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. Of Wounds of the Head.

LXXVIII. They are called in Greek, 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉. in Latin, Vulnera Capitis; and in English, Wounds of the Head.

LXXIX. The Kinds. They are of three Kinds: 1. Such wherein the Scull is not made bare. 2. Where the Scull is made bare, but not hurt. 3. Where the Scull is also hurt, but not fractured.

LXXX. The Signs. When the Scull is not made bare, you may know it by seeling with the Finger, if the Wound is large enough: and partly by the Probe, if with it you feel no hard substance; and if the Probe slip and slide, meeting with the Pericranium.

LXXXI. The Cure, where the Cranium is not made bare. These Wounds being made by Incision, dividing the Scalp to the Cra∣nium; yea if it cut the Scull, if there be no Symptoms of an internal Hurt, the lips of the Wound are to be brought close together, and healed by Agglu∣tination.

LXXXII. Some object against stitching these Wounds, lest the Matter thereby be pent in, and so foul the Bone. To this it is an∣swered, if no evil Symptoms be present, so that the Wound ought to be speedily healed; it may be safely done, (and it is easily done) both abroad in forein Parts, and with us here at home.

LXXXIII. But these kinds of Wounds are not to be crowded with Dossels; for thereby you may induce a Fever, and prolong the Cure.

LXXXIV. The Hair therefore being clipt or shaved off, you may stop the flux of Blood with Pulvis Galeni, or some other good Sty∣ptick; and lay over Emplast. è Bolo, or some other Defensative, with Compress and Bandage, bringing the lips close together.

LXXXV. The day following exhibit a Clyster, and at next Dressing embrocate the Parts about with Oils of Roses and Myrtles mixed with Vinegar, and dress up the Wound with Linimentum Arcaei, upon Pled∣gets, and it will quickly be well.

LXXXVI. But if the lips of the Wound were not brought close together at the first Dressing, then Digestives must be applied, such as these of Sennertus. ℞ Tur∣pentine ʒvi. Oil of Hypericon ʒiij. Frankincense in pouder ʒi. yolk of one Egg, mix them. Or this: ℞ Rosin ʒvi. yolk of one Egg, mix them. Or: ℞ Pure Tur∣pentine, Gum Elemi, A. ℥ j ss. Suet ℥ii. Lard ℥i. melt, and mix them.

LXXXVII. G•…•…d Pus appearing the third or fourth day, you may add to the Digestive Honey of Roses, for the deterging of the Wound; or simple clarified

Honey, or increase the propor∣tion of the Rosin and Frankin∣cense: or you may use this following Ointment. ℞ Venice-Turpentine ℥ii. Syrup of Roses, or Mel Rosarum ℥i. Aloes, Mastich, Myrrh, A. ʒss. mix them: after which, the Cure must be com∣pleated with Sarcoticks and Epuloticks.

LXXXVIII. Where the Scull is made bare, but not hurt, the Wound is to be cured two several ways; viz. either by Agglutination, or Incarnation; that is, by the first, or second Intention.

LXXXIX. If by Agglutination, first stitch the Wound, (if so large as to need stitching) then apply ••uivis Galeni, and Pledgets dipt in the white of an Egg: the next day dress it with Linimentum Arcaei, or some other Balsam; using neither Tents nor Pled∣gets, because they hinder Conso∣lidation. See Arcaeus, lib. 1. cap. 1.

XC. If the Wound yields much Pus, dress it twice a day, until the Quittor abates; and continue this manner of Dressing 'till the Wound is agglutinated; which is sometimes on the fourth, and sometimes on the sixth day.

XCI. If you cure by Incarna∣tion, or the Second Intention, which is chiefly where there is withal a less of Substance; 1. Sprinkle the Bone with some Cephalick Pouder, or that at Sect. 70. afore∣going: then apply dry Pled∣gets; and apply to the fleshy Parts some of the former Di∣gestives at Sect. 86. above; after which, fill up the Wound with Flesh by application of Sarcoticks, as Ʋng. Aureum, Basi∣licon, or Linimentum Arcaei.

XCII. Where the Scull is hurt, but not fractured. The Scull is hurt, when being made bare, it is dried, by being exposed to the open Air for two or three Hours; or if the upper Table is separated from the lower; or if both Tables of the Scull are cut through.

XCIII. In the first of these Cases, (which you may know by its not bleeding, being rasped with a Raspatory) the upper su∣perficies is to be removed by the Raspatory, that Blood may be made to come from the sound Bone; then the Wound is to be stitched, and the Cure is to be performed by Agglutination.

XCIV. If only a part of the Cranium separates it self from the rest, and sticks to the Cutis musculosa, it is to be taken away; and the Wound is to be cured either by Agglutination, or Con∣carnation, as the case may require.

XCV. If a part of the whole Cranium is broken from the rest, so that the Dura Mater may be seen, you must cure it as we shall direct in Lib. 6. of Fractures, following: yet this we shall say at present, that this part of the Scull sticking to the Cutis muscu∣losa, is not to be separated there-from, lest the Brain be deprived of its Cover: but it must be reduced into its place, and there kept, by bringing the lips of the Cutis musculosa to∣gether, with so may deep and strong Stitches as shall be necessary, and then to be

cured as other Wounds of the Hairy-scalp.