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 ...

ARS CHIRƲRGICA. Liber Quartus. OF WOUNDS.

The ARGUMENT.

I. Of Wounds in General. II. Of External Vulne∣raries. III. Of Internal Vulneraries. IV. Of an Hemorrhage in Wounds. V. Of Extraneous things in Wounds. VI. Of Stitching Wounds. VII. Of Binding up Wounds. VIII. Of Accidents in Wounds; as Pain, Indigestion, Fainting, Convulsions, Palsy. IX. Of a Flux of Humors. X. Of Hypersarcosis, or Proud Flesh XI. Of Wounds of Arteries and Veins. XII. Of the Nerves and Tendons; by Bruising, Pricking, Cutting. XIII. Of the Ligaments. XIV. Of the Limbs. XV. Of the Joints. XVI. Wounds with Contusion. XVII. Wounds by Biting of Poisonous Creatures; as Mad-dogs, Vipers, &c. XVIII. Wounds made with Poisonous Weapons. XIX. Wounds by Gun-shot in General. XX. Acci∣dents in Gun-shot Wounds. XXI. Gun-shot Wounds in the Thorax. XXII. Gun-shot Wounds in the Belly. XXIII. Gun-shot Wounds in the Limbs or Joints. XXIV. Burnings and Scaldings. XXV. Wounds of the Head without the Scull.

XXVI. Wounds of the Temporal Muscles. XXVII. Of the Meninges of the Brain. XXVIII. Of the Brain. XXIX. Of the Face. XXX. Of the Eyes. XXXI. Of the Ears. XXXII. Of the Nose. XXXIII. Of the Mouth and Tongue. XXXIV. Of the Neck. XXXV. Of the Wind-Pipe and Gullet. XXXVI. Of the Vessels of the Thorax. XXXVII. Of the Breast and Heart. XXXVIII. Of the Back, and Spinal Marrow. XXXIX. Of the Lungs. XL. Of the Liver and Spleen. XLI. Of the Stomach. XLII. Of the Belly. XLIII. Of the Guts. XLIV. Of the Reins. XLV. Of the Bladder. XLVI. Of the Womb. XLVII. Of the Yard. XLVIII. Of the Fingers and Toes.

CHAP. I. Of WOƲNDS in General.

I. THEY are called in Greek, 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, plu. 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉. in Latin, Vulnus, plu. Vulnera; and in English, a Wound, Wounds.

II. The Definition. A Wound is the Solution of Continuity or Ʋnity; new, bloody, and without putrifaction, made by external force: and this, as Joel saith, may be by erosion, incision, cutting off, puncture, biting, impulsion, contusion, fraction, rupture, distention, contusion, collision, and the opening of a closed Orifice.

III. Differences. 1. The first Difference arises from the place wounded; and so a Wound is said to be External, happening to any external part of the Body: or Internal, happening, and penetra∣ting into the Viscera; as the Brain, Stomach, Lungs, Heart, Liver, Spleen, Guts, Reins, Blad∣der, Womb, and the like.

IV. 2. The second Difference arises from the accidents of a Wound, and so it is said to be simple or complex: a Simple Wound is that to which no other Disease, or Symptom is

joined, and without contusion or loss of Substance. A Com∣plex Wound, is that which is compounded with some other Disease; as fracture, disloca∣tion, &c. or some other Sym∣ptoms, as contusion, loss of substance, intemperature, ill conformation of the Part wounded, rotting, inflamma∣tion, flux of Humors, proud Flesh, &c.

V. 3. The third Difference arises from the Effect, or Event; according to which a Wound is said to be, 1. Safe, and of easy cure; which happens to the Skin, and fleshy parts. 2. Ma∣lign, and of difficult cure; which happens to the Nerves, Liga∣ments, Bones, and several of the Bowels. 3. Mortal; which are such as happen to the Brain, Heart, Lungs, Liver, Diaphra∣gma, &c.

VI. 4. The fourth Difference arises from the manner of inflicting it, or the variety of the Weapon wounding: and so it is, 1. By Chopping or Cutting with a sharp-edg'd Tool. 2. By a Puncture, with a sharp-pointed Instrument. 3. By a Bullet shot out of a Gun. 4. By Biting, with the Teeth of Man or Beast. 5. By Stinging of Bees, Wasps, Hornets, &c. 6. By Falling from an High place, or from an Horse. 7. By Contusion with a blunt Instrument; wherein the Skin may be either broken, or not broken. 8. By Burning with Live-coals, or other things red-hot 9. Scaldings with Wa∣ter, Oil, Pitch, Tar, running Lead, &c. 10. By application of Caustick Medicaments.

VII. 5. The fifth Difference is taken from the Part wounded: and so one Wound is said to be of the Head, another of the Eyes, another of the Nose; others of the Arms, Back, Brest, Belly, Sides, Liver, Spleen, Womb, Bladder, Legs, Feet, Nerves, Ligaments, Joints.

VIII. 6. The sixth Difference is taken from the Site of the Wound: from whence it is said to be, 1. Right, according to the Lon∣gitude of the Part: or 2. Trans∣verse, according to the Latitude of the Part: or 3. Oblique, which is in a medium, between the other two.

IX. The Causes. And these are all sorts of External Instru∣ments, or other matters, which by accident or otherwise, are able to make a Solution of Continuity or Ʋnity: from whence, that made with a Sharp-edged In∣strument, is called a Cut; with a Pointed Instrument, a Stab; with a Club, by a Blow, a Contusion.

X. Signs. 1. A Wound of the Ar∣teries is known by the Blood coming forth; which is yellowish, hot, and thin; flowing forth violently, and with leaping.

XI. 2. A Wound of the Veins, chiefly of the greater, is known by its bleeding thick and red Blood; coming forth constantly and smoothly, without leaping.

XII. 3. If the great Arteries and Veins of the Thorax are hurt, there is an immoderate flux of Blood, want of Sense, cold Sweats, Swooning, and Death follows, often in a few Hours.

XIII. 4. If the Nerves are wounded, it is known, 1. From

the Place; Anatomy shewing in what Members the chief Nerves are inserted. 2. From the great Pain, causing Pulsation, Inflammation, Convulsion, and Frenzy: except the Nerve be cut in sunder, and then the Symptoms are not so vehement.

XIV. 5. If the Recurrent Nerves are wounded, there fol∣lows loss of Speech, Sense, and Motion, without recovery.

XV. 6. If the Tendons are wounded, the Signs and Sym∣ptoms are much the same, as when the Nerve is wounded; and are chiefly distinguished by the place.

XVI. 7. If the Ligaments, and Membranes covering the Bones, viz. the Periosteum and Peri∣cranium are wounded; the Signs are the same almost, as if the Nerves and Tendons were wounded, but the Symptoms are not full out so vehement.

XVII. 8. A Wound near the Joints, gives fear that a Tendon is hurt; because the Tendons terminate near the Joints.

XVIII. 9. A Poison'd Wound is known by vehement Pain, and a livid colour; becoming sud∣denly black, having Sym∣ptoms more violent than might be expected, from the quality of the Wound, as Burn∣ing over the whole Body, Faint-ing, Swooning, Trembling Frenzy, &c.

XIX. 10. The biting of a Mad-dog, is accompanied with anger, complaining, sadness, dis∣content, Vertigo, distention of the Members, foaming in the Fits, gnawing of the Stomach, abhor∣ring of Meat and Drink, fear∣fulness of Water.

XX. 11. Gun-shot Wounds are accompanied with Contu∣sion, Pain, Inflammation, Trem∣bling, Convulsion, and some∣times with Gangrene and Spha∣celus.

XXI. 12. If the Meninges of the Brain are wounded, there are most sharp Pains; especially upon the moving of the Jaws, with frequent vomiting, and sobbings, or sighings, and a profusion of Blood.

XXII. 13. If the substance of the Brain is wounded, Blood comes forth many times by the Nose and Ears; with vomiting Choler, voiding of Excrements, a ghastly Face, senselesness, and a Fever: and in a little time after, Convulsion, Delirium, or Raving, and Death.

XXIII. 14. If the Marrow of the Back-bone is wounded, there is a Convulsion, which takes away sense and motion, senseless evacuations of Excrements, Pu∣trifaction, and Death.

XXIV. 15. If the Gullet is wounded, there's difficult of breath∣ing and swallowing, with Hic∣cough, and a vomiting of Cho∣ler, Meat and Drink.

XXV. 16. If the Lungs are wounded, the Blood issuing forth is yellowish, and frothy; with a Cough, difficulty of breathing, and pain on the wounded side, yet lying thereon, is easiest.

XXVI. 17. If the Heart is wounded, there comes forth Blood thick and black, Pulse weak, Face pale, universal

Tremblings, cold Sweats, Swoon∣ing, and in short time, Death.

XXVII. 18. If the Brest is wounded, the Air comes out at the Wound; and the Patient finds the taste of things applied to the Wound, in his Mouth.

XXVIII. 19. If the Stomach is wounded, there follows Vo∣miting, Swooning, Fainting, Sickness at Heart, and Death.

XXIX. 20. If the Membra∣nous part of the Diaphragma is wounded, the Flank draws up, pain is in the middle of the Back, difficulty of breathing, coughing, acute Fever, raving, and death: but if it is hurt in the Fleshy part only, there is hope of life.

XXX. 21. If the Liver is wounded, there is vomiting, flux of Blood, pain, continual Fever, raving, Convulsions, cold Sweats, Swoonings, and at last, Death.

XXXI. 22. If the Spleen is hurt, the same Symptoms ap∣pear, but on the contrary side: yet we have seen the Spleen cut out of a living Dog, and the Dog to recover, and live many years after it.

XXXII. 23. If the Intestines or Guts are hurt, or wounded, the Excrements come thro' the Wound.

XXXIII. 24. If the Loins are wounded, they breathe with difficulty, void frothy Blood at the Mouth and Wound, and cave, having a high colour.

XXXIV. 25. If the Reins or Kidneys are wounded, there is a suppression of Urine, pain in the Groin and Testicles, pissing Blood, great Swelling, and danger of Death.

XXXV. 26. If the Bladder is wounded, the same Symptoms with the former appear, unless the Nervous part is hurt; then vomiting, voiding Urine at the Wound, loss of Sense, and lastly, Death it self ensues.

XXXVI. 27. If the Womb is wounded, there is great pain in the Hips and Thighs, and a flux of Blood, with loss of Speech, Reason, and Sense, and at last Death.

XXXVII. The Symptoms. The Symptoms follow, for the most part, according to the nature of the Parts wounded; which in the Cure of Wounds, are no less to be regarded than the Wound it self.

XXXVIII. And as we have in several other places taught, that almost no Disease, no Tumor preter∣natural, no Ʋlcer can be well cured; except first a regard be had to the Symptoms conjoin'd; either to diminish, or take them away. So also, the same thing is to be understood in the curing of Wounds.

XXXIX. The Symptoms in Wounds are manifold; but the most material are, 1. Hemor∣rhage. 2. Pain. 3. Inflamma∣tion. 4. An Erysipelas. 5. In∣digestion of serous Humors, which is made of good Blood, or Lympha converted thereinto; for want of good binding, or application of proper Medica∣ments. 6. A Fever. 7. Faint∣ing. 8. Convulsion and Deli∣rium. 9. Palsy. 10. Gangrene, or putrifaction of the Part.

XL. As to an Hemorrhage, it not only hinders the Cure, but also weakens the Body, and brings Death, if it is not suddenly stop∣ped; which in the greater Ves∣sels, especially the Arteries, is very hard to do: for which cause, those Wounds are for the most part mortal; since Medi∣cines which stop Blood are too weak, and hard ligature may endanger a Gangrene.

XLI. The Prognosticks. Be∣fore we go about the Cure of a Wound, we ought to judge whe∣ther it is curable, or incurable: and if Curable, whether the Cure will be easy or difficult, and will take up a shorter or longer time. And when Cure∣able, whether the Patient will have his perfect soundness re∣stored; or suffer by the hurt of the action of some other part.

XLII. For a Tendon being cut asunder, it oftentimes happens, that the Motive-faculty of some Part is wholly lost; the Menin∣ges being wounded, the Me∣mory or Rational-faculty is thereby hurt, &c.

XLIII. Again, whether it is absolutely mortal; or it be not more probable, that it will degenerate into some long-continuing Ulcer, which may induce a Marcor or Consum∣ption, and at length, Death.

XLIV. If therefore you would make true Prognosticks of Wounds, you must consider, 1. The Part affected, its dignity, substance temperature, situation, number, and use of the Part.

XLV. 2. The Adjuncts of the Wound; which are its magnitude, figure, situation, symptoms; and whether simple, or complicate with some other Disease, as French-pox, Dropsy, &c.

XLVI. 3. The Habit of the Body; whether it is good and healthful, or evil and cachectick, scorbutick, strumatick, hydro∣pick, plethorick, cacochymick, intemperate, gross, or consum∣ptive, &c.

XLVII. If therefore a Wound is made in a noble Part, which is continually in motion, and the fountain or original of some Fa∣culty, and that it is large or deep, and accompanied with evil Symptoms, in an evil habit of Body, it is generally mortal.

XLVIII. Whereas a Wound made in some ignoble Part, or remote from the principal Parts, in a place where the loss may be suffered, and the Wound it self not very big, nor having many ill Symptoms, nor in an evil or scorbutick habit of Body, is generally without danger.

XLIX. Wounds of the Heart do of all others most speedily bring on Death: because the Heart is a noble part, and the Store-house of Vital Spirits, and innate heat: which being extinguished, either by Suffocation, or Dissipation, Death immediately ensues: if the Wound penetrates into the Ventricles of the Heart, espe∣cially, to the left, the Patient of necessity dies quickly: but if the Wound terminates in the sub∣stance of the Heart, life may be continued for a while, but Death will be the end of the Work.

L. Wounds of the Brain are in

like manner deadly, if they pe∣netrate to the Basis: because it is a principal Part, the Fountain of the Animal-faculty, in continual motion, Inflammation and a sharp Fever ensuing. But if it is su∣perficial only, it is then said to be dangerous, because it is a principal Part; but with hopes of Recovery, because its soft substance admits of speedy con∣solidation.

LI. Wounds of the Lungs, with hurt some of the Vessels; as the Vena arteriosa, in that part of the Lungs next the Heart, are mortal: for that out of them a great quantity of Blood is poured forth unto the Heart, overwhelming it, and suffo∣cating the heat thereof: other Wounds of the Lungs are not mortal.

LII. Wounds in any of the greater Vessels, which cannot by any Art be closed up, are mortal; for that thro' pouring forth of great quantities of Blood (whe∣ther from Veins or Arteries) there will be of necessity a speedy suffocation of the woun∣ded person.

LIII. Wounds of the Eye, pene∣trating thro' it to the Brain, are mortal: for there is great in∣flammation, with vehement pains, fainting and swooning, and at length, strong Convul∣sions, and Death.

LIV. Wounds of the Aspera Arteria, where the Cartilaginous Rings are cut in sunder, are incu∣rable: for by reason of the hardness of their substance, they cannot be made to grow toge∣ther again; yet such Wounds do not cause a sudden Death, but a slow and lingring one: other Wounds of this Part are curable.

LV. Wounds of the Vena cava, within the Belly or Brest, are mortal: 1. By reason of the place, that cannot possibly be come at. 2. By reason of its substance; for being nervous, it hardly admits of consolidation.

LVI. Wounds of the Liver, tho' small, yet are dangerous, but they will admit of Consolidation: 1. Because the substance of the Liver is like coagulated Blood, and so may easily be united. 2. Because, if one part of it is wounded, other Parts will do their Office; as is seen in the Livers of such as are Scir∣rhous.

LVII. Wounds of the Diaphra∣gma in the Nervous parts are mortal; for a Delirium, by reason of the Inflammation, ensues always and sometimes Convulsions. But in the fleshy part of the Dia∣phragma, tho' we say not that they are mortal, yet they are dangerous: 1. Because they cannot be come at, to be drest. 2. Because it is in continual motion. 3. Because the parts within the Brest are easily inflamed.

LVIII. Wounds of the Spleen, if they be not great, or procure an Hemorrhage, are not mortal: for the Spleen is neither a principal part, nor the fountain or origination of any Faculty; but only a receptacle of black, melancholick, or fermentative Blood.

LIX. Wounds of the Stomach,

are not to be accounted amongst those which are simply mortal, which do suddenly destroy a Man; because we have had several Examples of Wounds in the Stomach, which have been cu∣red: but those Wounds which happen on its superior Orifice or Mouth, are especially mortal; because it has Nerves, which spring from those of the sixth Conjugation of the Brain; whereby it has a very near con∣sent with the Brain, and with the Heart also: so that it being wounded, vehement Symptoms, as Fainting, Swooning, Con∣vulsions, &c. presently arise.

LX. Wounds of the Gall-bladder are mortal, tho' not so presently as other mortal Wounds: but we cannot come to apply any thing to it; then it is of a Nervous substance, which does not easily admit Unition; and lastly, the Humor which it ought to con∣tain 'till Excretion, corrupts the parts amongst which it is spilt.

LXI. Wounds of the Reins, if they pass not to the cavity, bring not inevitable Death; but if they enter once into the cavities, are certainly mortal, yet at some little distance of time; there going before Vomitings, Sickness at Heart, Faintings, Swoonings, and Convulsions, often repeated.

LXII. Wounds of the Bladder are by Hippocrates accounted mortal. But here is a difference to be made: for a small Wound is soon healed by the interve∣ning of the Flesh, as experience does teach us. But if Hippo∣crates his Diacope happens, (which is, when the Bladder does happen to be cut quite thro') it is most perilous, and especially that which happens at the bottom of the Bladder, and the nervous part thereof; for by reason of the sharpness and vehemency of the pain, inflam∣mation follows, with a conti∣nent Fever, and Death soon after. But Wounds in the neck of the Bladder, which is fleshy, are curable; as we see even in cutting out the Stone.

LXIII. Wounds of the small Guts are for the most part mortal. 1. Because they are of a mem∣branous substance. 2. Because they are of an exquisite sense; more especially if they be cut transversly asunder. Wounds of the Jejunum, are more especially mortal; by reason of the great∣ness of the Vessels, and the almost nervous substance of the Tunicle of that Gut; from whence for the most part there follows vehement sharp Pains of the Bowels, Sobbing, Fainting, Swooning, and sometimes strong Convulsions, and Death.

