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 ...

CHAP. XXX. Of WOƲNDS of the EYES.

I. THey are 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 Latin, Vul∣nera Oculi, pl. Oculorum; in Eng∣lish, Wounds of the Eye, or Eyes.

II. In this Chapter we shall treat of Wounds of the Parts a∣bout the Eye, as well as of Wounds in the Eye it self; tho' the Eye-brow and Eye-lid are the pro∣per Appendices of the Face, and ought rather to have been treated of in the former Chap∣ter: But in respect to their Af∣finity to the Eye, and their Name, we rather chuse to treat of them here, where we shall discourse, 1. Of the Wounds of the Eye-brows. 2. Of Wounds of the Eye-lids. 3. Of Wounds of the Eye it self.

I. Wounds of the Eye-brows.

III. A Wound of the Eye-brow is called in Greek, 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉. and in Latin, Vulnus Supercilii.

IV. It is either a Contusion, a Burning, or an Incision. An Inci∣sion is either simple, or with loss of Substance: And if it is simple, it is either according to the Lon∣gitude or Ductus of the Fibres, or Transverse.

V. If it is only bruised, without breaking of the Skin, it contracts a livid, or black and blue Co∣lour, and then you must apply this. Take Whites of Eggs N^o iii. Wormwood-water ℥iss. fine Bole, or Terra Sigillata ʒi. mix and apply; or anoint the Brow with Ʋng. album Camphoratum.

VI. The livid colour is taken away with juice of Wormwood mix∣ed, with Honey, or juice of Sow∣bread, or Aloes mixt with Honey, or with a Cataplasm of Anise and Cumin-seed made by boiling in Water; or a Cataplasm of Meal and Faenugreek and Beans made with Honey: The Juice of the Root of Solomon's Seal is excellent in this case.

VII. If the Wound comes by burning, Take Vervain-water ℥iv. Quince-seeds ʒij. Faenugreek-seed ʒj. make a Mucitage, which ap∣ply; or you may use other things proper against Wounds.

VIII. If the Wound is caused by a simple Incision, according to the Ductus of the Fibres without loss of Substance, Agglutinatives, A∣stringents or Stypticks are chief∣ly to be used, which having Power to dry without sharpness, may hasten the Unition, and produce the Cicatrize.

IX. Some commend the use of Whites of Eggs, mixt with fine Bole, softned in Rose-water, ap∣plied upon Pledgets of Tow or Linnen Cloth, more especially if a little Saffron and Alom be added thereto.

X. Afterwards Oil of Hypericon, or some proper Ointment, may be used: Also Diapalma, or Emp. album. to say over the Wound, Sennertus commends Lac Virgi∣nis, or an Ointment made of Saccharum Saturni, or this Em∣plaster. Take Wax, Oil of Meli∣lot A℥j. Cummin-seed ℥ss. Cam∣phir ʒi. mix, and make an Em∣plaster.

XI. If the Wound is transverse without loss of substance, you must bring the Lips exactly together, so as to answer one another; for o∣therwise the Patient will not be able to lift up the Eye-lid, with∣out the help of his Finger, but the Eye will still remain shut.

XI. In this case you must take deep stitches, and as many as you shall see needful: The Lips be∣ing thus joined, you must apply Aglutinatives to reunite the parts.

XIII. If the Wound is with loss of substance, then you must not make too much haste in healing, lest the Scar becomes so hard, as to cause the Muscles to draw up too much the Eye-lid, whereby the whole Eye will not be covered: Here such Sarcoticks as are soft in Substance or Consistence are to be used, the Natural Balsams, Artificial Balsams, Linimentum Arcaei, &c.

XIV. If the Scar becomes so hard, that the Eye-lid cannot be wholly brought down to cover the Eye, then you must divide the Cicatrix or Scar by a Half-moon like Incision, according to the

Orbicular Ductus of the Fibres of the Muscle of the Eye, which draws down the Palpebra, or Eye-lid.

XV. This semicircular Incision you need not fear to make, for that this Muscle lies within the Orbit of the Eye, near to the Muscles which move the Eye, and so it cannot be hurt by such an Incision: Now the Incision must not reach to the internal Tunicle of the Eye-lid, but only to the divi∣ding of the Scar and the round Muscle, for so the Motion will not be taken away by such an Incision.

II. Wounds of the Eye-lids.

XVI. These Wounds are called in Greek 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, pl. 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉. and in Latin, Vulnera Palpebrae, pl. Palpebra∣rum.

XVII. Each Eye-lid has two Muscles which shut them, of a semicircular Figure; the one seated in the upper Eye-lid, which draws it down, and is the greater; the other in the lower Eye-lid, and pulls it only upwards, and is the lesser.

XVIII. And the upper Eye-lid is opened, or drawn up by a Muscle which arises from the upper part of the Frons, near to the temporal Muscle, where the hairy Scalp ends, and goes directly down, and is inserted into the Eye-brow: Now if this Muscle is transversely cut asunder, the Eye-lid cannot well be opened or pulled up, unless it be well agglutinated or united again.

