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. VI.

The Cure of some Symptoms, which somtimes be∣fall the delineated Skin.

THree sorts of Symptoms do somtimes befal the delinea∣ted Skin. A Mortification of some of the edge of the cutaneous Graft, an Inflammation of it, and of the parts adjacent, and profusion of Blood. There are several causes of Mortification in this case, a Disea∣sed and Veneral habit of Body; a lax and thin Skin, where the in∣nate heat is weak; too violent pinching with the Forceps, and too strait binding. Unless therefore the Patient be of a good habit of Body, especial care must be had, in taking up the Skin with the For∣ceps, to use such moderation as but just to keep it up, and not let it slip and hinder the operation. It is a good way to take enough of the Skin, that if a little Mortifica∣tion should happen, there may be still enough to serve the turn. Great care also, as we have said before, must be had in binding, that it be neither too strait nor over slack. But when you have a suspition of this mischief, (as you very well may in the forementioned Bodies,) the Wound must be open∣ed, and not let alone till the third or fourth day, you must look very narrowly to the edges, that time∣ly care may prevent the worst. You may know it is beginning, when upon trial by a Probe, sense is either small or quite lost, and if the part look very pale or livid. It must therefore be resisted by things that dry strongly, and de∣stroy Putrefaction. Such is Ʋn∣guentum Aegyptiacum, whereof there are several sorts; but this is the best; ℞. Alumin. virid. aeris, mellis, aceti acerrimi à. p. ae. M. Praecipitate is good either alone or in Oynment of Roses, and other Oyntments. Somtimes pulvis aloes strowed on the Skin has quite de∣stroyed the Malady. It is best to use a decoction of Lupiues, where∣in Aloes has been boiled. This is also a very safe Oyntment; ℞. te∣rebinth. letae ex succo absinth. ℥ j. farin. bord. cretae ℥ j. pollinis aloes purissim. ℥ ij. mell, albi sincerissim. q. s. agitetur mel, excipianturque singula, & ex arte paretur exter∣gens medicamentum. You may use it in Oyntments and apply them to the parts that are tending to Pu∣trefaction. Great care must be had of the Patient's Diet, especially were the Body is Cacochymick or Venercal. All things therefore must be drying and consumers of excrementitious moisture.

The next Symptom, which somtimes ends in the former, is an Inflammation. For because the Blood runs plentifully to that part, all there about is swollen, red, and

painful, and if not prevented, threat∣ens certain ruine to these parts, especially to the Graft. This is most apt to arise in the Spring time, and when People have fared plentifully before; wherefore it is altogether proper to prepare Folks Bodies before the operation. When an Inflammation doth arise, the best way is to bleed in the contrary Arm. The Patient's strength must define the quantity. Diet must be prescribed. The Patient must abstain from all hot things; and things of a penetrating sub∣stance. Coolers and Astringents are best. No Drink at all must be used; Spoon-Meat is sufficient. Rubbing the lower parts with course Cloaths, Cupping either without, or with very small Sca∣rification, when too little Blood has been taken away. Lotions of the extream parts are good, a little warm, with cooling Herbs boiled therein. Bleeding the Haemor∣rhoides with Leeches is proper.

The next Symptom is, profusi∣on of Blood, which may be stopt by letting Blood in the opposite Arm, if the Patient's strength will bear it; by Cupping, Scarifying Ligatures and Frictions. It is good to roll several Rollers pretty hard, not dry, but wet in Posca, hereby I have known Bleeding several times stopt. In this case it is best not to open the Wound till the fourth day. Next of all, the whole Region of the Shoulder must be fomented with Posca, and Cloths wet therein, frequently renewed, before they grow warm. When the Wound is opened, it is good to have things in readiness that stop Bleeding, if it should happen, such as singed Cotton applied either to the Wound or close by it. Castane•• cortex exiccatus, & in pollinem subtilissimum redactus, and gluten Galeni, quod aloos, thuris, masti∣ches aequas portiones continet, & ovi albumine excipiuntur, and Bol. Arm. sang. drac. & pil. lepor. in pollinem redacta. Abstinence both from Meat and Drink is here good. What is eaten should be Cooling and Incrassating. When the Pa∣tient rises he must keep his Arm steady in a sling made of a broad Roller. After the Seventh day is over, he may feed a little more plentifully till the Fourteenth, and then it will be time to take up the Graft.