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. Tumors arising from WIND.

CHAP. XXVIII. Of the WINDY-TƲMOR.

I. IT is called in Greek, 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, pl. 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉. 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, pl. 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉. 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, pl. 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉 in Latin, Em∣physema, pl. emphysemata; Apostema ventosum, Inflatio, Inflationes: in English, Windy Tumor, or Tumors, a Windy Apostem, &c.

II. Definition. A flatulent Tumor is a preternatural swelling, proceeding from Wind, shut up within the Membranes of several Parts, as under a thick Skin, or the interstices of the Mu∣scles, and yielding to the im∣pression of the Fingers, but suddenly returning again.

III. Or, It is a Swelling pro∣ceeding from Wind, not pitting, but yielding to the Fingers, con∣tained within Membranes, and which if shaken, makes a rum∣bling noise.

IV. Galen, lib. de rat. Vict. in Acut. Com. 4. Text. 21. Tumor est, collecto Spiritu flatulento in quibusdam cavitatibus, vel sensui expositis, vel ratione contempla∣bilibus. It is a Tumor made by á flatulent Spirit collected in certain cavities; these cavities being either exposed to the sense, or such as are to be ap∣prehended by reason.

V. Now what these Cavities are, which are to be apprehended by reason, he explains himself, ad Glauc. lib. 2. cap. 5. And that they are those very Pores of the Similary Parts, and those little spaces which are interposed between the said Similary Parts.

VI. Wiseman says, it is a light puffy Tumor, easily yielding to the pressure of the Fingers, and rises again in the instant you take them off.

VII. The Differences. 1. In respect to the kinds; being either pure, or mixed. A Pure Em∣physema is seldom found, unless in cases of Wounds in the Brest; where the Air getting in be∣tween the Muscles and Mem∣branes, does puff them up, much like to the inside of a Shoulder of Veal. A Mixed Em∣physema is that which is mixed with some Humor, which is chiefly, or always Phlegmatick.

VIII. 2. In respect to the place; some are inward, some are out∣ward. The Inward are in the membranes of the Bowels, and

sometimes in their very Cavi∣ties; as the Stomach, Abdomen, Womb, &c. of these we say nothing here. The Outward may be on the Eye-lids, the great Joints, the Scrotum, Navel, and other membranous parts; the Scrotum being the usual seat of the Hernia ventosa, of which in the next Chapter.

IX. 3. In respect to its quality: some are without pain, in which the Wind is in motion; others with pain, in which it is quiet, from its too great distention.

X. The Causes. The proxi∣mate or conjoined Cause is Wind, or a flatulent Spirit; which is, as Galen testifies, de Sympt. Caus. lib. 3. cap. 4. from a weak and languishing heat: for as absolute cold cannot excite any Vapor; so on the other side, vehement heat discusses the Vapor.

XI. The antecedent cause is Phlegm, viscous Lympha, or some other thick Humor; sometimes alone, and sometimes mixt with a little Choler, which as Ferment turns it into froth, and so gene∣rates Wind: and it always happens upon a debility of the Part; which endeavours a con∣coction of Humors, but is unable.

XII. The procatartick or remote causes are flatulent Meats and Drinks; cold, moist, and cloudy Air; idle and sedentary Life; the suppression of accustomed Evacuations, Stoppages of the Pores of the Part, and thickness of its Membranes; to which add, external injuries, which con∣tribute to the hurt and weak∣ness of the place affected.

XIII. The Signs. The Part is inflated like a Bladder, yields to the Fingers, but immediately rising again, and makes a kind of rumbling noise, if shaken.

XIV. It is of an uncertain bigness, sometimes very large, sometimes small; without any weight to the Part that it possesses.

XV. The Tumor being pressed with the Fingers, tho' it yields to them, yet it leaves no pit: whereby it is distinguished from ••edema; for that also yields to the Fingers; but then it leaves a Pit after it.

XVI. It is of the colour of the Skin, without any alteration: unless it is full of pain, by reason of its lying deep, among the sensible parts, or near the Periostion.

