cause of the Evil we could not through the whole length of the Arm find either Fracture or Dislocation but a very great Contusion of the whole Arm so that much of the Extravasate Bloud and also of the Humors adhering in the small passages of the Arm distorted by the Contusion stagnized and in a short time waxed acid whence that Imbecility Tumor and Dolour may rationally be concluded to have derived their Original Some to render the motion of the Bloud more pleasing do here presently cut a Vein whereas I on the contrary omitted the opening of a Vein gave to the Patient an Anodine Tincture prepared of Opium and other things which much more securely and with greater Utility diminished the motion of the Bloud After some few hours I exhibited to the Sick a sudorifick Powder which would also temperate the Acidity of the Extravasate Bloud and stagnizing Humors this I repeated the two following nights with good success This Powder consisted of Diaphoretick Antimony Crabs-eyes prepared Salt-prunella Antimoniat and other things and hereby the dolour was in no small measure remitted and the Extravasate Bloud was driven out to the Cutis which then all over the Arm from the Shoulder to the Fingers was very livid yea waxed black The Chyrurgeons that were present with me did in the beginning of the Cure without my consent anoint the whole Arm with Oyl of Roses which hurts not so much by reason of the Roses as by reason of the Oyl-Olive For although this might do some good yet it could not profit unless it could have penetrated to that place where the Extravasate Bloud and stagnizing Humours lay but so far it could not penetrate unless in form of Vapour and the heat of our Bodies is too weak to convert Oyl-Olive into such Vapours seeing indeed a sufficiently strong Fire made of Wood and Coals is not of force sufficient to reduce the Particles of Oyl-Olive put into a Pot into the form of Vapours Therefore the Oyl-Olive was so far from doing good that as I judged it rather did hurt because by its stringy Particles it augmented the Obstructions and so caused the Bloud and Humors yet more to stagnize and besides by its closing the Pores of the Skin it hindered the access of other Medicaments to the place affected If common Roses be cold as many think I should reject them in this case but because from their bitterness and penetrating Odour the contrary may be judged by those who laying aside their prejudices will rather follow Verity than Antiquity Therefore I in this case condemn Oyl of Roses by reason of the Oyl-Olive but not by reason of some Particles of the Roses mixt therewith The same Chyrurgeons applied to the whole Arm anointed with Oyl of Roses that Defensive Plaister the description of which is found in the Ultrajectine Pharmacopoeia which indeed I do not here wholly reject because it containeth many Ingredients temperating Acidity as Bolus Terra Sigillata Lithargyry and other things but to what end should here be added Myrtle-Berries Oyl of Myrtles and Austere Red-Wine These indeed bind up the Pores of the Skin and so wholly impede the penetration of other fit Ingredients to the affected part Experience did in a short time confirm the truth of my Assertion when many Pustles dispersed through the whole Arm came in sight Wherefore I prescribed the following Lavament which I substituted instead of the Oyl and Plaister as being a Medicament that would powerfully resist Acidity and consequently well dissolve the coagulated Bloud and Humors â„ž Roots Of the Flower de Luce. Of Calamus Aromaticus Of Bryony of each â„¥ ss Herbs Rosemary Betony Sage of each M. ss Berries Of Juniper Of Bays of eachÊ’iij Boyl these in a close Vessel with French-Wine and to two pound of the Colature add Of Gum AmmoniacÊ’ij Of Salt of TartarÊ’j Make a Lavament By this means the Pustles vanished the Dolour was diminished the motion of the Arm gradually returned and the Livid colour was turned yellow Then the Chyrurgeons willing the Medicaments should be changed instead of the Defensive Plaister which they again proposed I prescribed a Fumigation temperating Acidity which consisted of Bay-Berries Juniper-Berries Frankincense Mastich Myrrh and other things For if these latter could help in the aforesaid Plaister where they lay bound up by the Suet and Wax they must needs be much more profitable when in the form of Fume they could fly up and surround the Arm its superiour part being covered and so being forcibly enough agitated could enter the Pores of the Arm by that time well opened by the heat After this I commanded Spirit of Wine to be burnt the Vapour of which ascending to the Arm and entring through the Pores infringed the Acidity which had in no small measure coagulated the Bloud and Humours and by that means the Patient was healed the dolour and yellowness removed and the motion of the Arm restored I most assuredly perswade my self that the Contusion would not have been so great if a Fracture of the Bone in the Patients Arm had also been concomitant For the Bone when broken recedes and contuseth no more but when the Bone remains entire and consequently by reason of its hardness makes strenuous resistance and when there is on the other part a solid Body contusing then the interstanding Flesh is no otherwise pressed on either part than as if it were put under a Press and so it is in a strange manner contused And this is no more than what our daily practice