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. IX. What dressing must first be used, after the strange bodies are pluckt or drawn out of the Wound.

WHen the strange bodies are drawn or pluckt out of the Wound, by those means we have formerly recited, the chief of the cure must be to heal the contusion, and amend the distemper of the air if it be hot and moist, that is, subject to putrefaction. This shall be done by medicins taken inwardly, applyed outwardly, and put into the Wound. Things to be inwardly used in diet and Pharmacy I leave to the judgment of learned Physitians; for the par∣ticular and topick medicins,* 1.1 (unless from the present constitution of the air, the condition of the wounded part, or from some other cause, there be danger of a Gangrene) you must use suppuratives as you usually do in contusions; such as are oil of Whelps and that which we call a Digestive; you must chiefly forbear suppuratives, when as the wounded part is of a nervous nature. For all ner∣vous parts require dryer medicins than fleshy,* 1.2 as we have formerly delivered speaking of Wounds of the joints; wherefore in wounds of the joynts and nervous parts you shall use more Venice Tur∣pentine than oil. Laurentius Jobereus the Kings Physitian and Chancellour of the University of Mompelier, in a treatise which he writ of Wounds made with Gunshot, forbids the use of Escharo∣ticks both actual and potential, in these Wounds, if simple; for that they induce pain, inflammation, a feaver,* 1.3 Gangrene & other deadly symptoms. Besides also, an Eschar will hinder suppuration, which is to be desired in this kind of Wounds, that so the contused flesh may be severed from the sound, lest it be drawn to putrefaction by contagion. Which easily happens when an Eschar is drawn, as bar over it,* 1.4 for then the excrementitious humor remains longer in the part, and the putredinous vapours, hindred from passing forth, are encreased, and carryed from the lesser vessels to the bigger, and so over all the body. Wherefore, when you suspect putrefaction, letting alone sup∣puratives, use in the first place such things as resist putrefaction, as this following ointment. ℞ pulver. alumin. rechae, viridis aeris, vitrioli romani, mellis rosat. an. ℥ij. aceti beniquantum sufficit, bulli∣ant omnia simul secundum artem, & fiat medic••mentum ad formam mellis. This by reason of the heat and subtlety of the substance, hath a faculty to induce and attenuate the humors, as also to call forth the native heat drawn in and dissipated by the violent and forcible entrance of the Bullet into the body; furthermore also it corrects the venemous contagion of the virulent humor. Now this medicine shall be used, dissolved in Vinegar or aqua vit••, and be put into the Wound with tents, or pledgets. The tents which shall be used at the first dressing must be somewhat long and thick, that by dilating the Wound, they may make way for application of other remedies; otherwise you may make injection with a syringe, that so it may penetrate the more powerfully. But this described Aegypti••cum shall be tempered according to the condition of the affected parts, for the nervous parts will be offended with it as being too acrid; but it may be qualified by admixture of oil of Turpentine and Saint Johns-wort. Also we may well be without this Ae∣gyptiacum when there is no such pestilent constitution of the air,* 1.5 as was seen in the late Civill warrs. After the use of Aegyptiacum you shall with emollient and lenitive medicins procure the falling away of the Eschar, and such a medicine is this following Oil, being somewhat more than warm. ℞ Olei violati lib. iiij. in quibus coquantur catelli duo nuper nati, usque ad dissolutionem ossium, addendo v••rmium terrestrium, ut decet praeparatorum, lb. j. 〈…〉〈…〉 simul len•• igne, deinde fiat ex∣presso ad usum, addendo terebinth. venet. ℥iij. aqua vitae ℥j. This oil hath a wonderful force to as∣swage pain, to bring the Wound to suppuration, and cause the falling away of the Eschar. This

