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. IV. Of the Hemicrania, or Megrim.

THe Megrim is properly a disease affecting the one side of the head, right, or left. It sometimes passeth no higher than the temporal muscles, otherwhiles it reacheth to the top of the crown. The cause of such pain proceedeth either from the veins and external arteries, or from the Meninges, or from the very substance of the brain, or from the pericranium, or the hairy scalp covering the pericranium, or lastly, from putrid vapours arising to the head from the ventricle, womb, or other inferiour member. Yet an external cause may bring this affect, to wit, the too hot or cold constitution of the encompassing air, drunken∣ness, gluttony, the use of hot and vaporous meats, some noisom vapour or smoak, as of Anti∣mony, quick silver, or the like, drawn up by the nose, which is the reason that Goldsmiths, and such as gild metals are commonly troubled with this disease. But whensoever the cause of the evil proceedeth, it is either a simple distemper, or with matter: with matter, I say, which again is either simple or compound. Now, this affect is either alone, or accompanied with other affects, as inflammation and tension. The heaviness of head argues, plenty of hu∣mor; pricking, beating, and tension shewes that there is a plenty of vapours mixed with the humors, and shut up in the nervous, arterious, or membranous body of the head. If the pain proceed from the inflamed Meninges, a feaver followeth thereon, especially, if the humor causing pain do putrefie. If the pain be superficiary, it is seated in the pericranium: If pro∣found, deep and piercing to the bottom of the eyes, it is an argument that the meninges are affected, and a feaver ensues, if there be inflammation, and the matter putrefie; and then oft-times the tormenting pain is so great and grievous, that the patient is afraid to have his head touched, if it be but with your finger, neither can he away with any noise, or small murmuring, nor light, nor smells however sweet, no nor the fume of Wine. The pain is sometimes continual, othetwhiles by fits. If the cause of the pain proceed from hot, thin and vaporous blood, which will yield to no medecins, a very necessary, profitable and speedy remedy may be had by opening an artery in the temples, whether the disease pro∣ceed from the internal or external vessels. For, hence alwayes ensueth an evacuation of the conjunct matter, blood and spirits. I have experimented this in many, but especially in the Prince de la Roche-sur-you. His Physicians when he was troubled with this grievous Me∣grim, were Chaplain, the King's, and Castellane the Queen's chief Physicians, and Lewes Duret, who notwithstanding could help him nothing by blood-letting, cupping, bathes, frictions, diet or any other kinde of remedy either taken inwardly or applyed outwardly. I being called, said, that there was onely hope one way to recover his health, which was to open the artery of the temple in the same side that the pain was; for I thought it probable, that the cause of his pain was not contained in the veins, but in the arteries, in

which case by the testimony of the ancients, there was nothing better than the opening or bleeding of an artery, whereof I have made trial upon my self to my great good. When as the Physicians had approved of this my advice, I presently betake my self to the work, and choose out the artery in the pained temple, which was both the more swoln and beat more vehemently than the rest. I open this, as we use to do in the bleeding of a vein, with one in∣cision, and take more than two sawcers of blood flying out with great violence, and leaping; the pain presently ceased, neither did it ever molest him again. Yet this opening of an Artery is suspected by many, for that it is troublesom to stay the gushing forth blood, and cicatrize the place, by reason of the density, hardness, and continual pulsation of the arte∣ry; and lastly, for that when it is cicatrized, there may be danger of an Aneurisma. Where∣fore they think it better first to divide the skin, then to separate the artery from all the ad∣jacent particles, and then to binde it in two places; and lastly divide it, as we have formerly told you must be done in Varices. But this is the opinion of men who fear all things where there is no cause; for I have learn'd by frequent experience that the apertion of an attery, which is performed with a Lancet, as we do in opening a vein, is not at all dangerous; and the consolidation or healing is somewhat flower than in a vein, but yet will be done at length, but that no flux of blood will happen, if so be that the ligation be fitly performed, and remain so for four dayes with fitting pledgets.

Notes

• The differen∣ces.
• In what kinde of Megrim the opening of an Artery is good.
• A History.
• No danger in opening an ar∣tery.