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 May 31, 2024.

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II. Of the Puncture or Pricking of a Nerve or Tendon.

XLIV. The Puncture or Prick∣ing of a Nerve or Tendon, is either inconspicuous, not to be discerned by sight, which is called Punctura caeca: or, it is conspicuous, or manifest, and is discernible out∣wardly, and is called Punctura aperta.

XLV. The Signs. This disaf∣fection many times happens in let∣ting Blood, as well as by other Accidents: and it may be known by its Symptoms, which are sudden, vehement Pain, deflu∣xion of Humors, Faintings, and Convulsions.

XLVI. Nor does it terminate presently in Suppuration, but gleets, and will not yield to a simple Ano∣dyn-Cataplasm, made of White-bread and Milk, &c. but will be accompanied with a throbbing Pain, Inflammation, Fever, and Con∣vulsions as aforesaid; which Sym∣ptoms do never happen where the Nerve is wholly, and trans∣versly cut asunder; because then the Nerve, &c. no longer continues its commerce with the Brain, nor can it draw the same into a consent with it; whence no vehement Pain, nor Convul∣sion can be excited.

XLVII. It is known also, whe∣ther it is Cut or Prickt, from the kind of the Weapon it self which made the Wound, and the form and nature of the Wound, as narrow, manifest, or scarcely to be seen.

XLVIII. The Prognosticks. A Puncture is the most dangerous, among all the Wounds of the Nerves or Tendons; for so says Galen, Art. Med. cap. 92. as we have cited the Passage in Cap. 9. Sect. 82. aforegoing.

XLIX. And Galen, Meth. Med. lib. 2. cap. 6. also says, If a Nerve is prickt, Pain must needs invade the Person, greater than the Pain which is in any other Part; and then of necessity a Phlegmon will soon follow there∣upon.

L. If in a Puncture of the Nerves a Tumor appears, and then it suddenly disappears and vanishes again, a Convulsion and Delirium will ensue; as appears out of Hippocrates, Sect. 5. Aph. 65.

LI. Also the Pricking of a Nerve or Tendon is so much the more dangerous, by how much the Body it happens to is impure, or 〈◊〉〈◊〉 disposed, viz. Cacochymical, Cachectical, Strumatick, or Scor∣butick.

LII. The Cure. Tho' the Indi∣cation of Ʋnition has place here, as in all other Wounds; yet by

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reason a Puncture has a greater sense of Pain and Acrimony, with danger of an Inflammation. There∣fore the first Intention here, is, by Anodyns to ease the Pain, and that by all means the Inflammation may be pre∣vented.

LIII. That this may be done, care must be taken that Excre∣ments may not be heaped up in the Wound; which may be hindred, by not permitting the vitious Humors to flow to the wounded place, and Part affected; and by not suffering the Matter already in the Wound to continue there.

LIV. For which reason, the Skin, as also the Flesh which lyes upon the Nerve, must be kept open: but if the Wound is not open enough, you must make it yet wider, by incision of the Skin at right Angles, and of the Flesh, according to the ductus of the Fibres of the Muscle; that so the passage of the Excre∣ments forth, may be the more free.

LV. The Body is to be purged from vitious Humors, with some Lenitive Cathartick; or with Pulvis Cor∣nachini, or Our Family Pills; one or two small Pills being taken every Night going to Bed, as you shall see fit: or with some proper Purge, as Our Syrupus Catharticus, &c.

LVI. Now as to Topicks, you must consider whether the Nerve or Tendon lies bare, viz. open in view, or is covered with a Skin: if they lye covered under the Skin, or Membrana adiposa, then the Skin is to be opened, that the Medicaments may penetrate to the Puncture.

LVII. These Medicaments ought not to be cold, nor hot and moist, nor warm Water; for Water, and all cold things are Enemies to the Nerves; and things which are hot and moist, easily excite a putridness in the Nerves, &c.

LVIII. But we ought to use things which are hot and drying, and of thin and subtil parts; to digest, dry, and resist Putrefaction, but void of any acrimony or sharp∣ness.

LIX. And, the Wound (says Barbett) is also to be kept open, 'till the Cure is absolutely per∣formed; that the Matter may flow freely forth; which if kept in, will increase the Pain, and cause Putrefaction of the Nerve; which if it should happen, the corrupt Part is to be cut off, or removed by an Actual Cautery.

LX. If the Nerve is bare, warm Medicines only are conve∣nient: but if covered, hotter Me∣dicaments are required, Purging in the mean time not being neglected.