confirms in which I have often observed a Contusion where the Bone hath been broaken to be much less than where the Bone hath remained unhurt In this Cure my fear was that the Extravasate Bloud should be so much coagulated that it could not be afterwards dissolved and so might at length become so very acid and corrosive as to infect the adjacent parts with a Gangrene For it was not long before that I was called to a young Man who had for eight days neglected a Contusion of the Tibia after that I was called and seeing how it was compelled to open the contused part with a Lancet I perceived many sufficiently large Clots of Bloud firmly coagulated black and putrid which had in some sort infected the Cavity in which they were conteined with a Gangrene which notwithstanding I in a short time removed by washing it with Spirit of Wine and by inspersing the Pouders of Myrrh and Aloes OBSERVAT. VIII Of a Ganglion in the Hand A Youth aged Sixteen years complained of a Tumour hard and painful which sited in the upper part of his right Hand in magnitude equallized an Hazel-Nut and was of the same colour with the Cutis and there was now near three Months passed since the Patient by unaccustomed labour was affected with this Evil. The Tendon lay in the upper part of the Hand the small passages of which were by that unusual labour so distorted that the Humors
with an acid Spirit not to fly away as it is otherwise wont to do The end of the Fourth Decade DECADE V. OBSERVAT. I. Of a Wound of the Head A Youth aged Sixteen years fallen from an Horse to the ground received a sufficiently large Wound in the forepart of his Head which was indeed so great that the Bone presented it self bare to the sight in the mean while the Patient did often vomit and was very ill Two hours after this mishap were scarcely elapsed before I was called to this Youth in whose Head I could perceive neither Fissure nor Fracture nor imbowing of the Cranium and at that time the Vomiting ceased and the sick Youth was pretty sedate and complained not much of pain or of any other discommodity It would in this place be superfluous to explain whence this Vomiting proceeded the matter being as I judge sufficiently clear of it self The Hair being shaved off I filled the Wound with dry Lint and indeed did this for two reasons First that the Flux of Bloud might by this means be stopped And Secondly that the Lips of the Wound might be in some measure separated each from other to the end that the Cranium might the next day be the better discovered Then I superposited a Plaister made of the following Mass â„ž Emplast Diapalma â„¥ ij Bolus and common Chalk of eachÊ’ij Diaphoretic Antimony â„¥ j. Oyl of Bays Ê’ij Of Tartar p. d. Ê’ss Mix and make a Plaister The next day nothing of evil appeared in the Cranium discovered and the Patient was scarcely vexed with an evil Symptome whence I conceived hope that the Interior part of the Cranium had also received no hurt and that the Brain likewise lay unprejudiced within both its Infoldings Therefore the Bone being first covered with dry scraped Lint I applied to the Lips of the Wound this following Medicament â„ž Common Turpentine Honey of Roses of each â„¥ ss Myrrh Aloes of eachÊ’ss Mix these make an Unguent By this means the Patient was in a short time restored to his pristine state of health The Plaister was applied for temperating the Acidity and that it might speedily dissolve whatsoever was coagulated by the Contusion The Unguent was also added for restoring the Circulation of the Bloud and Humors somewhat impeded by reason of the small passages in the Wound interrupted and distorted The bared Cranium was covered with dry scraped Lint partly that the Pus issuing from the Lips of the Wound might infer no damage to the Bone and partly that the ambient Air might by this means be kept from the Cranium to which by reason of its Acidity with which it abounds it is very inimical as the daily coagulation of Bloud let out from a Vein cut caused by the external Air doth plainly teach But that kind of Lint which is in Dutch called Catoen is not convenient in Wounds because it is often wont by its acute Angles with which it abounds as by the help of a Microscope may easily be seen to excite Inflammation All fat things I here studiously avoided because they with their stringy Particles too pertinaciously obstruct the very small passages of the Cranium and so cause the Humors to stagnize and wax acid corrupt the Volatile Salt of the Cranium and induce rottenness and then the Cure must needs be not a little procrastinated by reason of the perished part of the Bone which must first be separated Scultetus in his Chyrurgick Armoury anoints the part adjoyning to a Wound with astringent Oyls for some time to prevent Inflammation as he judgeth but improperly For in an Inflammation the Circulation of the Bloud should not be stopped but promoted because the Bloud and Humors by reason of their coagulation in an Inflammation stagnize more than is fit therefore it would in this case be an Argument of much greater prudence to dissolve the coagulated Humors by Plaisters temperating Acidity The cutting of a Vein which many egregiously extol in Wounds of the Head I wholly omit because I see not any Utility thence to arise To distinguish Medicaments into Mundificatives and Narcoticks and to take sometimes These and afterwards Those into use is a matter of no