LXIV. Wounds of the greater or thick Guts are less dangerous, and more easily cured, especially if they be not great; because their substance is more thick, and so admits more easily of agglutination; and being not so sensible as the small Guts are, Faintings, Swoonings, and other fearful Symptoms do not so usually invade.

LXV. Wounds of the Mesen∣tery, are inevitably mortal; be∣cause there must be a great flux of Blood, by reason of the great

number of Veins in it: because we cannot approach it to apply Topicks; and because it is an hinderance of the Chylous Juice passing on, to mix with the Blood; whereby San∣guification is hindered, without which the Body must certainly dye.

LXVI. Wounds of the great Joints, if they are so deep as to let out the Glarea or humid sub∣stance, which is found in the said Joints to moisten them, much like to the whites of Eggs, the Joint grows stiff, and so the motion is impaired.

LXVII. As for Wounds in the vest of the Parts, Hippocrates truly pronounces them not mortal: and Experience teaches us, that the greatest and most dangerous Wounds have sometimes been cured; (of which Valeriola, lib. 4. Obs. 10. gives us many Histories, also Guil. Fabric. Hildanus, in his Writings and Observations:) and that very many dye, even of the most slight and inconsiderable Wounds.

LXVIII. A Wound made with a Poisoned Weapon, or Biting of a Mad-dog, Viper, &c. tho' it may seem little in it self, and very slight, yet many times brings Death with it.

LXiX. The Habit of the Body is also to be considered: for robust and healthful Bodies bear the most grievous Wounds, and are often cured without much to do, and beyond all hope and expectation, (when you would think them ready to dye) recover again.

LXX. Whereas the like Wound, or a lesser, happening in a Caco∣chymick or Evil Habit of Body. Nature being thereby irritated and stirred up, is wont to pro∣trude those vitious Humors to the Wound, which (tho' in a strong and sound, or pure Body might be cureable, yet) in a Body of this Evil Habit, will here become mortal.

LXXI. Those Wounds also which are grievous, dangerous, yea and mortal in an Old Man or Child; are many times not mortal, yea slight and inconsiderable, when they happen in a strong Young Man, of a good Habit of Body.

LXXII. Wounds of the Brain, Nerves, and Joints being unskil∣fully, and negligently handled, may have an Inflammation, Convul∣sion, Gangrene, &c. befal them, and so the Patient may mis∣carry and perish: when not∣withstanding that, the Wound, had it been rightly managed, was in it self absolutely cure∣able.

LXXIII. A Wound may happen in a Part ignoble, but yet of very exquisite sense; from whence comes vehemency of Pain, which causes presently an Afflux of Humors; and that Afflux, an Inflammation; the Inflamma∣tion, a Fever, a Gangrene, and Death it self: and this happens the more easily, when a Part that is noble may be drawn into consent with it.

LXXIV. By how much more principal and noble the Part affected is; or which may like∣wise bring a more noble Part into consent with it, by so

much the more dangerous is the Wound.

LXXV. Great Wound are more dangerous than small ones, all things else being answerable.

LXXVI. A Wound joined with a Contusion, is the more dan∣gerous; and therefore it is of the two, better to be wounded with a sharp-edged, or sharp-pointed Weapon, than with a blunt or dull one.

LXXVII. Wounds which have past beyond the last and utmost term of Acute Diseases, viz. the fortieth Day, are not in them∣selves mortal: but if the Patient dies, it is either from an ill Habit of Body, or from Errors committed in Diet, or from want of Skill in the Physician: however, such wounds are not cured without much difficulty; for that they indicate some grievous cause to be present, which hinders conglutination of the Wound.

LXXVIII. If an Inflammation should supervene upon a great Wound, it is not to be wondred at, nor should it terrify us, if it con∣tinues not long: but an Inflam∣mation to follow upon a small Wound, and it continuing long, is very dangerous indeed, be∣cause it is wont to excite Convulsions, and Delirium or Doating.

LXXIX. A vomiting of Choler (not voluntary or accustomed to be done) so soon, or presently after a Man is wounded; or while an Inflammation is pre∣sent, is an evil sign; for it shews, that the Nervous parts are wounded.

LXXX. The greater the Wound is, the more time (all things else being answerable) is required for the curing thereof: and the less it is, the less time it requires: so that some Wounds may be cured in 24 hours time, when others may require as many days to be perfectly healed.

LXXXI. All Wounds compli∣cated with other Affects, are so much the more difficultly cured: for the more the Affects are, the more Nature is hurt; and it is easier for her to correct or take away one only Affect, than many: and the more the con∣joined Affect does hurt the tem∣perament of the Part, so much the more difficult will the Cure be.

LXXXII. Wounds that are in the Muscles, far from the Joints, and Temples, are more easily cured than those that are in the Nerves, Tendons, and Mem∣branous parts and Joints.

LXXXIII. Wounds of the Nerves and Nervous parts, are for the most part dangerous; for that by reason of Pain; Inflammations, Convulsions, and other vehe∣ment Symptoms do easily happen.

LXXXIV. Celsus, lib. 5. cap. 26. says, the Age, habit of Body, the order and course of Life, with the time of the Year are to be considered. For a Child, Youth, or young Men, are sooner cured than one that is Ancient or in years: one of a strong constitution, is easier and sooner cured than one of a weak and infirm Body: one not over-fat nor over-lean, sooner than one that is either

of them: one of an intire and sound habit, than one that has an unsound and corrupt habit: one given to exercise is sooner cured, than one that is slothful and sluggish: and a sober and temperate Man, than one that is given to Wine and Women.

LXXXV. Those Wounds are most safe and easy to be cured, which are made in a streight and direct Line: but those with more difficulty, that are oblique; and those with most difficulty, which are round, and orbicular.

LXXXVI. That Wound is al∣ways evil, in which there is some∣thing cut off, or taken away; and by which the Flesh that is cut off from one Part, hangs upon some other.

LXXXVII. Celsus, l. 5. c. 26. says, the Inflammation will shew it self on the fifth day, how great it is like to be; on which day the Wound is to be uncovered, and the colour thereof to be well considered: if it is pale and wan, leaden coloured, of various colours, or black, it is certain that the Wound is evil and dangerous: but this, when∣ever we well consider it, is not much to terrify and af∣fright us.

LXXXVIII. A Wound in Arm, Hand, Thigh, Leg, or other Part; being so great, that by reason of the Arteries and Veins cut asun∣der, it cannot possibly receive any farther influx of Blood; the ex∣tream part then dyes; and therefore lest a Gangrene should happen to the sound part, the other is with all speed that may be, to be cut off.

LXXXIX. That Wound which is not purged and cleansed, but with much difficulty, is hard to cure, and slow in curing: because that which is an hinderance of the Cure, cannot be removed with∣out much difficulty.

XC. All things extraneous, or coming from without, sticking fast in the Wound; if they cannot at the very first be drawn or taken forth, they will much retard the Cure.

XCI. All the Wounds of the internal parts are much more dangerous, than are the Wounds of the external parts.

XCII. Wounds are more easily cured in the the Spring time, than in the cold of Winter, or heat of Summer.

XCIII. If a Nerve, Artery or Vein be wholly cut, or cut thro', there is less danger impending, than if but cut only in part: pro∣vided always, that they are none of the more principal or notable Nerves, Arteries or Veins, and situate in the deeper parts of the Body.

XCIV. For if a Nerve is wholly cut asunder, there is then no danger of a Convulsion; which we may always fear, if the Nerve is cut but only in part.

XCV. And so if a principal Artery or Vein be wholly cut, the danger of an Hemorrhage is wholly taken away, upon the contraction or drawing together of the Vessel: but if an Artery or Vein be only wounded, and not cut asunder, very dangerous He∣morrhagies do then often arise.

XCVI. But if it is one of the larger, or most notable of the Arteries or Veins, which is cut asunder; this then often befals the Part, that it is deprived of much of its usual native heat, and somtimes also is the cause of an Atrophy of the Part.

XCVII. Celsus, lib. 5. cap. 26. says, For a Wound over-much to swell up, is something dangerous; but not at all to swell up, is much more dangerous, yea the most perilous of all: the former being only the evidence of a great Inflammation, the latter a sign of a mortified or dead Body.

XCVIII. Hippocrates, Sect. 5. Aph. 65. Such, as together with their Ʋlcers are troubled with manifest Tumors, are not subject to any dangerous Convulsion, or Madness.

XCIX. But those in whom those Tumors presently vanish and disappear, if this happens on the hinder-part, then Convulsions and Cramps follow: but if on the fore-part, then comes Madness, sharp Pain of the Side, an Empyema and Dysentery, espe∣cially if the Tumor is redder than ordinary. Ibid.

C. Hippocrates, Sect. 5. Aph. 2. says, That a Convulsion in a Wound is very pernicious.

CI. Wounds happening unto Cachectical and Hydropical per∣sons, are cured with very much difficulty.

CII. A Wound in such a Part as is apt and ready to receive an Influx of Humors, is cured also with very much trouble.

CIII. Wounds being considered simply as Wounds, can have nothing to do with Critical Days; but as they may happen in conjunction with acute Diseases, so Critical Days may have some respect to them: for that Nature her self up∣on some certain and fixed Days, both concocts that which ought to be concocted, and allays the disturbance of the Humors.

CIV. Touching which, Hippo∣crates in Coacis, saith, That in Wounds of the Head, if a Fever begins on the fourth, or seventh, or eleventh days, it is very fatal or dangerous: but it is for the most part to be Judged of, if it begins on the fourth day of the Wound, and continues unto the eleventh: or if it begins on the seventh day, and con∣tinues unto the fourteenth or seventeenth: or if it begins on the eleventh, and continues unto the twentieth.

CV. And in his Book of Wounds of the Head, he saith, That when any Errour is committed in the Cure of a Wound; then for the most part, if it is in Winter time, a Fever comes upon it before the fourteenth day; but if it is in Sum∣mer, after the seventh day: and there he also asserts, That in Summer-time, some perish before the seventh day; and in Winter, before the fourteenth.

CVI. And therefore when-ever on the Critical Days, there is no change or alteration for the worse, but that all things proceed in a right manner, and that the Symptoms which before were present, are now quieted and allayed, it then presages great hopes of a happy Cure.

CVII. But if on the contrary,

in those days there happens any evil, as Pain, Inflammation, Con∣vulsion, or Fever; or if those Symptoms which were before pre∣sent are not lessened, but are rather become more intense, and greater than before, it then pre∣sages either Death, or a very difficult, long, and tedious Cure. See the third Edition of Our Synopsis Medicinae, lib. 1. cap. 50. sect. 1. ad 27.

CVIII. The Cure of a SIMPLE WOƲND. There are five principal Intentions of Cure, 1. The re∣moving things Extraneous, as coagulated Blood, Splinters of Bones, pieces of the Weapon, Rags, Hair, Sand, Dust, &c. which may hinder Unition. 2. To join the lips of the Wound even together. 3. To retain the lips so brought to∣gether, 'till they are consoli∣dated. 4. To conserve the native heat of the Part, in order to unition. 5. To prevent or correct ill accidents, which may intervene.

CIX. Thus much is required, if the Wound is only simplex; but if it is complex, with loss of substance, or contusion, then there is something more to do: as in loss of substance, with Sar∣coticks, to assist Nature in re∣storing what is lost: and if contused, the converting the contused substance into pus or matter, which must be done, before there can be possibly any healing.

CX. As to the first Intention, there must be a removing all things that are extraneous, or of a dif∣ferent substance; for so long as they remain, they will hinder unition; nor 'till then, can you hope in the least to make a Cure of the Wound. But before any thing of this kind is done, you are to consider, 1. Whether it can be done, or not. 2. Whether if it can be done, it can be done safely.

CXI. For sometimes the broken Weapon or Matter sticks so fast, that it can by no means be extracted; then you must of necessity leave it to Nature, who, in this case, does sometimes wonderful things. Splin∣ters, &c. have sometimes stuck so fast, or have been so in∣closed, that by no Artifice they could be gotten forth; yet at length, upon Apostemation of the Part, they have been thrust out.

CXII. If it may be done, whe∣ther it may be done with safety? For some will live a Day or more with the Weapon in their Bodies, who would otherwise dye, upon the moment of ex∣traction. But if you find the Patient is recoverable, then make haste with the extraction, and let it be taken forth before the wounded Part is inflamed. How extraneous things are in particular to be drawn forth, we teach at large, in Chap. 5. following.

CXIII. The Extraneous mat∣ters being now drawn forth, and the Wound cleansed by washing it with a little White-wine mixt with a third part of Spirit of Wine; you may permit the Wound to bleed, according as in judgment you shall see fit, respect being had, 1. To the

strength, and habit or consti∣tution of the Body. 2. To hinder Inflammation, as the generation of much matter.

CXIV. The bleeding being staid, (whether naturally, or by Art, it matters not much) let the Hair about the Wound (if any be) be shaved off; and wipe away the clotted Blood with Spunge dipt in Red-wine or Alicant, Oxy∣crate or Posca, (which is Vin∣egar and Water mixt together, or Wine mixt with Water, &c.)

CXV. But if the clotted Blood sticks deep in the Wound, be not too busy to remove it with your armed Probe, lest you stir up a new Hemorrhage or Bleeding: and understand, that this coagulated Blood keeps the Wound warm, and defends it from the injuries of the ambient Air; and that Nature will cast it out in due season, by Dige∣stion.

CXVI. The second Intention, is the exact Joyning of the Lips of the Wound together: for with∣out this exact conjoining, a slow, and a deformed Healing will follow: and this truly is the sole work of the Artist, for Nature has nothing at all to do in this business.

CXVII. You must not lay a Pledget, or a Dossel of lint, or put a Tent into a little Wound; for those are the ways to keep the Wound open, make it painful, cause defluxions of Humors, weaken the native heat of the Part, and prolong the Cure, which is diametrically contrary to the true intention of Healing.

CXVIII. The parts, or lips of the Wound then separated, are to be brought together gently and equally; that they may just touch one another, and so be prepared for Unition.

CXIX. It is to be done, as Fal∣lopius says, by little and little, not hastily, and at once: if they be equally soft, bring them equally together; if the one is soft, and the other hard, or immoveable, or not to be moved but with difficulty, then bring the soft part to that other.

CXX. If the Parts are grown stiff with Cold, (as some are, who have lain in the Field all Night;) in this case, you are to supple them with a Fomen∣tation of hot Milk, or warm Water; or embrocate them with Oil, till the lips are soft enough, and then endeavour their reunion.

CXXI. They are also to be con∣join'd equally, that the parts cut asunder may answer one another, both in the top and in the bottom; brim to brim, lips to lips, vessels to vessels; that Nature may be put into a condition to do her own work; and by virtue of its innate Balsam, reunite, agglu∣tinate, and consolidate or heal the Wound: in all which Intentions she is the Agent, the Chirurgeon only is the Assistant.

CXXII. The third Intention of Cure, is to retain the lips so brought together, 'till they be con∣solidated; and this is done by deli∣gation, which is the dressing and binding up of the Wound: for the accomplishing of which, the

great Masters of this Art have left us two principal means; viz. 1. Suturae, Stitching up the Wound. 2. Fasciae, Binding of it up.

CXXIII. As to Sutures, they they are said to be of three sorts; viz. 1. The Incarnative. 2. The Restringent. 3. The Conserver: to which add one more, which is called the Dry-stitch, or Suture.

CXXIV. The first of these is most in use with us, and is done by making so many Stitches at a set distance. Now you are to con∣sider the Wound; if it is but an Inch, little more more or less, in length, 'tis needless to be stitched; your Medicaments and Bandage will be enough to keep the lips together, and heal it.

CXXV. But if it is two inches or more in length, make one stitch in the middle; if it is three inches long, make two stitches; if four inches long, make three stitches, and so on; making the stitches less by one, than are the inches it is long: and in declining Parts, we many times make the stitches at a little more distance.

CXXVI. The Restringent-stitch, which is called the Glovers-stitch, is much in use with the Spaniards, who stitch almost all Wounds with it: in the Fore∣head and Face, it brings the lips very close; the third day they draw the Thread out, and with the Dry-suture they keep the lips together 'till the Wound is well, which is commonly in two or three days more. This Stitch is best in great Fluxes of Blood; but then in stitching, you must endeavour to bring the wounded Arteries and Veins to their wounded fellows.

CXXVII. The Conserver, or third Stitch is mostly of use in great Wounds; as those of the Oesophagus, Hare-lips, &c. to hold the parts forcibly together, and is performed with Pins or Needles, &c.

CXXVIII. The Ancients make another Stitch in Wounds of the Peritonaeum, which is thus: Have a fit Needle, with a long, strong, round, white Thread in it, and therewith take up the Peritonaeum on one side, and leave it on the other; then take it up on the other side, and leave it on this. It it so made, that the Peritonaeum, which is a dry Body, may be united with the Musculous Flesh: otherwise the fleshy parts would only unite, and the Peritonaeum lye open; upon which a Hernia would certainly succeed, and the Patient put to the perpetual trouble of wearing a Truss the remaining part of his life.

CXXIX. The Dry-suture, is the last kind of Stitch, which is proper chiefly to the Face, to keep the lips of those wounds close together, and avoid as much as may be the making Scars; and to be applied also after some of the former Stitches, to keep the lips together, 'till the Wound is perfectly congluti∣nated.

CXXX. As to the time of taking out the Stitches, it ought

to be when the lips are aggluti∣nated; which may be sooner or later, according to the habit of the Body, season of the Year, and nature of the Wound.

CXXXI. In transverse Wounds eight days are required; in lesser Wounds not so deep, three or four days: in the Face, it ought to be done the next dressing, lest the Stitches make so many Scars; but in this, every Man must use his own Judgment. As to the man∣ner and way, how these Stitches are to be performed, we leave you to the Directions of Chap. 6. following.

CXXXII. Now we come to the Bandage, or Binding the Wound up. If the Wound is small, and in a fleshy part, Bandage alone, without Stitching, will do the work: for Nature in giving nourishment to both sides of the lips equally, will finish the Unition, without any more to do.