ensuing oil is made more easily. ℞ olei seminis lini,* 1.6 & lilior. an. ℥iij. unguent. basilic. ℥j. liq•• fiant simul. & fiat medicamentum; put of this a sufficient quantity into the Wound; for this being ap∣plyed indifferent hot, hath power to asswage Pain, to soften and humect the orifice of the wound, and help forwards suppuration, which is the true manner of curing these kind of Wounds, accor∣ding to the rule of Hippocrates, which wishes every contused wound to be presently brought to suppuration, for so it will be lesse subject to a Phlegmon, and besides, all the rent and bruised flesh must putrefie, dissolve and turn to quitture, that new and good flesh may be generated in stead thereof. Laurentius Iaubertus much commends this following medicine, of whose efficacy, as yet, I have made no triall. ℞ pulver. mercur. bis calcinati, ℥j. adipis porci recentis, vel butyri recentis, ℥iiij. Camph••rae in aqua vitae dissolutae, ʒij. misce omnia simul, addendo tantillum olei lili••rum, aut lini. Experience taught him, and reason also shewes, that this kind of remedy is very commendable;* 1.7 for the powder of Mercury, if mixed with a grosse and humecting matter, doth in a short space turn the bruised flesh into Pus, without causing any great pain. For the Camphire, whether it be hot or cold, in temper, it much conduces to that purpose, by reason of the subtlety of the parts whereof it consists.* 1.8 For by means of this quality the medicines enter with more facility into the affected bodies, and perform their parts; besides also, Camphire resists Putrefaction. Some drop into the Wound aqua vitae, wherein they have dissolved some calcined vitriol. Which kind of remedy is not suppurative, but yet much resists putrefaction, so that we may use it with good suc∣cess, when the weather is hot, moist, and foggie. But when the Wound is made very neer at hand, it cannot but be burnt by the flame of the powder; in which, remedies used for Burns, will be useful, not omitting such as are fit for Contusions. But for those parts which lye next the Wound, you shall not, unless at the first dressing, apply refrigerating and astringent things, but rather e∣mollient and suppurative. For those things which have a refrigerating faculty, weaken the part, and hinder suppuration. For astringents constipate the skin, which is the cause, that, the putrid vapours shut up and hindred from transpiration and passage forth, a gangrene and mortification easily seise upon the part.* 1.9 But if the contusion be great and diffuse it self more largely over the flesh, the part must be much scarified; that so the contused and concreat blood, and therefore subject to putrefaction, may be evacuated. But for those parts, which somewhat farther distant from the Wound encompass the contused flesh, they require refrigerating and strengthening me∣dicins,* 1.10 so to hinder the falling down and setling of the humor in that part which is this ensuing me∣dicine. ℞ pul. boli. armen. sanguin. Dracon. Myrrhae, an. ℥j. succi solan. sempervivi, per••u••c. an. ℥.ss. a••••um iiij. overum. ••xyhodin. quantum sufficit; fiat linimentum, ut d••cet. You may use this, and the like untill the suspected symptome be past fear. Neither must you have less care,* 1.11 of binding up and rolling the part, than of your medicins; for it doth not a little conduce to the care, to bind it so fitly up as it may be without pain. The Wound at the beginning of the cure,* 1.12 must be dres∣sed but once in 24 houres, that is, untill the Wound come to suppuration; but when the q••••t∣ture begins to flow from it, and consequently the pain and feaver are encreased, it shall be drest twice a day, that is, every twelve hours. And when the quitture flowes more abundantly than usual, so that the collection thereof is very troublesome to the Patient, it will be requisite to dress it every 8 hours; that is, thrice a day. Now when as this abundant efflux is somewhat s••••ked, and begins to decrease it will suffice to dress it twice a day. But when the Ulcer is filled with flesh, and consequently casts forth but little matter, it will serve to dress it once a day, as you did at the first.

Notes

• * 1.1

  A Caution in the use of Sup∣puratives.
• * 1.2

  Why E••charo∣ticks must be eschewed in these kinds if they be simple.
• * 1.3

  How an Es∣char may cause putrefaction.
• * 1.4

  The descripti∣on of an Ae∣gyptiacum.
• * 1.5

  How and when to temper this Aegyptiacum.
• * 1.6

  The oil of Whelps a di∣gestive, ano∣dyne, and fit medicine to procure the falling away of an Eschar. Lib. de ulcer.
• * 1.7

  The faculties of the powder of Mercury.
• * 1.8

  The force of calcined vit••iol How wounds made by Gun∣shot may be combust.
• * 1.9

  Scarification.
• * 1.10

  An Astringent repelling me∣d••cine.
• * 1.11

  The binding up.
• * 1.12

  How oft the wound must be drest in a day.