Ars chirurgica a compendium of the theory and practice of chirurgery in seven books ... shewing the names, causes, signs, differences, prognosticks, and various intentions of curing all kinds of chirurgick diseases ... : to which is added Pharmacopoeia chirurgica, or, The medical store, Latin and English ... / by William Salmon ...

IV. Wounds dangerous.

XIV. And these are all such as are large, or bruised, and much battered, with Fracture of the Bone, or where much of the Flesh is cut quite away, or cut out and hanging on, or where the Wound is of a Circular Figure: The safest are, such as are small, in a fleshy Part, and in a right Line; and in a Child, Youth, or young Person; for such heal sooner than in elder People, or in such as are weak and infirm, of an evil Habit, Voluptuous, Idle, or Intemperate, &c.

XV. Also Wounds in the Heads of the Muscles, in the Cranium, or Skull, Brest or Belly; and Wounds of the Nerves, or Nervous Wounds, as Galen says, with all such as have an equal tendency to Life and Death, may be ac∣counted dangerous.

XVI. Wounds under the Clavi∣cula, and the inner Process of the Scapula, are very dangerous; be∣cause the Axillar Artery and Vein, and fifth Pair of Nerves running from the Vertebrae of the Neck to the Arms, may be hurt. And of this kind, as Cel∣sus says, are many of those Wounds in the Arm-pits and Hams, about the Anus and Testi∣cles, in the Thighs, and among the Fingers, all which are very difficult to Cure.

XVII. Among the dangerous Wounds also, are those of the end of a Muscle, of a Nerve, Artery, Membrane, Cartilage, or Bone. In which respect, Wounds of the Neck are many times of evil Consequence; because some∣times some considerable Nerve or Tendon may be hurt, espe∣cially if the Wound reaches to the Spinal Marrow. Wounds near the Navel, about which lie the perforated Tendons of the Oblique and Transverse Muscles, are not without danger, though they be not deep. Wounds also

in the back part of the Thorax, which, though they reach not the Cavity, yet by reason of the proximate dispersion of large Arteries, Veins, and many Nerves, are accounted very dan∣gerous.

XVIII. Wounds in the Joints are of dangerous Consequence, be∣cause of their Tendons and Liga∣ments, which being hurt, many times produce malign Symptoms; especially in a Wound of the inside of the Arm. And of this kind, may be esteemed Wounds of the Arm-pits, bending of the Elbow, inside of the Wrist, and outside of the Leg; because in these there are great Veins, Ar∣teries, Nerves, and Tendons, which hazard violent Fluxes of Blood, Pain, Inflammations, Gangrenes, Convulsions, &c.

XIX. When Nerves, Tendons, and Membranes, investing the Skull or other Bones, are cut or wound∣ed, there is sometimes hurt of the Sense, numbness of the Part, violent Pain, Inflammation, Convulsion, and sometimes a Delirium, by consent of the Brain; and these many times happen, when the Ligaments of the Joints are cut: But the Pain is more violent, and Inflammations, Tu∣mors, or Convulsions oftner suc∣ceed, when the Nerve, or Ten∣don is prick'd, or partly cut, than when they are quite cut asunder.

XX. Wounds of the Nerves are rarely Mortal, unless by Accident; but they are indeed oftentimes very dangerous. Now under the name of Nerves, Galen comprehends both the Nerves themselves, springing from the Brain and Spinal Marrow, and also Liga∣ments and Tendons, which be∣ing wounded, he esteems Ma∣lignant and Dangerous, but ne∣ver Mortal. For, says he, if that no principal Part be drawn into Consent, nor the Wounded or Contused Nerve is affected with an Inflammation, Wounds of the Nerves may be cured without any Danger; and if these Accidents should attend, yet neither shall Pu∣trifaction, or Convulsion, or Death ensue; for Mortal Wounds can only be inflicted on those Parts that are either Principal, or de∣stroy Strength by large Effusion of Blood and Spirits; or serve to some necessary use of Life; all which being seriously considred, the Nerves can never be found of those kinds: For, an Hand, an Arm, or Leg, and their Nerves, may be cut off with∣out loss of Life; and therefore doubtless, Wounds of the Nerves can never be accounted among such as are Mortal, but only a∣mong such as are Dangerous.

XXI. But Nerves which have their Original immediately from the Brain, or mediately from the interposition of the Spinal Marrow, are more apt to cause Convulsions, than Tendons, which are composed of a Nerve and a Ligament. But if the Tendon insert it self into a Muscle, the more of Nerve there is in it, the more of Dan∣ger there is in it; but a wounded Ligament, if it proceeds from one Bone to another, is not of so dangerous a Consequence.

XXII. Lastly, many of those Wounds, which we have said, are

for the most part Mortal, may (when they are small) be account∣ed among the Dangerous: As, Wounds of the Dura Mater, of the edges of the Liver, Lungs, Spleen, Womb, &c. when they are slightly wounded.