CXXXIII. And by Bandage, as the union of Parts cut asunder are promoted, so also such as would unnaturally grow together, are kept asunder; as in Burnings and Scaldings, the Fingers would many times grow together, were they not by the binding up, hindred.

CXXXIV. There are three several kinds of Fasciation, Rowling, or Binding-up: viz. 1. Agglutinatrix, or Incarnatrix. 2. Retentrix, or Retentive. 3. Expultrix, or Expulsive.

CXXXV. By the Fascia Ag∣glutinatrix, or Incarnatrix, the lips of the Wound are brought to∣gether, and conserved in their right form: it is more strict than the Retentive, and more loose than the Expulsive; and is most of use in simple, fresh, and yet-bleeding Wounds.

CXXXVI. The Fascia Reten∣trix is used to keep Dressings on, close about the Wound. This for the most part is of use in Wounds of the Head; and is moderately to be bound on, not so hard as the former.

CXXXVII. Fascia Expultrix, which is done by a Rowler of one head; whose special use is, to force or expel out of sinu∣ous Ulcers or Fistula's, the Pus or Matter lodg'd therein: as also to prevent the afflux of Humors, and to press out of the substance of the Part wound∣ed, and places adjacent to it, such Humors as have already seated themselves there.

CXXXVIII. For the matter of your Rowlers, they must be made of good, strong, even, white Cloth, clean and gentle, without hems, seams, or threads hanging by: let the length be such as the place affected requires: and their breadth; for the Shoul∣ders about 6 inches, for the Thighs 5 inches, for the Legs 4 inches, for the Arms 3 inches, and for Fingers and Toes, 1 inch broad.

CXXXIX. Concerning Ban∣dages, Hippocrates saith, Vincu∣lorum aliud per se remedio est, aliud iis quae remedio sunt sub∣servit: among Ligatures, some are Remedies of themselves, others subserve to them which are Remedies. And so it is; the Incarnative and Expulsive

are Remedies in themselves; the Retentive is as the common Servant to the other. Now as to the way and manner, how this Ligature or Bandage is to be performed, you may see at large in Chap. 7. following.

CXL. The fourth Intention, is to preserve the native heat of the Part; that thereby agglutination, incarnation, and healing may be obtained; which tho' it is affirm'd to be the work of Nature alone, yet she generally acts by the help of a Medium, which answers in power to Glew, or things of a glewing nature.

CXLI. As soon as the Wound is made, there is a Balsam of Nature ready at hand for the Cure; which Balsam is Blood, at least the lymphatick, or serous part of it, by which Nature does the Cure, both by the first and second Intention.

CXLII. A Cure performed by the first Intention, is done per Symphysin, by Symphysis; which is a reunion of the parts, without any Medium, viz. without any Callus, Flesh, or other Body interposed; but in this case, the Balsam of Nature is the Medium, the Instrument of Unity, which knits the parts together.

CXLIII. A Cure performed by the second Intention, is done per Syssarcosin, by Syssarcosis; which is a reunion of the parts, by, or with the help of a Medium, viz. with Flesh, or a Callous substance, in∣terposing, or filling up the space between the lips of the Wound.

CXLIV. And therefore great care is to be taken, that the Blood may not offend either in quantity or quality: too much is the cause of proud and loose Flesh; and too little affords not a sufficiency of matter for the Work. And as to its Quality, if it is cacochymick or evil, it cannot produce good Flesh; for such as the Blood is, such will the Flesh be.

CXLV. Now to make the Blood such as it ought to be, the Patient is to observe a good Diet: which ought to be rather slen∣der than full; because a full Diet is hurtful in Wounds, espe∣cially in gross Bodies, where there is danger of great Inflam∣mations, Pain, and other evil Symptoms.

CXLVI. But a greater liberty may be given to those, who have thin and exhausted Bodies; so that they may be allowed new-laid Eggs, strong Broths, Jellies, &c. also some Wine, where the Body has been long accustomed to the plentiful use thereof; or the total forbidding thereof, may very much hinder the Cure: and for other things, such Diet is to be observed, as their strength or weakness may re∣quire, and their Stomach permit.

CXLVII. As to Internals; Purging with strong, hot, or violent Catharticks is not fit; lest stimu∣lating or stirring up the Matter, it should flow to the weak or wounded part: but in gross and cacochymick Bodies, Lenitives are allowed; as Cassia, Manna, Tamarinds, Rhubarb, Sena with Sal Prunellae; also Syrupus Cathar∣ticus, and Broths, wherein Bor∣rage, Bugloss, Endive, Fumitory,

Lettice, Purslane, Sorrel, Suc∣cory, &c. have been boiled.

CXLVIII. And at set times of the day, they may take Vulnerary-Drinks; made of Adders-tongue, Agrimony, Avens, Bis∣tort-roots, Bugle, Cinkfoil, Cen∣tory, Comfrey, Fluellin, Ground-Ivy, Golden-rod, Herb-trinity, Horse-tail, Hypericon, Knot∣grass, Ladies-mantle, Mouse-ear, Mugwort, Pauls-Betony, Per∣winkle, Plantane, red Roses, Sanicle, Snakeweed, Scordium, Strawberry leaves and roots, Tormentil-roots, Vervain, Vale∣rian, wild Tansy, Yarrow, &c. as we shew more at large, in Chap. 3. ensuing.

CXLIX. Now in particular, for preserving the innate or native heat, and tone of the Part, without which no Ʋnition can be hoped for, Topicks are usually applied: it is true, that in small and simple Wounds, which are superficial, Nature of her own accord com∣monly does the Cure, and seldom requires more of us, than to bring the lips of the Wound close together, and defend it from fluxion: a Pledget of Linimentum Arcaei may be laid on, and over it Emplast. Diapalma; and then bound up, to keep all things on.

CL. But in greater Wounds, which will not so easily be cured, you must stitch the lips together; and then strew upon them the following Pouder. ℞ Fine Bole, Terra sigillata, A. ℥ss. Sanguis Draconis, Frankincense, A. ℥i. mix them: over which lay some of the same Pouder mixt with the white of an Egg, and over that a Compress, squeezed out of Oxycrate, and a suitable Bandage over all. This is the general use.

CLI. But lest by the sticking-to of the Emplastick-medicine, the lips of the Wound should be torn or disturbed, in taking off the Dres∣sing; you may apply over the sprinkling of the Pouder, the following Sarcotick-Ointment. ℞ Strasburgh-Turpentine ℥ iii. Gum-Elemi ℥ ii. Frankincense, Mastich, Olibanum, Sanguis Draconis, A. ʒii. mix, and make an Ointment; which spread upon a Pledget, and apply.

CLII. And over the former Pledget you may put Emplastr. Diapalmae, Empl. de Bolo, Cae∣saris, or the like; and then bind it up, as before directed.

CLIII. Or, applying first this Pouder: ℞ Aloes, Galls, red Roses, fine Bole, Sanguis draconis, Olibanum, Rosin, Catechu, A. ℥i. mix them; and mix some of the same Pouder with Turpen∣tine, Gum Elemi, A. q.s. which spread upon a Pledget, and put over the Pouder.

CLIV. And if there is any fear of an Afflux of Humors, or Inflam∣mation, dip Stuphs in juices of Plantain, Horse-tail, Yarrow, Perwinkle; or in red Wine, or Oxycrate: over which lay Em∣plast. Diapalmae, è Bolo, or some other like Emplaster; and lastly, bind it up, as before.

CLV. But if you design to cure by Agglutination, forbear the use of Fomentations, or other humid Medicaments; and preserving, your Stitches, you will find,

that Nature will do her part towards the consolidation of the Wound; nor will you have occasion for such Applications, if you have proceeded metho∣dically.

Hitherto of Wounds simplex: now a word or two of the Cure of Wounds complex.

CLVI. These kinds of Wounds are not so often seen in times of Peace, as in times of War; in which they are frequent, when the Horse fall in among the In∣fantry, and cruelly hack them; some cutting twice or thrice in or near the same place: whereby the Wound is made large, deep, oblique, and trans∣verse at the same time, the lips being contracted various ways. See Sect. 109. aforegoing.

CLVII. In order to the Cure of these Wounds, where there is loss of Substance, you must first cleanse them, and then as much as may be, bring their lips toge∣ther by the Incarnative-stitch, making so many stitches as may hold them together: and if in some of them you think it not sufficient, you may as in the Hare-lip, pass Needles thro' the lips of the Wound, with little Plates of Lead, to secure them from tearing out.

CLVIII. If the Wound has been long undressed, or was not stitcht at first dressing, whereby it is so stubborn and contracted, that the lips will not be brought near one another; or if it is so deep as you may suspect the Incarnating, you must leave a declining Orifice, for discharge of the Matter; and then foment warm with some Lenient-decoction, made of the leaves and roots of Althea, Mallows, Violets, Lin∣seed, &c. or foment with new Milk, then join their lips to∣gether, and dress them as Wounds so stitcht.

CLIX. But if you leave a de∣clining Orifice, you must keep it open with a small Tent, dipt in some digestive; and after Dige∣stion, then you must withdraw the Tent, and heal up the Wound.

CLX. But the greater Wounds, which cannot be brought together by Suture, must be digested, and so disposed, that new Flesh may be generated to fill up the Ca∣vity; for which purpose, this Digestive is good: ℞ Turpen∣tine ℥iii. Gum Elemi ℥i. Barley-flower ℥i. Frankincense ʒi. mix, and make it up with the yolk of one or two Eggs.

CLXI. To the former Digestive, after a day or two may be added, Honey of Roses, to make it more cleansing.

CLXII. During the former Applications, the Humors ought to be diverted or revulst from the Wound, by gentle Purging; such as we have directed in Sect. 146 aforegoing.

CLXIII. And outwardly apply. Topical refrigeratives, with good Compress and Bandage, to press the lips of the Wound toge∣ther, that it may be the sooner cured.

CLXIV. When you find that the Wound is indeed digested, you may cleanse with this Mundificative

of Quercetan, which is also a good Sarcotick: ℞ Leaves of Smallage, Plantain, A. M. j. red Roses P. ij. red Wine ℥viii. boil to the consumption of one half, then strain out, and dissolve therein brown Sugar ℥ii. Turpentine ℥i. pouder of Juniper-berries, Orobus-meal, A. ʒvi. Aloes, Myrrh, A. ʒi. boil again gently; then add Wax q.s. and make an Ointment.

CLXV. This is excellent. ℞ Juice of Smallage brought to the thickness of new Honey, Melliginous Extract of Juniper-berries, Honey of Roses, A. ℥i. Turpentine, Gum Elemi, A. ℥ss. pouder of Scammony ℥ii. mix them. It is inferior to no ordinary Detersive.

CLXVI. But in these larger Wounds, you may do well to foment with warm Stuphs nipt out of Red or Alicant Wine; wherein the flowers of red Roses and Balaustians, Cortex Peruanus, or Cypress-Nuts, and Catechu, have been infused or boiled.

CLXVII. If these Wounds abound with Maggots, as many times they will, in hot Weather and Summer∣time, if not soon looked after; you may wash them with a Decoction of Carduus Bened. Wormword, Gentian-roots and Myrrh, made with half Water, half Wine: or an Infusion of Aloes and Myrrh in Wine alone: for a mixture of Wine with a half part of Ox or Hogs or Sheeps-Gall. The Worms being killed, you may proceed in the Cure, as before directed.

CLXVIII. If the Wound is with Contusion, endeavour that the contused Flesh be digested, and turn'd into matter; for which purpose is proper, Ʋng. Basi∣licon applied hot upon Lint, or dissolved in Linseed-Oil, or Oil of Earthworms, or the like, an∣ointing the parts about with Oil of Roses and Myrtles, beaten up with the white of an Egg.

CLXIX. And with that mix∣ture, you may make a Restrictive; by adding fine Bole, Terra sigil∣lata, Dragons-blood, and pouder of red Roses; which mix, and apply over all.

CLXX. But if the Wound has been neglected for some days, then foment it with Discussives; and embrocate the contused Parts with this: ℞ Oil-olive ℥i. Oil of Lavender and Limons, A. ʒi. mix them well, by shaking in a Glass: and be sedulous in the application of Suppuratives, after the manner we have taught in Lib. 3. cap. 5. sect. 134, 135, 136, 137, 145, 146, 147, 148, 149. aforegoing, of this Work.

CLXXI. After the separation of the contused Flesh, the loss of substance must be supplied or restored by Sarcoticks or In∣carnatives, and then healed up with Epuloticks.

CLXXII. If the Wound is deep, and the orifice narrow, yet capable of being made larger, it ought to be laid open in proportion; that the Matter may not be kept in to create a greater hollowness, and putrify the adjacent parts.

CLXXIII. But if the Sinus is of any great length, and so de∣scending, that the Matter cannot be discharged by the Wound; you may then make a perforation in the lower part thereof, for that purpose, by Incision-knife,

or Caustick, or both; first the Caustick, then the Knife: or by a Seton-Needle, or Syringotomus, as we shall shew in Sinuous Ʋlcers.

CLXXIV. As to the time of Dressing of Wounds, the second dressing ought not to be till the third Day; by which time, they may be supposed to be somewhat di∣gested: and from that time, every other day may be sufficient.

CLXXV. Galen, discoursing of the Dressing of Ʋlcers, says he drest them but every third day, tho' the Matter flowed very much; and but every fourth day in Winter.

CLXXVI. 'Tis really true, that too frequent dressing of Wounds is hurt∣ful, and hinders the speedy Cure: yet there may be occasion of opening them sooner, than what we have here proposed; either for strengthning the Bandage, or for preserving the Stitches, by using the Dry-suture; or for the vehemence of some Sym∣ptom inforcing it; the consi∣deration of which is left to the judgment of the Artist.

CLXXVII. After the Wound is filled up with Flesh, you may Cicatrize with Epuloticks; as Ʋnguent. Desiccativum Rubrum, Aqua Calcis vivae; or with Vi∣triol and Alum-stone, and dry Lint, or some proper Styptick-Water.

CLXXVIII. A word or two now, of Tents: they are not necessary in Wounds which are superficia∣ry, streight, and breed but little Pus; nor ought the Cure of Wounds to be retarded by put∣ting them in.

CLXXIX. But if the Wound is deep, oblique, and breeds much Pus; they are sometimes necessary, that a passage may be kept open by them, for the purulent Matter to pass out; and for Medicines to enter into the inside of the Wound, that the orifice may not be closed up, before the lowest, and most inward part of it is digested, deterged, and in∣carned in order to healing.

CLXXX. And tho' Tents are useful and necessary, yet are they many times less necessary in green Wounds; yea hurtful, and hin∣derers of the Cure: concerning which, Tulplus, Lib. 4. Obs. 22. has a very remarkable History.

CLXXXI. A young Woman having six Wounds, rather by pricking or stabbing, than cutting, was according to custom, tented; but these Tents were so uneasy to her, that the same night she was forced to take them out; unless she should have been kept all night from sleeping, into which she fell, so soon as they were taken out; and linnen Cloths being dipt in Spirit of Wine were only outwardly applied; by the benefit whereof, before the twelfth day, her Wounds were both happily filled up with Flesh, and healed.

CLXXXII. From this Obser∣vation, Tulpius wonders at the folly and madness of some Men; who that they may be thought to do something, fill green Wounds up with Tents, thereby hindering them from healing: for that the mutual contact being prevented, they hinder the necessary coalition; (which is directly against the first Intention of Cure.) Another

Remark I make, which is on the mighty healing power and vir∣tue, of Spirit of Wine.

CLXXXIII. The fifth and last Intention of Cure of Wounds, is either the preventing of Symptoms, before they arise; or the correcting and removing them, after they once appear: for as much as no sin∣cere Healing can possibly be, whil'st they are present.

CLXXXIV. There are many Symptoms and Accidents of Wounds, such as we have enume∣rated in Sect. 39. of this Chapter aforegoing: of which we shall treat at large in Chap. 9. of this Book following. But because the three first of them, viz. Hemorrhage, Pain, and Inflam∣mation, are incident to almost all Wounds, and many times nearly as old as the Wound it self, we shall speak something to them here.

CLXXXV. 1. Hemorrhage. This is incident to all Wounds, more or less, and sometimes the Cause of all other Accidents. Outwardly, you must bring the lips of the Wound close together by su∣ture, and then apply such Medicines as have a drying and agglutinative faculty: as Galen's Pouder, made of Aloes ℥i. Frank∣incense ℥ii. white of an Egg, q.s. to make it of the thickness of Honey: in this dip the wool of a Hare, and apply it: also a Plaster over it, made of the same Re∣strictives, with Compress and Bandage.

CLXXXVI. But if the Wound is such, as you cannot bring the lips of it together, apply the aforesaid Pouder; or this fol∣lowing, upon Dossels, on the bleeding Vessels.

CLXXXVII. ℞ Salt extracted out of the Cap. mort. of Vitriol, calcin'd almost to blackness, pou∣der of Man's. Blood, of the flesh of a Toad, Catechu, Saccharum Sa∣turni, A. ℥ss. Opium in pouder ʒii. mix them.

CLXXXVIII. And over the Dossels, put next, your astringent Emplaster, with Compress and Bandage over all: which done, place the Member in such a position, as may be most for the ease of the Patient.

CLXXXIX. 2. Pain, is the next thing to be considered; in easing of which we ought to be as speedy as may be, because nothing dispi∣rits and weakens the Patient more; nor in Wounds espe∣cially, causes more disturbance, inducing an Afflux of Humors, Inflammation, &c.

CXC. Outwardly, apply Ano∣dyns; made of the roots and leaves of Mallows, Henbane, Hemlock, flowers of red Roses, Camomil and Melilot, Linseed, White-Poppy-seed, Opium, &c. which may be made into Fo∣mentations, Cataplasms, &c. being boiled in Sheeps-head-broth, Oxycrate, or new Milk; and the Cataplasm may be brought to a thickness with Barley-flower.

CXCI. And Inwardly, give Our Specifick Laudanum, or Guttae Vitae, in a proper Dose; which in extream pains in Wounds, re∣stores Nature, by giving re∣spite, and causing gentle rest; strengthens her in her Faculties, and accelerates her Operations

of Digestion, Suppuration, De∣tersion, Incarnating, &c.

