The workes of that famous chirurgion Ambrose Parey translated out of Latin and compared with the French. by Tho: Johnson. Whereunto are added three tractates our of Adrianus Spigelius of the veines, arteries, & nerves, with large figures. Also a table of the bookes and chapters.

CHAP. XXIX. Of the Wounds of the Neck and Throat.

THe Wounds of the Neck and Throat are somewhiles simple,* 1.1 as those which only use the continuity of the muscles; otherwhiles compound, such as those which have conjoyned with them a fracture of the Bones, as of the Vertebrae, or hurt of the internal and external jugular Veins, or sleepy Arteries; sometimes the Trachea Arteria, or Weazon, and the oesopha∣gus or gullet are wounded; sometimes wholly cut off, whence present death ensues. Wherefore let not the Chirurgeon meddle with such wounds, unless he first foretel the danger of death, or the loss of some motion to those that are present.* 1.2 For it often happens that some notable nerve or tendon is violated by a wound in the neck, whence a Palsie ensues, and that absolutely incurable, if the wound shall penetrate to the spinal marrow, also hurt therewith. Wounds of the Gullet and Weazon are difficultly cured because they are in perpetual motion; and chiefly of the latter, by reason it is gristly and without bloud. The wounds of the gullet are known, by spitting of bloud,* 1.3 by the breaking forth of meat and drink by the wound; but if the Gullet be quite cut asunder, the Patient cannot swallow at all. For the cut parts are both contracted in themselves, the one upwards, and the other downwards. But we know the weazon is hurt, by casting up bloud at the mouth with a continual cough, and by the coming forth of the breath or wind by the Wound.* 1.4 The Wounds of the jugular Veins and sleepy Arteries, if they be great are usually deadly, because they cannot be straitly bound up; for you cannot bind the throat hard without danger of choaking or strang∣ling the Patient. But for defect of a strait ligature in this case the flux of bloud proves deadly. If the recurrent Nerve of either side be cut, it makes the voyce hoarse; if cut on both sides, it takes away the use of speech, by hurting those instruments which impart motion to the muscles of the Larinx. For the cure, if the wound be small, and not associated with the hurt of any notable vessel,* 1.5 nor of the Weazon and Gullet, it is speedily and easily cured; and if there shall be need you shall use a Suture, then you shall put therein a sufficient quantity of Venice-Turpentine mixed with Bole-Armenick; or else some of my Balsam, of which this the Receipt. ℞ Terebinth. venetae lb ss. gum. elemi ℥ iiij. olei hypericonis ℥ iij. boli armen. & sang. draconis an. ℥ j. aqua vitae ℥ ij.* 1.6 liquefiant si∣mul omnia lento igne, & fiat Balsamum ut artis est, ad dendo pulveris ireos florent. aloes, mastiches, myr∣rhae an. ʒ j. I have done wonders with this Balsom in the agglutination of simple wounds, wherein no strange body hath been. Now when you have put it in,* 1.7 lay upon it a plaister of Diacalcitheos dis∣solved in Oyl of Roses and Vinegar, as that which hath power to repress the flowing down of humors, and hinder inflammation, or in stead thereof you may apply Emp. de Gratia Dei, or Emp. de Janua. But if the jugular Veins and sleepy Arteries be cut, let the bleeding be stayed, as we have shewed in a chapter, treating thereof. When the Weazon or Gullet are wounded,* 1.8 the Chi∣rurgeon shall sow them up as neatly as he can; and the Patient shall not endeavour to swallow any hard thing, but be content to be fed with gellies and broths. When a gargarism is needful, this following is very good. ℞ hordei M. j. florum rosar. p. j. passul. mund. ju••ubarum an. ℥ ss. glycyrhizae ℥ j. bulliant omnia simul, addendo mellis ros. & Julep. ros. an. ℥ ij. fiat gargarisma, ut artis est.* 1.9

With which being warm, the Patient shall moisten his mouth, and throat, for it will mitigate the harshness of the part, asswage pain, cleanse and agglutinate, and make him breathe more freely. But that the Chirurgeon may not despair of, or leave any thing unattempted in such like wounds,* 1.10 I have thought good to demonstrate by some examples how wonderful the works of Nature are, if they be assisted by Art.