LXI. Medicines for this purpose are, old Oil-olive, of Earth-Worms, of Dill, of Rofemary, of Costmary, of Hypericon, of Castor, of Turpentine, of Wax, of Marjoram, of Sage, of Savin, of Sassafras, of Aniseeds, of Caraways, of Juniper-berries, of Lavender, of Oranges, of Limons, and of Tyme; most of them Chymically extracted; to to which add Spirit of Wine, Potestates, &c.

LXII. Of Gums and Bal∣sams; Gum Elemi, Tacamahacca,

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Bdellium, Camphir, Caranna, Euphorbium, Frankincense, Opo∣balsamum, Balsam of Sulphur, Balsam Capivii, de Chili, of Gilead, of Peru, of Tolu, and all the kinds of Turpentine, liquid Storax, liquid Amber, Petroleum, &c. are to be chosen.

LXIII. Be sure to proportionate the Topicks to the vehemency of the Symptoms, which you will know by the pleasantness of the Heat; as that of the Sun, in temperate Weather: and by the pleasing∣ness of the Medicine, causing a kind of Itching: if there is no Heat, there can be no Attra∣ction: if it is immoderate, it will draw Humors, and cause Inflammation.

LXIV. When the Puncture is bare, either by the Wound, or made so, you need not apply Medicines so very hot, dry, and piercing, as when it is hid: in this case, some common Artificial Balsam, or some Natural Balsam, as of Capivii, Chili, Peru, or Turpen∣tine, dropt on warm, will serve the turn; for by their Unctuo∣sity they smooth the Part; and by their Heat, they make At∣traction, and ease the Pain, discharging the Place of its Sanies; and lastly, by their Moisture, they both open, and keep open the Orifice.

LXV. The Medicament (says Wiseman) ought to be hot, dry, and of subtil parts; that it may consume the Ichorous Water, which first affects them, and causes the Putrefaction.

LXVI. In the beginning, he used Oil of Roses with a little Bay-Salt dissolved in it: this he dropt into the Part scalding-hot, upon which he applied a Pledget spread with Basilicon, dipt in the same Oil; and em∣brocated the Part about with Oil of Earth-worms; and put over it Empl. è Bolo, as a De∣fensative.

LXVII. If the Inflammation and Tumor is great, he applies this Cataplasm. ℞ Barley and Bean flower, A. ℥iv. pouder of Linseed and Fenugrek seeds, A.℥i. flowers of Red-roses, of Camomil, of Elder, and Wormwood, A.ʒiii. Wine, or common Lixivium, q.s. boil to a consistency, adding Oxymel ℥ii. Oil of Roses ℥i. mix them, and rowl up the Part gently.

LXVIII. If the Wound requires Medicines of more drying and sub∣til parts, you may use this Mix∣ture: ℞ Chymical Oils of Savin and Turpentine, A.℥ss. mix them. Or you may dress it with Tur∣pentine-Balsam of Sulphur, or with Oil of Costus, or of Rue, or of Savin, or of Dill, or of Scor∣pions, &c. these are all proper Medicines to dress with; but Oil of Roses, and Salt (says Wise∣man) have always served my purpose.

LXiX. If there is much pain, you may dress it twice a day with the Cataplasm at Sect. 67 above: if the hardness goes off with the contraction, and the lips of the Wound relax, it is a good Sign.

LXX. Barbett commends Oils of Wax, Lime-water, and Ung. Fuscum Wurtzii, being rightly used: also this following Oint∣ment. ℞ Oil of Hypericon, Venice Turpentine, Tears of the Fir-tree,

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A. ℥i. Tacamahac, Balsam of Peru, A. ℥ss. Propolis ʒvi. Ca∣ranna ʒii. mix, and make an Ointment.

LXXI. Sennertus says, we ought to use Oils of a thin sub∣stance, as that of Earth-worms, or of Whelps, or Foxes; if these ease not the pain, to apply a Cataplasm, made of flowers of Barley, Beans, Orobus, and Lu∣pins; adding Betony, Camomil-flowers, and Oil-olive; for this eases Pain, dries, discusses, strengthens the Native Heat, and resists Putrefaction.

LXXII. But if the Nerves begin to be inflamed, or to pu∣trefy, the Cataplasm is to be made with Oxymel, or with the common Lixivium; and the Wound is to be managed almost in the same manner, as in the Cure of a Gangren in begin∣ning.

LXXIII. Oil of Turpentine may be used alone of it self, in Chil∣dren, Women, and such persons as are of a cold and moist habit of Body; but in such as have drier Bodies, some Euphorbium may be mixed therewith; also Ammoniacum, Galbanum, roots of round Birthwort, and all Roots that are bitter, without Astriction.

LXXIV. Propolis may also be used alone; or with Sagapenum, or with Oil of Turpentine, or Tears of the Fir-tree, and other Artificial Balsams, which have power to extract the Excrements from the bottom of the Wound; and withal to corroborate and augment the native heat of the Nerves, which of it self (but more especially in wounded Nerves) is very weak.