XIX. The Wounds of this part then are either straight or trans∣verse: The straight reach from one corner of the Eye to the o∣ther; for this is the Ductus of the Fibres of the semicircular Muscles of the Eye. Transverse, are only those Wounds which reach directly down from the Supercilium or Eye-brow, to∣wards the Ball or Cavity of the Eye.

XX. Again, these Wounds ei∣ther divide the outer Skin and Muscles only, or they also divide the internal Membrane of the Eye-lid also, which does imme∣diately touch and cover the Eye.

XXI. If the external Skin and semicircular Muscle are only divi∣ded, you may stitch them together, but with a very small Needle and Thred well waxed; then you must apply Agglutinatives and Sarcoticks, as those things described at Sect. 9, and 10. a∣foregoing.

XXII. Or this. ℞ Fine Bole, Terra Sigillata A.ʒii. Sarcocolla, Sanguis Draconis A. ʒi. mix, and make a fine Pouder, which apply on a soft Linnen Cloth dipt in the White of an Egg: And above this apply Bolsters dipt in a Tincture of Catechu, made in e∣qual parts of Red Wine, and red Rose-water; which done, let the Eye be rouled or bound up.

XXIII. If there is need of im∣brocating the adjacent parts with Oil of Roses, or some other Oil, take heed that none of it goes into the Eye, because they are apt to do hurt, and cause an Inflammation.

XXIV. If also the internal Membrane of the Eye-lid is di∣vided, you must not stitch with Needle and Thred, because the Thred touching the Body of the Eye would offend it, and be apt to induce an Inflammation: In this case the dry Suture is most convenient, after which you are to heal it as other like Wounds, taking heed that the two Lids grow not together.

III. Wounds of the Eye it self.

XXV. A Wound of the Eye is called in Greek 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉. and in Latin, Vulnus Oculi.

XXVI. The Prognosticks. It is of difficult Cure, 1. Because of the exquisite sense of the part. 2. Because of a Flux of Humours to which it is apt to be obnoxi∣ous. 3. Because of the Excellency and curious Frame of the Part. 4. Because of the continual Moti∣on of the Arteries. 5. Because of its consent with the Brain, as it has respect to the Optick Nerve, or the Motory, or the Muscles of the Eye, which have many Twigs of Nerves, or Capillaries, from the first, second, third and eighth Pairs.

XXVII. The Differences. Wounds of the Eye are either su∣perficial or deep: Superficial are such as pass not through the Cornea: The Deep are such as pass through the Cornea to other more inward parts of the Eye.

XXVIII. The Cure. First, You must forbear all Oils, fat and unctious things, because they in∣flame the Eye, and cause Pain.

XXIX. Secondly, When one Eye only is wounded, you must bind up both Eyes: 1. That Darkness may be procured every way, be∣cause Light offends all sore Eyes. 2. That the sound Fye may be kept from Motion. 3. That the Cure may be facilitated; for when one Eye moves, the other of necessity moves also; and so the wounded Eye being moved at the motion of the sound un∣covered Eye, the Cure is also hindered, and an Inflammation induced.

XXX. Thirdly, The Head ought to lie somewhat high, but not so as to bend forwards, for fear of a Flux of Humours.

XXXI. The Cure of a superfi∣cial VVound. You must apply things to ease the Pain, abate the Flux of Humours, and prevent Inflam∣mation, of which kind are Whites of Eggs, Frog Spawn-water, rotten Apples and Pears, Plan∣tan, Purslane, and Nightshade Juices and Waters; Well, Rain, and Snow-waters, Mucilages of Flea-wort and Quince-seed, and of Gum Tragacanth, Emulsions or Decoctions of Poppey and Henbane-seed, Decoction of Cy∣press-nuts, of Galls, Pomegra∣nate-Peels and Balaustians, Wine of Pomegranates, Womans Milk, and Milk of all kinds; also the Blood of Pigeons, Turtle-doves, and Chickens or Pullets, drawn from the Veins under the Wings.

XXXII. These may be singly applied; or you may make Compo∣sitions of them, as you see need re∣quire, which you may apply above the Eye-lid, the Eye being shut, un∣less much Pus abound, or a Sanies

runs from the Eye; for then it will be necessary to wash the Eye with red Rose-water, Rain, or Plantane-water, or Juice of Fu∣mitory, or some of those Wa∣ters in which a little Alom or white Vitriol has been dissolved, or Rose-water mixed with Ho∣ney of Roses.

XXXIII. Then apply Bolsters made of fine soft Rags dipt in Rose-water, in which Sief Album has been dissolved: And if the Pain be great, let it be that with O∣pium; applying also to the Fore∣head, Temples and Cheeks, some Anodyn and astringent Cata∣plasm, as, ℞ rotten Apples, or Pulp of roasted Apples, Pulp of Cassia A. ℥ii, Mucilage of Flea∣wort-seeds ℥ss. fine Bole, Catechu, Dragon's Blood, A. ℥ss. Barley flower q.s. mix, and make a Pla∣ster.

