physitians Celsus sayes elegantly In the mean time in diseases of the eyes they who practise Physick may learn rather to administer those thing which bring the phlegm out by the palat then to draw the noxious humors to the nostrils That I may conceal besides the danger which they avoid that more profit arises from the medicines that void the phlegm out of the head through the mouth which both long experience hath hitherto taught and Anatomy perswades when the optick nerves in their original are not far distant from the palat but farther from the spongy bone and it is a preternatural way by which the humors are carried as hath been already demonstrated by the learned Vesalius Then it is disputed by what means the eye can fall out of its orb the optick nerve not being broke whereof we may have very many histories But it is not hard to give an answer to wit that the nerves may be very much extended in length Whilest therefore this nerve receives much moisture in the inflammations of the eyes it easily comes to pass that it is slackned but the muscles themselves swelling very much when they can no longer be contained in the orb leap forth out of it For this falling forth of the eyes most commonly proceeds from inflammations such as are the stories the most learned Vega who cured a woman in this case by procuring the flux of her terms and a young man by digesting ointments But the question is very worthy to be made memtion of and that gives me an occasion to explain it which I have read in some Authors that such as were before blind upon receiving of a wound overthwart the forehead and some upon a great loosness of the belly arising on a sodain have received their sight and that presently The cause of their blindness was no other then the compression of these nerves proceeding from the neighbour-vessels to wit the veins and arteries being swoln with blood which such a wound presently emptyed Wherefore I also sometimes and not without success in that species of blindness with the Barbarians tall Gutta serena open the middle vein of the fore-head out of which I draw blood so long till it ceases to run of its one accord The second pair It s original The second pair arises as the ancient Anatomists say
appointing a convenient diet in the six things which are termed not-natural The second by evacuating and diverting the antecedent matter both by purging and phlebotomy The third by topick medicines according to the condition of the morbifick humor and nature The fourth by correcting the symptoms but especially the pain whereof in these affects there is oft-times so great excess by reason of the inexplicable and invincible malignity of the virulent quality associating the humor that it alone is oft-times sufficient to kill the patient And because the variety of morbifick causes brings a variety of remedies fitted to these four intentions An argument taken from that which helpeth or giveth case is not alwaies certain therefore it behoovs a Physician to be most attentive in the distinction of the causes For he may be easily deceived and mistake one for another for arthritick pains proceeding from a cold matter if they be mitigated by the application of Narcotick and cold medicines it may induce us to believe that the material cause is hot though really it be not so for Narcoticks asswage pain not for that they are contrary to the caus thereof but because they take away the sense by induceing a numnesse on the contrary the material cause may sometimes seem cold How cold diseases may be helped by cold and hot by hot medicines which notwithstanding is hot for that it becomes better by application of hot medicines that is by takeing an argument from that which helps because contraries are cured by contraries and the like preserved by the like But herein consists the error for that hot medicines profit not by their contrariety but by the attenuation of â—he gross matter by the rarefaction of the skin and dissipating them into air Whence you may gather The first thing that may deceive a Physician that an argument drawn from that which helps and hurts is very deceitful moreover it may happen that a large quantity of cold matter flowing down from the brain may cause great pain by reason of the virulencie and a small quantity of choler mixed therewith which serves for a vehicle to carry down the tough and slow phlegm into the joints whence the patient becomes thirsty and feaverish by reason of the heat and inflammation of these parts whereby such as are less cautelous and heedy will easily be induced to believe that some hot matter is the occasion of this Gout Now when as not some one simple humor but different by reason of mixture causeth the Gout the yellowish colour of the part may deceive one The second as if the evil matter should proceed from choler only which by the tenuity of its substance leaving the center easily possesseth the circumference of the body or part and notwithstanding much phlegm being as it were