CXCII. But if the Pain is caused by Matter which wants a passage forth; you must give it a vent by the Knife, or by Caustick, or by both, as you may see rea∣son.

CXCIII. 3. Inflammation. If an Inflammation is already in∣duced, hasten Revulsion by Vesi∣catories, Clysters, and Lenient Purges, to loosen the Body; and lay upon the Part already in∣flamed, this: ℞ Henbane-leaves, boil them in Milk; add thereto a new-laid Egg, Camphir in pou∣der ʒi. Saffron ℈i. Oil of Poppy∣seed ℥i. and with Barley-flower make a Cataplasm, which apply.

CXCIV. If after this Applica∣tion, it shall seem to tend to suppuration; then you must pro∣ceed exactly as we have taught in Lib. 3. Cap. 5. aforegoing of this Work, and to which I refer you.

CXCV. Thus have we com∣pleated this our Discourse of Wounds in General, which we thought not at first to have made half thus long: but the matter multiplied upon us; and we were the more willing to be large here, be∣cause it is the true Ground or Foun∣dation of the whole Art of Curing Wonuds of all sorts: and therefore this being at first well under∣stood, the whole Superstructure following, which is built upon it, will become very easy, and intelligible.

CHAP. II. Of External VULNERARIES.

I. WOƲNDS are cured either by the first In∣tention, or by the second: if by the first, there is no need of Di∣gestives, Incarnatives, or Cica∣trizers; for one only Medica∣ment generally does the work, and commonly at one dressing; of which kind are Balsamick Bodies, and such things as preserve from Putrifaction: and Stypticks, these are purely cal∣led by the name of Vulneraries.

II. Wounds cured by the second Intention, require more orders of Medicaments, without which, the Work cannot be performed: if Contusion is, there must be Digestives; if loss of Substance, Sarcoticks or Incarnatives; and where loss of Skin, there must be Epuloticks, or Cicatrizers.

III. So that the kinds of Medicaments to answer both the first, and second Intention of Curing, seem to stand in this Order.

• 1. Pure Vulneraries, or Heal∣ers.
• 2. Digestives, or Maturatives.
• 3. Sarcoticks, or Incarna∣tives.
• 4. Epuloticks; or Cicatrizers.

IV. Sennertus also says, where the Cure is attempted by the second Intention, that in regard Digestive Medicaments are more moist than others, they are to be used with great caution: for if they be over-long applied, the matter will not only be digested, but al∣so so putrify, and the Wound will degenerate into a sordid Ulcer.

V. Wherefore says he, the safest way is, not always to confide in one Medicament alone, but ra∣ther to compound them according to the nature and temper of the Part, and to mingle Digestives with Sarcoticks: since that Ex∣perience testifies, that such are used with far better success than meer Maturatives.

VI. And Franciscus Arcaeus saith, that with his Balsam or Ʋnguent, forthwith applied in the very beginning, he himself most happily cured the greatest, and most grievous Wounds; the use whereof I my self (says Sen∣nertus) have likewise very often experienced with very happy success.

I. Pure Vulneraries.

VII. Simple Vulneraries are, Turpentine Common, that of Strasburgh, of Venice, and Scio, Gum Elemi, Frankincense, Myrrh, Turpentine or Balsam of the Cedar-tree, Balsam Ca∣pivii, de Chili, of Gilead, of Peru and Tolu: of these, Compound-Balsams are made, as follows.

VIII. Balsam or Liniment of Arcaeus. ℞ Sheep-suet ℥ii. Gum Elemi, Turpentine, A. ℥jss. Hogs∣grease ℥i. melt them at the Fire, and make a Balsam.

IX. Another. ℞ Sheep-suet ℥iv. Gum Elemi, Balsam Capivii, Balsam of Peru, A. ℥ii. Oil of Petre ℥i. melt, mix, and make a Balsam.

X. Another. ℞ Sheep-suet ℥viii. Frankincense, Strasburgh-Turpentine, Oleum Terrae rubrum, A. ℥iv. Balsam Capivii, Gum Elemi, Balsam of Peru, A. ℥ii. Oil-olive, Oil of Petre, A. ℥i. mix, melt, and make a Balsum.

XI. Another. ℞ Sheep-suet ℥viii. Balsams of Capivii, Chili, Peru, Tolu; Strasburg-Turpentine, A. ℥ii. Petroleum ℥i. mix, melt, and make a Balsam.

XII. Another. ℞ Sheep-suet ℥viii. Gum Elemi ℥iv. Stras∣burg-Turpentine, Balsam Capivii, of Chili, Tolu, and Peru, A. ℥ii. Frankincense ℥i. Oil of Juniper∣berries, of Lavender, of Limons, of Oranges, and of Sassafras, A.ʒiii. mix, melt, and make a Balsam.

XIII. Another. ℞ Oil-olive lbijss. juice of Tobacco lbjss. tops of Hypericon, Adders-tongue, Bu∣gle, Sanicle, Self-heal, Solomons-seal, A. M. jss. Hounds-tongue, Plantane, Wintergreen, Smallage, Yarrow, A. M.j. roots of Solo∣mons-seal ℥iv. cut all these things very small with a Chopping-knife; mix them with the Oil and Juice, and boil to the consumption of the watery humidity, and strain forth: to the strained Liquor, add Gum Elemi ℥viii. Balsam Capi∣vii ℥iv. Balsam of Peru and Tolu, Chio-Turpentine, A. ℥ii. mix, and make a Balsam.

XIV. An Emplaster. ℞ Fat Frankincense lbiv. juice of Tobacco

lbii. Sheep-suet, Bees-wax, Oil-Olive, A. lbi. mix, and boil to the consistence of an Emplaster; to which add Gum Elemi, Balsam of Tolu, A. lbss. mix them.

XV. An Ointment. ℞ Sheep-suet, Oil-olive, A. lbii. juices of Melilot and Tobacco, A.lbi. Adders-tongue, Hypericon, Sanicle, Self-heal, Smallage, Solomons-seal, Yarrow, A. M. iii. chop the Herbs very small with a Chopping-knife, and boil all together, to the con∣sumption of the Juices: strain out by pressing, and to the strained Liquor add Cypress-Turpentine, Gum Elemi, Balsam Capivii and Tolu, A. ℥v. Frankincense ℥iv. Wax ℥iii. Petroleum ℥ii. Oil of Juniper ℥i. mix them.

II. Digestives, or Maturatives.

XVI. Simple Digestives are, Juices of Adders-tongue, of of Bugle, of Hypericon, of Ladies-mantle, of Plantane, of Sanicle, of Self-heal, of Parsley, and of Smallage, boil'd up to the thickness of new Honey; Meals of Wheat, Barley, Pease, Beans, and Fenugreek; Gum Elemi, Frankincense, Mastich, Olibanum, Turpentine all the kinds, Sugar, Oil of Ben, Oil of Olives, Oil of Roses, Oil of Mastich, Sheep-suet, fresh Butter, Hogs-lard, Neats-foot-Oil, Honey, yolks of Eggs, Ox-Gall; pulps of Figs, Raisons, Corans, Dates, Saffron, Briony-roots boiled soft. Of these Compounds may be made, as follows.

XVII. Unguentum Basilicon, or Tetrapharmacon. ℞ Oil-Olive ℥ix. Bees-wax, Frankin∣cense, Ship-Pitch, A. ℥vi. mix, melt, and make an Ointment.

XVIII. Another. ℞ Bees-wax, Frankincense, ship-pitch, Turpentine, Sheeps or Beef Suet, A.℥i. Gum Elemi ℥ii. Oil ℥v. mix, and melt; to which add, being almost cold, Myrrh and Olibanum, both in fine pouder, A. ℥i. mix them well.

XIX. Another. ℞ Stras∣burgh-Turpentine ℥i. yolks of Eggs N^o ii. mix them well toge∣ther.

XX. Another. ℞ Strasburgh-Turpentine ℥ii. Honey ℥i. yolks of Eggs N^o ii. mix them well together.

XXI. Another. ℞ Turpentine washt in White-wine ℥ii. yolk of one Egg; Barley-flower, Honey, A. q.s. mix them.

XXII. Or, ℞ Turpentine washed in Wine, fresh Butter, A. ℥i. Frankincense, Mastich, A. q.s. mix them.

XXIII. Another. ℞ Fresh Butter ℥i. Turpentine ℥ss. yolk of one Egg; Frankincense ʒi. mix them.

XXIV. Another. ℞ Oil ℥iv. Bees-wax ℥i. Frankincense, Ma∣stich, A. ʒii. yolks of Eggs N^o ii. Butter q.s. mix them.

XXV. Another. ℞ Turpen∣tine ℥i. yolk of one Egg; Oil of Roses ℥ss. mix the Turpentine and Yolk first, after the Oil, which mix well.

XXVI. Or, ℞ Rosin, Wax, Turpentine, Oil of Roses, A ℥ii. yolks of Eggs N^o iii. Frankin∣cense, Mastich, Myrrh, A. ʒii. mix, and make an Ointment.

XXVII. Or, ℞ Oil lbjss. Wax lbss. Turpentine ℥iii. Frankincense,

Olibanum, Rosin, A. ℥ii. Mastich ℥i. Saffron ʒi. mix, and make an Ointment.

XXVIII. Or, ℞ Juices of To∣bacco, Melilot, A. ℥x. juices of Ladies-mantle, of Sanicle and Saracens-consound, A. ℥v. Turpen∣tine ℥iii. Beef-suet, Oil, A.q.s. make an Ointment.

XXIX. Or, ℞ Oil of Bays ℥ii. Sheeps-suet ℥i. Frankincense, Mastich, Olibanum, Turpentine, A. ℥ss. mix them.

XXX. Or, ℞ Oil of Hypericon, Turpentine, Gum Elemi, Wax, Rosin, Ship-Pitch, Frankincense, A. ℥viii. Galbanum, Ammonia∣cum, Oil of Aniseeds, of Myrrh, and of Wax, A. ℥iv. mix them.

III. Sarcoticks, or Incarnatives.

XXXI. Simple Sarcoticks are, 1. Roots of Bistort, Birthwort, Cinkfoil, the greater Consound, Comfrey, Hermodacts, Orrice, Sanicle, Solomons-seal, Tormen∣til. 2. Leaves of Agrimony, Avens, Balsam-apple, Bawm, Betony, Birthwort, Burnet, Cen∣tory, Cinkfoil, Costmary, Con∣sound, Cyperus, Doves-foot, Fe∣therfew, Flixweed, Germander, Goldenrod, Hypericon, Horstail, Hounds-tongue, Ladies-mantle, Maudlin, Melilot, Mouse-ear, Orpin, Plantane, Sanicle, Self-heal, Scordium, Speedwel, Shep∣herds-purse, Scabious, Tansy, Vervain, Yarrow. 3. Flowers of Hypericon, Pomgranates, Red-Roses. 4. Seeds of Agnus castus, Bay-berries, Acorus. 5. Meals of Wheat, Barley, Mault, Pease, Beans, Cicers, Lentils, Lupins, Orobus, Tares. 6. Rosins, Gums; Aloes, Colophony, Elemi, Frank∣incense, Mastich, Myrrh, Oli∣banum, Pitch, Pine-Rosin, Larch-Rosin, Sarcocol, Sandararcha, Sanguis draconis, Scammony, Tacamahacca, Turpentine of all sorts, all Natural Balsams. 7. Earths; as fine Bole, Terra Lemnia, Sigillata, Chalk. 8. Mi∣nerals; as Alum, burnt Alum, Ceruse, Litharge, burnt Lead, Pompholix, Lapis Haematitis, Calaminaris, Tutia, Spodium, Vitriol, Caput mort. of Vitriol, and Salt of the same, Crocus Martis, Saccharum Saturni, Calx Jovis, Bezoar minerale. 9. Oils; Oil-Olive, of Ben, of Roses, of the Balsam-apple. 10. Fats; as of Beef, Sheep, Goat, Deer, Hog. 11. Bees-wax, Honey, Honey of Roses, Ox-gall. Of all these you may make Com∣pound Oils, Balsams, Lini∣ments, Ointments, Cerates, and Emplasters at pleasure: and among some Compounds, we have these following.

XXXII. A Vulnerary Oil. ℞ Turpentine, Oil of Bays, A. ℥iv. Oil of Roses ℥vi. Oil of Eggs ℥ii. mix, and digest in the Sun, 'till they have a yellow colour.

XXXIII. An Oil, or distilled Balsam, for Wounds of the Nerves. ℞ Oil lbiii. Turpen∣tine lbii. Oil of Bays ℥vi. Eu∣phorbium, Cloves, Gum of Ivy, Ammoniacum, Galbanum, Opopa∣nax, Sagapenum, Frankincense, Mastich, A. ℥i. mix all together, and distil an Oil or Balsam by Retort.

XXXIV. An Oil for Wounds of the Nerves, Veins, Bones.

℞ Turpentine lbii. Linseed-Oil lbi. Pine-Rosin ℥vi. Aloes, Frank∣incense, Mastich, Sarcocol, A. ℥iii. Mace, Xyloaloes, A. ℥ii. Saffron ℥ss. distil in a Retort, with a gentle Fire: so have you a clear Water, and a reddish Oil; augment the Fire to the end of the Distil∣lation, and separate the Oil from the Water. This Oil consolidates speedily, and without pain.

XXXV. Another Oil for the same. ℞ Turpentine lbi. Galba∣num, Gum Elemi, of Ivy, Frank∣incense, Mastich, Myrrh, A. ℥iv. Aloes, Xyloaloes, Galanga, Cloves, Cinnamon, Nutmegs, Cubebs, A. ℥ii. Spir. Vini, q.s. digest 24 hours, then distil in a copper Ve∣sica.

XXXVI. A Vulnerary Oil. ℞ Flowers of Sulphur ℥iii. Oil of Myrtles ℥ jss. Camphir ℥ss. Turpentine ℥vi. mix, digest, distil, and keep the Oil for use.

XXXVII. The Oil of Hispa∣nia, so called. ℞ Old Oil lbiii. Malmsey lbiii. Oil of Turpentine lbii. Frankincense lbi. Carduus, Hypericon, Valerian, A. lbss. Co∣chinele in fine pouder, Pine-Rosin, Myrrh, A. ℥iv. bruise the Herbs, and digest them in Wine 24 hours; then mix the other things boil to the consumption of the humidity, and strain out the Oil by pressing: after which add Oil of Turpentine.

XXXVIII. A Vulnerary Bal∣sam. ℞ Oil of Roses ℥ viii. Turpentine, Frankincense, Mastich, Olibanum, and Rosin, A. ℥jss. Oil of Turpentine, and of Bays, A. ℥i. Oil 〈…〉〈…〉 and of Juniper, A.℥ss. Saccharum Saturni ʒii. mix, boil a little, and stir it, 'till it is cold.

XXXIX. An Incarnative Em∣plaster. ℞ Gum Elemi ℥i. Mum∣mey, Aloes, Mastich, Litharge of Gold, Sanguis draconis, Rosin, A. ʒii. roots of Comfrey and round Birthwort in pouder, A. ℥ss. Tur∣pentine, q.s. mix, and make an Emplaster.

XL. Another for the same. ℞ Wax, Rosin, Pitch, Olibanum, Vitriol, A. ℥iv. Turpentine ℥vi. red Myrrh, Oil of Juniper, Oil of Eggs, A. ℥ss. Camphir ʒii. Oil of Roses q.s. mix, and make an Emplaster.

XLI. An Emplaster for a Wound, new or old. ℞ Wax ℥xx. old Oil ℥xviii. Litharge of Gold ℥xii. Ammoniacum ℥iv. Bdel∣lium, Olibanum, A. ℥iii. Load∣stone ℥ii. Galbanum, Opopanax, Mastich, Myrrh, A.℥jss. Verdi∣grise, long Birthwort roots, A. ℥i. Lapis Calaminaris, Tutia, A. ℥ss. dissolve the Gums in Vinegar, pouder the rest; mix, and make an Emplaster.

XLII. Another for the same. ℞ Wax, Rosin, A. lbi. Sheeps-suet, Hogs-grease, Turpentine, A. ℥iv. Vinegar ℥iii. mix them.

XLIII. An Emplaster for a Puncture, or Pricking. ℞ Oil, Rosin, Bears-fat, Sheep and Beef Suet, A.℥ii. Oil of Cow-heels ℥iijss. May-Butter ℥ vi. Litharge of Silver ℥ xii. Scales of Brass, Mastich, A. ℥jss. Oil of Wax ℥iv. mix, and make an Emplaster.

XLIV. A Balsam of Mindere∣rus. ℞ Cyprus Turpentine, Oil of Hypericon, A. ℥iv. fine Gum Elemi ℥vi. distilled Oil of Wax q.s. mix, and make a Balsam.

XLV. A Balsam. ℞ Roots of the greater Consound, cut and

bruised ℥i. Oil-olive lbiv. boil, and press forth the Liquor, in this Liquor put fresh Roots lbi. and boil as before; which repeat the third time, and continue boiling till all the Aquosity is gone. Take of this Oil lbii. Oil of Tur∣pentine lbi. Flowers of Hypericon and of Celandine, A. q.s. put all into a glass Vesica, or Bolt-head, and digest in a Sand-heat 20 days; then strain out the Oil by pressing and repeat the infusion of the Flowers to the third time; then press forth, and keep the Balsam for use; which you are to drop warm into the Wound.

XLVI. A soft Emplaster. ℞ Frankincense, Rosin, Sheeps-suet, Wax, A. ℥viii. Olibanum ℥iv. Tur∣pentine ℥ijss. Mastich, Myrrh, A.℥i. Camphir ʒii. Wine lbss. boil them to an Emplaster.

