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IT is the ancient doctrine of the antient Physitians, that the wounds of the nervous parts should not presently be agglutinated (which notwithstanding the general and first indication usually
taken from the solution of continuity requires,) but rather, chiefly if they be too strait,* 1.1 that the punctures should be dilated, by cutting the parts which are above them, and let them be kept long open that the filth may pass freely forth, and the medicine enter well in. Yet I in many cures have not followed this counsel, but rather that which the common indication requires.
That cure is in fresh memory which I performed upon Monsieur le Co••q, a Proctor of the spiri∣tual Court, who dwelt in our Ladies-street; he gathering and binding up some loose Papers,* 1.2 run a Penknife which was hid amongst them, through his hand. Also one of his neighbours who went to spit a piece of Bief, thrust the spit through the midst of his hand; But I presently agglutinated both their wounds, without any danger, dropping presently in at the first dressing a little of my Balsom warm, and putting about it a repelling and astringent medicine, and by this means they were both of them healed in a short time, no symptom thereupon happening. Yet I would not have the young Chirurgeon to run this hazard: for first, he must be well practised and accustomed to know the tempers and habit of men, for this manner of curing would not do well in a plethorick body, or in a body replete with ill humors, or indued with exquisite sense. Therefore in such a case it will be safer to follow the course here set down. For wounds of the nerves do not only differ from other wounds, but also among themselves in manner of curing. For although all medicines which draw from far, and waste sanious humors, may be reputed good for the wounds of the nerves; yet those which must be applyed to punctures, and to those nerves which are not wholly laid open, ought to be far more powerful, sharp and drying; yet so that they be not without biting, that so penetrating more deep they may draw forth the matter, or else consume and discuss that which either lies about the nerves, or moistens their substance. On the contrary,* 1.3 when the sinews are bared from flesh and adjoyning particles, they stand in need but of medicines, which may only dry. Here you may furnish your selves with sufficient store of medicines good for the nerves how∣soever pricked. As ℞ Terebinth. vin. & olei veteris an. ℥ j. aquae. vitae parum. Or ℞ olei Terebinth. ℥j. aqua vitae ʒ j. cuphor. ʒ ss. Or ℞ radices Dracontiae, Brioniae, Valerianae & Gentianae exsiccatas, & in pulverem redactas, misce cum decocto centaurii, aut oleo, aut exungia veteri; drop hereof warm into the wound as much as shall suffice. Or else put some Hogs, Goose, Capons, or Bears-grease, old Oyl, Oyl of Lillies, or the like, to Gall anum, pure Rozin, opopanax dissolved in Aqua-vitae and strong Vinegar. Or ℞ olei hypericonis sam••uti, & de cuphor••io an. ℥ j. su••phuris vivi subtiliter pulverisati ℥ ss, gummi ammoni. bdellii an. ʒ ij. aceti boni ℥ ij. vermium terrest. praeparat. ℥ j. bulliant omnia simul ad consumptionem aceti. Let as much hereof as shall suffice be dropped into the wound; then ap∣ply this following Cerate, which draws very powerfully. ℞ olei supra-scripti ℥ j. Terebinth. venet. ℥ ss, diachylonis albi cum gummi, ʒ x. ammoniac. ••dellii in aceto dissoluterum, an. ʒ ij. resin. pini gum. clemi, picis navalis an. ʒ v. cerae quod sufficit, fiat ceratum satis molle. We must use some whiles one, some whiles another of these medicines in punctures of the Nerves with choice and judgment, ac∣cording to their conditions, manner, depth, and the temperaments and habits of the wounded bo∣dies. But if the pain yield not to such remedies, but rather increase,* 1.4 with the inflammation of the affected part, a swelling of the lips of the wound, and sweating forth of a serous, thin and virulent matter or filth, then you shall pour into it scalding Oyl, and shall touch three or four times not only the surface of the wound, but the bottom thereof with a rag dipped therein and tyed to the end of a Spatula. For this will take away the sense from the Nerve, Tendon, or Membrane,* 1.5 like as if they were burnt with a cautery, and so the pain will be eased. So in the most grievous pains of rotten teeth, the thrusting of an hot iron into their roots, or stopping them with Cotton dipped in Oyl of Vitriol, or Aqua-vitae, gives most certain ease; for by burning the Nerve which is in∣serted into their roots, the sense, and so, consequently, the pain is taken away. So also in malignant,* 1.6 gnawing, eating, and spreading ulcers, which are alwayes associated with much pain, the pain ceases by applying an Escharotick, the powder of Alum, or Mercury, or Aegyptiacum made some∣what more strong than usual. That the young Chirurgeon may be more ready for this practise and the use of the former medicines, I have thought good to insert the following History, both for the lateness of the thing and the pleasing memory of the most laudable Prince.
