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I. THEY are called in Greek, 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉. in Latin, Vul∣nera Hepatis & Lienis; and in English, Wounds of the Liver and Spleen.
II. The Kinds. Sometimes the Wound is superficiary, sometimes it penetrates deeply; sometimes the
gibbous part, sometimes the ca∣veous part is wounded. In some Wounds the substance of the Liver is only hurt; in others, the Vessels are also cut.
III. Sometimes the Wound is made with a sharp Weapon, and sometimes with a dull or blunt; by which it is rather contused, than cut: sometimes also a part of it is cut off.
IV. Signs. Whether it is a Wound or a Contusion, may be known by the external violence, and the kind of the Weapon, and the consequent Effects.
V. Wounds in the Liver are most commonly made on the right side; and if any of the larger Vessels are wounded, there is a great flux of Blood on the right side.
VI. The Hpochonders or sides draw towards the Back-bone; they often eject Blood, by Stool and Ʋrine: there is a pricking Pa•…•… up to the Neck and right Souther-blade, the Face is wan, and the Sick desires to lye on his Belly.
VII. Sometimes there is a Vo∣miting of Choler, and sometimes an Hemorrhage at the Nostrils; and a heaviness and pain is perceived in the region of the Liver, and parts adjacent. Celsus, lib. 5. cap. 26.
VIII. The Prognosticks. Hip∣pocrates, lib. 6. aph. 18. says, If the Bladder, or Brain, or Mid∣riff, or Small-gut, or Stomach, or Liver be wounded, it is mortal.
IX. Yet Paulus Aegineta, lib. 6. cap. 28. has delivered to us, That upon a Wound of the Liver, even where some part of it has been cut off, the Patient has recovered.
X. And Gemma Cosmocritic. lib. 1. cap. 6. tells us of a Spanish Youth, who being wounded thro' the right Flank, had lost a large part of his Liver, and yet was restored to his health. And Ber∣tinius, Medic. lib. 13. cap. 7. gives us another like History: others also have observed the same.
XI. From whence it follows, that where the Wound is only superficial, or the substance only wounded, without hurt of any of the great Vessels, as the trunks of the Vena Portae, and Vena Cava, the Patient is curable.
XII. But where the large Ves∣sels are wounded, the Sick cannot escape; because of the imme∣diate large effusion of Blood: for before the Vessel can be agglutinated, the Patient will dye.
XIII. A Contusion of the Liver is more dangerous than a Wound, and oftentimes degenerates into an Abscess or Apostem.
XIV. Th••se Wounds are also more dangerous in a Cachectick Habit of Body, and in Old Persons, than in such as are of a sound habit, strong, and juvenile. Sen∣nert. Med. Pract. lib. 3. part. 6. sect. 1. cap. 7.
XV. If the Patient, has cold Sweats upon his Forehead and Neck; if he often faints, if the Extremities grow cold, and great weakness attends, then Death is at hand.
XVI. The Cure. Immediate∣ly Astringents and Glutinatives are to be exhibited, such 〈◊〉〈◊〉 we
commonly give in Spitting Blood: Sennertus commends Red-roses dried, given ad ʒii. also Ba∣laustians, fine Bole, Trochsci de Spodio, de Rosis, Rhubarb in Decoction of Hounds-tongue, Cinkfoil, or Plantan.
XVII. But nothing exceeds Catechu, given in substance ad ʒss. or ʒi. or the Tincture there∣of made with common Brandy; given from ℥ss. ad ℥i. in some proper Vehicle.
XVIII. Some commend Pulvis Dysentericus Croll••i, given in a little Syrup of Roses, strength∣ning the Viscera with Spices, and Aromaticks, adding also such things as may provoke Urine, and loosen the Belly, if bound, with Emollient Clysters.
XIX. Where you suspect there is a Concretion of Blood, you must give such things as dissolve the Concretion: of which kind are Rhubarb, Rhapontick, Sperma Ceti, Lacca, Mumia, Sanguis draconis, Crabs-eyes, Amber, pou∣der of Earthworms, Hog-lice, Schoenanth, Spicknard, fine Bole, Terra sigillata, roots of Madder, of Tormentil, Chervil, and all Volatil Animal Salts and Spirits; which may be exhibited in Vinegar, or Chervil, or Tor∣mentil Waters, &c.
XX. ℞ Rhubarb ʒjss. Spick∣nard, Schoenanth, A. gr.xv. Mum∣my ʒss. make a pouder. Dose, ʒi. Or, ℞ Pine Bole ʒiii. Lacca, Sperma Ceti, A.ʒii. Roubarb ℈••i. Mummy ℈ss. make a pouder. Dose, ʒi. or ʒjss. in Vinegar, or Chervil-water.
XXI. ℞ Rhubarb, Rhapontick, A. ℈ii. Mummy, Sperma Ceti, Crabs-eyes, roots of Avens, of Tormentil, A. gr. xii. make a pouder, for two Doses. Or, Take Mummy ʒii. Rhubarb, Crabs-eyes, fine Bole, A.ʒ i. Saffron, Sperma Ceti, Sanguis Draconis, A. ʒss. make a pouder. Dose, ʒi.