IV. Epuloticks, or Cicatrizers.

XLVII. Simple Epuloticks are, 1. Roots of Avens, Cinkfoil, Madder, Comfrey, Hermodacts, Sarsa, Tormentil. 2. Leaves of Agrimony, Avens, Archangel, Betony, Buckshorn, Burdock, Coltsfoot, Devilsbit, Flixweed, Fluellin, Horsetail, Hawkweed, Hypericon, Ladies-mantle, Lo∣vage, Mugwort, Mint, Mullein, Plantane, Perwinkle, Sanicle, Speedwel, Sage, Shepherds-purse, Strawberry, Self-heal, Scabious, Southernwood, Tan∣sy wild, Trefoil, Yarrow. 3. Flowers; as red Roses, Ba∣laustians. 4. Barks or Peels; Jesaits-bark, Pomgranate-peels. 5. Woods; Sanders red, white, yellow; wood of Aloes, Lignum Rhodium. 6. Gums, Rosins; as Aloes, Dragons-blood, Mastich, Myrrh, Olibanum, Sarcocol∣la, Scammony. 7. Fruits; as Acorns, Galls, Sumach-berries, Grape-stones. 8. Earths; as fine Bole, Terra Sigillata, Cate∣chu, Chalk. 9. Stones; La∣pis Calaminaris, Spunge-stone, Spunge burnt, Alum. 10. Me∣tals; Lead burnt, Litharge, Minium, Saccharum Saturni, Mer∣curius coagulatus, Ceruse, Brass burnt and washt. 11. Minerals; Tutty, Spodium, Pompholix, Cadmia, Antimony calcin'd, Ca∣put mort. of Vitriol, Salt of the Caput mort. flowers of Sulphur. Among Compounds, we have these following.

XLVIII. A Pouder. ℞ Scam∣mony, Hermodactyls, A. ℥i. Ca∣techu ℥ss. make each into a fine pouder, and mix them.

XLIX. Another. ℞ Roots of Tormentil, Bistort, round Birth∣wort, burnt Egg-shells, Frank∣incense, Dragons-blood, A. ℥ss. Lapis Calaminaris ʒi. Litharge ʒii. make a Pouder.

L. Another. ℞ Salt of the Caput mortuum of Vitriol, Alum in fine pouder, Saccharum Sa∣turni, Chalk, A. ℥i. mix.

LI. Another. ℞ Fine Ceruse, Saccharum Saturni, fine Bole, cal∣cined Talck, Sanguis draconis, Crabs-eyes, Mastich, Tutty, A. ʒi. Camphir ʒss. pouder finely, and mix them.

LII. Another. ℞ Scammo∣ny, Mastich, Olibanum, Rosm, A.℥i. make each into fine pouder, and mix them.

LIII. An Ointment. ℞ Oil∣omphacine, Oil of Roses, A. ℥iii. Oil of Myrtles, Ung. Populeum,

A. ℥ii. Plantane and Nightshade chopt small and bruised, A. M. i. boil for some time, and then press forth; to which add Litharge of Gold ℥iii. Wax ℥ii. Ceruse ℥i. burnt Lead ℥ss. Tutia, Brass burnt, A. ʒii. Camphir ʒi. rub them in a leaden Mortar to an Ointment.

LIV. A Cerate. ℞ Unguent. Diapompholigos, Empl. Diapal∣mae, Grisaei, A.℥i. Gum Elemi ℥ss. Saccharum Saturni ʒi. Wax, Oil A. q.s. make all into a Cerate.

LV. An Emplaster. ℞ Oil of Roses, Litharge, A. lbi. mucilage of Linseed, and Orrice-roots, A.℥ii. mix, and boil to a due consistency, then add Wax, Turpentine, A. ℥ii. Frankincense, Mastich, A.℥i. mix, and make an Emplaster.

LVI. A Mixture. ℞ Pulvis Mercurii coagulati ℥ iv. Ung-Diapompholigos, Empl. de Mi∣nio, with a little Oil, q.s. mix them, and apply it: it exceeds most Epuloticks.

LVII. ℞ Empl. de Caranna cum Mercurio, Empl. de Ranis cum Mercurio, or in place of the latter, Our Emplast. Mercuriale, Ana, melt them together over a very gentle heat, and apply it to the Part. This not only Skins immediately, but discusses Swellings, and drives back a Flux of Humors, tho' in a de∣pending Part: my own Expe∣rience can commend it. After these Examples, you may make a thousand others.

CHAP. III. Of Internal VƲLNERARIES, or WOƲND-DRINKS.

I. THE next thing to be con∣sidered, is the preparation of Internal Vulneraries, and Wound-Drinks: for we are to take care to promote an inward Habit of Healing, as well as an outward; for as much as by these Vulne∣rary-Potions, Physicians affirm (as Manardus, and others) they have alone cured the worst and most desperate Ulcers.

II. Now of these, some Phy∣sicians will have two sorts: some, which they call by the general name of Alteratives; and others, which they specially call Vulne∣raries, or Traumaticks.

III. Alteratives under our pre∣sent consideration, are such things as are cooling, and incrassating, or thickning; and withal some∣thing astringent, but not greatly astrictive; lest they might otherwise breed Obstructions.

IV. These Alteratives are ad∣ministred for this purpose, that they may hinder the Humors from growing hot; whereby they grow fluxil, and so are made apt to receive a putridness.

V. These Alteratives are for∣med out of such-like Simples, as these following: Alehoof, Apples, Asparagus, Barley, Beets, Bloodwort, Borrage, Bugloss, Bucks-horn-Plantain, Citron the juice, Coral leviga∣ted, Cucumbers, Corans their juice, Crabs-eyes, Daisies, Dan∣delion, Dock sharp-pointed, Endive, Fumitory, Grass, Harts-horn the Jelly, Lettice, Limon-juice, Mouse-ear, Nitre, Orange-juice, Orpin, Pellitory of the Wall, Pearl levigated, Pomgranat-juice, Poplar-buds, Poppy-beads, Plan∣tain, Purslain, Quinces the juice, Roses, Sorrel, Sal Prunellae, San∣ders, Shepherds-purse, Solomons-seal, Succory, Tartar its cream, Tormentil, Vine leaves and tendrils, Violets, Water-lillys, Whey clarified, Wood-sorrel, Winter-cherries, Yarrow.

VI. And out of these you may make Juices, Infusions, Decoctons, Saline Tinctures, Distilled Waters, Syrups, Electuaries, Pouders, Potions, &c. according to the Form most agreeable to the Palate of the Patient, and convenient to the strength, or weakness, and habit or constitution of the Sick: and these things may be either Simple, prepared out of one single thing; or Compound, prepared out of many of them together, as the Physician in reason shall think fit.

VII. Vulnerary-Potions, or Wound-Drinks are no where made mention of by Hippocrates, or any of the Ancients; but Mo∣odern Physicians have loudly spoken of them, and pro∣claimed their Praises.

VIII. Nothwithstanding, be∣cause the Ancients have said no∣thing of them, there are some that will (right or wrong) speak against them, with offers of some weak Arguments, in confirmation of their Opinion: amongst whom is Balduinus Roussaeus, in his Medicinal Epistles, Epist. 66. who tho' he admits them, in those cases where they reach the wounded Parts; as the Gul∣let, Stomach, Intestines, &c. where they have but the place of Topicks; yet will by no means allow them an Use in Wounds of the External Parts, but re∣jects them, for these Reasons:

IX. 1. Because Hippocrates and the Ancients made no mention of them. 2. Because they cannot possibly penetrate unto the extream Part; as Limbs, or Head, &c. partly because of their distance, and partly, because Astringents being mixed with them, may hinder their more deep pene∣tration. 3. Because the Medi∣caments themselves greatly differ; some of them being hot and opening, others cold and astringent: whereby it appears not of what quality or faculty the Medicaments should be, out of which the Potions are to be pre∣pared. 4. Because that being mostly astringent, they may do more hurt than good to the Pa∣tient; for that they may obstruct the Liver and other the more noble Viscera.

X. To which we answer, 1. That tho' Hippocrates nor some of the more ancient ancient Phy∣sicians have said nothing of them; yet Galen, Method. Med. lib. 5.

cap. 9. plainly inculcates their use, and has something which comes near to the Wound-drinks we now make use of, where he speaks touching Potions to be used in Wounds of the Thorax. But however, if nothing had been said of them by any of the Ancients: Are they the Mea∣sures, and utmost Standards of Knowledge and Wisdom to all succeeding Generations; have they fixed the Pillars, Ne plus ultra, to all Mankind besides? If not, why should not Poste∣rity have room and liberty for Invention; and the priviledge of enquiring after, and the hopes of finding out those Secrets and Truths, which the Ancients knew nothing at all of.

XI. 2. To the second Ob∣jection we Answer, That if Roussaeus had known any thing of the Circulation of the Blood, he would never have made this poor Objection; for the Virtues of these Medicaments are mixed with the Chylous Juice, and conveyed by the same into the Blood; where circulating therewith, they are conveyed to all parts of the Body: and withal, the sub∣stance of the Blood is made more Balsamick, and so endued with a more Sanative property; by which the Wound is induced to a more speedy Healing.

XII. 3. To the third Ob∣jection we Answer, 1. That such Simples are to be chosen, as may best suit with the Habit, or Con∣stitution of the Patient. 2. That Harmonies are produced out of Discords: and tho' the Simples may seem almost diametrically opposite as to their first, and it may be second qualities; yet by a due and skilful mixtion, one of an equal temprament may result, having all the Sana∣tive Virtues required. However, 'tis necessary that all Vulneraries have an Astringency in them, for the strengthning the Crasis of the Blood, which is the Na∣tural Balsam of Life, and the Healing-principle; and for that reason, most Wound-drinks are astringent: nor does their astringency hinder their pene∣trating, since they are con∣veyed every where with the Blood.

XIII. 4. The last Objection is void; for many things are very opening, which are also very astringent: What think you of the opening Vitriol of Mars, and the opening Crocus Martis, which are certainly the greatest Openers in the World, and yet not much inferior in astringency and stypti∣city to the Crocus Martis astrin∣gens, which wants the Aperitive quality; the Liver it self is opened and strengthned by Astringents, as by Rhubarb in Dropsies; and with proper Astringents, which are Openers, all the Viscera are fortified and strengthned, and made able to do their duties, and resist, or refuse the Matter obstructing, let it be of what kind soever.

XIV. And if it should be granted, that none of the An∣cients have made any mention of these Wound-drinks: I pray how many other things have they been ignorant of? Is it not evident,

that many of the most useful Medicaments have been found out, by those of after-times, which the Ancients were altoge∣ther ignorant concerning? there is nothing more certain.

XV. Nor are the Virtues of any Wound-drink, to be estimated only from the first or second qualities of their Ingredients, or such as arise from and depend upon them: but from the Properties and Effects which result from the whole Substance, and are made manifest or known to us, only by Experience.

XVI. These things being said, we will now see what modern Authors say in their behalf: Jo∣hannes Manardus, Annotat. in Composita Mesuae, calce Distinct. 11. says, that these Wound-drinks are very useful in the Cure of both new and old Wounds, and that he had more than once made trial of them; and that with them alone, he had cured the worst, and most desperate Ulcers.

XVII. And to this their Ʋse∣fulness assent, not only Empericks, but also the most learned, able, and skilful Physicians and Chir∣urgeons of later times; as Guido, John de Vigo, Johannes Angli∣cus, Nicholaus Massa, Johannes Tagautius, Johannes Andraeas à Cruce, Gabriel Fallopius, Andraeas Matthiolus, Ambrose Paraeus, Fabricius ab Aquapen∣dente, Ludovicus Septalius, Da∣niel Sennertus, and a Cloud of other Witnesses, too tedious here to enumerate.

XVIII. Tagautius, Institut. Chirurg. lib. 2. cap. 12. says, that some kind of Meats are more fit, and convenient for wounded per∣sons, and some again more offensive and hurtful: Why may we not therefore give the Patient to drink such Medicaments, as may cause all things in the Blood, and about the affected Part, to be rightly disposed, and be in good order?

XIX. Guido, Tract. 3. doct. 1. c. 1. says, that he has sometimes used these Potions in old Ulcers, and Fistula's, Parts Cancerated, in Congelations of Blood in the Inward-parts, and in a gathering together of Sanies or Matter in the Brest and Lungs, &c.

XX. Matthiolus upon Dioscori∣des, l. 4. c. 16. says, shat by such Po∣tions he had seen healed, as well the Wounds of the Thorax, as those of the Intestines, which were thought to be mortal, and altogether incurable, by any help or means whatsoever.

XXI. Ludovicus Septalius, in his Medicinal Animadversions, lib. 8. N^o 181. saith, we thought good oftentimes to make use of some Vulnerary Potions for many days together, until we saw the Matter was wholly con∣sumed: and this was when he perceived great store of Excre∣ments to be from day to day generated; either from errors of Diets, or the over-abounding of evil and vitious Humors in the whole Body; or from some∣thing amiss and faulty in the Wound; the Body being first evacuated, and the Inflamma∣tion abated.

XXII. And Paraeus, lib. 18. cap. 28. says, that Nature being assisted by such a Potion, has

oftentimes seemed to him to work Effects wonderful and mi∣raculous in the recovery of rotten Bones, cleansing of Apo∣stems, and healing of Ulcers.

XXIII. For these Potions, (says he) tho' they do not by the Belly purge away the noxious Hu∣mors, yet nevertheless they are very efficacious in the cleansing of Ʋlcers, and in the preserving and freeing them from all the filth of Excrementitious Humors, the defecating and carrying away the dregs of the Blood, and the purging the Wound from its ichorous matter and impurity: in the conglutinating also of broken Bones, and restoring the Nerves to their pristin Union.

XXIV. And (says he) by these admirable Medicines, the Flesh, or any other substance that is lost and perished, may readily be restored, and made good again, and the Part restored to its former health.

XXV. Sennertus, Med. Pract. lib. 5. part. 4. cap. 11. says also, that these Medicaments consume the excessive humidity of the Blood, which is wholly unfit for agglutination; they supply a due and fit matter for the generating of Flesh; and by their moderate astriction, they prevent and hinder the flux of Humors unto the wounded Part.

XXVI. As for my own Opinion, it is deduced from Experience; and I know that they beget a healthful habit of Body, and a disposition in the Wound to healing. For whatsoever things they are which hurt the Wound, they are all of them for the most part communicated to the Wound, by the fault of the Blood: and therefore these rectifying the discrasy of the Blood, the distemper of the Wound is accordingly altered, and so disposed to healing.

XXVII. Yet this all Authors observe, and agree to, that they are not to be used in the begin∣ning, and while there is no danger from the Wound, but that Topicks may be sufficient for the perfect cure thereof; nor yet if there is a Fever present, or an Inflam∣mation. But when the Part wounded is vitiated, the Habit of the Body is cacoethick, and the Wound it self putrifies, and succeeds not in the Cure: in these cases they may become very successful, not only in Wounds, but likewise in old Ulcers, and dangerous Fistula's.

XXVIII. The most usual simple Vulneraries, for the preparation of Wound-Drinks, are these fol∣lowing. 1. Roots; of Avens, Angelica, Alehoof, Birthwort long and round, Bistort, China, Ceterach, Cinkfoil, Dittany white, Gentian, Orrice, Rha∣pontick, Rhubarb, Sanicle, So∣lomon-seal, Sarsa, Tormentil, Valerian or Setwal. 2. Herbs; Adders-tongue, Agrimony, Ale∣hoof, All-heal, Angelica, Avens, Bramble-tops, Buckhorn-Plan∣tane, Bugle, Bugloss, Burnet, Cabbage red, Calamint, Cen∣tory the less, Cinkfoil, Com∣frey, Consound greater and les∣ser, Consound Saracen's, Daisies, Devilsbit, Fluellin, Golden∣rod, Harts-tongue, Herb-trinity,

Horse-tail, Hounds-tongue, Hy∣pericon, Hyssop, Ladies-mantle, Mousear, Mugwort, Orpin, Per∣wincle, Pimpernel, Plantan, Ribwort, Rupturewort, Sanicle, Savin, Saxifrage, Scabious, Sage, Wood-Sage, Sena, Scordium, Self-heal, Solomons-seal, Speed∣wel, Strawberry-leaves, Tansy, Tansy wild, Vervain, Vipers-Bugloss, Wintergreen, Yarrow. 3. Flowers; of Clove-gilly-flowers, Hypericon, Lilly-con∣vally, Roses, Rosemary, Sage. 4. To these things add, Fine Bole, Cloves, Mace, Mummy, Winter's Cinamon, Guaiacum, Lentisk-wood, Sassafras, River-Crabs, Sperma Ceti, Vipers-flesh, Steel prepared, Vitriol of Mars, Crabs-eyes levigated. And out of these Simples, compound Diet-drinks are made, according to the following Examples.

XXIX. 1. A Vulnerary of Barbett. ℞ Roots of Comfrey ℥ss. Wintergreen M. ii. Sanicle P.ii. Strawberry-leaves, Ladies-mantle, Sage, A. M. i. red Wine q.s. boil, strain, and dulcify with white Sugar. Dose, ℥iii.

XXX. 2. ℞ Red Mugwort, leaves of Tree-Ivy, Sanicle greater and lesser, Wintergreen, Ladies-mantle, Saracens Consound, A. ℥i. Daisies ℥ss. cut all small, and infuse in the best Wine lbss. fair Water lbjss. digest in a close B.M. for three hours; after let them stand all night, then strain out, and add, Nutmegs Crabs-eyes, Mummy, A. ʒii. and dulcify with Sugar ℥iv. Dose, ℥iii.

XXXI. 3. Or, ℞ Red Mugwort, Sanicle, Ground-Ivy, Saracens Con∣sound, Ladies-mantle, A. M. i. of the best Wine lbvi. boil them them in a close Pot, over a gentle Fire, till a quarter is wasted; then strain out, and dulcify. Give a Draught Morning and Night.

XXXII. 4. A Vulnerary-Drink of Barbett, where the Bone is broken. ℞ Round Birth∣wort-roots ℥j ss. Sowbread ℥i. Self-heal, Cranes-bill, A. M. i. Savin, Crabs-eyes, A.ʒiv. Mummy, Galangal, A. ʒii. cut and pouder all grossly, and boil in red Wine lbiv ss. till lbiii. only remains; strain out, and sweeten with Syrup of Comfrey ℥ iv. Dose, ℥ iii. Morning, Noon, and Night.

XXXIII. 5. A Traumatick, from Sennertus. ℞ Winter-green, Perwincle, Bugle, Mugwort, Pim∣pernel, Agrimony, A. M.ii. boil in Wine q.s. to the wasting of a quarter-part. Dose, ℥vi. Mor∣ning, Noon, and Night.

