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. XVI. Of the particular cure of a Gangrene.

THe cure of a Gangrene, caused by the too plentiful and violent defluxion of humors suffocating the native heat, by reason of great Phlegmons is performed by evacuating and drying up the humors,* 1.1 which putrefie by delay and collection in the part. For this purpose scarifications and incisions, great, in differe••s, small, deep, and superficiary, according to the condition of the Gangrene, are much commen••••d; that so the burdened part may injoy the benefit of perspiration; and the contained humor•• of difflation, or evacuation of their sooty excrements. Let Incisions be made when the ••ffe•••• 〈◊〉〈◊〉, deep in, and neer to mortification. But scarifications may be used when the part first 〈◊〉〈◊〉 to putrefie, for the greatness of the re∣medy must answer in proportion to that of the dis••••••••. Wherefore if it penetrate to the bones, it will be fit to cut the skin and flesh with m•••••• ••••d deep Incisions, with an Incision-knife made for that purpose; yet take heed of cutting the larger nerves and vessels, unless they be wholly putrefied, for if they be not yet putrefied, you shall make your Incisions in the spaces between them; if the Gangrene be less, we must rest satisfied with only scarifying it. When the Scarifications and Incisions are made, we must suffer 〈◊〉〈◊〉 bloud to flow forth, that so the conjunct matter may be evacuated. Then must we apply and put upon it such medicins as may by heating, drying, resolving, clensing and opening, amend and correct the putrefaction, and by piercing to the bottom may have power to overcome the virulency already impact in the part. For this purpose, Lotions made of the Lye of the Ashes of Fig-tree, or Oak, wherein Lupins have been throughly boyled, are good. Or you may with less trouble make a medicine with Salt-water, wherein you may dissolve Aloes and Aegyptiacum, adding in the conclusion a little Aqua vitae,* 1.2 for Aqua vitae and calcined Vitriol are singular medicins for a Gangrene. Or ℞ acet. optmi lb j. mel. ros. ℥ iiij. syrup. acetosi ℥ iij. salis com. ℥ v. lulliant simul, adde aqua vitae, lb. s. Let the part be frequently washed with this medicine, for it hath much force to repress Gangrenes. Af∣ter your Lotion, lay Aegyptiacum for a Liniment, and put it into the Incisions, for there is no medicine, more powerful against putrefaction, for by causing an Eschar, it separates the putrid flesh from the sound. But we must not in this kind of affect expect that the putrid flesh may

of it self fall from the sound; but rather cut off with your Incision-knife, or Scissers, whatsoever thereof you can, and then put to it Aegyptiacum as oft as need shall require. The knowledg hereof may be acquired from the colour, smell, and sensibleness of the flesh it self. The descrip∣tion of the Aegyptiacum, whose wondrous effects I have often tryed in these causes, is this. ℞ flo∣ris aeris, aluminis roch. mellis com. an. ℥ iij. aceti. acerrimi ℥ v. salis com. ℥j. vitrioli rom. ℥ ss. sublimati pul. ʒ ij. bulliant omnia simul ad ignem, fiat unguent. If the force of the putrefaction in the part be not so great, a weaker Aegyptiacum may serve. When you have put in the Aegyptiacum, then presently lay the following Cataplasm thereupon. For it hinders putrefaction, resolves, clenses and dryes up the virulent sanies, and by the dry subtlety of the parts penetrates into the member, strengthens it, and asswages the pain. ℞ farin. fabar. hordei orobi, lent. lupin. an. lb. s. sal. com.* 1.3 mellis rosat. an. ℥ iiij. succi absinth. marrub. an. ℥ iiss. aloes, mastiches, myrrhae, & aqua vit. an. ℥ ij. o∣xymelitis simpl. quantum sufficit; fiat Cataplasma molle secundum artem; Somewhat higher than the part affected, apply this following astrigent, or defensitive, to hinder the flowing down of the humors into the part, and the rising up of the vapours from the putrid part into the whole body. ℞ olci rosati, & myrtill. an. ℥ iiij. succi plantag. solani, sempervivi an. ℥ ij. album ovorum 5. boli arme∣ni, terrae sigillatae subtiliter pulverisatorum, an. ℥ j. oxycrati quantum sufficit, misce ad usum dictum. But these medicins must be often renewed. If the grief be so stubborn, that it will not yield to the described remedies, we must come to stronger, to wit, Cauteries, after whose application,* 1.4 Ga∣len bids to put upon it the juyce of a Leek with Salt beaten and dissolved therewith, for that this medicin hath a piercing and drying faculty, and consequently to hinder putrefaction. But if you prevail nothing with Cauteries, then must you come to the last remedy and refuge, that is, the amputation of the part; For, according to Hippocrates,* 1.5 to extream diseases exquisitely extream re∣medies are best to be applyed. Yet first be certain of the mortification of the part; for it is no little or small matter to cut off a member without a cause.

Therefore I have thought it fit to set down the signs, whereby you may know a perfect and ab∣solute mortification.

Notes

• * 1.1

  The cure of a Gangrene made by in∣flammation.
• * 1.2

  The descripti∣on of an Ae∣gyptiacum.
• * 1.3

  Astringents that may be used in cure of a Gangrene.
• * 1.4

  Gal. 2. ad Glauconem.
• * 1.5

  Aphor 6. sect. 11.