Utility for our Unguent onely is sufficient and performs whatsoever is necessary whilst it temperates Acidity and restores the Circulation of the Humors But in the mean while it is to be observed that when the Wound was almost filled up with flesh omitting the aforesaid Unguent we at length applied dry scraped Lint for otherwise the Flesh would have been too luxuriant and risen higher than was fit The Ancients in Wounds of the Head used a Swathe which is called Cancer the delineation of which may be seen in Scultetus but in these our days a common Napkin fitly applied is generally used Vomiting in a Wound of the Head for the most part portends much evil but that it is not always an infallible sign of a Fracture of the Cranium of a Fissure or any other very great discommodity is clearly evident by our proposed case Full of peril is a Wound of the Head which beguiles us most when it seems most pleasing Therefore no Wound of the Head though very small should be lightly esteemed or negligently handled but here we should rather suspect all things because where Chyrurgeons are most secure there commonly lies a Snake in the Grass Having for some time pondered these things in my mind I judge it worth while before I put an end to this Observation to enlarge my Discourse more than I am wont to do that if in this case I cannot satisfie others I may at least give satisfaction to my self for whose Instruction I write these It is out of all doubt that a very small Wound of the Head long after it hath been inflicted may infer Death yet this hinders not but that it may sometimes happen that a Patient having a Wound of his Head accounted almost by all men most dangerous and mortal may recover contrary to the expectation of Physicians and Chyrurgeons So I remember some years since to my Fathers care was committed a certain wounded man who had with a Spade received so horrid a Wound in the forepart of his Head that by the stroke inflicted not onely a very great part of the Cranium but also no small portion of the Brain it self was shattered and notwithstanding this the same man is at this time at Arenacum living and well yet his Hemiplegia still remains By this History I shall perhaps prove the opinion of the most famous Willis to be false who endeavours to perswade his Reader that the seat of the Memory is found to be in the Cortex of the Brain for if this were true then our above-recited Patient must needs have had his Memory much impaired whereas it is at this time no less vigorous than it was before the Wound received But what do I speak of those who have recovered of an horrid Wound of the Head
which should rather be diminished Paulus Berbette wills that the influx of Humours in this case be prohibited but improperly because that influx being natural should not be stopped That man undoubtedly saw in 2 Dislocations the near adjoyning parts often elevated into a Tumour Also he observed by frequent experience that Frankincense Mastich Bolus and the like removed this Tumour But when he judged this Tumour to be produced from an influx more copious than usual and when according to this stated opinion he thought his Medicaments did therefore help because they prohibited that Influx then I say he erred For Obstructions were the cause that the Humours were coacervated and elevated into a Tumour and so waxed acid and the said Medicaments onely profit because they remove the Obstructions and temperate the Acidity Having now spoken of the Dislocation of the Shoulder suddenly happening there is yet another Dislocation slowly invading and more slowly sanable viz. when by External force the Ligaments of the Shoulder are contused so that the small passages are distorted whence the Humours circulating through the Ligaments do there subsist and in process of time insinuate themselves into the Pores of the Fibrils of which the Ligaments consists and extend those Pores not according to the breadth but according to the length of the Ligaments For the Ligaments when motion is are often extended in length even so the Ligaments which otherwise were wont to contain the head of the Bone in its Cavity are now so far prolonged that the Bone falls out of its proper seat This Dislocation is easily restored but the Bone reposited is very difficultly retained in its place External Medicaments helpful to retain a Bone reduced to its place are such as consist of much Volatile Salt because Volatile Salt can attenuate the Particles inherent in the Pores of the Ligaments and so force them out and restore the circulation of Humours But the cure will be rendred more easie and in less time accomplished if we contribute help to the external Medicaments by a Decoction to be inwardly taken consisting of Lign Guaiacum Root of Sarsaparilla China and other Medicaments abounding with much Volatile Salt The end of the first Decade of Chyrurgick Observations DECADE II. OBSERVAT. I. Of the Puncture of a Nerve A Young Man aged Twenty years exercised in Chyrurgery with the Puncture of a Lancet hurt the middle Finger of his left Hand about the middle Article whence arose pain at first not very great but by the next morning it was vastly augmented and besides redness invaded the whole Finger attended with burning heat and swelling and the Cutis in places nigh the Wound was separarated pallid and insensible After I had accurately considered the Phaenomena's I concluded the Nerve to be