The surgeons mate or Military & domestique surgery Discouering faithfully & plainly ye method and order of ye surgeons chest, ye uses of the instruments, the vertues and operations of ye medicines, with ye exact cures of wounds made by gunshott, and otherwise as namely: wounds, apos fumes, ulcers, fistula's, fractures, dislocations, with ye most easie & safest wayes of amputation or dismembring. The cures of the scuruey, of ye fluxes of ye belly, of ye collicke and iliaca passio, of tenasmus and exitus ani, and of the calenture, with A treatise of ye cure of ye plague. Published for the service of his Ma. tie and of the com:wealth. By John Woodall Mr. in chyrurgerie.

A Definition of Sphacelus, and the cure thereof from some ancient Writers, to shew the Reader their opinions and judgments thereof, for that some Artists have grounded their judgments, that their relations are according to good practice; and therefore are to be imitated.

A Sphacelus, saith Falopius, and likewise Fabritius, is an affect of a part already utterly mortified, and therefore not to be cured but by amputation, that the whole body come not to corrup∣tion thereby,* 1.1 and this abscission is not done without great danger of death: for often, even in the instant act of amputation, the Patient dyeth by the profusion of blood and spirits, wherefore the strength of the sick is to be considered: and Cornelius Celsus alledgeth, Cap. 25.* 1.2 lib. 5. that in his time they used to take off the Sphacelated member, by cutting the flesh round about unto the bone, in the whole part, near the rotten or sphacelated part, and cutting ever in the live flesh, not leaving any of the mortified flesh untaken away; further Celsus (say* 1.3 they) doth admonish us in this work, that the skin and also the flesh, be brought and drawn upwards, that the bone may be the better co∣vered by some of the said part, in the healing of the stump; but the same Authour confesseth also, that by such abscission causing exceeding pain, with over-large effusion of blood and spirits, death usually fol∣loweth: therefore to avoid hemorrage, they must presently use actual Cauteries to burn the parts adjacent, in which may be conjectured, how cruel that course is to the Patient, and uncomfortable; and pre∣pare the upper part thick enough, to be a firm cover to the vessels.

But after himself not approving that course, he saith, that he took another way of curing, which as he said, happily succeeded; by which work no profusion of blood hapned, because no blood floweth from a mortified part, neither is grief moved therein; but lest the corruption should spread it self further, (saith the said Authour) I burned the putrefied part, remaining every where with red-hot Irons, that were heavy and well burnt, untill the Patient did feel the heat of the fire, and that he suffered some small pain; and the rather they did it, they write, because the same operation is very profitable, and therefore burned ever some of the sound flesh also, because the putrefaction is best to be drawn out by a red-hot Iron, as I suppose, saith he, which is apparent to the eye, for the humours are apparently seen to boyl about the Iron; and likewise the weaknesse of the parts considered by burning, it is fortified, the adjacent parts being freed from many noxi∣ous humours thereby, so that the weak part receiveth strength, and within a few dayes begins to separate the living from the dead part, and

so afterwards the dead part falls off, and the living part is conserved. And this manner in my judgment, saith Fabritius, is best; but this Authour conceiveth Fabritius to be but a relater, not a true practiser of the aforesaid course in amputation, for that that work is so terrible and cruel neverthelesse.

In this recited Chapter you have the opinions of some of the ancient* 1.4 and learned Writers touching Sphacelated members, and the manner of the amputation of those times, since which the Art hath been (by Gods favour) very much illustrated, so that where the complaint for∣merly was, that by reason of great hemorrage, namely, the large ef∣fusion of blood and spirits in the work of their amputations, many of their Patients perished under the Surgeons hands in the very act of amputation: I may to Gods glory, and so justly do I affirm for a truth, that for the space of near 24 years I have been a Surgeon in the Hospi∣tal of Saint Bartholomews, where I have taken off, and holpen to take off many more then one hundred of legs and arms, besides very many hands, and fingers; amongst all which, not one of them all hath dyed in the time of their dismembering, nor afterwards, through the exceed∣ing effusion of blood, in the operation, that ever I could gather or conceive: and furthermore, I affirm, that not above four of each twenty dismembred, but lived to have been healed, and have been delivered whole out of the Hospital, notwithstanding whatsoever their diseases have been, and for that horrid cruel course mentioned by the aforesaid recited Ancients, of burning the ends of the stumps in the the tender, living, and most sensible parts, since I have known the Art of Surgery, which hath been by the space of 50 years, that I have used it, I never saw it used by any in England, nor elsewhere; and yet I will not deny but the best Artist that is, in the first work of amputation, or in the second dressing of the Patient after amputation, may be so put to it, that if he provide not himself of a cauterizing button, he may hear∣tily wish he had had a small button ready, for fear of the losse of his Patient, upon an unexpected flux; and howsoever, it is a good Art, and safe to my knowledge, both for the Patient and Surgeon, and but fitting for him, so to be provided for fear of need: onely I advise it to be privately absconded for the reputation sake. Thus much of the manner of amputation from the Ancients. This precedent D••finition I have takes out of some of the ancient Authours, from their own words verbatim, that the Reader may consider how far it differeth from the scope hereafter to be handled.

Notes

• * 1.1

  Extremum ge∣nus morbi re∣quirit extrema remedia.
• * 1.2

  The opinion of Celsus concern∣ing Sphacelus.
• * 1.3

  Another way of amputation.
• * 1.4

  The way of amputation made better by experien••••.