XVII. A crackling is often felt, if it is in the Knee, or other outward part: and it most com∣monly affects the Joints, but chiefly the Knee and Wrist; and Parts membranous.

XVIII. The Prognosticks. If they be small, and proceed not from any rebellious cause; or affect only the lesser Joints, they are of easy cure; and if need be, may be opened at any time.

XIX. If it is great, it argues a great debility of natural Heat, and great plenty of morbifick Matter; and therefore the more difficult of cure, because more stubborn and rebellious.

XX. An Emphysema affecting the greater Joints, is of most difficult cure, and not to be opened without great consi∣deration.

XXI. If the Matter is detained

in the Muscles, it is then hardly cured, and with much trouble; for that the Spirit is produced, bound up and included by the containing Membranes, and dis∣per'sd into all parts of the Muscle.

XXII. The Cure. The Wind that distends the Part, is to be taken away. Means also must be used, that it may not breed again, and flow to the Part. And the Pain, if any be, is to be mitigated, and removed.

XXIII. In order to the per∣formance of these things, the Diet is first to be considered; which is to be the same as in Oedema, Pease, Beans, Carrots, and all crude Fruits, and windy things do extreamly hurt. Wine, and other things moderately heating; as the Potestates Anisi, Carui, Caryophyllorum, Ju∣niperi, Lavendulae, Limonum, Rosmarini, Rutae, Salviae, &c. do very much profit.

XXIV. The Matter out of which the Wind is bred, is to be evacuated; which is ef∣fectually done by purging once or twice a week with Tinctura purgans, Syrupus catharticus, or Oxymel scilliticum.

XXV. The Stomach and whole Body is to be corroborated by giving inwardly Tinctura Cordialis, Tinct. Martis, Tinct. Sacra, Tinct. Salis Tartari, Elixir Me∣tallorum, &c. as also, Sudori∣ficks, the chief whereof are, Our Specifick Laudanum, Guttae Vitae, Theriaca Chymica, Lauda∣num Samech, &c.

XXVI. Every night going to bed, after taking a Dose of Lau∣danum, &c. let the Patient take a glass of Hippocras, or spiced Wine; and a like draught of the same every morning fasting.

XXVII. But for correcting the Wind, expelling it, and to hinder its breeding, nothing is better than the Spiritus nitratus, which effectually opens all Obstru∣ctions, and causes a dissipation thereof; take it ad ʒii. in a glass of Hippocras, or spiced Wine.

XXVIII. As to Topicks, they are to be such as by their heating and attenuating quality, may open the Pores, and discuss the Flatulencies; which of Simples these are chief: Roots of Ange∣lica, Galangal, Lovage; Herbs, as Avens, Bawm, Camomil, Dill, Fennel, Fetherfew, Hys∣sop, Marjoram, Mint, Penni∣royal, Rue, Southernwood, Tansy; Flowers, of Camomil, Elder, Melilot, Saffron; Seeds, Anise, Caraways, Cumin, Fen∣nel; Oils of Mace, Nutmegs, Spike, and all hot distilled Oils.

XXIX. Of Compounds, this is good. ℞ Tops of Angelica, Bawm, Camomil, Dill, Hyssop, Ori∣ganum, Southernwood, A. M.j. Wine lbvi. boil, and make a Fomenta∣tion, which apply for half an hour or better: or you may make it in a small Lixivium of Pot-ashes.

XXX. You may also em∣brocate with the following Mixture. ℞ Powers of Rose∣mary, Juniper, Savin, Amber, A. ℥i. Powers of Turpentine ℥ii. mix, and bathe therewith: or you may mix with them

Oil-olive ℥ i. and so anoint with them.

XXXI. Or you may anoint with this Liniment commended by Barbett. ℞ Common Oils of Wormwood and Rue, A. ʒii. Oil of Nutmegs by expressision ʒi. distilled Oil of Mace ʒss. Castor dissolved in Aqua vitae ℈ii. mix, and make a Liniment.

