CHAP. XXIX. Of the cure of an ulcerated Cancer.
* 1.1AN Ulcerated Cancer hath many signs common with that which is not ulcerated, as the roundness of the tumor, the inequality, roughness, and pain; to the judgment of the eye, the tumor seems soft, but it is hard to the touch; the Ulcer is filthy, with lips, thick, swoln, hard, knotty, turned out, and standing up, having a horrid aspect, and casting forth icho∣rous, filthy, and carion-like filth, sometimes black, sometimes mixed with rotten filth, and other∣whiles with much bloud. This kind of ulcer is malign, rebellious, and untractable, as that which contemns milde remedies, and becomes more fierce by acrid and strong; the pain, feaver, and all the symptoms being increased, from whence the powers are dejected, the wasting and con∣sumption of the body follows,* 1.2 and lastly, death. Yet if it be small, and in a part which may suf∣fer amputation, the body being first purged, and bloud drawn, the strength of the Patient not dis∣swading, it will be convenient to use the hand, and to take hold of, and cut away whatsoever is corrupt, even to the quick, that no fear of contagion may remain, or be left behind. The am∣putation finished, the bloud must not be presently stopped, but permitted to flow out in some measure, yea verily pressed forth all about it, that so the veins swoln with black and melancholy bloud may be disburdened.* 1.3 When you have taken a sufficient quantity of bloud, the place must be seared with an actual cautery. For that will strengthen the part affected, draw forth the vene∣nate quality, and also stay the defluxion. Then must you apply mitigating medicines, and procure the falling away of the Eschar. To conclude, that which remains must be performed according to the cure of other Ulcers.* 1.4 Now we know, and understand, that all the Cancer is cut away, and all the malignity thereof extinct, when the ulcer casts forth laudable matter, when that good flesh begins to grow by little and little, like to the grains of a Pomegranate, the pricking pain, and all the symptoms being asswaged. Yet the cure of an ulcerated Cancer which shall possess the lips may be more happily and mildly performed, no caustick medicine being applyed after section, so also that scarse any deformity will be left, when it is cicatrized. Which new and never former∣ly tryed, or written of way, as far as I know, I found and performed in a man of fifty years old. Doctor John Altine, a most learned Physitian being called to Counsel, James Guillemeau, and Ma∣ster Eustachius the King's Chirurgeons, and John Le Jeune, the Duke of Guise his most worthy Chirurgeon being present.
* 1.5The way is this; The Cancer must be thrust through the lips on both sides, above and below with a needle and thred, that so you may rule and govern the Cancer with your left hand, by the benefit of the thread (lest any portion thereof should scape the instrument in cutting) and then with your Sizers in the right hand, you may cut it off all at once; yet it must be so done, that some substance of the inner part of the lip, which is next to the teeth may remain (if so be that the Cancer be not grown quite through) which may serve, as it were, for a foundation to generate flesh to fill up the hollowness again. Then when it hath bled sufficiently, the sides and brinks of the wound must be scarified on the right and left sides, within, and without, with somewhat a deep scarification, that so (when we would draw together the sides and lips of the wound, by that man∣ner of stitching, which is used in an hare-lip) we may have the flesh more pliant and tractable to the needle and thred. The residue of the cure must be performed just after the same manner as we use in hare-lips, of which we shall treat hereafter.