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 ...

V. Wounds of the Nerves, and Back-bone.

XXIII. Not only the hurt of the Muscles, but the hurt of the Nerves also, hinder Motion; because distri∣buted through the Muscles, and being the chief Cause of Motion. For, Galen says, that in all Mus∣cles, whether you wound their Nerves, or cut their Fibres a∣thwart, you immediately de∣prive them of all Motion: Now the Faculty of Motion is deri∣ved from the Brain, and distri∣buted to the other Parts by the Nerves; which, because they are not sufficient of themselves for Motion, the Muscles were ordained, to be as it were, Lea∣vers, that one might the more easily raise up any Weight: For which reason, every Muscle has a Nerve inserted into it, from whence it derives its Motion: And since the original Cause of Motion, is from the Animal Spi∣rit, if that be stopt or inter∣cepted by Cutting, Compressing, or Bruising the Chanel in which it runs, to wit, the Nerves, all Motion and Sense in that Part will cease: But those Parts will yet retain both Motion and Sense, through which the remaining part of the Nerve runs, which it continues with the Brain.

XXIV. Now, the Nerves seldom run along the outside of the Body, into the Muscles, but, for safety sake, as it were, run along the inside. The Nerves that come along to the Hand, run along the inside of the Arm; but contra∣riwise in the Leg; for they run along the backside of the Thigh, because of its Fleshiness. For which cause sake, not any Nerves pass by, or upon, the Elbow, Knee-pan, or Shin-bone, be∣cause they have little or no Flesh upon them; but always deep among the Fleshy Parts of the Limbs, Cartilages, and Liga∣ments.

XXV. If the Nerves springing from the fifth, sixth, and seventh Vertebrae of the Cervix, along the Arm-pits; and from the first and second Vertebrae of the Thorax (which accounted from the begin∣ning, may be called the eighth and ninth pair) being very strangely intermixt, and crossing one a∣nother, descending to the Arm and Hand; if these, I say, be wounded in the Vertebrae, the Motion of the Arms and Hands will be hurt, according to the Magnitude of the Wound.

XXVI. If the Nerves proceed∣ing from the Vertebrae of the Loins and Os Sacrum, which in∣termix and cross one another also, in a various complication, be wound∣ed, there will be a hurt in like manner to the Motions of the Thigh, Leg, and Foot: For whatsoever Pair of Nerves pro∣ceeding from the aforesaid Ver∣tebrae, are hurt, the Muscles un∣derneath will also be hurt.

XXVII. If the Spinal Marrow be cut quite through (says Galen)

in the Region of the third or fourth Vertebrae, the Person will pre∣sently be depriv'd of Breathing; not the Thorax only, but the whole Body below the Wound, becoming immoveable.

XXVIII. If it be cut through, below the second or first Vertebrae, or in the very beginning of the Spinal Marrow, the Person im∣mediately falls down dead. But if the Spinal Marrow be cut quite through, lower than the Fourth Vertebra, all the Muscles of the Brest lose their Motion, and Respiration is performed by the benefit of the Diaphragma, or Midriff only; but a Cut a∣bout the seventh Vertebra, much less, cuts under the eighth or ninth, hinders not the Function of the Thoracick Muscles: And the lower the Wound is yet made, the more Muscles of the Thorax will do their Office.

XXIX. If the Wound of the Spinal Marrow be in a right Line, up and downwards, none of the Intercostal, Lumbar, nor Crural Nerves will lose their use; but if it be cut half way cross, all the Nerves springing thence on the same side, perish. But ge∣nerally hurts of the Parts, from Wounds of the Medulla Spina∣lis, are Mortal, there being not much difference between Wounds of that, and Wounds of the Brain.