LXXV. The Ancients com∣mended Sulphur vive, unslaked Lime, Arsenick, Sandrarcha, Pompholyx, Verdigrise, Chalcitis burnt, &c. which are not safe to be used, especially, if the Nerve is bare or naked: we have now found out better things, and Medicines prepared by the Chy∣mical Art, which do their Office without any pain or danger, and which may be safely ap∣plied, whether the Nerve, &c. is naked, or otherwise.

LXXVI. Many of them we have enumerated at Sect. 61 and 62 aforegoing, and other places follow∣ing them in this Chapter; all which obtain that Faculty which Galen and the Ancients have proposed, and have in them no corroding quality at all, but a true Balsamick Virtue, which those of the Ancients wanted; absterging the Wound from the Excrements, agreeable to the Nerves, and greatly strengthning the Native Heat of the wounded Part.

LXXVII. If the Medicament is of thin and volatil parts, which may easily be dissipated; as Oil of Turpentine, or Spike, or Sa∣vin, &c. then you may mix with it Gum Elemi, Capivii, Turpen∣tine, Tacamahacca, dissolved in Oil of Hypericon, simple, or compound.

LXXVIII. Caesar Magatus, de Vulner. lib. 2. cap. 5. has given these following Compounds or Mixtures. ℞ Ammoniacum, Opo∣panax, Sagapenum, (dissolved in warm Water) Propolis, Turpentine,

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A.℥ ss. Oil of Earthworms, made with old Oil-olive ℥jss. mix, and make an Ointment.

LXXIX. ℞ Opopanax, Pro∣polis, Sagapenum; A. ℥ss. Oil of Turpentine, or Tears of the Fig∣tree ℥jss. Tacamahac ʒiii. Sulphur vive ʒjss. mix them for an Oint∣ment.

LXXX. ℞ Fir-tree-tears, Opo∣panax, Propolis, Tacamahac, A.ʒii. Artificial Balsam ʒvi. mix, and make an Ointment.

LXXXI. ℞ Diacyhilon cum Gummi ℥i. Carana, Propolis, Ro∣sin of the Pine, Sagapenum, Ship-Pitch, Tacamahac, A. ʒiii. Arti∣ficial Balsam ℥ss. Euphorbium ℈ii. mix, and make a Cerat.

LXXXII. ℞ Oil of Turpentine, or Tears of the Fir-tree ℥i. Pro∣polis, Sagapenum, A. ℥ss. Euphor∣bium ʒi. mix them.

LXXXIII. Galen, Meth. Med. lib. 6. cap. 2. commends an Emplaster made of Euphor∣bium, where he takes a great deal of pains, and is very exact and large in treating of Euphor∣bium in Wounds of the Nerves; the Composition of which is this: ℞ Wax ℥jss. Turpentine, Pitch, A. ʒvi. Euphorbium ʒ i. mix, and make a Cerat.

LXXXIV. Now you ought to consider whether the Euphorbium is new or old: if it is new, it is to be mixed with a triple quan∣tity of Wax: as ℞ Oil-olive ʒx, or ʒxii. Wax ʒiii. Euphorbium ʒi. mix, and make a Liniment.

LXXXV. But if it is old, (which is very hard and dry) it ought to be mixed in somewhat a greater proportion: as, ℞ Oil-Olive ʒ xii. Wax ʒiii. Euphor∣bium, à ʒi, ad ʒiii. (ac∣cording to its Age, which is much to be minded) mix, and make a Liniment.

LXXXVI. If at last, the Pun∣cture yields not to a Cure, by such Medicaments as have been proposed the Nerve or Tendon is to be di∣vided, to prevent worse accidents; as Convulsions, Spasms, Gan∣grens, &c. after which, the Cure is to be done as in other Wounds; this only requiring more care in the position, and keeping the Member steady, if it is in such a Joint, where there are Nerves and Tendons which move contrariwise.

LXXXVII. An Observation from Wiseman. A Tendon being prickt in letting Blood in the Sa∣phena, near the Ancle, it was drest with Oil of Turpentine hot; the Pain increased, and I was consulted, and saw the Chirurgeon ready to apply his hot Oils: but on sight of the Wound, the lips being turgid and dry, and the parts about it inflamed, I shewed him his error, and caused it to be dressed with Ʋng. Basilicon, warm; and to embrocate with Oil of Roses; and to apply over Diapalma, malaxed with some of the same Oil, and to forbear dressing it for some two or three days: during which time, it was cu∣red. The over-using hot Oils, has in some cases been very hurtful and mischievous to many.

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