XXXIV. 6. Another, from Sennertus. ℞ Tormentil, Straw∣berry-leaves, Sanicle, Ladies-bed∣straw, Wintergreen, A. M. i. boil in new Beer, q s. Dose, ℥viii. Morning, Noon, and Night.

XXXV. 7. Or thus: ℞ Win∣tergreen M. iv. leaves of Ground-Ivy, M.iii. roots of white Gen∣tian ℥iv. cut them small, and put them into six quarts of new Beer: after two days the Patient may drink it. Dose, ℥vi. Morning, Noon, and Night.

XXXVI. 8. Or thus: ℞ Sa∣racens Consound the whole Plant M. iii. boil it in Wine lbiii. to lbii. then strain out. Dose, ℥iv. Mor∣ning, Noon, and Night.

XXXVII. 9. A powerful Diet-Drink. ℞ Shavings or Saw-dust of Oak-wood, of Lentisk-wood,

of Misselto, A. ℥ii. roots of Birth∣wort, of Consound, of Centory, of Madder, of Tormentil, of Vale∣rian, A. ℥ss. Chalybeated-water, viz. that in which Steel has been oftentime quenched, as Smiths Forge-water lbxii. boil them in a double Vessel, 'till a third or more is wasted; then add Alehoof, Parsley-roots, Bramble-tops, Hemp-tops, Mousear, Herb-trinity, Peri∣winkle, Horsetail, Strawberry-leaves, flowers of Lilly-convally, A. M. ss. Cinamon, Rhapontick, A. ℥ss. and boiling again, almost half an hour; strain out, and add thereto Aromatick-wine lbiii. lastly, dulcifie with Sugar. Dose, ℥vi. Morning, Noon, and Night.

XXXVIII. 10. ℞ Clary, Win∣tergreen, Periwinkle, Saracens-Consound, Woodbind, Sanicle, Speed∣wel, Ladies-mantle, Tree-ivy, Mugwort, A. M.iii. stale, or rather new Beer six quarts: mix, and digest fourteen days, or 'till it is a little sharp; then draw off the humidity in a glass Vesica, in B.M. to driness. Dose, three spoon∣fuls at a time, three times a day.

XXXIX. 11. Another. ℞ Raspings of Guajacum ℥iv. bark of the same Wood, Sarsaparilla, A. ℥ii. yellow Sanders, roots of Bistort, of Consound, of white Dittany, of Tormentil, of Valerian, A. ℥ss. Spring-water two gallons: infuse all together for 24 hours, after boil in a double Vessel, or Diet-pot, to the consumption of a third part: then add Horsetail, Betony, Mousear, Dittany of Creet, Wintergreen, wild Tansy, tops of Brambles, Herb-trinity, Strawberry-leaves, A. M. ss. Ci∣namon ℥ss. boil 'till three quarts only remain after a strong expres∣sion; and then add of the best white Port-wine lbiii. and make it pleasant with Sugar. Dose, ℥iv. or more; Morning, Noon, and Night.

XL. 12. A Wound-Drink, which I have had great Expe∣rience of. ℞ Scabious, Sanicle, Self-heal, Wintergreen, A. M.ii. An∣gelica, Betony, Sage, Bawm, Scordi∣um, Centory, Ladies-mantle, Herb∣trinity, Avens, Perwincle, Speedwel, Hops, A. M.i. Plantan, Buckhorn-Plantan, Borrage, Bugloss, Comfrey, Agrimony, Hypericon, Cinkfoil, Bramble-buds, Mint, young Oak leaves or buds, Woodbind-leaves, wild Daisies, Adders-tongue, Rose∣mary, red Beets, A. M.ss. Guaja∣cum and Sassafras rasped, Sarsa∣parilla bruised, A. ℥iv. Rhodium rasped, roots of Bistort, of Contra∣yerva, of Tormentil, of Valerian, A.℥ijss. Coriander-seed, Caraways, A. ℥ii. all being cut and bruised put them up into a Bag with a Stone in it; which put into six Gallons of well-brewed Ale, and one Gallon of Whitewine, with choice Honey lbiv. let all work together, and after two or three days, the Patient may drink of it as his ordinary Drink.

XLI. 13. Another Excellent Wound-Drink. ℞ Avens, Herb∣trinity, Ladies-mantle, Peri∣winkle, A. M. iv. bruise them, and cut them small, and boil them in Water, Wine, A. lbvi. 'till one third is consumed: strain out, and add good Spirit of Wine or Brandy lbii. white Sugar lbi. or enough to make it pleasant. Dose, ℥iv. Morning, Noon, and Night.

XLII. Now here is to be noted, that Andraeas à Cruce saith that these four, viz. Avens, Herb∣trinity, Ladies-mantle and Per∣winkle, are to be extolled and commended for this use: without doubt they are excellent things, but twice or thrice that number are to be had full as good, and which upon trial, you will find nothing inferior.

XLIII. Sennertus also says, that Herbs appropriated to the wounded Part, ought to be observed and chosen; as Betony, Roses, &c. for Wounds of the Head; Speed∣wel, &c. for Wounds of the Brest; Agrimony, &c. for Wounds of the Liver; Ceterach or Spleen∣wort, &c. for Wounds of the Spleen; Strawberry-leaves, &c. for Wounds of the Reins.

XLIV. And to the Examples here given, you may add, 1. Decoctum Traumaticum, 2. De∣coctum Vulnerarium, 3. Decoctum Cancri, 4. Decoctum Sudorificum, 5. Decoctum aperitivum majus, 6. Decoctum aperitivum minus, 7. Decoctum Vulnerarium Myn∣sichti: all which you may see in Our Pharmacopoeia Lon••inensis, lib. 4. cap. 14. sect. 5.8.11.20.26.28.30. also Our Deco∣ctum Traumaticum, and Barbett's Vinum Hydragogum, both which you may see in Our Doron Medi∣cum, lib. 2. cap. 14. sect. 4. & cap. 12. sect. 7. of the same Book.

XLV. Sennertus also has a specifick Traumatick-pouder, which for the excellency of it, we will give you here. ℞ Crabs-eyes levigated ℥jss. Nutmegs in fine pouder ℥i. mix them. Dose, ʒss, to ʒi. in white Port-wine. Or thus: ℞ Crabs-eyes levigated ℥ii. Ivory calcin'd white, Pearl, A.ʒvi. Coral ʒiii. all being in a fine or levigated pouder mix them. Dose, ʒi. at a time in Wine, or Wine mixt with Water.

CHAP. IV. Of an HAEMORRHAGE in Wounds.

I. IT is called in Greek, 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉. in Latin, Haemorrhagia Vulneris; in English, the Bleeding of a Wound; which is always to be understood of a violent and symptomatical Bleeding.

II. And it is distinguished from 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, from the Part and Occasion; this latter being for the most part a spon∣taneous bleeding at the Nose.

III. The Kinds. It is three∣fold: 1. That which proceeds from wounded Arteries. 2. That which proceeds from wounded Veins. 3. That which proceeds from a Wound or hurt of both those Vessels.

IV. The Causes. The chief cause is declared in the Kinds, which is from a hurt of one or more of the Vessels; which then always produces some notable

Haemorrhage; from whence proceeds oftentimes Faintings, Swoonings, and other dangerous Symptoms.

V. Now tho' the Wound in∣flicted upon the Vessels is the prime or principal Cause; yet it hap∣pens, and that oftentimes, that the Blood may be now and then stopt for a season; and that it may afterwards suddenly break forth again.

VI. This is many times caused from trouble or commotion of Mind, anger, vexation, or (if the Wound was made by an Enemy) the presence of the Adversary; by which the Spirits being per∣turbed, give a sudden motion to the Blood, and so induces a new and fresh Haemorrhage in the Wound.

VII. Sennertus gives an Ex∣ample, in two Brothers, the one of which had wounded the other: while the Wound was binding up, the Brother which gave the Wound came in to visit the the other; whereupon (tho' they were now reconciled) the Blood presently broke forth afresh; which was without doubt from some secret commo∣tion of the Mind: for upon that Brother's departure, and being forbidden any more visits, the Blood immediately stanched.

VIII. The Signs. It is known by sight: if it is from an Artery, the Blood is seen to come forth by leaping, and with violence; being more hot, fervent, thin, yellow, and frothy, than that which comes out of the Veins; and is always accompanied with some notable alteration of the Pulse, weakness, and dejection of strength.

IX. If it is from a Vein, the Blood is more thick, black, dark, and less hot; coming forth with∣out any violence or rushing, smoothly, and with an equal pulse; far less dejecting the Spirits, than that which comes forth by the Arteries.

X. If the greater Vessels are wounded, the Blood flows forth in greater abundance, and with greater violence; but with far less, if it is one of the lesser Vessels which is hurt.

XI. The Prognosticks. An Ar∣terial Haemorrhage is more dan∣gerous than a Venal; because an Artery wounded, is more diffi∣cult to be cured and consoli∣dated, than a wounded Vein, because of its hardness, perpe∣tual motion, and violent leaping forth of the Blood.

XII. An Haemorrhage from an Artery wounded longwise, obliquely or transversly; is much more difficult to be stopt, than where the Artery is cut perfectly asun∣der.

XIII. An Haemorrhage from an Artery cut transversly asunder, is more easily curable; because the Artery will be again contracted, and its Orifices close and shut again, and more easily meet, and grow together again, and be the sooner covered and consoli∣dated, with the circumjacent Flesh lying round about it.

XIV. An over-great Haemor∣rhage in Wounds, in what kind soever, is very dangerous, because the Blood is the Fountain and

Treasure of Life: for when the Vital Spirits are called forth, it causes a weakness of the Pulse, with a frequency and in∣equality, and sometimes an in∣termission; also a Syncope, or fainting and swooning, Chilness of the outward parts, extream Coldness, inordinate Sweats, Convulsions, Sighings, Sobbings, Delirium, and sometimes at length Death it self.

XV. Hence Hippocrates, Sect. 5. Aph. 5. says, that a Convulsion or Sighing, happening upon an abun∣dant Flux of Blood, is always very evil and dangerous.

XVI. And in Sect. 7. Aph. 9. that a Delirium or Convulsion hap∣pening upon a great Hemorrhage, is evil, and full of danger.

XVII. And this is more espe∣cially caused by an Arterial Hae∣morrhage; because therewith, there is a greater effusion and dissipation of Native Heat, and Vital Spirits.

XVIII. A Venal Haemorrhage is without danger, if it is in an external place; where Applica∣tions can be easily made, and the smaller Veins only are wounded.

XIX. The Cure. The Indica∣tions of Cure are twofold: 1. The union and consolidation of the wounded Vessels, of which we shall say nothing in this Chapter; it belonging to Chap. 11. following. 2. The stopping of the Haemorrhage, or stanching of the Blood; which where it is very great, dejecting the Spirits, Strength, and Powers of the Body, ought first to be done, before the unition and conglutination of the Vessels; that the Patient may not run a manifest hazard of his Life.

XX. Now an Haemorrhage may be stopt by application of fit Reme∣dies, and well Binding-up: but if by this means the Blood cannot be stanched, but shall yet break thro' the closed Wound and Bandage, by reason of its impe∣tuous violence, then all those things which do induce that violence, are to be removed and forbidden.

XXI. As Anger, vehement Joy, Drinking of Wine, Brandy, or other hot Liquors; hot and thin Humors of the Body fermenting, violent motions of the Body, or action of the Part wounded; the declining, and downward-position of the Mem∣ber, and the motion of an Ar∣tery not wholly cut asunder.

XXII. There are several ways by which Blood may be stanched: 1. By the application of Dossels or Pledgets of Lint or Towe, moist∣ned either in the glair of Eggs; or in a mixture of Vinegar p. i. with Water p. iii. in tender Bo∣dies: or Vinegar p. i. with Water p. ii. in more hardy Bodies.

XXIII. This Mixture is called Posca, and is to be applied warm; because cold Applications are hurt∣ful to Wounds. Dry Lint or Towe must be avoided, because they stick so fast to the lips of the wounded Parts; that by re∣moving them, (which must be with some force) a new flux of Blood is often caused; and if fomenting with some fit Liquor is used, as Milk, Butter and Beer warmed, &c. it is often prejudicial in Wounds of the fleshy Parts.

XXIV. 2. By the application

of Crepitus Lupi, than which there is scarcely any thing to be named, which can more powerfully and cer∣tainly do it.

XXV. For it being of a nature extremely dry, and drying, as it will no way admit of the flowing forth of the Blood; (which those Medicaments do which are na∣turally moist, and therefore are less useful in stanching of Blood;) so it will likewise subsist, and stick fast in the Vessels.

XXVI. But it will be most use∣ful for this purpose, if it is first with a Thread tied round, and then pressed hard together in a Screw-Press, letting it lye therein for some certain time: for so when it comes to be im∣posed upon the Wound, it again dilates it self, and puts a stop to the Haemorrhage or flux of Blood.

XXVII. 3. By Deligation of the Vessels (where it may be) whether Vein or Artery: this is only used when great Vessels are Wounded. Now here is to be observed, first that if a Nerve accompanies the Vessel, (as in the Soporal-Artery which has the recurrent Nerve annexed to it) you must separate the Nerve therefrom, for otherwise, that part into which the Nerve is in∣serted will be deprived both of moving and feeling, besides the great pain which will be exci∣ted.

XXVIII. Secondly, in the de∣ligation of the Vessel, the binding is not to be too strait, because the thread will cut the Vessel asunder too soon, and so cause a now He∣morrhage: the thread ought to be either of strong Silk, or Steel Hemp, as they call it, such as is Sealing thread, which will not easily rot, whereby there will be less fear of a new flux of Blood, which latter may prove more dangerous than the for∣mer. Ambrose Parey lib. 11. cap. 20. used this way after Am∣putation, but it is very trouble∣som, and not mightily appro∣ved of now.

XXIX. 4. By Application of Sarcoticks or Incarnatives. Ga∣len, Meth. Med. lib. 5. cap. 4. Prescribes this. ℞ fine Aloes ℥iii. Frankincense ℥ii. make them into a pouder, and mix it with doun of a Hare, and white of an Egg, so much as to bring it to the consistence of Honey. Spread this upon Dossels of Tow, and so lay it upon the Vessel, and the whole Wound; the Vessel be∣ing first closed with the finger, and then cleansed from the Clot∣ted Blood and moisture, with a piece of Sounge dipt in red Wine, or some astringent De∣coction, and the parts of the Wound about your Finger be sprinkled with the former Pou∣der.

XXX. The Pledget or Dossel armed as aforesaid, being laid on, presently press it down with your finger; which keep so, till you have filled up the Wound with more ar•…•…ed Pledgets or Dossels.

XXXI. This done, apply a dou∣ble Cloth over all, moistned in some astringent or styptick Liquor, and wrung out; and then in a fit and convenient manner bind up the Wound with Swaths or Rousers,

beginning to rowl below the Wound; but when you are come to the Wound, you may com∣pass it with three or four Cir∣cumvolutions, then ascend and roul the part above the Wound, to press the Blood out of the Vessel, that the flux of Blood may be stayed; and open not the Wound till the third or fourth day.

XXXII. When you come to dress it, all the Pledgets or Dossels are to be taken away, except the first, which imediately sticks to, and closes the Vessel; which done, the Wound is to be sprinkled with more of the pouder, as before, and then over it new Armed Dossels are to be apply∣ed; and thus the Wound is to be drest every other day, till it is incarnated, and no fear is left, of another Hemorrhage.

XXXIII. But if after the first dressing, the Blood shall begin again to flow, and the Pledgets of their own accord grow loose; then with your Finger, press down gently upon the Vessel that nothing may flow forth, and take away the former moistned Pledget very carefully, dry the Wound, strew on more of the dry pou∣der, and then apply new Arm∣ed Pledgets, binding it careful∣ly up as before; for so long as the Pledgets or Dossels shall be softned by the Blood, the He∣morrhage cannot be said to be sufficiently stopt.

XXXIV. These following compositions are also commend∣ed in this case. ℞ Aloes, Frank∣incense, white Starch, fine Bole, doun of a Hare, Cobwebs, A.q.s. mix and make a pouder. ℞ Archangel, Moss of the Sloe-tree, Nettleroots, Dragons, A. q.s. make a pouder and strow upon the Wound.

XXXV. Guilielmus Fabrici∣us, commends this following. ℞ white Starch ℥iii: Water-frogs dryed and poudred ℥i: Whites of Eggs dryed and poud∣red, new Spunge torrified and pou∣dred, Sanguis draconis, Frank∣incense, moss of a Mans Skull Parget, A. ℥ss. fine Bole, Ter∣ra Sigillata, A. ʒii: Doun of a Hare torrified and poudred ʒi: make all into a very fine pouder.

XXXVI. ℞ Catechu, Cor∣tex Peruanus, fine Aloes, Oliba∣num, Myrrh, Pouder of Toads-Flesh, A. ℥i: Sanguis Draconis, ashes of an old Hat, Saccharum Saturni, Man's Blood dryed, Cro∣cus Martis astringens, Nut-galls, Opium, A. ℥ss: make each into a fine pouder, and mix them. Now here is to be noted, that these Medicines are to be used, till so much flesh is bred about the Vessel, as to close up its Orifice; for till then, the fear of an He∣morrhage will not be over. See lib. 3. cap. 7. sect. 16. ad 20. and cap. 15. sect. 24, 25.

XXXVII. 5. By application of Astringents and Stypticks, which are yet the more powerful stoppers of an Haemorrahage. Sennertus, lib. 5. par. 4. cap. 14. com∣mends this. Take Roch-alum, q.v. pouder it, and put it into an Ox-bladder, and so put it into a Kettle of hot Water to be dis∣solved; distil this Water by an Alembick, and continue the Work so long, till the Faeces are dry:

these Faeces dissolve again in an Ox-bladder as before, and distil again; and repeat this Work till the whole substance of the Alum shall be converted by Distillation into Water.

XXXVIII. This Recipe is the same, and differs not much in the Preparation from the Alumen dulce liquidum in Our Pharma∣copoeia Bateana, lib. 1. cap. 9. sect. 10. § 5. pag. 376. a. which is a Magisterial Spirit of Alum, and is accounted one of the best Stypticks known in the World.

