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 ...

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Title
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 ...
Author
Salmon, William, 1644-1713.
Publication
London : Printed for J. Dawks ... and sold by S. Sprint [and 6 others] ...,
M.DC.XCVIII [1698]
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Subject terms
Medicine -- 15th-18th centuries.
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http://name.umdl.umich.edu/A60561.0001.001
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"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 ..." In the digital collection Early English Books Online 2. https://name.umdl.umich.edu/A60561.0001.001. University of Michigan Library Digital Collections. Accessed October 31, 2024.

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CHAP. LI. REPORTS, from Wounds External.
I. Of the Malignity of Wounds.

I. WOunds, both Mortal and Dangerous, Internal and External, are accompanied some∣times with Malignity. Now the times wherein this Malignity manifests it self, remains to be enquired into. Guido, and Ta∣gaultius from him, limit three times, wherein Malign Signs shew themselves, viz. the seventh, ninth, and fourteenth Days. And indeed, many among the Mo∣derns suspend their Judgment till the ninth day is over, be∣cause in that time they think, that hopeful or malign Signs

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will shew themselves, with re∣spect to the Constitution of the Patient, Quality of the Air, and Condition of the Wound.

II. But indeed, it is the Criti∣cal Day which ought to be taken notice of, viz. the Times when the Moon comes to her Sinister or Dex∣ter Quartils, or Oppositions, &c. And these are the Times which Hippocrates intends, when speak∣ing of a Wound in the Head, he says, a Fever in Summer time, seizes him about the seventh Day, but in Winter, about the fourteenth Day: If any Error has been committed, and if evil Symptoms seem to come on apace, the Patient will die in Summer, before the seventh Day; and in Winter, before the four∣teenth. This seems to be rati∣onal, as being deduced from the Crises; and why they happen later in Winter than in Summer, is evident, because in Winter our internal Heat is more vigo∣rous and strong, and therefore resists malign Causes the more powerfully.

III. Therefore, if the Patient be strong of Constitution, has Youth of its side, and the Wound was given in perfect Health, and in Winter time, you ought to wait till the second Crisis, for the ap∣pearance of the Symptoms, and before you may adventure to de∣liver your Prognosticks. At what time, if Evil and Malign Sym∣ptoms come on, Death may be predicted, on, or before the next Critical Day, according as they approach, slowly or hasti∣ly: But if a Wound happens to a weakly Person, Aged, and of a cold and dry Complexion, Cacochymick, and in Summer time, I should expect the Sym∣ptoms to be manifest, about the time of the first Crisis.

II. Whether a Wound will kill, or not kill.

IV. Now, to know whether a Man dies of his Wound, or of something else, you are to consider, whether the Wound present, be Mor∣tal in its own Nature, or is for the most part so; if it be, the Wound may be truly said to be the Cause of Death: But, if the Wound be safe, and without danger, the Death of the Per∣son must be imputed to some∣thing else.

V. But, if Wounds be in their own Nature, dangerous and doubt∣ful; so also ought your Presages to be. For, if they be great, they may then be the occasion of Death; but if small, Death must be imputed to some other Mat∣ter or Cause. If then, a great Wound be made in a Joint, whereby the Nerves, Tendons, and Vessels are torn; though this in it self is not Mortal, yet because it is very dangerous (it yielding to no Errors without prejudice and requiring an exact Cure, with all Care and Dili∣gence;) if the Person dies, you may report the Wound to be the Cause of Death; unless some egregious Fault has been committed in the Cure, either by the Chirurgian, or the Pa∣tient, or some other unavoida∣ble ill accident should intervene. And though without the fault,

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the wounded Man might have died, yet since the Case is du∣bious, where any fault has been committed, the Report should always be in Favour of the Li∣ving.

VI. In dangerous Wounds of the Skull, where there is occasion to open it, if the Patient dies, (un∣less some egregious and plain fault has been committed) the Wound may be said to be the Cause of Death: But when the Salubrity of the Clime shall be admitted, then all Wounds of the Head, even if the Bone be broken or perforated, (if the Membranes be but safe) are to be accounted safe, unless much of the Skull be taken away; for then, be∣cause it is impossible for the Meninges not to be wounded; you ought to esteem such Wounds dangerous: As for o∣ther Wounds, though they rank themselves with the Dangerous, yet they approach nearer to the Nature of such as are safe.