A certain servant of Monsieur de Champaigne, a gentleman of Anjou, was wounded in the throat with a sword, whereby one of the Jugular-veins was cut together with his Weazon.* 1.11 He bled much and could not speak; and these symptoms remained, until such time as the wound was sowed up, and covered with medicines. But if medicines at any time were more liquid, he, as it were, sucked them by the wound and spaces between the stitches, and presently put forth at his mouth

that which he had sucked or drawn in. Wherefore more exactly considering with my self, the greatness of the wound, the spermatick, and therefore dry and bloudless nature unapt to aggluti∣nation, of the affected part, but chiefly of the Weazon and Jugular-vein; as also for that the rough Artery is obnoxious to those motions which the gullet performs in swallowing, by reason of the in∣ner coat, which is continued to the coat of the gullet, by which means these parts mutually serve each other with a reciprocal motion, even as the ropes which run to the wheel of a pulley; fur∣thermore, weighing that the Artery was necessary for the breathing, and tempering the heat of the heart, as the Jugular-veins served for the nourishment of the upper parts; and lastly, weighing with my self the great quantity of bloud he had lost, which is, as it were, the treasure of Nature, I told those which were present, that death was near and certainly at hand. And yet beyond excepta∣tion, rather by divine favour then our Art, he recovered his health.

* 1.12Equally admirable is this History following. Two Englishmen walked out of the City of Paris for their recreation to the wood of Vincenne; but one of them lying in wait to rob the other of his money, and a massie chain of gold which he wore, set upon him at unawares, cut his throat and rob∣bed him, and so left him amongst the Vines which were in the way, supposing he had kill'd him, having with his dagger c••t the Weazon and Gullet. This murderer came back to the City; the other half-dead, crawled with much ado to a certain Peasant's house, and being dressed with such medicines as were present, and at hand, he was brought to the City, and by his acquaintants com∣mitted to my care to be cured. I at the first, as diligently as I could, sowed up the Weazon which was cut quite asunder, and put the lips of the wound as close together as I could; I could not get hold of the Gullet, because it was fallen down into the Stomach, then I bound up the wound with medicines, pledgets, and fit ligatures. After he was thus drest he begun to speak, and tell the name of the villain the author of this fact, so that he was taken and fastened to the wheel, and having his limbs broken, lost his wretched life, for the life of the innocent wounded man who dyed the fourth day after he was hurt.

* 1.13The like hurt befel a certain German, who lay at the house of one Perots, in the street of Nuts; he being frantick, in the night cut his throat with a sword: I being called in the morning by his friends who went to see him, drest him just after the same manner as I dressed the Englishman. Wherefore he presently recovered his speech, which before could not utter one syllable, freed from suspition of the crime and prison the servant, who, lying in the same chamber with him, was upon suspition committed to Prison, and confessing the thing as it was done, lived four days after the wound, be∣ing nourished with Broths put into his Fundament like Clysters, and with the grateful vapour of comfortable things, as Bread newly drawn out of the Oven and soaked in strong Wine; I having thus by Art of Chirurgery made the dumb speak for the space of four days.

Notes

• * 1.1

  The differen∣ces of wounds of the neck and throat.
• * 1.2

  The Palsie fol∣lows upon wounds of the neck.
• * 1.3

  Signs that the gullet is wounded.
• * 1.4

  The wounds of the jugular veins and sleepy Arteries are deadly by accident.
• * 1.5

  By hurting the recurrent Nerve, the voyce is hurt.
• * 1.6

  The descripti∣on of the Au∣thor's Balsom.
• * 1.7

  The faculty of Diacalcitheos.
• * 1.8

  The cure of the wounded Weazon and Gullet.
• * 1.9

  A Gargarism.
• * 1.10

  The manifold use thereof.
• * 1.11

  A History.
• * 1.12

  A strange Hi∣story.
• * 1.13

  Another Hi∣story.