XXXIX. And to this you may add the Aqua Styptica, and its Succedaneum; also Stypticum Regis, or Royal Styptick, Terra Vitrioli dulcis, Arcanum Alumi∣nis: which you may see in Our Pharm. Bateana, lib. 1. cap. 1. sect. 56. & 57. pag. 29. & 30. cap. 9. sect. 12. pag. 378. & sect. 104. pag. 581. and those described in lib. 3. cap. 11. sect. 111, 112. aforegoing, of this Work.

XL. If you cannot come to reach the Vessel with your Finger, you may inject some astringent Liquor; made of fine Bole, Terra Sigil∣lata, red Oker, Sanguis Draco∣nis, new Galls, Hypocistis, juice of Sloes, Acacia, juices of Plan∣tan, Comfrey, Knotgrass, Horse∣tail, Leeks, Bistort, Docks, Yar∣row, &c. out of which you may make such a Liquor as this is.

XLI. Take Smiths-forge-water lbjss. juices of Comfrey, Knot∣grass, Horsetail, Bistort, Yarrow, A. ℥ii. Vitriol-stone in fine pouder ʒi. fine Bole, Terra sigillata, Roch-Alum, Saccharum Saturni, A. ʒii. mix, and make an Injection; which inject softly into the Wound with a Syringe.

XLII. 6. By Application of Specificks. Some things are said to stanch the Blood by a spe∣cifick property; for which pur∣pose, Strawberry-water is com∣mended in all Haemorrhages. So also the root of Pseudomelanthium, which some call Lychnis, sive Lychnoides Segetum, sive Nigella∣strum, Cockle, or Corn wild Campion, being held under the Tongue, is said to stop an Haemorrhage.

XLIII. And there are some which recommend to us for this purpose, the roots of Succory with the white flower; and it has been found by experience, that holding the Jasper-stone in the hollow of the Hand, the Blood has been stopt: others have been cured, by holding Lapis Haematitis, or the Blood-stone in the Hand, or tying it to the brawny part of the Arm.

XLIV. Others have been cured, by applying to the Part affected the pouder of the Blood-stone in good quantity; also the pouder of the Loadstone, and Crocus Martis astringens: but nothing stops a Haemorrhage more power∣fully, that we have yet met with, than the Moss which grows up∣on Humane Sculls, Human Blood dried, Pouder of Toads, and Catechu.

XLV. 7. By applying Revul∣sives, and Interceptives or Repel∣lers. Revulsives, are Cupping-Glasses, both without and with Scarification; which, as need shall require, are to be put upon remote and opposite places:

and some Authors prescribe Bleeding in opposite places, yet this can be, but when the strength of the Patient is but little impaired; and then to be taken away by little and little, and not at once.

XLVI. Interceptives are ap∣plied, to drive back, or hinder the Afflux, and incrassate the Blood while it is flowing: and these are to be applied unto the Vessels by which the Blood flows unto the wounded Part; but above upon the Part, to∣wards the root of the Vessel, and more especially (where it may be done) on the exterior Parts, where only the Veins ly hid under the Skin, and not covered with much Flesh.

XLVII. We ought (says Hip∣pocrates, Sect. 5. Aph. 23.) to make use of some cold Medica∣ment, in those who have any Haemorrhage, or are likely to be troubled therewith; and this Me∣dicament is not to be applied unto the some place, but to those places from whence it flows.

XLVIII. Now these Intercepters are made of things cold and astringent; as Posca, rough and acid Wine, Rose-water, Plantan-water, Oak and Nightshade Waters, Barley-meal, Henbane-seeds, pouder of Myrtle-berries, fine Bole, Terra sigillata, Dragons-blood, Mastich, Olibanum, red Roses, Balaustians, whites of Eggs, &c.

XLIX. Out of which, and others of like kind, which we have enu∣merated more at large, in Lib. 3. cap. 5. sect. 57. ad 78. afore∣going; you may compound and make various Forms, as you shall see fit; of which you have also various Examples in the places before cited, so that no more need be said thereof here.

L. The Interceptive being laid on, the Part is to be bound up with a Swath or Rowler, which may bind close the Vessel towards the root thereof: and the Ligature is not to be loosned before the third or fourth day; or indeed it is not to be removed, till the Haemorrhage is throughly stopt.

LI. 8. By cutting the Vessels quite thro', or asunder, where the Haemorrhage is made by a Wound of the Vessel oblique, or transverse. This is known by the great effu∣sion of Blood, which follows upon the Wound; which is al∣ways greater, than if the Vessel was wholly cut asunder.

LII. In this case, you must cut the Vessel compleatly thro', or asunder; for so you will the more easily stanch the Blood: for the Vessel will be drawn back, and on both sides contracted within it self; and so its Orifice will be covered, and shut up with the Bodies which lye round about it.

LIII. And then you may apply those things which we have before directed for stopping the Haemor∣rhage; whereby the Orifices of the Vessel will be perfectly closed, and the Patient secured against a future Flux.

LIV. 9. By application of Esca∣roticks. One of the chief of these things, is Vitriol, which some beat into pouder, and

apply crude, sprinkling it upon the Wound, for stopping the Haemorrhage: others dissolve it in Water, and then moisten linnen Cloths therein, and lay them upon the Wound.

LV. Others apply Calcanthum, Atramentum Sutorium, or English Copperas, either in pouder, or else dissolved in some Styptick-water; which is of good use in Wounds, where the Orifice of the Vessel cannot be closed by compression, or the application of the Crepitus Lupi.

LVI. Now this Calcanthum being dissolved in Liquor, pene∣trates even thro' the wounded Vessel: for which reason we are to beware, that the Nerves (if any be near) be not hurt: and therefore that into such deep Wounds, where Nerves are pre∣sent, other more safe Stypticks are to be injected.

LVII. Some Authors, besides Vitriol, in this case commend Alum, Aegyptiacum acuated with calcin'd Vitriol, Oils of Vitriol and Sulphur, &c.

LVIII. This of Barbett is of good use, because it operates with little or no pain. Take unslakt Lime, black Soap, A. q.s. mix, and make a Cataplasm, and apply it.

LIX. Or thus. Take Ʋmber (with Spanish-Brown) in fine pouder, unslakt Lime rubbed to a fine pouder, A.q.s. whites of Eggs beaten into glair; mix them into the consistence of a Liniment, ad∣ding also the doun of a Hare. This causes little pain, and also mightily closes the Mouths of the Vessels.

LX. Fallopius in his Book of Wounds, advises to take a Reed answerable in thickness to the ca∣pacity of the wounded Vessel; and stopping one end of it with a Cork, then to fill it with German or Hungarian Vitriol melted: which when cold, is to be thrust in at the one end, so as it may be an inch without the Reed at the other end; and then to be applied to the Vessel, and held there for the space of an hour, in which time the mouth of the Vessel will be compleatly closed.

LXI. Colcothar (which is Vi∣triol calcin'd to redness) being also applied to Wounds, does imme∣diately stop their bleeding; and its Salt being dissolved in Water, and injected into deep Wounds, does also the same thing: but in this case, care ought to be taken of the Nerves. See its Preparation in Our Seplasium, or Druggist's Shop, lib. 2. cap. 12. sect. 14.

LXII. 10. By exhibition of Inter∣nals, which are Coolers, Iucrassa∣tives, and Narcoticks. Coolers, are Barberries, Bole-armoniack, Co∣rans, Coral, Lettice, Purslan, Pom∣granates, Pears, Quinces, Roses, Succory, &c.

LXIII. Incrassatives, are Myr∣tle-berries, Terra sigillata, Hypoci∣stis, Acacia, Sloes, Acorns, Com∣frey, Lapis Haematitis, Crocus Martis, Jesuits Bark, Bistort-root, Tormentil, Catechu; which last is inferior to no other thing in the World.

LXIV. Narcoticks, are Man∣drake apples and roots, Hen∣bane juice, roots, and seed;

juice, flowers and seeds of Pop∣pies, Opium; which last among Physicians is instar omnium, and the most powerful thickner, not only of the Blood, but of all the other Juices.

LXV. Cut of these things you may prepare Waters, Syrups, Lo∣hochs, Po••ions, Juleps, Pouders, Electuaries, Pills, Tinctures, &c. which may be easily given, and in small Dose: Our Tinctura mi∣rabilis, given to one or two spoonfuls, in Ale or Wine and Water, stops Bleeding to a miracle, and upon the spot; which may be repeated as often as need requires.

LXVI. This following Potion is also of singular use. Take Diascordium ʒi. Philonum Per∣sicum, Acacia, A. ʒss. Tinctura mirabilis ʒiii. Syrup of white Poppies ℥i. Corn-poppy water ℥iv. mix, and make a Potion.

LXVII. You may also give Our volatil or specifick Laudanum; or Dr. Gardner's Laudanum Tar∣tarizatum, à gr. i. ad gr. iv. liquid Laudanum, à gut. x. ad gut. xx. or xxvi. or Our Guttae Vitae, à gut. 20. ad lx. or more; according to the age and strength, &c. in some fit Ve∣hicle.

LXVIII. When the Blood is fully stanched, and shall become clotted, then we must use the best of our skill to prevent its putrifying; and endeavour to dissolve it, as we have taught in Lib. 3. cap. 7. sect. 23. ad 29.

LXiX. Or you may give this: Take Rhubarb, fine Bole, Terra sigillata, Mummy, A. ʒi. make a Pouder. Dose, ʒ i. in Chervil or Parsley Water. Or, Take Terra sigillata, Madder, Mum∣my, Comfrey, Rhubarb, A. ʒi. make a Pouder. Dose, ʒi. or more.

LXX. Or, Take Terra sigil∣lata, Crabs-eyes, A. ʒi. Goats-blood dried, Sperma Ceti, Ange∣lica and Gentian roots, Rhubarb, Snakeroot, A. ʒss. Salt of Beef, Cloves, A. ℈ss. make a Pouder, for six Doses, in Hydropiper-Water.

LXXI. Or, Take Crabs-eyes, Mummy, Madder, Goats-blood dried, roots of Madder, Rhubarb, round Birthwort, sweet Fennel seed, A. ʒi. make all into a pouder. Dose, ʒi. in Syrup of Sorrel, or Juice of Citrons, or in Oxycrate, or Posca.

LXXII. And Posca, which is a mixture of Vinegar and Water, is an excellent thing of it self: but the Vinegar ought not to be mixt in so large a quantity with the Water, as to excite a Coughing: being given warm two or three times a day, it dissolves coagulated Blood.

LXXIII. Donatus commends this. Take Rhubarb ʒi. Mummy gr. vi. Madder gr. iv. make a Pouder; which give in Posca, or Red-wine.

LXXIV. The Diet also should be so ordered, to contribute to the stopping of the free course of the Blood: for which purpose, Meats ought to be made of Rice, Amylum, fine Wheat-flower, Barley-flower, Biscuit, Corans, Medlars, Pears, Quinces, Services, &c. and to abstain from Wine, and all hot and

spirituous Liquors, violent Mo∣tion and Exercise of the Body, Anger, Vexation of Spirit, and all Trouble, and Commotion of Mind, &c.

CHAP. V. Of EXTRANEOƲS THINGS in WOƲNDS.

I. IF any Extraneous Body or Thing is contained in the Wound, which may hinder unition, conglutination, or healing, it is to be taken forth. And therefore if only the lesser Vessels be wounded, the Haemorrhage is not immediately to be stopped; but we must permit what Blood we find flowing from the lesser Veins which are cut asunder, freely to flow forth.

II. For by this means there will be a less quantity of Pus generated, and all the danger of Inflamma∣tion and Putrifaction will be pre∣vented: which is evident from those, who out of simple Wounds are wont either to draw forth the Blood by sucking with their Mouth; or else to squeeze it out, by compression of the wounded Part with their Fin∣gers.

III. This being premised, we are to consider, what kinds of Extra∣neous Bodies or Things they are, which are to be removed out of Wounds: and these are extra∣neous either by accident, or of their own nature.

IV. Things which are extra∣neous by accident, are, 1. Hair. 2. Clots of Blood. 3. Contused Flesh. 4. Separated pieces of Flesh. 5. Fatty Substances. 6. Membranes. 7. Tendons. 8. Ligaments. 9. Cartilages. 10. Pieces or Splinters of bro∣ken Bones.

V. Those things which are ex∣traneous of their own nature, are, 1. Pieces of Garments. 2. Sand, or Gravel. 3. Earth. 4. Stones. 5. Plugs. 6. Glass. 7. Small∣shot. 8. Bullets. 9. Pieces of Iron. 10. Splinters of Wood. 11. Heads of Arrows. Or, 12. Pieces of Weapons, of various kinds.

VI. If there are Hairs near about the Wound, they are to be shaved away with a Razor; lest they fall within the lips of the Wound.

VII. If Clots of Blood be in the Wound, which may hinder Ʋnition, excite pain, putrify, and cause a Feve; they may be washed away with a piece of Spunge, or lin∣nen Cloth, dipt in warm white or red Port-Wine, Aqua Vitae, Posca, Brandy and Water mixt together, Oxymel dissolved in Water: or, in the Country where these things cannot be

had, in Milk, or Ale warmed: or if need require, they may be taken forth by help of some proper Instrument.

VIII. But in doing this, you must use no manner of violence at first: neither is all the clotted Blood to be taken forth, especially if a Haemorrhage is feared; for that the clotted Blood does in some manner stop the Orifices of the Vessels, which may grow together under them: but the removing them wholly is to be deferred to the second or third Dressing, when Nature her self will begin to expel whatsoever is extraneous, and be helping and assisting in the case.

IX. Nor are you to omit cleansing of the Wound with your Probe, armed with Lint; and repeated with fresh Lint, as oft as need requires.

X. Pieces or Splinters of bro∣ken Bones likewise, if any such, are to be taken forth, either with your Forceps, or Ravensbil; so also pieces of Fat or Flesh, Membranes, Tendons, Liga∣ments, or Cartilages, which may stick in the Wound.

XI. But however in the first dressing, those things only are to be taken forth, that are free and loose; so that they may be taken out of the Wound, without offering any violence to it.

XII. But as for such small pieces of Bones which stick fast unto the Flesh, or other Bones; you are to wait for Natures help in expelling them: whereby you will see, whether she will unite these Fragments to the rest of the Bone; or make a separation there-from, and ex∣clude them.

XIII. As for Sand, Gravel, or Earth, they are to be washed out, and taken away; as we have directed at Sect. 7. above, about clotted Blood.

XIV. If pieces of Garments, or Iron, or if Glass is broken in the Wound, they are to be taken forth: and this is also to be done, if any other kind of Matter, or Weapon, or part of a Weapon stick in the Wound.

XV. But before we assay the Extraction of these things, we are to consider, whether or no the wounded Person is like to live after their taking forth: for if there is no hopes of Life, the Artist ought not to attempt their removal, not of the Weapon it self; lest the Patient dying under his hands, it should be thought that he had hastned his Death.

XVI. As is oftentimes manifest in Wounds of the Brain, and of the Heart, of the Vena cava, and great Artery; where if the Wea∣pon is left in, the Patient may possibly live for the space of a day: whereas if it be taken forth, a vehement Haemor∣rhage follows thereupon, and the Patient instantly dyes.

XVII. But where there is hopes of recovery, we ought to endeavour the extraction of the Weapon, or other extraneous Matter: for tho' pieces of Weapons, and leaden Bullets may sometimes stick very long in the Wound, yet it is a very rare thing, that the Wound should be perfectly healed, with∣out their drawing forth.

XVIII. However, you are not to assay the drawing out of such Bodies, as cannot but with great difficulty and danger, be taken forth; and which remaining in the Body, the Wound may be cured: as leaden Bullets, and Small-shot, which sticking very deep, in extream fleshy Parts, or in great Joints, as the Shoulder, Elbow, Knee, &c. where being in∣closed with Flesh, the Wound is sometimes healed with them remaining in it.

XIX. This being said, we now come to shew how those other fo∣rein Substances, which are not loose, or cannot be wiped or washed away, may be taken forth; and that is by a twofold means: 1. By the help of Medicaments. 2. By the help of Instruments.

I. By the help of Medicines.

XX. Medicines for this purpose, are either Simple, or Compound: and the Simple are of three kinds; 1. Such as operate by a Specifick Virtue: 2. Such as operate by a Digestive or Putri∣factive Virtue: 3. Such as ope∣rate by an Attractive Virtue.

XXI. Specifick Simple Medi∣caments are; Pimpernel, Brook∣lime, Dittany of Creet, roots of round Birthwort, Anemony, roots of Narcissus, of Gladiol or Corn-flag, and Reed-roots, beaten into a Cataplasm with Honey: Henbane-leaves beaten, and ap∣plied in form of a Pultiss: Horned-Poppy-leaves beaten, and used in like manner: and the Heads of Lizards beaten in∣to a mass, and imposed. See Dioscorides, lib. 2. cap. 58. and Paulus Aegineta, lib. 4. cap. 52.

XXII. Digestive and Putrifa∣ctive Medicaments for this pur∣pose are; Turpentine, Honey, yolks of Eggs, Sheeps and Beef Suet, Birdlime, old Pigeons dung, Hens dung, Ducks, Goose and Turkies dung; leven, and the like.

XXIII. Attractive Simple Me∣dicaments for this purpose are; Gum Ammoniacum, Assa foetida, Aloes Hepatica, Capivi, Elemi, Euphorbium, Galbanum, Opo∣panax, Pitch, Pine-Rosin, Pro∣polis, Tar, leaves and roots of Dittany, Garlick, Leeks, Onions, Shelots; and other like things, hot in the third or fourth degree, of subtile and thin parts.

XXIV. Out of the substance of these simple things, compound Medicaments are prepared: as, 1. The Emplaster of Avicen. ℞ Leven, Propolis or Honey, A. lbss. Birdlime, oldest Oil, A. ℥ iii. Ammoniacum ℥ ii. mix, and make an Emplaster.