XXXIV. If both the Eye-lid and the Tunica Conjunctiva are wounded, you must have a care that they grow not together; which will happen, if not prevented; which you may do by keeping them asunder with Leaf-Gold, or Leaf-Silver, or Tinfoil.

XXXV. The Cure of a deep VVound. The VVeapon either pas∣ses through, about the ends of the Bones of the Orbita, through which the Nerves pass into the Brain; or, it passes not so deep. In the first case, if the Weapon passes into the Brain, then the Wound is mortal; but the Patient ought to be dress'd, because the Artist can never see the inward state of the Wound, and so sometimes by accident may save Life.

XXXVI. If the VVound passes not so deep, then the Humour A∣quosus only issues forth, or the Crystalline and Vitreous also.

XXXVII. If the Aqueous comes out only, then it issues forth either wholly or in part: If it whol∣ly comes out, the Sight will be to∣tally lost. But if a small quan∣tity only comes out, the Preju∣dice may be retrieved, more e∣specially in Children, whose Moisture will supply the lost Humour; and this Hurt is cured as a superficial Wound.

XXXVIII. If the Crystalline and Vitreous Humours come forth, the Sight must also of necessity be lost. Here if there is a Flux of Blood, you may stop it with what we have formerly directed, or with this. ℞ Trochisci albi Rhasis, Tutia prepared, fine Aloes, A. ℈j. Mucilages of Fleawort-seed and Tragacanth, A.ʒii. Red VVine ℥ii. Rose and Plantane-water ℥iv. mix, and make a Collyrium.

XXXIX. If the Pain is great, use Anodyns, or inject VVoman's Breast-milk warm, or Pigeons Blood, Or this, ℞ Breast-milk ℥iv. Honey ℥j. VVhices of Eggs N^o 1. Or add to the Composition in the former Section Opium ℈j. and outwardly apply this Cataplasm, ℞ Rotten Apples ℥ii. Meal of Lin∣seed ℥ss. Mucilage of Fleawort-seed ʒii. Opium ʒss. Yolks of Eggs q.s. mix, and apply it.

XL. Sennertus Med. Pract. lib. 1. part. 3. sect. 7. cap. 20. ad∣vises to purge Choler, and to use such things as alter the bili∣ous Humour, and cool the Head. Cùm bilis (dixit ille) aliorum humorum sit ad caput vehiculum.

XLI. Outwardly to the Eye, he applies Repellers, made of whites of Eggs beaten with Rose-water, to which a little fine Bole may be added. Or this: ℞ VVhites of Eggs N^o ii. Rose and Tormentil VVater, A. ℥i. beat them together, adding Alum, Saf∣fron, A. ℈i.

XLII. Sarcotick Pouders, made very subtil, are commended, as Tutia and Calaminaris prepared, fine Bole, Terra Sigillata, Sanguis Draconis, Sarcocolla, Gum San∣darachi, Aes ustum.

XLIII. Sennertus advises to this: ℞ Ceruse, white Starch, A.ʒii. Frankincense ʒjss. Sarco∣colla, Tragacanth, A.ʒi. Camphir ʒss. infuse in Rose-water in a Vessel close stopt: boil in Balneo, and strain, keeping the Water for use.

XLIV. Or, Take Gum Arabick dissolved in Rose-water ʒiii. juice of Comfrey-roots ℥jss. fine pouder of Frankincense, and of Aloes-rosata, A. ℈i. mix them.

XLV. Or, Take Sief album Rhasis sine Opio ʒjss. whites of Eggs ʒii. Tutia prepared ʒss. Rose-water ℥jss. mix all in a Leaden Mortar, by much grinding.

XLVI. After seven days are past, things drying are to be ap∣plied; and such also as have a detersive quality, and withal generate Flesh: as, Take Myrrh, Sarcocol, Breast-milk, A. ℥ ss. Tutia prepared ʒi. Honey of Roses q.s. mix, and make a Liniment.

XLVII. This is wonderfully commended: ℞ Fine Bole ℥i. Tutia, Dragons-blood, Gum Arabick, A. ℥ss. Rose-water lbi. boil in B.M. in a Glass close stopt for an Hour; then add juice of Pomgranates ℥i. strain, and keep it for use.

XLVIII. Or, Take Honey ℥ii. juice of red Roses ℥iv. fine Ver∣digrise ʒi. Amber in fine pouder ʒss. digest in B.M. and strain: of this Liquor you may drop gut. ii. or more, often into the Eye.

XLIX. Oleum Rubrum Sa∣turni is also much commended; so also the Water which is found in the Bladders of the Elm-tree-leaves in the Month of May; which does wonders in curing Wounds of the Eyes, even where the Humor Aqueus, and part of the Vitreus were let forth; as Henricus ab Heer, Obs. Rarior. has experimentally te∣stified.

L. Lastly, Epuloticks are to be applied, to compleat the Cicatrice: and then when the Eye is healed, you may cause an Artifi∣cial Glass-Eye to be made, which may be put in the place of the Natural, to avoid (as much as may be) deformity.