XXXII. Oil made of wild Cucumbers, is approved of, as a most excellent thing to anoint with: or this, ℞ Oils of wild Cucumbers, of Dill, of Rue, A. ℥ss. expressed Oil of Nutmegs ʒii. Oil of Amber ʒss. mix, to anoint withal.

XXXIII. It is good to bathe with Spiritus mirabilis, or an∣oint with Ʋnguentum mirabile, or with this Balsam following. ℞ Common Oil of Rue ℥ii. Tur∣pentine half an ounce: mix with the Turpentine Oil of Vitriol ʒvi. till the Turpentine is perfectly dissolved; then mix that with the Oil of Rue, and make a Balsam.

XXXIV. After, you may apply this Cataplasm of Barbett: ℞ Rue, Calamint, A. M. ss. Goats dung ℥vi. Bean meal ℥ii. seeds of Anise and Cumin, A. ℥ss. Bay-berries, Salt, A. ʒiii. Nitre, Sulphur, A. ʒi. Wine q.s. mix, and boil to softness, and beat all up into a Cataplasm.

XXXV. Or this Emplaster. ℞ Oil of Spike ʒiv. Mastich, Venice-Soap, A. ʒiii. seeds of Cumin, Caraways, A. ʒii. Castor dissolved in Aqua vitae ʒi. roots of Pellitory of Spain, ashes of Earthworms, A. ʒss. Wax, Tur∣pentine, A. q.s. mix, and make an Emplaster.

XXXVI. Or this: ℞ Faeces of new Wax from the Press lbjss. crums of brown Bread lbss. flowers of red Roses ℥iv. boil all in White-wine, then beat them together, and add Gloves, Nut∣megs, Ginger, Pepper in fine pou∣der, A. ʒiii. seeds of Anise, Bishops-weed, Cumin, Fennel, A.ʒiv. Oils of Camomil, Dill, and Rue, A. ℥ii. mix, and make a Cataplasm.

XXXVII. If need require, Blistering, Scarifying, and Cupping are to be done: but if neither by these things, nor the former applications, the Tumor will discuss, but is inflamed, and grows painful, you must then use Anodyns.

XXXVIII. But if the Tumor is in a place where it may be safely opened, the speediest way of Cure will be by cutting into it; and then it is to be cured, as in the Cure of an Absceess we have shewed.

XXXIX. A Tumor in the Knee of long standing, great, soft, and loose, was cured by this Ca∣taplasm. ℞ Roots of Briony, Orrice, Lillies, Daffodils fresh gathered, beat them together, and boil them in Wine and Aqua vitae, and make a Cataplasm: this was applied hot every day upon the Swelling, and bound on; and in three Weeks time it did the Cure. Platerus, Observ. lib. 3.

XL. The like has been done by application of a Cataplasm, made with wild Radish roots and Vinegar, and applied hot.

XLI. Great Inflations of the Knee, have been sometimes cured, by application of a large bli∣string Plaster, made with Can∣tharides, sour Leven, and a little Vinegar.

XLII. A Woman thirty years old, had a swelling on her right Knee, encompassing the Rotula, and had been growing near two years. It was supposed flatulent, and so was treated with Fomen∣tations, Embrocations, and Em∣plasters: but it heating, and increasing, Empl. de Bolo was applied, and a Knee-piece laced on: by the continued use of which the Tumor was re∣strained, and the Knee reco∣vered its former strength. Wiseman.

XLIII. Another Person had in the Knee a round soft Tumor, lying on each side the Rotula, of the same colour with the Skin, which much disabled her from walking: Empl. ad Herniam was applied, with an addition of Ceratum Hyssopi; and a Com∣press of brown Paper, soaked in Aqua Fabrorum, over which a laced Knee-piece was put on, and streightned proportionably: by renewing these Dressings, in about ten days the Swelling discussed, and her Knee re∣covered its former strength. Wiseman, lib. 1. cap. 27. Obs. 4 & 5.