III. How Men are said to Die of small Wounds.

VII. A Person having received a Wound not Mortal, may Die; but then it cannot be of the Wound, but of some other Cause; as from the evil Habit of Body, weak∣ness of the Part wounded, irre∣gular Living, malign Constitu∣tion of the Air, Ignorance, or Negligence of the Chirurgian, or some other unhappy Acci∣dent, as some new hurt, strain∣ing of the Part, bruiting it, &c.

VIII. If it happens on a Person Cacochymick, or Cachestick, tain∣ted with the Dropsie, Rheuma∣tism, Kings-Evil, Consumption, Leprsie, Pox, &c. Though the Wound may be in a Carnous Part, and not subject to danger, there may from such a Habit of Body, be great Defluxions, ve∣hement Pains, strong Inflamma∣tions, Fevers, Convulsions, Gan∣grenes, Sphacelus, or other ill Symptoms, the malign and tain∣ted Humours flowing many ways into the Part.

IX. If there be a weakness in the Part wounded, as Strumous Nodes, Gout, Rheumatism, Para∣lysis, Numbness, Flux of Humours for a long time before, or other Weaknesses: Into what a great danger may a small Wound (though in it self not Mortal) put him? especially if it be in a Joint, or a Nerve, or Tendon be wounded; and be joined also with a Cacochymick Habit of Body.

X. If the Patient lives irre∣gularly, eating Gluttonously, drink∣ing to be Drunk, keeps unseason∣able Hours, lies in the Cold, is unsatiable in Venery, perplext with Cares, and uses violent Exercises; he may bring upon himself Sur∣feits, Dropsies, Rheums, Agues, Inflammation of the wounded Part, Gangrenes, Consumptions, Hecticks, &c. and other Dis∣eases so great, as to send him into another World; in these Cases, the irregular Living, join∣ed with the Wound, is the Cause of Death, not the Wound simply it self.

XI. If there be a malign Con∣stitution of the Air, as in the Plague time, or when some other Epide∣mick

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Disease Reigns; at such a time, a small Wound is apt to receive its malign Influences, and pestilential Miasms; from whence arise Convulsions, Faintings, Cacoethick Ulcers, Inflammations, Gangrenes, ma∣lign Fevers, the Distemper of the Time, and other dangerous Symptoms, the least of which are able to destroy the Patient.

XII. If there be Ignorance, or Negligence, in the Chirurgian, it is easie to be apprehended, how an Error of that kind, may create an irreparable Evil, and bring the Wound into such a Condition, as either to put the Patient into apparent danger of his Life, or, at least, to bring upon him some incurable Ulcer, or leave him Lame and Helpless all the days of his Life after.

XIII. Lastly, if any other un∣happy Accident should happen, as lying upon the wounded Part, or bruising it, or otherwise hurting or straining of it, a Defluxion, In∣flammation, Gangrene, and Spha∣celus may be introduced; by which (though the Wound it self was small, in an ignoble Part, in no bad Place, nor in the least Mortal in its own na∣ture, yet) the Patient may un∣happily die.

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

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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

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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.

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)

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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.

VI. Wounds of the Head.

XXX. If a deep Wound be made in the Neck behind, so as to reach the Parts under, you will hurt the Motions of the Head. For there being six Pair of Muscles which draw the Head backward, they all of them lie under some other ex∣ternal Muscles, the Exterior under the Musculous Dilatation, which moves the Cheeks, the Posterior under the Scapular Muscle; where∣fore a superficial Wound cannot hinder the Motion of the Head: All these six Pair of Muscles, come from the Spines of the first five Vertebrae, and reach almost half way up the hinder part of the Head.

XXXI. And there is one Pair of Muscles which bend the Head forward, these arise from the top of the Thorax, and end of the Clavicula, being long, round and strong, and are apparent before the Skin is taken off, and are inserted into the Mamillary Processes: If these be both mo∣ved, the Head is bent forwards; but if it be drawn on one side only, one of them only acts; these, if they be cut, hinder the Motion of the Head forwards or side-ways.

