The method of curing vvounds made by gun-shot Also by arrowes and darts, with their accidents. Written by Ambrose Parie of Laual, counsellor and chiefe chirurgean to the French King. Faithfully done into English out of the French copie, by Walter Hamond chirurgean.

CHAP. VIII. Of the Indications which ought to bee obserued in the saide wounds.

THE mundification and the extraction of the saide strange bodies being done, it followeth then to aide Nature; both to regenerate flesh, & also to cicatrice it, as wel by things taken inward∣ly, as by outward Medicines hereunto conueni∣ent, and to proceede therein by certaine Indica∣tions, which are taken first from the essence of the disease, and from the cause thereof. If it bee pre∣sent although that from the primitiue cau••e (ac∣cording to Galen in the third of his Method) ••here

ought no Indication to bee taken, no more then from the time wherein hee meaneth from the ab∣sent cause, and from the time past. In like manner Indication ought to be taken from the foure vni∣uersall times of the cureable disease, that is to say, from the beginning, increasing, state, and decli∣nation: according to the which times, the reme∣dies ought to be diuersied. Another Indication is takē from the temperature of the Pa••ient, which also changeth the curation.* 1.1 For euery rationall and Methodicke Chirurgian knoweth well, that other remedies are required in a Chollericke bo∣dy, then in a Flegmatick; and so of the other tem∣peratures both simple and compound. Vnder the which Indication of the temperature, shall bee comprehended that of the Age, which receyueth not all remedies alike, but demaundeth some for the yong persons, and others for the old.

Moreouer, Indication is to bee taken from the custome or manner of liuing of the Patient; as whether hee hath beene accustomed to eate and drink much, and at all houres: for then you ought not to ordaine him such an exquisite dyet as vnto him that is accustomed to eate and drinke but lit∣tle, and at certaine houres: and therefore the di∣et of Panades are not so proper vnto vs as vnto the Italians, because our bodies require more leni∣tiue things: which effect it woorketh with them, because of Custome, which is a second Nature. Vnder this accustomed manner of liuing, ought to be vnderstood the condition of the life, and the

exercise of the Patient, forasmuch as you ought to vse stronger remedies vnto the robusticke & men of labour, such as haue their flesh hard, then you ought to vse vpon the delicate, and such which la∣bour but little, and exercise lesse. Some there bee that had rather comprehend this Indication vnder that of the temperature. For my part I wil not dis∣pute of it, but will leaue the resolution thereof wholly to the Doctors.

* 1.2The Indication taken from the vertue of the patient, is aboue all other things to be respected, because that it failing or being very weake, all o∣ther things ought necessarily to bee best to come vnto it. As when we are inforced through neces∣sity to take off a member, or to make any great in∣cisions, or such like things, if the patient haue not vertue sufficient to indure the paine; it is necessa∣ry to deferre such operations (if it possible) vntill that Nature be restored, and hath recouered her vertues both by good nourishment and rest.

Another Indication may bee taken from the Ayre which doth encompasse vs: vnder the which are comprehended the seasons of the yeere, the region, the place of our abiding, and the constitu∣tion of the time. For accordi••g to the heat, cold∣nesse, drinesse, and moysture of the aire, also ac∣cording to the continuation of these qual••ties, the Medicines ought to be prepared. And therefore (as sayth Guido) the wounds in the head are more difficult to heale at Paris then at Auignon;* 1.3 and the wounds in the legges are more tedious at Auig∣non

then in Paris; by reason that in Paris the ayre is more cold and moyst then at Auignon, which is a contrary thing, especially to all woundes in the head. Contrarywise, in Auignon, the heate of the incompassing aire doeth melt and subtillize the humors; whereby such humours more easily and in greater abundance do fall downe into the legs: from whence it commeth that the wounds in the legges are more difficult to cure at Auignon then at Paris. But if any one doe alledge experience to the contrary, that the woundes in the head, do more often become lethall or mortal in hotte Re∣gions then in colde. To him I answer, that that proceedeth not by reason of the aire, inasmuch as it is hot and dry, but because of some superflu∣ous humidity or euill vapour communicated with the aire; as in those partes of Prouence and Italy, which are neere to the Mediterranean sea.

The Indication of curation may also bee taken from the temperature of the wounded partes:* 1.4 for the fleshy parts doe require other remedies then the Bones or the Neruous partes, and so others. The like ought to bee obserued concerning the sensibility of the saide parts, which in like manner altereth the manner of curation: for it is not sit∣ting to apply such sharpe and violent medicines to the Nerues and Tendons, as to the Ligaments and other insensible parts. The dignity and action of the wounded parts hath no lesse priuiledge in the act of curation then the former. For, if the wound be in the Braine, or in any other of the vi∣tall

or naturall parts, it behooueth that their Me∣dicines diuersified and applied according to their dignity and action, because that from the con∣templation of these wounds, is oftentimes gathe∣red a certain iudgement of the insuing accidents. For such woundes which doe penetrate into the ventricle of the Braine, the Heart, or in the great vessels,* 1.5 in the Chest, in the Neruous part of Dia∣phragma, in the Liuer, in the stomack, in the smal guts, and in the bladder, if the wound bee great, they are necessarily mortall. Also such which are in the ioynts, or neere thereunto, and in bodies Cacochymed or of an ill habitude are oftentimes mortall, as hath beene sayde heere before. In like manner, the Indications which are taken from the position and colligance of the affected part ought not to bee forgotten, neither the figure thereof, as Galan hath sufficiently explained in the 7. of his Method, and in the second to Glaucus.

Notes

• * 1.1

  Indication taken f••om the tempe∣rature of the bodye.
• * 1.2

  The Indica∣tio•• taken from the vertue of the patient.
• * 1.3

  Sentence of Guido.
• * 1.4

  Indication taken from the woun∣ded part.
• * 1.5

  Aph••ris. 18. Boo•••• 1••.