Charles the ninth, the French King, being sick of a Feaver,* 1.7 Monsieur Chapellan and Castellan his Physitians thought it fit he should be let bloud; for the performance whereof, there was called a Chirurgeon wondrous famous for that business; but when as he by chance had pricked a nerve in stead of a vein, the King cryed out, that he felt a mighty pain in that place. Then I bid, that the ligature should straight-wayes be loosed, otherwise the arm would presently be much swel∣led. But he going slowly about it, behold the arm began to swell with such contraction, that he could not bend it, nor put it forth, and cruel pain molested not only the pricked particle, but all the whole member besides. I forthwith laid upon the wound a plaister of Basilicon, to hinder the agglutination thereof, and then I wrapped all the arm in a double linnen cloth dipped in Oxy∣crate, putting upon it an expulsive ligature, which beginning at the wrist, and ending at the top of the shoulder, might keep the bloud and spirits from fear of defluxion and inflammation. This being thus performed, we went aside to consult what was necessary to be done, both to asswage the pain, as also to divert the other symptoms, which usually happen upon punctures of the nerves. I being desired, thus delivered my opinion, that in my mind, there were nothing better, then pre∣sently to drop into the wound some Oyl of Turpentine warmed and mixed with a little Aqua-vitae. And then all the arm should be covered with a plaister of Diacalcitheos dissolved in Vinegar and Oyl of Roses, bound over and besides with the expulsive ligature, which we formerly mentioned. For the Oyl and Aqua-vitae have a faculty to penetrate into the bottom of the wound, and to ex∣haust
and dry up the serous and virulent humor, which sweats from the substance of the pricked nerve; and also to mitigate the pain by its actual heat. Furthermore emplaister Diacalcitheos hath a faculty to dissolve the humor which hath already fallen down into the arm, and to hinder the entrance and defluxion of any new matter. And the ligature is such as by its moderate astriction would serve to strengthen the muscles, and to press out and repel the humors which were fallen down into the upper part, and to prohibit that which is ready to fall down. Mine advice being approved of the Physitians both in word and deed, the pain was mitigated. But the humor stayed in the part,* 1.8 for the dissolving and drying whereof, this following remedy was used. ℞ far. hordei & crobi an. ʒ ij. flor. chamaem. & melilot. an. p. ij. butyr. recentis siue sale ℥ i ss. lixivii ••arbitonsoris quod sufficit, fiat cataplasma ad formam pultis. By these remedies the King at last after three months space was perfectly healed, so that there remained no sign of the depraved action in the part. But if at any time there shall be so great contumacy, that it will not yield to these means, but that there is imminent danger of a convulsion; it will be better to cut it in sunder whether Nerve, Tendon, or Membrane, than to expose the Patient to the danger of a deadly convulsion; for thus indeed the peculiar action of that part will be lost, but the whole body preserved thereby; for so we had determined by common consent, that if the pain which afflicted the King would not yield to the prescribed remedies, either to pour in scalding Oyl, or else to cut the sinew quite asunder.
* 1.9For the late and sad memory of Mistris Courtin dwelling in the street of Holy-Cross was in our minds, who of a vein not well opened in her arm fell into a Gangrene and total mortification of that whole part, of which she dyed, because she was not dressed with the formerly mentioned me∣dicines. Yet we must abstain from these two powerful remedies, when the pricked nerve shall lye bare, for else the pain would be increased, and more grievous symptoms follow. Wherefore as I formerly wished; more mild medicines must be applyed, which may dry up the serous humor without biting or acrimony, as ℞ Terebinth. venet. in aq. ros. lota ℥ ij. boli armeni subtiliter pulve∣risati, ʒ ij.* 1.10 incorporentur simul. Our Balsom also is excellent in this case, and this of Vigo's which follows. ℞ Olei rosar. emphacini ℥ j ss. olei de terebinth. ʒ iij. succi plantag. ℥ ss. semin. hypericonis aliquantulum contriti••m. ss. tutiae praepar. ʒ iij. calcis decies lotae cum aqua plantagin. ʒ ij. antimonii ʒ j. s••vi hircini, & vitulini, an. ℥ v. vermium terrestrium cum vino lotorum ℥jss. bulliant omnia simul dempta tutia in cyatho decoctionis hordei, ad consumptionem aquae & vini, colentur rursum{que} igni admoveantur, addendo tutiam, & fiat linimentum cum cera alba, & ℥ ss. croci. This liniment asswages pains, and covers the bared nerves with flesh. This cure of punctured nerves, may with choyce and judge∣ment, and observing the proportion of the parts be transferred to the pricked Tendons and mem∣branes. But take this as a general and common rule,* 1.11 that all nervous bodies howsoever hurt, are to be comforted by anointing them with hot Oyls, such as the Oyl of Bays, Lillies, of Worms, Sage, or some other such like remedy being applyed to their originals and more notable passages; as to the original of the spinal marrow, the armpits and groins. Neither do I think it fit in this place to omit an affect which sometimes happens to the large Tendon of the heel, of which we former∣ly made mention. For it oft-times is rent or torn by a small occasion without any sign of injury or solution of continuity apparent on the outside as by a little jump, the slipping aside of the foot, the too nimble getting on Horse-back, or the slipping of the foot out of the stirrop in mounting in∣to the saddle. When this chance happens, it will give a crack like Coach-mans whip; above the heel, where the tendon is broken, the depressed cavity may be felt with your finger, there is great pain in the part, and the party is not able to go. This mischance may be amended by long lying and resting in bed, and repelling medicines applyed to the part affected in the beginning of the disease, for fear of more grievous symptoms, and then applying the Black-plaister, or Diacal∣citheos, or some other such, as need shall require; neither must we hereupon promise to our selves, or the Patient, certain or absolute health. But, on the contrary, at the beginning of the disease we must foretel that it will never be so cured, but that some reliques may remain, as the depres∣sion of the part affected and depravation of the action and going; for the ends of this broken or relaxed Tendon by reason of its thickness and contumacy cannot easily be adjoyned, nor, be∣ing adjoyned, united.
A wound of the nervous parts indicates contrary to the general cure of wounds.
A History.
Medicines fit for wounds of the nerves.
What wounds of the N rves must be burnt.
A certain A∣nodyne in pain of the teeth.
Why Escharo∣ticks must be used to spread∣ing ulcers.
A famous Hi∣story.
A discussing and drying ca∣taplasm.
A History.
An Anodyne and Saicotick Balsom.
A general rule for all wounds of all Ner∣vous parts.