XXXII. A Wound in the Head in the Cutaneous Part, which only makes bare, or breaks the Bone, but hurts not the Meninges, is safe, because it is in the Skin, or a Carnous Part, no Nervous, or Principal Part being hurt. But such a Wound may be in some respects dangerous, because near the Brain, and may put a Per∣son into more hazard, than Wounds of other Parts; and therefore Judgment ought to be delivered concerning them very cautiously, because they produce many and vehement Symptoms, not happening in Wounds of

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other Parts, arising from the Nature of the Part, faults in Management, and difficulty of Cure: For such is the formation of the Head; that whatsoever Wound happens in its Skinny or Carnous Substance, it may easi∣ly, by a Fracture of the Skull, be communicated to the Me∣ninges, and the Brain it self; because there may be a Fissure of the Cranium, in another Part than where the Wound is, as Hippocrates affirms, which is cal∣led Resonitus Cranii, or, a Con∣trafissure: And Avicen says, the Skull may be oftentimes broken, whilst the Skin remains whole. And Celsus, That though the Bone be perfectly whole, yet some Vein in the Membrane of the Brain, may be broken and bleed; in all which Cases, a wise Artist may be in a doubt what to do, and make more than small faults, by his Mistakes in Curing.

XXXIII. Such a Fracture of the Cranium, as lays the Meninx, or Dura Mater bare, is full of Danger; for they have place a∣mong Nervous Wounds, which are dangerous. Yet in giving Judg∣ment, consider the Temper of the Clime, Nature of the Place, Quality of the Season, and Habit of the Body, and accordingly deliver your Opinion.

VII. Wounds of the Forehead, and upper Eye-lids.

XXXIV. A Wound in the Fore∣head, near the Eye-brows, if long∣ways, according to the Course of the Fibres, when healed, will not hurt the Function of the Part, or Eye-lid; but if it be transverse and deep, the Eye-brow and Skin un∣der it will be drawn downwards, causing a great trouble to the Eyes, because the upper Eye-lid cannot open freely, nor perfectly do its Duty. This Substance lying up∣on the Forehead, and sticking fast to it, Galen calls a Musculous Skin; Vesalius, not a Musculous, but a Carnous Membrane, but Fallopius says, it is perfect Mus∣cle, from its Fibres and Motion; and Realdus, that it is duplicate, because he has seen one side of the Forehead convulst, whilst the sound side was entire in its Function. These Muscles have no Tendon, because it is not a Bone, but a Skin that is to be moved, and is terminated in that common Suture, which di∣vides the Bones of the Head from those of the upper Jaw: And their Fibres (as Vesalius says) run in a direct Line from the top of the Nose to the begin∣ning of the Forehead; but Co∣lumous says, they run obliquely, from the top of the Nose, to the said middle of the Fore∣head.

XXXV. If the upper Eye-lid is wounded transverse, in the space between the Corners of the Eye, the total loss of the Function of the Eye-lid follows, if the Wound be deep; but if not deep, it will only not shut close. For in this Case, the two oblique Muscles moving and lifting up the Eye-lid, must be cut asunder, or much hurt, according to the Effect following.

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VIII. Wounds of the Cheeks.

XXXVI. If the Musculus la∣tus be wounded, whose use is, to draw the Cheeks from one side to theother, and perform some other Motions, without moving the lower Jaw, or opening the Mouth, the Functions of the Cheeks must ne∣cessarily be hurt: This Action is very manifest, in that Convul∣sion, or Contraction, called Spasmus Cynicus; for therein, this Muscle is extreamly stretcht, and contracted-towards its Ori∣ginal: Its Fibres are carried, partly up to the Lips, as in that part of the Muscle which ascends to the Os Pectoris, and middle of the Clavicula; and partly run obliquely from the same, as in that part of it which rises from the rest of the Clavicula, top of the Shoulder, the Sca∣pula, and Region of the Neck.

XXXVII. If the two Muscles descending Obliquely from the Cheeks, moving the upper Lip; and the two Muscles ascending from the end of the Jaw, where the Chin is, be wounded, the Fun∣ctions, or Actions of the Lips will cease, or be hurt. Now let the Wound in these Parts be made which way it will, it is always transverse, and cuts the Fibres across; because the Fibres of those Muscles are strangely in∣terwoven, and complicate one with another.