hurt by the Razor whence at first arose but small pain But by reason of the small passages bordering on the wounded Nerve Humours interrupted by that small Wound otherwise freely circulating were constrained to subsist about the Wound and there became acid and so by the Humours following them were driven to the wounded Nerve where permixt with the Animal Spirits hastning through the Nerve they excited a certain effervescency by reason of the Volatile Salt contained in those Animal Spirits and by this means the acid Particles constituted in motion great enough with the acuteness of their sides egregiously vellicated the Fibrils of the wounded Nerve and so excited that grievous dolour I even now spake of The acid Humours thus forced into an effervescency with the Animal Spirits not onely irritated and disturbed the Fibrils of the wounded Nerve but also the Fibrils of the adjacent parts yea of the whole Finger whence many small passages were so distorted that the Bloud and Humours setled in them and by a short delay there assumed the nature of Acidity whence the heat and tumour of the whole Finger or inflammation of 〈◊〉 same were readily induced The same acid Particles exercising their Effervescency had wholly cut in sunder those Fibrils which knit the Skin sited round about the Wound together with the subjected part and so the Cutis was separated pallid and insensible because those often-cited acid and cutting Particles had cut in sunder very many Fibrils constituting the same Cutis which Fibrils crisping on heaps produced so many and so pertinacious Obstructions that the circulation of the Bloud Humours and Spirits through the Cutis was totally impeded Things being thus I judged the Wound sufficiently dangerous and therefore the cure thereof to be diligently set about having long before seen a French Souldier whose Nerve about the Cubit of the Arm was but lightly prickt with a Sword who after a long series of time and many difficulties overcome was with very great care and pains at last restored to his pristine state of health Yea I also saw an Husbandman the Nerve of whose Thigh was wounded with a Leaden-bullet shot out of a Gun this man a Convulsion being excited died in a short time after the wound was inflicted I had often before mixed Oyl of Turpentine with the acid Oyl of Vitriol and saw an Effervescencâ—â—o arise thence yea with my hands I â—ave felt sufficient heat produced in the Glass containing those Liquors Hence I did without difficulty perceive how powerfully Oyl of Turpentine did resist Acidity and by consequence how excellently serviceable it would prove in this our case wherefore I poured Oyl of Turpentine before made sufficiently hot into the Wound that so the Parades thereof of put into greater motion might more easily and more profoundly penetrate and consequently act more powerfully in temperating the peccant Acidity Then I applied Paracelsus his Stiptick Plaister which also temperates Acidity Afterward on the Finger and indeed all over the Hand I laid a doubled Cloath moistned with a Lavament consisting of Spirit of Wine Water of Elder Camphire and Salt-prunella changing these twice a day and with an Instrument removing the Cutis already separated from the subjacent flesh Thus our Young man was cured in a short time In the mean while it is worthy observation that I saw a necessity of being industriously careful to prevent the access of the ambient Air because that contains in it self Acidity which is apparent thus viz. because it coagulates Milk yea Bloud it self when extravasate is in a short time coagulated by the Air whereas the same is found to persist in its wonted Fluidness for several days if it remain in the Vessels of any Carkass where it is free from the ambient Air. By the aforesaid it is sufficiently manifest why there is much less dolour in a Nerve wholly cut off than in that which is onely prickt or but lightly wounded for when a Nerve is totally cut in sunder one Extreamity is retracted to this part the other to another and is absconded by the flesh so that the acid Humour inherent in the Wound and the ambient Air cannot have access to the Nerve The famous Sylvius
must needs be livid and very painful But what may hence be inferred Can cold Water profit in a Contusion It seems more likely to do hurt because it incrassates coagulates and stagnizeth the extravasate Bloud Would not Spirit of Wine and other Medicaments that increase the motion of the Bloud be more convenient in this case That you may the more clearly conceive the solution of this difficulty it is behooful to know that in the parts hurt by the Ball so forcibly driven certain very small sanguiferous Vessels were opened which had they before the Water was applied poured out the Bloud into the small passages of the Parts hurt then the cold Water would have done hurt but this cold Water was applied before the Bloud issued out and so not onely by its coldness again closed these very small Vessels but also was the cause that no new Bloud could for a certain space of time enter the same Vessels So we see our Face to be red for no other reason than because through the Cutis of the same very many small Vessels full of Bloud lie dispersed and discern the same to wax pale by the coldness of Water Air and other things because such coldness for a time prohibits the Bloud from entring these very small Vessels of the Face So we see the