XLIV. A young Woman had a puffy Swelling on her left Foot, near her Toes, stretching over the Toe next the little one, of about two Fingers breadth, without in∣flammation, or much pain. It was endeavoured to be discussed, but it resisted, and was inflamed: then Emplast. è Bolo was ap∣plied, and a Sock to be laced, with a Bracer lockt to it, for the Toe; and by Compress and careful lacing, the Tumor was suppressed, and she had much ease, and in some Months she was cured. Wiseman, ibid. Observ. 7.

CHAP. XXIX. Of a WINDY RƲPTƲRE.

I. IT is called in Greek, 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉. ex 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, Ventus, & 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, Ramex, Ru∣ptura; in Latin, Pneumatocele, Hernia ventosa, Ramex vento∣sus, Ruptura ventosa; in English, a Windy Rupture.

II. The Kinds. It is twofold: 1. 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, Hernia ventosa Scroti, a Windy Rupture of the Cods. 2. 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, Hernia Umbilicalis ventosa, a Windy Rupture of the Navel. See Synop. Ased. lib. 5. cap. 18.

III. Definition. It is a col∣lection of Wind in the Scrotum, and parts adjacent to it; or else in the Navel, making the parts to swell, or stick out.

IV. The Causes. The proxi∣mate or conjoined Cause is Wind, or a flatulent Spirit, protruded into the Part thro' its weak∣ness, or want of natural Heat; the antecedent is a viscous Lym∣pha, or a superabundance of Phlegmatick matter: and the procatartick or prime Causes, are, evil temper of the Air,

Food of evil Juice, violent mo∣tions, and overstraining of the Body; and in Children many times strugling and crying.

V. The Signs. They are known partly by the swelling out of the Part. That in the Groin is many times large, sometimes hard, sometimes not; but that in the Cod is for the most part hard; because it is apt to swell much, is sud∣denly grown to its bigness, round, and yet light, possessing for the most part the whole Scrotum, and Cremaster-muscle, and sometimes the very Yard, it self.

VI. When it is at its full big∣ness, it resists the touch, and is clear, like unto a Bladder full of Wind; and the Yard is some∣times greater in one place, than in another. If it is in the Groin, it is nothing near so large, and more oblong, and seldom affects the Yard.

VII. That in the Navel is known by the protuberance, clear∣ness of the Skin, softness, and easily yielding to the touch; be∣ing also less painful than the former.

VIII. The Prognosticks. If it is recent, it is easy of Cure; but if it is inveterate, or of great magnitude, the Cure will be performed with much difficulty.

IX. If it has been of long standing, and in a Scorbutick or Cacochymick Habit of Body, it is dangerous; so also if it proceeds from any malign Cause.

X. If it be not discussed, or reduced, it causes in length of time many other Diseases; and sometimes it so spreads, as to possess the whole Body.

XI. The Cure. The Indications of Cure are, 1. To expel or carry off the Humor causing the Wind. 2. To strengthen the Viscera, by Carminatives. 3. To remove the conjoined Cause, by Topicks and proper Compresses.

XII. Purge the Body (if strong, with Oxymel scilliticum) with Syrupus Catharticus, Electua∣rium Catharticum, Pulvis Cor∣nachini, Pulvis Antimonii, or Pulvis Catharticus; which last is a most admirable thing; and re∣peat the Purgation two, three, or four times, or as oft as you see occasion.

XIII. Strengthen the Bowels with Carminatives, as Potestates seminum Anisi, baccarum Juni∣peri, Cariophyllorum, Limo∣num, Virtutum; Tinctura Cor∣dialis, Tinctura Martis, Salis Tartari, Sacra; Spiritus Nitra∣tus, Elixir Metallorum; or other things of like nature.

XIV. As to Topicks, foment in the beginning with this: ℞ Angelica, Bawm, Calamint, Ca∣momil, Fenel, Fetherfew, Origanum, Southernwood, Tansy, A. M.i. bruise, and boil all in Posca, or a mixture of equal parts of Wine and Water lbiv. boil to the Con∣sumption of a third part; and foment hot with Spunges.

XV. Or you may embrocate with this: ℞ Oil-olive, or Oil of Ben ℥iii. Oils of Caraways, Ju∣niper, and Aniseed, A. ʒi. mix them, and anoint therewith. Some anoint with Oils of Euphorbium and Elder, mixt together.