XXXVIII. If the Region which lies between the Ear, the Fore∣head, and Os Jugale, making an imperfect Circle, called the Tem∣ples, be wounded, the lifting up of the upper Jaw, and the shutting of the Mouth will be hurt. For the Crotaphites, or Temporal Mus∣cle lies there, which arising from the Os Verticis, Frontis, & Temporis, is fastned to the crooked Point of the lower Jaw, drawing it up to shut the Mouth. And the Fibres of this Muscle, run from the Circumference to the Centre, which they do in no other Muscle besides. A Wound in this Muscles causes also (as Hippocrates and Galen say) Con∣vulsions, Fevers, Sleepiness and Doting, because near to the prin∣cipal Nerves.

XXXIX. If the Space between the Os Jugale, and Root of the Ear, at the beginning of the neat her Jaw, be wounded, Mastication, or Chewing will be hindred. For there the Masseter, or Chewing Muscle lies, which you may ea∣sily feel with your Fingers, when the Mouth is open; arising from that part of the Head where the Processus Styloeides are, compre∣hending all the neather Jaw, and drawing it round.

IX. Wounds of the Arms.

XL. If the Muscles dedicated to any Function of the Arm, are wounded, those Functions will be hurt. That which lies upon the Epomis being wounded, the Mo∣tion drawing the Arm upright is hurt. If those two which come by the sides of the former, from the Scapula, be wounded, the Motion which draws the Arm backward or forward, according as they are on this or that side, is hurt. If the three Muscles

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which draw the Arm to the Brest are wounded, that Motion also is frustrate. If the four Muscles, proceeding from the Scapula, and that from the lower end of the lowest Rib, under the Scapula, be wounded, the Mo∣tion which turns the Arm back∣ward is prejudiced.

XLI. If the Muscles dedicated to the Cubit, or Elbow, are wound∣ed, the Functions of the Cubit will also be hurt. If the Muscle which appears near the Humeral Vein, having two Heads, one upon the edge of the Head of the Sca∣pula, and another upon the Pro∣cess, and cleaving first to the Os Brachii, and then to the Ra∣dius, having a second under it, assistent to the same Action, be wounded, the Motion extending the Cubit will be hurt: But if a Wound be made in the hinder Part, opposite to the aforesaid Muscles, touching their ends, the Office of bending the Elbow will be lost. If the long Muscle arising from the Os Humeri, and implanted into the lower Ap∣pendix of the Radius, being the second of them which draw the Radius forwards, be wounded, the Motion raising the Radius supinely will be hindred. But if the lower Part of the Ʋlna, going along to the lower Part of the Wrist, be wounded, all the Motions of the Wrist will be hurt; for there all the four Muscles of the Cubit, which are the cause of all the Motion of the Arm, are extended.

XLII. If a Wound be made in the inside of the Cubit, inclining a little back, then the second Joints of the four Fingers cannot bend; for there runs one Muscle, the first among the Internal, which moves the upper part of the Hand, which arising from the lower Swelling of the Humerus, is hid under others, till it comes to the Elbow, where coming forth, it is seen under the Skin, except what the former Muscle does pass over: This then ha∣ving passed the Wrist, is divi∣ded into four Tendons, each of which being fixt to the second Bones of the Fingers, are their Benders. And therefore, what∣ever of the internal Muscles, which run down with the first to the Wrist, are cut, certainly hurt the Function of Contracti∣on, or bending.

XLIII. The Hand is manifestly extended by the external Muscles, placed in the back part of the Arm. If therefore the first of these be wounded, which having past the Elbow, appears, and is seen un∣der the Skin, and runs under another, which extends the Wrist, which being divided in∣to four Tendons, runs to all the Joints of all the Fingers, and extends them; the Motion cau∣sing these Extensions will be frustrate. The second Muscle, by which the Palm is formed, having the same Original with the former, is to be seen under the Skin with the first, proceed∣ing underneath to the Hand; this is that, by which the little Finger is drawn aside from the rest; therefore, if this Muscle is wounded, and the Wound be made in the lower Region, the Function of the little Finger

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will be hurt; but if it be made a little above, the Function of the three next Fingers then suffer.

