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CHAP. IX. What remaines for the Chirurgion to doe in this kinde of wounds.
THe Chirurgion must first of all be skilfull and labour to asswage paine, hin∣der defluxions, prescribe a dyet in these sixe things we call Not naturall, forbidding the use of hot and acrid things, as also of wine; for such atte∣nuate the humors and make them more apt for defluxion. Therefore at * 1.1 the first let his dyet be slender, that so the course of the humors may bee diverted from the affected part; for the stomacke being empty and not well filled, drawes from the parts about it, whereby it consequently followes, that the utmost and re∣motest parts are at the length evacuated; which is the cause, that such as are woun∣ded, must keepe so spare a dyet for the next dayes following. Venery is very perniti∣ous, for that it inflames the spirits and humors farre beyond other motions; whereby it happens that the humors waxing hot, are too plentifully carryed to the wounded and overheated part. The bleeding must not bee stanched presently upon the re∣ceiving of the wound, for by the more plentifull effluxe thereof the part is freed from danger of inflammation and fulnesse. Wherefore if the wound bleede not * 1.2 sufficiently at the first, you shall the next day open a veine, and take blood accor∣ding to the strength and plenitude of the patient; for there usually flowes no great store of blood from wounds of this nature; for that by the greatnesse of the con∣tusion and vehemencie of the mooved ayre, the spirits are forced in, as also I have observed in those who have one of their limbes taken away with a Cannon bullet. For in the time when the wound is received, there flowes no great quantity of blood, although there be large veines and arteries torne in sunder thereby. But on the 4, 5, 6. or some more dayes after, the blood flowes in greater abundance, and with more violence, the native heate and spirits returning into the part. The belly must be so qualified, that he may have at the least one stoole a day, either by nature, or Art; and if by Art, then rather with a glister than purging medicines taken by the mouth, for that the agitation of humors, chiefely in the first dayes of the disease, is to be sus∣spected, least we increase the defluxion falling downe upon the wounded part. Yet Galen writes that both the evacuations are heere needefull, that is, blood-letting and * 1.3 purging, though the Patient bee neither phethoricke, nor repleate with ill hu∣mors. But the care hereof must be committed to the judgement of the learned Phy∣sition. Paine if ioyned with inflammation shall be mitigated, by anointing the parts neere unto the wound with Vnguent. nutritum, composed with the juyce of Plantaine, Housleeke, Nightshade and the like. Vnguentum Diacalcitheos described by Galen * 1.4 dissolved with vinegar, oyle of Poppyes and Roses is of no lesse efficacy; nor un∣guent. de bolo, nor divers other things of the same faculty, though properly no ano∣dynes, as those which are not hot and moyst in the first degree, but rather cold, but yet not so as to have any narcoticke faculty. Now these forementioned things as∣swage paine for that they correct the hot distemper, and stay the acride and cho∣lericke defluxions, whose violence is more than cold. After the use of repercussives, it will be good to apply this following cataplasme. ℞ Micae panis infusae in lacte vac∣cino lb. j. ss. bulliant parum addendo olei violacei, & rosar. an. ℥iij. vitellos ovorum nu. iiij. * 1.5 pulver. rosar. rub. flor. chamaem. & meliloti, an. ℥ij. farin. fabar. & hordei, an. ℥j. misce, fiat cataplasma secundum artom. Also in this case you may easily make a medicine, of bread crummes boyled in Oxycrate and oyle of Roses. The cure of Tumors, if any associate the wound, may be found in their proper place. Natures motion, whether to suppuration, or any such thing, must still be observed, and helped by the Physition and Chirurgion, as the ministers or servants thereof.