Chirurgorum comes, or, The whole practice of chirurgery begun by the learned Dr. Read ; continued and completed by a Member of the College of physicians in London.

CHAP. V.

The Cure of the delineated Grast.

NOW it remains, that we lay down the cure of the deli∣neated Skin, as soon as the whites of Eggs are taken off, and what course of Diet the Patient ought exactly to observe, till all fear of Inflammation be over. And the Cure of the Wounded part does chiefly consist in suppuration, not neglecting the use of Repellents in the mean time. For since Hu∣mours are perpetually running thither, and abundance of them, through the weakness of the part, do gather there, the Chirurgeon's chief aim should be to disenss by Suppuraters whatever is gathered there, and to hinder by Repellents whatever comes from any where else. This Hippocrates does intimate, where he says, that an Ʋlcer the s••••nest suppurated is the safest from Inflamation, and the soonest De∣terse and siled with Flesh. Now since there are several sorts of sup∣puratives, there may be as many several sorts of Medicaments, which according to the Heat and Cold, and the several Seasons of the year, may as occasion requires be made choice of. In the later end of Spring, and all Summer, Sallet Oyl drawn from ripe Olives, pure Wax and Turpentine in equal quantities will be proper. For these mightily promote Pus, and I frequently use it. For the wealthy and delicate you may use this following. ℞. Terebinth. let. ex Rosac. ℥ v. ol. res. comp. ℥ j. Addatur cerae albis∣simae, quod par fuerit his omnibus excrpiendis, & ex arte conficiatur unguentum. But in a cold Season, when the heat retires inwards, we must use much stronger means. Therefore in the later end of Au∣tumn and all Winter, you may use such a Medicine, ℞. cl. commun.

℥ viij. cerae pune ℥ ij. colophon. picis naval. sagapen. a. ℥ j. mastich. thur. galb. terebinth. à. ℥ v. ubi oleum cum cera ad ignem probè liquata fuerint, injiciatur colophonia pri∣mum, deinde pix navalis, saga∣penum, terebinthina, mox & reli∣qua, & refrigerata recondantur. This also is good, ℞. cer. alb. resin. pin. sevi vaccin. pic. naval. terebinth. th••••. myrrh. à ℥ v. M. & in pulverem, quae convenit, re∣dactis, cum ol. q. s. f. Ʋngu. ex arte. Next follows the use of Re∣pellents, which (because they are applied only to the outside of the Wound, and the suppuratives to the inside,) may best be applied to the upper part of the Humerus. But before we proceed to them, we will discourse of the admini∣stration of suppuratives. Within a day or two, or after all fear of a Haemorrhage is over, in the Morn∣ing the whites of Eggs may be re∣moved, and that very gently, lest any little branch of a Vein might upon a slight touch bleed afresh. Wherefore it were good to have some singed cotton to apply to the Wound. If the Cloaths be hard and dry, and do stick fast, they must be softned by moistning. Posea is good for this use, and then Oyl of unripe Roses. These may somtimes be mist and applied either cold or a little warm, ha∣ving always regard to the Season, and other Medical Circumstances. For Medicines when they are mo∣derately warm do better insinuate themselves, and by the modera∣tion of their quality perform what we desire. But the Artist must have a care they be not too hot, lest the Blood being stimulated thereby, burst out again. Let therefore the Assistents stand on each Hand, one of which must hold a Bason to receive what comes from the Wound, and the other must have liquor, fit to moisten the Cloaths. In the mean while the Roller must be taken off, with all the gentleness imaginable, so as not to disturb the Arm or the Pa∣tient. Wherefore it were best to clip it with Scissars, not all the Rounds at once, but one by one, and rather on the outside than the inside of the Arm. For in so doing we shall neither disturb those parts by its motion, nor shall we come near those great Vessels of the Arm, which it is the best not to touch at all. When the Rounds of the Rollers are stiff with Blood, it is the Assistents part to irrigate them by dropping liquor from on high. Then he may take them off with a Probe, or, when joyned, he may gently sever them with his Fingers, and throw them into the Bason, and when the Wound is laid bare, he may cover it with a white Linnen Cloth made warm, while the Artist is making ready for the rest of his Work; who must take that Cloth off, and apply another to the Wound, spread with sup∣puratives. Where note, that the first Cloth must not be taken off, till the other is ready to clap on, which must be done as near the same instant as may be: Which is a rule ever to be observed. Then the Artist must take up the end of the Linen. Cloth, which is run under, in the outside of the Arm, and sew another of the same big∣ness to it, running the Needle along, and no where sewing double, lest

by its bulk it might exasperate the Wound. Then with his Right Hand taking hold of the inner end let him raise it, and draw it through till all the old is come through, and the new is drawn into the Wound. Then one of the Assi∣stents must clip off the Old, and throw it into the bason with the rest. But if the Lips turn inwards, then let the Artist with his Probe spread it again gently, and drop in a little Turpentine either alone, or mixt with Oyl of Roses, then let him apply Lint dipt in Suppura∣tives, and upon that Linen Cloths, wet in Repellents, warm; then in the same moderation that was for∣merly prescribed, let him bind all up again, and place the Arm in a middle posture. These Repellents differ nothing or but very little from the other. If they do, it is best to apply gentle ones to the Graft, and stronger to the Shoul∣der and Armpits. These are pro∣per for the Grast; ℞. olei Ros. omphac. olei Ros. comp. à ℥ j. M. Or, ℞. olei ros. comp. myrt. à. ℥ j. M. These you may use sing∣ly, and, with a Cloth dipt in them a little warm, you may irrigate the Graft all over. For the Shoulder this is good; ℞. ol. omph. myrt. à p. ae. And this Liniment; ℞. Sant. rubr. gran. myrt. ros. rub. à. ℥ v. ungu. ros. Mes. ℥jss. redi∣gantur in tenuissimum pollinem santali, mnti & rosae, paretur∣que ex arte linimentum.

As for Diet, it must be very spare in the beginning, and so continued for about four days, till the Humours are setled. The Drink must be small. Wine must not be touched. After the fourth day is over, you may advance a lit∣tle. After the seventh is over you may indulge your self yet more liberally. And this may suffice for the cure of the Skin, when first delineated.