The Primitive causes of these are dull blows, fallings from high places, strains, and other such like occasions. But the antecedent and conjunct causes are the same with those of an Atheroma, Meliceris, and Steatoma.
The description formerly set down, will furnish you with the signs by which you may know when they are present; certainly, from very small beginnings they grow by little and little to a great bigness, in the space of six or seven years, some of them yield much to the touch, and almost all of them are without pain.
You may hinder such as are beginning and first growing from encrease, by somewhat a strong and frequent rubbing with your fingers. For so their bag, or bladder, together with the skin, wax thin, and the contained humor grows hot, is attenuated, and resolved. But if so you nothing prevail, you must lie upon them with your whole hand, or a flatted piece of wood, as heavy as you can, until such time as the cist, or bag, be broken by your impression; Then apply and strong∣ly bind unto it a plate of Lead, rubbed over with Quick-silver; for I have many times found by experience, that it hath a wonderful force to resolve and waste the subject humor. But if the Wen be in such a place in which you can make no strong impression, as in the face, chest, belly, and throat, let there be applyed an emplaister which hath a resolving force, such as this following hath; ℞ gummi ammon. bdellii, galban. an. ℥ iij, liquefiant in aceto, & trajiciantur per setaceum, ad∣dendo olei liliorum & lauri, an. ℥ i, aqu. vitae parum, pulveris ireos, salis ammon. sulphur. vivi, vitrioli Romani, an. ʒ ss. Let them be incorporated together, and make an Emplaister according to Art. But if the tumor cannot be thus resolved, it must be opened with a knife, or cautery. And after the Eschar is removed, and the bag wasted by Aegyptiacum, Mercury, and the like, the ulcer must be cleansed, replenished with flesh, and cicatrized.
Sometimes Wens grow to so great a mass, that they cannot be cured by the described remedies, wherefore they must be taken away by the root, by your Hand and Instrument, if so be that there be no danger by reason of their greatness, and so that they adhere not too closely to the adjacent parts, and if they be not too nigh to the greater veins and arteries; for it will be better in such a cause to let them alone. This shall be your way to cut them off, or take them away. A small Inci∣sion must be made, even to the bladder, or bag, by which thrust in a Probe of a finger's thickness, hollowed in the midst, round at the end, and as long as need shall require; then draw it many times about between the skin and the bag, even to the root of the Wen, that so the skin may be di∣vided long wayes, then it will be requisite to make another Incision overthwart, so that they may intersect each other like a cross; then presently draw the skin from the bladder, from the cor∣ners of the Wen, towards the root, and that with your finger covered with a fine linnen cloth, or else with a Razor, if need require.
But you must observe, that in a Wen there are alwayes certain vessels, which are small in the beginning, but much encreased in process of time, according to the encrease of the Wen, whereof they are, as it were, the roots; wherefore if any Haemorrhagie, or flux of bloud happen, let it be stopped by binding the vessels at their heads & roots, or make a strait ligature at the roots of the Wen, with a piece of whipcord, or with a many times doubled thred, and let the ends hang forth until it fall away of its own accord. Neither will it be sufficient to have cut away all this tumor, but also it will be fit to cut away a portion of the skin, wherewith the tumor was covered, and only to leave so much as shall suffice to cover the part; then with a needle and thred draw together the lips of the incision, but in the interim let tents be put into the bottom of the ulcer until it be per∣fectly cleansed, & the rest of the cure be workman-like performed, even to the cicatrizing thereof.
The Chirurgeon Collo, and I, using this method, in the presence of Master Dr. Violanius the Kings Physitian, took away a Wen from Martial Colard, the Maior of Burbon; it hanged at his neck, as big as a man's head, and it weighed eight pounds; which made it so troublesome and burdensom to him, that he was forced to carry it bound up in a towel, as in a scrip.
Verily, if these kind of tumors have a slender root and broad top, they must be straitly tyed, and so cut off. But it is very difficult and full of dangerous chance, to take away such Wens as are seated in the neck, near unto the Jugular-veins, those under the Arm-holes, in the Groins, and such as are under the ham; by reason of the deadly force of such symptoms, as may thence arise. We can only conjecture, not certainly say, what kind of matter may be contained in them. We can only know of what sort it is, when by incision it is presented to our sight. Yet in such as are very hard, and do much resist the Touch, there are often found matters, which in consistence may be resembled to little stones or pibles.
I being on a time called to open the body of a great Lady, found in one of her brests a body which might equal the bigness of an Hens egg, hard, and compact like a rough pible; it was held, whilst she lived, both by the Physitians and the Chirurgeons, to be a Cancer, because this hardness was very painful to her, when it was but gently pressed down.
But also some few years agon, I, being called to the cure of a very honest woman, which was troubled with the same disease, strongly withstood the Physitians and Chirurgeons, affirming it to be a Cancer, for the tumor had taken no deep root, the habit of the part was not changed from the native colour, the veins about it were not swollen, neither was there any other convincing sign of a Cancer. For this same woman had her courses at their due and usual time, and was well liking, and had a good colour in her face and body, was free from all sort of pain, unless when you pressed down the part affected. Besides, thence forward the tumor grew not at all; no other evil accident befel her, yea verily she lives merrily, and well both in body and mind.