pleasant redness of the Lips in a beautiful Virgin augmented by the kiss of a young man to be changed into a pallid colour by Acidity restraining the Bloud from entring the small Vessels distributed throughout the Superficies of the Lips But whosoever he be that will attempt such a way of Cure as this here mentioned after the small passages of the parts contused shall be replete with extravasate Bloud seems to me to be not well in his wits for I have not seldom known a Gangrene to arise in a part contused from the unseasonable application of cold and astringent things OBSERVAT. IX Of an hard Tumor of the Abdomen A Girl Five years of Age accustomed to evil Diet was for a long time afflicted with a very great Tumor and hardness of her Abdomen and her face was very pale The following Liniment had before been in vain used â„ž Vnguent Altheae comp Oyl of white Lillies of eachÊ’ss Of TilesÊ’j Mix these Which notwithstanding in a like case is not a little commended by the famous Sylvius in the first Book of his Praxis Chap. 14. under the Title 56. Well considering the matter I judged the Bloud of this sick child to be very viscous and acid and by reason of this that many Glandules of the Omentum were obstructed and augmented to a strange bulk But which way Paleness of the Face is induced by such Bloud I suppose to be known to every man therefore needs not be here explained Perhaps some one will wonder and not believe it possible that the Glandules of the Omentum should increase to so great a Magnitude as to become the cause of so great and hard a Tumor as was in the Abdomen of this Child perceptible by the touch but I would have him peruse Fabritius Hildanus who in the 62 Observation of his Third Century declares that he opened a Carcass the Omentum of which by reason of the tumified Glandules weighed Fifty six pounds Things being thus I judged nothing would be more profitable than Paracelsus his Stiptick Plaister which I commanded to be applied to the Abdomen after it was spread upon a Linnen Cloath and anointed with Oyl of Nutmegs To correct the viscous and acid Bloud I commanded certain drops of oyly Volatile Salt to be given daily twice a day and by this means our little Patient in the space of a few Months was happily restored to her pristine state of health OBSERVAT. X. Of the Scurvey A Man aged Thirty years every day evily accustoming himself to viscous and sowre Aliments according to the bad custom of the Gelders was afflicted with heaviness and dolour of his hands and Feet his Gums in a great measure consumed would bleed with the least touch his Spittle was in taste salt as Brine Having diligently considered these things I judged the Bloud too acid and viscous to be here peccant which by reason of Acidity inferred that dolour of Hands and Feet and corroded the Gum and its sanguiferous Vessels and by its too great Viscosity did so obstruct the small passages of the Hands and Feet that the usually-free transit of the Animal Spirits into the Muscles was somewhat impeded whence arose the aforesaid Heaviness I speak here of the Animal Spirits for seeing the Liquor that is through the Nerves for exciting motion carried into the Muscle is subtile I know not why this Nervous Liquor should less deserve to be insignized with the name of Spirit than that Liquor which in Chymical Distillation is extracted from Hartshorn But omitting vain Disputes about the Name let us set about the Matter it self This Disease is very familiar in these Regions and is generally known by the name of The Scurvey and is most difficultly cured if in process of time it have taken deep root Wherefore I presently applied my self to the Cure of this Disease seriously commanding the Patient for the future to eat no more acid and viscous Aliments and prescribing the following Medicament â„ž Syrup of Scurvy grass â„¥ ss Of Salt Armoniac distilled with Salt of Tartar â„¥ ij Oyl of Tartar per deliquium Tincture of May-worms of eachÊ’j I commanded the Patient to take 16 drops of this Medicine thrice a day in a Decoction of the Tops of Firr and indeed to the end that the Spirits of Scurvey-grass and Sal-Armoniac and the Tincture of May-worms with the aforesaid Decoction might attenuate the viscous Bloud and infringe the Acidity thereof I added Oyl of Tartar per deliquium that by this means the Volatile Salt of the Bloud subdued and bound by the Acidity might again recover its pristine liberty and so render the Bloud more fluid and more agile As we see the Volatile Salt of Hartshorn or any other Volatile Salt coagulated and conjoyned with an Acid Spirit with the help of an Alkali-Salt and Common Water by distillation to be again restored to its pristine liberty and separated from that Acidity As to the Tincture of May-worms it is to be observed that that ought not to be extracted with the acid Spirit of Salt as Artists are wont to do because by this means the Volatile Salt of the May-worms is infringed and enervated By these Remedies our Scorbutick Patient was cured in a short time But before I put an end to this Third Decade a Difficulty not very small remains yet to be removed I here affirm the Cause of this Disease to be Acidity and in the mean while say the Spittle was imbibed with a Saline taste how do these agree Do they not manifestly contradict each other No. I promise to unfold this Riddle in few words No small quantity of Volatile Salt contained in the