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 ...

II. Wounds of the Jugular Veins, and Soporal Arteries.

III. The Signs. The Artery is known to be wounded, 1. Be∣cause the Blood comes forth leaping. 2. It is thinner than the Venal. 3. It is of a bright red colour. 4. It is very hot, or much hotter than the Venal.

IV. The Vein is known to be wounded, 1. Because the Blood comes forth softly and smoothly. 2. It is of a thicker consistence: because, 3. It is cooler than the Arterial Blood. 4. It is of a blacker, or duller colour.

V. The Prognosticks. A Wound of the Artery is more dangerous than a Wound of the Vein: 1. Be∣cause the Blood of the Artery is thinner, and so more apt to flow, and also fuller of Spirits. 2. Because the Tunicles of the Artery are hard, and the Vessel is in continual motion.

VI. Hippocrates, Pror. lib. 2. says, those Wounds are mortal, where the thick, large, and great Veins of the Neck and Groin are wounded.

VII. Celsus, lib. 5. cap. 26. says, Periculosa sunt Vulnera, ubieunque Venae majores sunt: those Wounds are dangerous,

where-ever great Veins are.

VIII. Forestus, Observ. Chirurg. lib. 6. cap. 4. says, that if the Jugular Veins have a great Wound made in them, they hardly, and very seldom are cured, because of the great loss of Vital Spirits, and large effu∣sion of Blood; and because these Wounds will not admit of such sufficient Bandage, as is necessary for stopping the Blood.

IX. Fabricius Hildanus, Cent. 4. Obs. 2. proves this thing by an Example. When an Emperick cut out a Struma in the Neck of a Maid, which had inclosed the Jugular Vein and Recurrent Nerve, so great a flux of Blood followed, that the Maid died in the Operation.

X. From what has been said, it is manifest, that if the internal Jugular Veins and Soporal Ar∣teries are deeply and largely wounded, the Patient can scarcely escape Death. And the Reasons are, 1. Because the vehemency of the Flux is such, that the Patient for the most part dyes before the Chirurgeon can come at him. 2. Because no strait Ligature can be there applied, for so the Patient might also be strangled.

XI. The Cure. There are two chief Intentions of Cure. 1. To stop the Hemorrhage. 2. To agglutinate the Wound.

XII. The stoppage of the He∣morrhage is performed either by by deligation, or by application of Medicaments.

XIII. If by deligation, you must first lift up the Vessel which bleeds from the subjacent and and adjacent parts with a small Hook, made of Silver or Steel, then you are to bind them above and under the Wound strongly, and afterwards cut them asunder between the deli∣gations.

XIV. The Medicaments are either Astringent and Styptick, or Escarotick.

XV. An Astringent may be made after this manner. Take Mummy in fine pouder, Mans∣blood dried, pouder of Toads-flesh, A. ℥i. fine Aloes, Alum, Catechu, Dragons-blood, fine Bole, Ʋmber, A. ℥ss. Terra sigillata, fine pouder of Puff-balls, Mastich, Olibanum, Salt of Vitriol, A.ʒii. make all into a subtil pouder, and mix them.

XVI. A Styptick. Take Caput mortuum of Vitriol ℥ iii. Dr. Gardner's Styptick-salt ℥i. mix them, and apply it.

XVII. An Escarotick. Take fine Bole ℥ii. Vitriol calcin'd ℥i. burnt Alum ℥ss. red Precipitate ʒii. Calx vive ʒi. make each into a fine pouder, and mix them. Or this: Take of the Pouder at Sect. 15. ℥ii. Calx vive, Vitriol calcin'd, A. ℥i. Auripigmentum, burnt Alum, A. ℥ss. make all into a fine pouder, and mix them.

XVIII. Any of the aforegoing Pouders are to be mixed with the whites of Eggs, to the consistence of Honey, then the down of a Hare is to be added; which being made into Dossels, the Wound is to be filled with them: and above the Dossels, large Pled∣gets are to be applied, and about the Wound, armed in like manner with the same.

XIX. But because strait Li∣gature cannot be used about the Neck, for fear of strangling, you ought to have several Servants in a readinss; that with their hands they may hold the Medi∣caments on by turns, till the Hemorrhage is stopt: after which, they are to lye upon the Wound for three days.

XX. Then you may remove them, but when you do that, and are come to the lowermost Dossels in the Wound; if they stick, you are not to remove them, lest a fresh Flux is caused: the others are only to be taken off, and the Wound is to be filled up with some Astringent Pouder, or Sarcotick.

XXI. If you use the Actual Cautery, (which is very cruel) it must be applied red-hot; for then it speedily makes the Escar, and that the thicker.

XXII. This done, you must do all that may be to Incarnate, lest the Escar should fall off, before the Flesh is generated; and so, the Wound become worse and more dangerous, by a new Hemorrhage.

XXIII. When you come to Incar∣nation, about an Artery, you must use Sarcotick Pouders, which dry very strongly.

XXIV. Let the Diet be cooling, vulnerary, and drying: and at Bed-time, this following may be given, to cause pleasant rest. ℞ Poppy-water ℥iii. Syrup of white Poppies ʒ vi. Diascordium ʒi. Laudanum liquidum gut. 8. mix for a Dose. Or, ℞ Barley∣watèr ℥iv. of Our Guttae Vitae, à ʒss. ad ʒi. white Sugarcandy q.s. mix.

XXV. The Hemorrhage being sufficiently stopt, you must consum∣mate the Cure with Agglutinatives and Epuloticks; of which you may find great variety in Cap. 3. aforegoing of this Book.