XXII. Let his Diet be thin, and glutinating: let him abstain from Wine, and drink a Deco∣ction of Jujubes or Coriander∣seeds, sweetned with a little Sugar of Roses.
XXIII. Outwardly Astringents and Glutinatives are also to be applied: if the Wound gapes, or is open, you may sprinkle in this Pouder: ℞ Catechu, fine Bole, Terra sigillata, A. ʒi. pou∣der of Red-roses ʒss. Lapis Hae∣matitis ℈ i. white Starch ʒ ii. make a Pouder.
XXIV. You may also apply this Liniment. ℞ Syrup of Red-roses dried, Honey of Roses, A. ℥i. Pulvis Dysentericus, or Sperniolae Crollii ℥jss. fine Aloes, fine Bole, A. ℥i. Catechu ʒvi. Oil of Wax, q.s. mix, and make a Liniment.
XXV. Sennertus commends an Ointment made of Turpentine, fine Bole, and Mummy, or of Mastich and Frankincense; anointing also the parts adjacent with Oils of Mastich and Roses.
XXVI. And upon the Region of the Liver this Cataplasm may be applied. ℞ Fresh Violet-leaves, Endive, Succory, A. P.iii. Agrimony, tops of Dill, of Hypericon, A. P.ii. pouder of Camomil-flowers, of Me∣lilot, and Red-roses, A. P.i. Barley and Bean flower, A. ℥jss. Red. Wine q.s. make a Cataplasm, ad∣ding at the end, Oil of Roses ℥jss.
It is good to be applied also in a Contusion of the Liver.
XXVII. In which case also, this following Pouder may be given. ℞ White Amber, fine Bole, Dragons-blood, Lacca, Ba∣laustians, Red-roses, Crabs-eyes, A. ℥ ss. make a pouder. Dose, ʒi. in Plantan-water ℥ vi. in which Tragacanth ℈ss. has been dissolved.
XXVIII. The Kinds. Its Wounds are either superficiary, or profound: and it is only wounded, or a part of it may be cut off.
XXIX. The Signs. Celsus, lib. 5. cap. 26. says, That black Blood does issue out of the left side; and the side it self, and Stomach do become hard; the Patient is troubled with great Thirst, and the Pain reaches to the Neck.
XXX. The Prognosticks. Cel∣sus, in the place aforecited says, That deep Wounds of the Spleen are for the most part mortal, or that they are scarcely ever cured.
XXXI. The Reasons of which are, 1. Because of a dreadful Hemorrhage not only of Venal, but Arterial Blood. 2. Because it helps towards the perfecting the Sanguification. 3. Because it is very easy to be inflamed, being full of Blood. 4. Because it has a great consent with the Heart; for that a multitude of Arteries communicate with it.
XXXII. Tho' profound or deep ••ounds of the Spleen may be mortal, yet the whole Spleen may be cut out, and the Party live. And this I have been an Eye∣witness of in a Dog, in which, before the Spleen was cut off, it was drawn forth out of the Body, and the Sanguiferous Ves∣sels bound with good Ligature, to prevent the great Hemorrhage which would have ensued; then it was wholly cut away, and the apertion of the Abdo∣men stitcht up, and so left to Nature to heal; the Dog reco∣vered and did well, and lived four or five Years after it, but was very much dispirited; nor could we searcely ever provoke him to bark from that time forth.
XXXIII. But if the Superficies, or its substance, (not the Vessels) are wounded, it is not (says Sennertus) necessary that such a Wound should be mortal.
XXXIV. The Cure. It is not performed as in those of the Liver, in which (sometimes in desperate cases) Nature does Wonders: you may exhibit this Vulnerary Potion. ℞ Comfrey-roots ℥ss. Raisons ℥i. Speedwel M. i. Agri∣mony, Spleenwort, Hypericon, Red-Roses, A. M.ss. Self-heal, Winter∣green, A. P.i. Water q.s. make a Decoction, strain, and Aromatize with Cinamon ʒiii.
XXXV. And to prevent an afflux of Matter to the Spleen, an Emollient, or Lenitive Clyster may be given, to keep the Body open: if the Pus seems to be expelled by Urine, Medicines moving Urine (made of Fennel-roots, the Four greater Cold Seeds, red Cicers, and the like) are to be given.
XXXVI. But by what ways the Pus is carried to the Ʋreters, Authors are scarcely agreed on. Some will have it, that it is carried by the Ramus Splenicus to the Vena Portae, from thence to the Liver, and thro' the Li∣ver to the Vena Cava, and so at length to the Emulgent Ar∣teries.
XXXVII. But this, says Sen∣nertus, Med. Pract. lib. 3. part. 4. cap. 7. is too long a way, and by too many ambages; a shorter way (says he) is by the Coeliac Ar∣tery to the Trunk of the Aorta, or Arteria magna, and so from thence to the Emulgent Ar∣teries.
XXXVIII. Others say, that the Blood or Pus, which falls into the cavity of the Abdomen, is either discussed by the Natu∣ral Heat, or else comes forth by an Apostem in the Groin.