CHAP. XXIII. Of the wounds of the face.
HAving treated of the wonnds of the head by their causes, signes and cure, it followes that we now speake of the wounds of the face, if but for this, * 1.1 that when they are carelessely handled, they leave deformed scarres in the most specious and beautifull part of the body. The causes are the same which are incident to the scull, that is, externall. But this may bee added to the kindes and differences of the wounds, that the life may be out of danger though any one whole part of the face, (as the eare, eye, nose, lippe) may bee cut a∣way by a wound, but not so in the head or scull. Wherefore beginning at the wounds of the eye browes, wee will prosecute in order the wounds of the other parts of the face.
This is chiefely to bee observed in wounds of the eye-browes, that they are oft * 1.2 times cut so overtwhart, that the muscles, and fleshy pannicle which moove and lift them up, are wholy rent and torne. In which case the eye liddes cannot be opened, and the eyes remaine covered, and as it were shut up in the cases of their lids; so that even after the agglutination of the wound, if the patient would looke upon any thing, he is forc'd to hold up the eye-lids with his hand; with which insirmity I have seene many troubled, yet oft times not so much by the violence of the wound, as by the unskilfulnesse of the Chirurgion who cured them; that is, by the negligent application of boulsters, an unfit ligature and more unfit suture. In this case the skil∣full Chirurgion which is called to the patient shall cut off as much of the skinne and fleshy pannicle as shall serve the eyelids, that so they may by their owne strength holde and keepe open, without the helpe of the hand: then he shall sow the wound as is fit, with such a stitch as the Furriers, and Glovers use; and then he shall poure thereon some of the balsome of my description, and shall lay such a medicine to the neigh∣bouring parts.
R Olei rosar. ℥ss. album. o••••r. nu. ij. boli armeni, sanguinis Dracon. Mastich. an ʒj. agi∣tentur simul, fiat medicamentum. Then let the part be bound with a fitting ligature. Afterwards you shall use Emplast. degratia Dei, Empl. de Betonica, Diacalcitheos, or some other like, untill the wound be cicatrized. But such like and all other wounds of the face may be easily healed, unlesse they either bee associated with some maligne symptomes, or the patient body be repleate with ill humors.
There sometimes happens a quite contrary accident in wounds of the eye-browes, * 1.3 that is, when the eye-lids stand so up that the patient is forc'd to sleepe with his eyes open, wherefore those which are so aflected are called by the Greeks Lagophthal••i. The cause of this affect is often internall, as a carbuncle or other kinde of abscesse, as a blow or stroake. It shall be cured by a crooked or semicircular incision made above the eye-liddes, but so that the extreames of the semicircle bend downewards, that they may be pressed downe and ioyned as much as is needefull to amend the stif∣nesse of the eye-lidde. But you must not violate the gristle with your Instrument, for so they could no more be lifted up; the residue of the cure must bee performed as is fit.