X. Wounds of the Hands.

XLIV. If the back of the Hand be wounded, where (not Muscles, but) Tendons creep along to their Joints, then the Function of that Finger will be hurt, which is next to the Muscle, or Tendon, Cut or Wounded. But many times, when these exterior Tendons have been cut, the Fingers have yet been extended, but the Fun∣ction has been the more weakly performed; the cause of this remaining ability of Extension, is from other Muscles arising in the Palm, which exercising the same Function of extending, with those which were cut, makes the prejudice, or hurt of the Function the less: And this is evident, because, if the Palm of the Hand be wounded, the Motion of the Fingers is many times hurt thereby.

XLV. If therefore the broad Tendon in the Palm, which lies next the Skin, and four Muscles which lie under it, from the mid∣dle of the Palm, to the setting on of the Fingers; which (though they be internal) extend the four Fingers and the Thumb: If, I say, these be Wounded, the Function, or Action of extending the Thumb and Fingers must be hurt. And these four arise from the Tendons of that Muscle, which bends the third Joints of the four Fingers, and then running to the exter∣nal Part, are implanted in the said third Joints, and so extend them.

XLVI. If a Wound be about the little Finger, that Muscle will be hurt, which arises from the fourth Bone of the Matacarpus, and draws it aside from the other Fin∣gers. If the Ball of the Thumb is wounded, the three Muscles which bend the Thumb will be hurt; and whatever Wound it is which hinders its Function, it must be either in it, or very near it, because the Thumb has this peculiar property in it self, to take nothing to it, from any upper part.

XI. Wounds of the Thighs.

XLVII. A Wound any where in that Region of the Buttock, which reaches from the Os Sacrum and Coccyx, half over the Os Ilium, unless it be shallow, will hinder the Extension of the Thigh. For, the Muscle giving this Motion, arises from the aforesaid Parts, and ends at length in the great Trochanter, making the Buttock. But since this Function requires much strength, other Muscles are helpful to it, lest by the hurt of one Muscle, the whole Action of the Part should be lost.

XLVIII. A Wound in the Thigh, in the forepart, between the tops of the Knee-pan, will prejudice the Extension of the Leg. For under that place, there runs the seventh Muscle of them that move the Leg, and under that the eighth Muscle, to be seen above the Knee: But, because it has other Muscles assistant in this Action,

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the total loss of this Extension need not be feared, from the wounding of one Muscle.

XLIX. And if that Muscle be wounded, which descends obliquely, almost from the Groin, like a Bor∣der along the inside of the Thigh, and ending in the Shin, that Mo∣tion or Action of the Leg, which draws it towards the Groin on the other side, or to the Thigh, will be very much hurt. And if the hinder part of the Thigh, between the end of the Buttock and the Ham, be wounded, it hinders Contraction; especially if the Tendons be cut, which appear so evidently in the sides of the Ham; that when the Knee is bent, they may be plainly felt by the Fingers.

XII. Wounds of the Legs.

L. If those Muscles, which co∣ming up above the Knee, do by their Bellies, on each side of the Leg, make up the Calf, and at length make the strongest Tendon of the whole Body, coming to the Heel: If these, I say, be wounded, or that Tendon be cut, then the Action of the Foot, which stret∣ches it forth, will be hurt: But the hurt, or wounding of one Muscle, is not sufficient to destroy the Action of the whole; for four other Auxiliary Muscles, lend their Assistance to this Fun∣ction.

LI. If the two Muscles running between the Calf and the Os Tibiae, or Shin bone; one of which next the Calf, extends four of the Toes; the other running by the Os Tibiae, extends the end of the Foot: If, I say, these be wounded, the Action of extending will cer∣tainly be hurt.

LII. If the Metapedium, or Instep he wounded athwart deep, and the Wound be not healed at one Intention, by reason of the Con∣course of Arteries, Veins, Nerves, Muscles, and Tendons, and the easie afflux of Humours, as being a depending Part. If the use of the Foot be not wholly lost, yet the Ulcer will be of difficult Cure, and long in Healing.

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