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. XXXIII. What Prognosticks may be made in pestilent Buboes and Carbuncle.

* 1.1SOme having the pestilence have but one Carbuncle, and some more in divers parts of their body, and in many it happeneth that they have the Bubo and carbuncle before they have any Fever; which giveth better hope of health, if there be no other malign accident there∣with: for it is a sign that nature is the victor, and hath gotten the upper-hand, which excluded the pestilent venom before it could come to assault the heart. But if a Carbuncle & Bubo come after the Fever, it is mortal; for it is a token that the heart is affected, moved and incensed with the furi∣ous rage of the venom; whereof presently cometh a feverish heat or burning, and corruption of the humors, sent as it were, from the center unto the superficies of the body. It is a good sign, when the patients minde is not troubled, from the beginning until the seventh day; but when the Bubo or Carbuncle sinketh down again shortly after that it is risen, it is a mortal sign, especially if ill accidents follow it. If after they are brought to suppuration they presently wax drie without any reason thereof, it is an ill sign: Those Carbuncles that are generated of blood have a greater Eschar then those that are made of choler: because that blood is of a gross consistence, and thereof occu∣pieth a greater room in the flesh: contrariwise, a cholerick humor is more small in quantity and thin, and it taketh little room in the upper part of the flesh only, as you may see in an Erysipelas. And I have seen Carbuncles whose Eschars were as broad and as large as half the back: also I have seen others, which going up by the shoulders to the throat, did so eat away the flesh that was under them, that the rough artery or winde-pipe might be seen bare, when the Eschar was fallen away: I had once a Carbuncle which was in the midst of my belly, so that when the Eschar was fal∣len away, I might very plainly see the Peritoneum or Rim: and the cicatrice that remaineth is, as broad as my hand: but they do not spread themselves so far, without the great danger or death of the patient. There are also some Carbuncles which beginning at the parts under the chin, disperse themselves by little and little unto the battle-bones, and so strangle the patient. So in many, the Buboes in the groin ar••se above a great part of the muscles of the Epigastrium. Truly of those ab∣scesses that are so large & great in quantity,* 1.2 and so terrible to be seen, there is great danger of death to the patient, or at least to the grieved part: For after the consolidation, the part remaineth as if it were leprous, which abolisheth the action of the part, as I have seen in many. Oftentimes also the corruption of the matter is so great, that the flesh leaveth the bones bare: but Carbuncles often leave the joints and ligaments quite resolved, through the occasion of the moisture that is soa∣ked and sunk into them; for they often cast out putrefied ••nd virulent sanious matter, where∣by eating and creeping ulcers are bred, many blisters and pustles arising up in the parts round about it; which shortly breaking into one, make a great ulcer. These come very seldom and slowly un••o suppuration, or at least to cast out laudable matter, especially if they have their o∣rigional of choler; because the matter is sooner burned with heat, then suppurated. There∣fore then, if they can be brought to suppuration by no medicines; if the tumor still remain black;* 1.3 if when they are opened, nothing at all, or else a very little sharp moisture doth come forth, they a••e altogether mortal; and there is scarce one of a thousand who hath these accidents that recovereth health. Dispersed small blisters, coming of vapors stirred up by the matter that is under the skin, and are there staied and kept from passage forth, do not necessarily fore-shew death ••n Carbuncles. But if the part be swoln or puffed ••p, if it be of a green or black colour, and if it feel neither pricking not burning, it is a sign of a mortal Gangrene. Buboes or Carbuncles seldom or never come without a Fever: but the Fever is more vehement when they are in the em∣unctaries or nervous parts, then when they are in the fleshly parts; yet it is less, and all Symptoms are less, and more tolerable in a man that is strong and of a good temperature: Carbuncles not only affect the outward, but also the inward parts, and oftentimes both together. Jf the heart be vexed in such sort with a Carbuncle that nothing thereof appeareth forth on the superficial parts,

all hope of life is past, and those die suddenly, eating, drinking, or walking, and not thinking any thing of death. If the Carbuncle be in the midriff or lungs, they are soon suffocated: If it be in the brain, the patient becometh frantick, and so dieth; If it be in the parts appointed for the passage of the urine, they die of the suppression of their water, as it happened in the Queen-mo∣thers waiting maid, at the Castle of Rossilion of whom I spak before. If it be in the stomach, it interreth the accidents that are shewed in this history following.

While I was Surgeon in the Hospital of Paris a young and strong Monk of the order of St. Victor being overseer of the woman that kept the sick people of that place,* 1.4 fell into a continual Fe∣ver very suddenly, with his tongue black, dry, rough, (by reason of the putrefied and cor∣rupted humors, and the vapors rising from the whole body unto that place) and hanging out ••••••e unto an hounds, with unquenchable thirst, often swounding and desire to vomit; He hath convulsions over all his body, through the vehemency and malignity of the disease, and so he died the third day: Wherefore those that kept the sick people in the Hospital, thought that he had been poisoned, for the certain knowledg whereof the, Governors of the Hospital commanded his body to be opened.

I therefore calling to me a Physician and Surgeon, we found in the bottom of his stomach, a print or impression, as if it had been with an hot iron or potential Cautery, with an Eschar or ••ru••••, as broad as ones nail, all the rest of his stomach was greatly contracted and shrunk up to∣gether, and as it were horny; which we considering, and especially the Eschar which was deep in the substance of the stomach, we all said with one voice, that he was poysoned with Sublimate or Arsenick. But behold, while I was sowing up his belly, I perceived many black spots dis∣persed diversly throughout the skin: then I asked my company, what they thought of those spots; truly (said I) it seemeth unto me that they are like unto the purple spots or marks that are in the pestilence. The Physician and the Surgeon denied it, and said that they were the bitings of fleas. But I perswaded them to consider the number of them over all the whole body, and also of their great depth and depression into the flesh; for when we had thrust needles deep into the flesh in the middest of them, and so cut away the flesh about the needle,* 1.5 we found the flesh about the needle to be black: moreover his nostrils, nails, and ears were livid, and all the con∣stitution of his body was contrary, and far unlike to the bodies of those that died of other sick∣nesses or diseases. Also it was credibly reported unto us by those that kept him, that his face was so altered a little before he died, that his familiar friends could hardly know him. We perswaded by these proofs, revoked our former opinion and sentence, and made a Certificate to be sent unto the Governors and Masters of the Hospital, setting our hands and seals unto it to cer∣tifie them that he died of a pestilent Carbuncle.

Notes

• * 1.1

  Why it is dead∣ly to have a sore come after the Fever.
• * 1.2

  Huge pestilent Abscesses com∣monly deadly.
• * 1.3

  Deadly Car∣buncles.
• * 1.4

  An history.
• * 1.5

  How to distin∣guish purple spots from flea bitings.