XVI. If the Tumor is with

pain and inflammation, use Ano∣dyns; applying such Cataplasms and Cerats or Emplasters, as have power to soften and re∣solve.

XVII. As these Diseases are most incident to Children, so they ought to be used with great care and mildness: Fienus cured se∣veral, by often heating them against the Fire, and making dry Fomentations, with hot Cloths oftentimes applied.

XVIII. The Emplaster (which ought to be either ad Herniam, or some such as we have described in the former Chapter) being applied, the Part is to be bound up, either with a Bag-truss, or a Bolster-bandage, according to the Place affected; both to keep the Part warm, and keep the Applications on: and so to be continued, 'till such time as the Cure is perfected.

XIX. The Hernia Umbilicalis ventosa, is to be cured exactly after the former manner: but the Cure also consists in the well reducing of it, and retaining it so by Agglutinatives, strong Binders, and good Bandage.

XX. If thro' neglecting it, the Skin should wear thin, and mor∣tify, you must dress it as a Morti∣fication: and after the separa∣tion of the Escar, you must endeavour to take up the Peritonaeum, stitch it close, and incarn it with the rest of the Ulcer; and being cicatriz'd, apply good Bandage, to retain it in its place.

OBSERVATIONS.

XXI. A Child seven years old had a Hernia ventosa in the Groin, as big as a Pullets Egg, soft, but yet so strait, as it scarcely yielded to pressure. Bandage did it no good, but made it more painful; Fomentations and Em∣plasters we applied, as in a fla∣tulent Tumor, and it was bound up with a Bolster-truss; and with proper Internals, it was cured in some time after. Wise∣man, lib. 1. cap. 28. Obs. 7.

XXII. A Child had a Hernia ventosa in his left Testicle, the Wind being gotten into the Tunica vaginalis which encompassed the Testicle round, so as the Testicle could not be felt. The Tumor was so intense, that it would not yield to pressure. For the Cure Discussives and a Bag-truss were advised. Wiseman. ib. Obs. 8.

XXIII. A Child three years old, had one of these Tumors lying the whole length of the production of the Testicle, like to the upper∣most of those Bladders we find in Carps: and the same Wind having raised up the Tunica vaginalis, made the Testicle, not unlike the lower round Bladders which are united to the afore∣mentioned upper Bladders in the same Fish: the Cure was performed by Discutients, and a Bag-truss. Wiseman, ibid. Observ. 9.

XXIV. A Child two months old had a Hernia ventosa in the right Inguen, down into the Tunica vaginalis; the Tunicle of the other Testicle was also distended: Empl. è Cymino was put over the Scrotum and In∣guina, with a Bag-truss, the Tumor not being capable of Reduction or other Bandage.

The Child had an ill Nurse, and was galled by its Piss; for which cause, Empl. Diachalciteos was applied, and renewed daily: upon good Bandage, the Tumor would be very inconsiderable, and sometimes quite discussed: but upon neglect of bracing the Truss close, it would appear big again: it had a Rupture in both Groins; upon which ac∣count, a double Bolster-truss was laid on. Wiseman, ibid. Observ. 10.

XXV. The same Child had a Hernia Umbilicalis ventosa, which was cured by external ap∣plication of Astringents and Com∣pression, exactly according to the method of the following Obser∣vation. Wiseman, ibid.

XXVI. A Child four months old had a Hernia Umbilicalis ventosa, to which was applied a mixture made of pouders of Frankincense, Mastich, Aloes, Sanguis draconis, with the white of an Egg; Emplastr. è Bolo, with a small Button sticking in the middle, made of some snips of the same Emplaster; by which the Emplaster under it was kept the closer: these were bound on to make a Com∣pression. Above the Navel, it had also another Rupture: a Compress was made of some pieces of Empl. ad Herniam, which was kept upon the place, by applying over Empl. è Bolo: by this method, these Hernia's were in few weeks cured. Wise∣man, ibid. Obs. 1.