enraged by the admixtion of a little choler may be the chief cause of the disease and may peradventure be discovered by the encrease of pain in the night season The third A feaver ariseing by means of pain and watching may encrease the conceived opinion of choler which attenuating and diffusing the humors drives them into the joints and causeth fiery urines tinctured with much choler and a quick pulse Yet notwithstanding the Physician shall be in an error if deceived with these appearances he attempt the cure of this Gout as ariseing from a hot The fourth and not from a cold cause yet I am not ignorant that the cure of the proper disease must be neglected for the cure of the symptoms Besides also it may come to pass that choler may be the cause of the Gout The fifth and notwithstanding no signs thereof may appear in the skin and surface of the affected part because the coldness of the ambient air and the force of applyed Narcoticks may have destroyed the colour of the juices lying thereunder and as it were imprinted a certain blackness The sixâ—h It also happens that the body being over-charged with a great quantity of gross viscid humors the expulsive faculty may discharge some portion thereof unto the joints but leave the rest impact in the cavity of some entrail where causing obstruction and putrefaction may presently cause a fever and that intermitting if it be small and obstruct only the lesser veins and these of the habit of the body Wherefore then it is not sufficient that the Physician employ himself in the cure of the Gout but it behooves him much to attend the cure of the feaver which if it be continual it discredits the Physician and endangers the patient if it be intermitting it easily becomes continual unless it be withstood with fit remedies that is unless you let blood the belly being first gently purged and nature be presently freed by a stronger purge of the troublesome burden of humors Now it is convenient Why strong purges must be given to such as have the Gout the purge be somewhat stronger then ordinary for if it should be took weak it will stir up the humors but not carry them away and they thus agitated will fall into the pained and weak joints and cause the Gout to encrease By this it appears how deceitful that conjecture is which relies and is grounded on one sign as often as we must pronounce judgment of morbifick causes Wherefore to conclude we must think that opinion most certain concerning the matter of the disease That judgment most certain which rests upon multiplicity of signs which is strengthened with multiplicity of signs as those which are drawn from the colour of the part the heat or coldness manifest to the touch those things that help and hurt the pâ—tients familiar and usuâ—l diet temper age region season of the year propriety of pain the exacerbation or excess thereof in what daies and in what hours of the day the length of these fits the urine and other excrements coming from the patients body But for that not a few are in that heresie Why we must use purging and â—leeding in the Gout that they think that we must neither purge nor let blood in the Gout we must here convince that opinion For seeing that physick is the addition of that which wants and the taking of those things that are supeâ—fluous and the Gout is a disease which hath its essence from the plenty of abundounding humors certainly without the evacuation of them by purging and bleeding we cannot hope to cure eâ—ther it or the pain which accompanies it Metrius in his Treatise of the Gout writes Lib. de affect uâ—bi de Arthrit loquitur Adaph 23. sect 1. Lib. de cur per. â—ang m ssionem that it muâ—â— be cured by purging used not only in the declination but also in the height of the disease which we have found true by experience and it is consonant to this saying of Hippocrates in pains we must purge by the stool Besides also Galen professeth that in great inflammations fevers and
of the whole skin immoderate grosness and clamminess of the blood and by eating of raw fruits and drinking of cold water by sluggishness and thickness of the vessels and also the obstruction of them by the defaults and diseases of the womb by distemperature an abscess 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 The foolish endeavor of making the â—rifice of the womb narrow is â—â—warded with the discommodity of stopping of the flowers What women are called Viragines Lib. 6. epidem sect 7. The women that are called viragines are barren by injecting of astringent things into the neck of the womb which place many women endeavor foolishly to make narrow I speak nothing of age greatness with childe and nursing of children because these causes are not besides nature neither do they require the help of the Physitian Many women when their flowers or terms be stopped degenerate after a manner into a certain manly nature whence they are called Viragines that is to say stout or manly women therefore their voice is more loud and big like unto a mans and they become bearded In the City Abdera saith Hippocrates Phaethusa the wife of Pytheas at the first did bear children and was fruitful 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 monthly flux and yet nevertheless enjoy their perfect health they must necessarily be hot and dry or rather of a manly heat and driness that they may so disperse and dissipate by transpiration as men do the excrements that are gathered but verily all such are barren CHAP. LII What accidents follow the suppression or stopping of the monthly flux or flowers WHen the flowers or monthly flux are stopped diseases affect the womb and from thence pass into all the whole body For thereof commeth suffocation of the womb head-ach swouning beating of the heart and swelling of the breasts and secret parts Why the strangury or bloodiness of the urine followeth the suppression of the flowers inflammation of the womb an abscess ulcer cancer a feaver nauseousness vomitings difficult and slow concoction the dropsie strangury the full womb pressing upon the orifice of the bladder black and bloody urine by reason that portion of the blood sweateth out into the bladder In many women the stopped matter of the monthly flux is excluded by vomiting urine and the haemorrhoids in some it groweth into varices In my wife when she wss a maid the menstrual matter was excluded and purged by the nostrils Histories of such as were purged of their menstrual flux by the nose and dugs The wife of Peter Feure of Casteaudun was purged of her menstrual matter by the dugs every month and in such abundance that scarce three or four cloaths were able to drie it and suck it up In those that have not the flux monthly to evacuate this plenitude by some part or place of the body there often follows difficulty of breathing melancholy madness the gout an ill disposition of the whole body dissolution of the strength of the whole body want of appetite a consumption the falling sickness an apoplexie Those whose blood is laudable yet not so abundant do receive no other discommodity by the suppression of the flowers unless it be that the womb burns or itcheâ—h with the desire of copulation by reason that the womb is distended with hot and iâ—ching blood especially if they lead a sedentary life To what women the suppression of the months is most grievous Those women that have been accustomed to bear 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 been 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 color because that the heat with the spirits go from without inwards so to help and aid the expulsive faculty CHAP. LIII Of provoking the flowers or courses Why the vein called Basilica in the arm must be opened beâ—ore the vein â—aphena in the foot Hors-leeches to be aplied to the neck of the womb THe suppression of the flowers is a plethorick disease and therefore must be cured by evacuation which must be done by opening the vein called Saphena which is at the ankle but first let the basilike vein of the arm be opened especially if the body be plethorick lest that there should a greater attraction be made into the womb and by such attraction or flowing in there should come a greater obstruction When the veins of the womb are distended with so great a swelling that they may be seen it will be very profitable to apply hors-leeches to the neck thereof pessaries for women may be used but fumigations of aromatick things are more meet for maids because they are bashful and shamefac'd Unguents liniments emplasters cataplasms that serve for that matter are to be prescribed and applied to the secret parts ligatures and frictions of the thighs and legs are not to be omitted fomentations and sternutatories are to be used and cupping glasses are to be applied to the groins walking dancing riding often and wanton copulation with her husband and such like exercises provoke the flowers Of plants the flowers of St. John's-Wurt the roots of fennel and asparagus bruscus or butchers-broom Plants that provoke the flowers or parsly brook-lime basil balm betony garlick onions crista marina cost-mary the rinde or bark of cassia fistula calamint origanum penniroyal mugwort thyme hyssop sage marjorum rosemary horehound rue savin spurge saffron agarick the flowers of elder bay-berries Sweet things the berries of Ivy scammony Cantharides pyrethrum or pellitory of Spain euphorbium The aromatick things are amomum cinnamon squinanth nutmegs calamus aromaticus cyperus ginger cloves galingal pepper cubibes amber musk spiknard and such like of all which let fomentations fumigations baths broaths boles potions pils syrups apozemes and opiates be made as the Physicians shall think good An apozeme to provoke the flowers The apozeme that followeth is proved to be very effectual â„ž fol. flor dictam an p. ii pimpinel m ss omnium capillar an p.i. artemis thymi marjor origan an m. ss rad rub major petrosâ—lin 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