XXV. 2. ℞ Virgin-wax ℥iv. Turpentine ℥ii. Loadstone ℥jss. Bean-flower ℥i. Deers-suet ℥ss. mix, and make an Emplaster.

XXVI. 3. Fallopius his Ca∣taplasm. ℞ Propolis, Sagapenum, Dittany-roots fresh gathered, A. ʒiss. Leven, Pigeons-dung, A. ℥i. one Onion boiled, Tar, Honey, A. q.s. beat all together in a Mortar to a Cataplasm.

XXVII. 4. Another of Fal∣lopius, stronger. Take fresh Dit∣tany roots, pouder of Dittany of Crcet, Assa foetida, Elemi, Saga∣penum, Pine-Rosin, A. ℥i. Birdlime

℥ss. Sulphur vive ʒi. Euphor∣bium ʒss. Tar, Honey, A. q.s. mix, and beat them into a Cata∣plasm.

XXVIII. 5. Take Bees Wax lbi. Colophony, yellow Rosin, Oil of yolks of Eggs, A.℥iv. Loadstone in pouder ℥v. juice of Citrons ℥iii. Ammoniacum ℥ii. Bdellium ℥i. mix, and make an Emplaster.

XXIX. 6. Take Wax, Turpen∣tine, A. ℥ vi. Ceruse, Roman Vi∣triol, A. ℥iv. Oil of Juniper ℥jss. Oil of Earthworms, Colophony, Ship-Pitch, Frankincense, Cam∣phir, Mummy, Dragons-blood, A. ℥i. Oil of Eggs ʒvi. Mastich, Oil of Hypericon, A. ℥ss. pouder of Haematitis or Blood-stone, Load∣stone, Oil of Cloves, A. ʒii. make an Emplaster.

XXX. 7. Take Oil-olive lbjss. new Wax lbi. melt them toge∣ther, and add Litharge of Gold lbjss. boil them; afterwards add Ammoniacum, Bdellium, A. ℥ii. Galbanum, Opopanax, A. ℥i. dis∣solved first in Vinegar. These things being mixt, add pouders of round Birthwort root, Tobacco, Myrrh, Frankincense, Mastich, A. ℥ii. boil all with a gentle Fire, adding in the end of the boiling, Oil of Bays, Turpentine, A.℥v. stir them well together, and pour all into cold Water; and with Oil of Camomil or Turpentine, an∣ointing your Hands, make the Emplaster up into long Rouls.

XXXI. 8. Take Oil lbii. Litharge lbi. Colophony lbss. Wax ℥ iv. Ammoniacum, round Birthwort roots, A. ℥ii. Galbanum, Frank∣incense, A. ℥jss. Gentian ℥i. Pro∣polis, Aloes Hepatica, Verdigrise, burnt Brass, Dittany of Creet, A. ʒvi. mix, and make an Em∣plaster.

XXXII. 9. Take bulbous Nar∣cissus roots N^o ii. Reed-root ℥i. Gladiol-root ℥ss. rotten Doves-dung ℥i. Mullein-leaves M.i. roots of the wild Cucumber, of round Birthwort, of white Dittany, Dit∣tany of Creet, meal of Orobus, A.℥ss. Honey q.s. mix, and make an Emplaster.

XXXIII. 10. Take Pine-rosin ℥ii. Stone-pitch ℥i. Ammoniacum, Sagapenum, Elemi, A. ℥ ss. roots of round Birthwort and of white Dittany, Dittany of Creet, A. ʒii. old Oil q.s. mix, and make a Cerat.

II. By the help of Instruments.

XXXIV. But if by nothing of Medicinal means the extraneous Body can be drawn out, we must then make the attempt by help of Instruments: wherein we must first consider the substance, nature, figure, situation and con∣nexion of the Parts offended, and Parts adjacent. Secondly, the diversity of the Matter to be drawn forth; its substance, magnitude, and figure; that the Arteries, Veins, Nerves, and Tendons may not be torn or violated: for it would be much unbecoming an Artist, that it should be said, that his Hand had done more hurt than the Weapon.

XXXV. You are also to consider, 1. That the Matter may easily be drawn forth. 2. The fears of an Apostemation, which may corrupt the wounded Part.

3. The fears of the Matter to be drawn out, being poi∣soned.

XXXVI. Then in order to this Work, you must consider also; 1. The situation the Body was in, when wounded. 2. The depth of the place where the Matter is lodged. 3. The way by which the Extraneous Matter may be best drawn forth. 4. The Symptoms of the wounded Part; as well those future, as those which are present. For Example sake; if there is great pain, en∣dangering Convulsions, the ex∣traneous Matter is without delay to be extracted: but if a dreadful flux of Blood should ensue after extraction, it is to be deferred, because this latter may sometimes bring present 〈◊〉〈◊〉.

XXXVII. In 〈◊〉〈◊〉 therefore to the Extractive of these things, four things are to be known: 1. With what Instruments they are to be 〈◊〉〈◊〉 out. 2. The time when it is most fit 〈◊〉〈◊〉 do it. 3. By what ways they are to be taken forth. 4. The form of the Matters to be ex∣tracted.

XXXVIII. 1. As to the Instru∣ments mostly in use in this case, they are chiefly seven. 1. A sharp, well-set Incision-Knife, smoothly pointed. 2. Two Pair of good Scissers; the one with sharp Points, the other with one Point knobbed. 3. A blunt Steel or Silver Hook; to lift up a Vein, Artery, or Nerve, when a Bullet, &c. is taken out of a Musculous Part. 4. A Pair or two of Forceps, hollow, strong, and of good Steel, to lay hold of the Matter. 5. Goose-bills, round, and hollow at the Points, double and single, to take out Bullets, &c. 6. The Ravens or Crows-Bill of Steel, and very strong; to take out Bones, Splinters, Arrow-heads, &c. 7. Forcipes incisorii; which be∣ing dilated, cut on each side, to make the way out wider; and are of use when a Wound is to be incised, for the drawing out any extraneous matter: they ought to be of good Steel, well tempered, and very sharp.

XXXIX. 2. As to the Time, when the Work is to be done. If the Pain is vehement, the Mat∣ter is immediately to be taken out; yet we are not to add pain to pain, but this being once done, the pain will cease.

XL. If the Matter is poisoned or cankred, you must not defer the Extraction, tho' you may be forced to divide the Muscles, Vessels, and Nerves; because the whole Man is more valuable than a part. In this case, you need not fear the Actual Cautery; for Fire destroys Poison, and takes away all fears of a Convulsion.

XLI. But in some cases, you must forbear the Extraction: as, 1. Where an Hemorrhage endangering Life may ensue; which will be where great Ar∣teries and Veins are placed. 2. Where fearful Symptoms may happen; as vehement Pain, Convulsions, Syncope, sharp Fevers, &c. 3. If the Matter is round, or made of Lead; for which reasons, it may more securely be left in. 4. Where

the Orifice of the Wound is made narrow, by Inflammation, Tumor, &c. in which cases, you must defer the Work till those Accidents be removed; lest vehement Pain, Swoonings, Convulsions, Fever, Gangrene, or Sphacelus ensue. 5. When you have not a fit Instrument at hand for the Extraction: for should you then attempt it, you will torment the Patient with∣out any effect; and thereby make him unwilling to undergo the Operation, when you are better provided.

XLII. 3. The Form of the Matter to be extracted: this is perfectly to be understood and considered; for the knowledge of the Figure or Form of the Matter to be extracted, con∣tributes much to the informa∣tion of the Artist; as to the way and manner, how the Ex∣traneous Matter is to be taken forth, and whether it will be done with ease, or with dif∣ficulty.

XLIII. 4. The way and manner how the Extraction is to be per∣formed. Now the Matter to be taken forth, is to be taken forth either by Extraction or Expul∣sion; by extraction, it is taken out the same way it went in: by expulsion, it is taken forth by the opposite way, viz. by the way it tendeth.

XLIV. If the Matter has not pierced very deep, or has not passed thro' the great Vessels and Nervous places: if that either right op∣posite to it, or the way that it tends, it has Bones, Veins, Arte∣ries, or Nerves, Or, if there is no great fear of the wide opening of the Orifice by which it entred: in all these Cases it may be drawn back the same way by which it entred in, and that without any Section at all.

XLV. But if from the Form of the Matter to be extracted (as rough Arrow-heads) there appears to be danger that the Flesh may be torn, if it is drawn back the same way by which it entred: in this case the Wound is to be dilated, either by Section, with the Forceps incisorius; or else dilated with the Instrument which Celsus, lib. 7. cap. 5. calls Ypsiloeides, or else with a Swans-bill or Storks-bill, or some other dilating Instrument; that the Matter may be the more easily drawn out.

XLVI. This Ypsiloeides is a kind of steel Instrument, made in the form of a Bill, but so, that if the shanks of the handle are nipt together, the Bill opens, and so dilates the Orifice of the Wound: after which dilatation, the ex∣traneous Matter is to be taken forth with the Hands; or when it sticks deeper, with the Vol∣sella or Puller, or other such-like Instruments; of which sort are the long Scissers, full of teeth, strait or callaper-fashion'd, broad in their extream part, and likewise round; to which various Names are given, as Crows-bills, Storks-bills, Ducks-bills, Goose-bills; whose Figures you may see in Paraeus, lib. 10. cap. 18. as also in Andraeas à Cruce, Scultetus, and others. The Figure of the Volsella see in Scultetus,

Tab. 4. Fig. 1. where it is largely described, with its use.

XLVII. But in the following cases, it is to be thrust out the contrary way: 1. If it is almost thro', chiefly towards a depen∣ding Part; for so the Pain will be less, and the Pus flow better from the Wound. 2. If the Figure of the Matter or Body will not suffer it to be extracted the same way, by which it went in; as in barbed Arrow-heads, &c. 3. If there is no fear of cutting of great Arteries, Veins, or Nerves. In all other cases, it is to be drawn out the same way it went in.

XLVIII. Brittle things, as Glass, Bones, &c. which stick in a Wound, are to be taken forth whole, if possible: but if they cannot be taken out whole, without much Pain, and fear of evil Symptoms to ensue, they are to be broken, and then taken out.

XLIX. If also the Matter or Bo∣dy is thrust in between two Bones; the Parts lying next to them are to be widened, and drawn or dilated several ways; that so the space between the Bones may be looser and wider, for the pulling forth of the Matter got in.

L. But if by no Artificial Means whether of Medicines or Instru∣ments, the extraneous Body can be drawn forth; the whole Busi∣siness is then to be committed to Nature, which in these cases, does many times do wonders, expelling those preternatural things beyond expectations, which various Histories almost every where confirm.

LI. Hippocrates, Epidem. 5. tells us of one that had an Arrow shot into his Groin, whose head was taken forth six years after. Guil. Fabricius, Cent. 1. Obs. 62. gives relation of one who had a Knife run into the Spina Dorsi, and broke in it, and he took it forth two years after: and Cent. 2. Obs. 74. he gives a re∣lation of a Man wounded in the Pylorus or Colon, with a sharp-pointed Sword, the point of which was broken off, and left in the Wound; the Wound was healed up, and in about a year after, going to stool, he voided with his Excrements the very point of the Sword which was thrust into him.

CHAP. VI. Of STITCHING WOƲNDS.

I. AS to the Stitching up of Wounds, we have said something of it already, in Cap. 1. Sect. 123. ad 131. But because what we have there said, is too briefly laid down, (because it

was neessary to carry on the Thread of the Discourse) we shall now resume the Argument again, and here do that more explicitly and largely, which there we past over only with a slender stroke of our Pen.

II. Now the Cure of all sorts of Wounds is performed either by the first Intention, or by the second Intention.

III. The first Intention is 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, Agglutinatio, the Ʋnition of divided or wounded Parts, no other substance concurring, or coming between: and this kind of Union or Healing is per∣formed by the first Intention.

IV. The second Intention is 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, Concarnatio, the Ʋnition of divided Parts, by the intervention or medium of some other substance, as Flesh, &c. which is to be bred by Incar∣nating Medicines; and this kind of Union, is the Healing of a Wound by the second Inten∣tion. See Chap. 1. Sect. 142, and 143. and Chap. 10. fol∣lowing.

V. We shall first shew how Symphysis, or Agglutination is performed; which is a more simple kind of Ʋnion, because it is per∣formed without any Medium coming between: also, because it is more speedily performed than Syssarcosis or Concarnation; and because it requires neither such skill, or yet such choice of Medicaments to be applied.

VI. Now whereas in transverse and long Wounds, Swathing alone is not enough; for drawing the lips of the Wound together, and to keep and preserve them in such a close condition: for this cause sake, Stitching was designed.

VII. To bring this Symphysis to pass, there are four chief Indi∣cations. 1. The bringing of the Lips of the Wound together. 2. To hold them together by Stitching. 3. To apply Agglu∣tinative Medicaments. 4. Pro∣per Swathing, Rowling, or Binding up: the two first we shall perform in this Chapter; the two latter we shall treat of in the Chapter following.

VIII. The first Indication is to be performed by the Hands of the Chirurgeon, wherein he is to bring the Lips of the gaping Wound to∣gether; which is to be done, 1. Gently, and by degrees; not violently. 2. They are to be brought equally together, not stretching one part more than another. 3. That their super∣ficies also be even, otherwise the Cicatrix will be unequal and deformed. 4. That if the Lips are stiff thro' Cold, they are to be fomented with Hydrelaeum; viz: a Mixture of Oil and Wa∣ter, or Oil and Ale: in dry Bodies, more Oil than Water; in moist Bodies, more Water than Oil. 5. That no Pledget or Dossel be put between the parts wounded, when you intend to consolidate by the first In∣tention.

IX. The second Indication, is the keeping of the conjoined parts together by Stitching: and this is twofold; 1. Sutura, Stitching with a Needle. 2. Laqueatio, Dry-stitching, or Lacing.

I. Stitching with the Needle.

X. Sutura, or Stitching then, is the holding together of the Lips of a Wound, by help of a Nee∣dle and Thread: Wherein we are to consider, 1. The Instru∣ments of the Operation. 2. The Kinds of this Stitching. 3. Its Uses. 4. Observations in per∣forming it.

XI. The Instruments are, Nee∣dles, Thread, and the Stitching Quill.

XII. The Needles ought to be either of Steel or Silver. The steel Needles you may soften by wrapping them in brown wet Pa∣per, and holding them for a while in the flame of a Candle. Those of Silver will bend best; but you ought to have some straight, and some crooked; and their points may be round, flat, or three-square, which last pierce best.

XIII. The Thread. We most commonly use white or crimson silk-Thread (black is rotten and frets) but strong white Thread made of Hemp may do as well, or better; because it swells in the Wound, and cuts not as Silk does.

XIV. The stitching Quill, call∣ed Canaliculus fenestratus: It ought to be of Silver (for Honours sake) and has two Ʋses; 1. To keep the Needles in. 2. In stitching, to stay the opposite part of the Wound, that the Needle may the more readily pass.

XV. The kinds of this Stitch∣ing. There is, 1. Sutura Conti∣nuata, vel Retentiva, the Glover's Stitch; which is used in Wounds of the Guts, when the Excre∣ments come out of the Wound. As also in the Great Branches of the Aorta & Vena Cava, if we can conveniently come at them. The Spaniards stitch almost all Wounds with this Stitch, and it is called also, The Restrin••eat Stitch.

XVI. 2. Sutura incarnativa, vel non continuata, The Incarnative Stich. This is done by taking di∣vers stitches, each distant one from another, so far as the large∣ness of the Wound shall require; and so many as may be able to bring or keep the lips of the Wound in an equality, evenness and smoothness: In every of which stitches, the ends of the thread are to be cut off near the knot, that they may not stick to the Emplaster.

XVII. 3. 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, Ga∣stroraphia, Sutura Abdominis; The Belly stitch, which is used when the Great Muscles of the Abdomen, and the Peritonaeum are divided by a large Wound; of which Galen has wrote Anat. Admin. lib. 5. cap. 6. and some others. See cap. 1. sect. 124, 126, 128.

XVIII. 4. Sutura Conserva∣trix, The Conserver. This is when the Needles are left in the Wound, passed through the lips; and the lips being brought toge∣ther, the thread is twisted about both ends of the Needles, as Tay∣lors do when they fasten them to their sleeves. This stitch is used in the Cure of Hare Lips, and when the Oesophagus or Trachea Arteria are wounded:

Instead of Needles you may use Silver or Brass Pins, whose ends (after the thread is twisted a∣bout) may be cut off with a pair of Shears or Sciffors.

XIX. The Ʋses of this stitch∣ing. They are threefold, 1. To procure a quick agglutination to the Wound, which is done by the Su∣tura Incarnativa. 2. To keep the lips of a Wound at a due distance one from another; and this is done by the Sutura Retentiva; which is of use when a Wound cannot be Cured by the first In∣tention, but by the second: In which the lips are not to be too far a-sunder, lest the Air cool the Parts too much; nor too near, because the Agglutination is not to be expected without a medium. 3. To stop Bleeding; as when an Artery or Vein is wound∣ed; and this is called, Sutura Suppressiva.

XX. Observations in perform∣ing this Work. 1. In stitching, the lips of the Wound must not be too straitly drawn together; for then the flowing of the Quittor will be hindred, and so a Tumor may be induced. On the contra∣ry, If they be left gaping, the inner Parts may be cooled by the Air: But Ligaments cut a-sunder, are not to be stitch'd, because they are only united by the second Intention.

XXI. 2. A sufficient quantity or substance of the lips of the Wound is to be taken hold of by the stitches, otherwise they may break out again, and cause Scars: And withal, you must be sure that your knots are fast; for should they loosen, you will be enfor∣ced to stitch a second time, which will be more painful to the Patient than at first.

XXII. 3. You must also be∣ware of the Nerves and Tendons; for if they be prick'd or touched, vehement pain will be caused: But in all parts of the Body the Skin may be stitch'd, yea, in the Joints, deep Wounds, and Wounds of the Bones, after smoothing with the Rasp; for thereby the Spermatick Parts will be covered, and defended from Air, and the natural heat kept in, whereby the Cure will be the better performed.

XXIII. 4. In deep Wounds of the fleshy Parts, you must take deep stitches; for if the Skin only be stitched, the Wound will only superficially heal, and the Pus settling in the bottom, may cause an Apostem, and caver∣nous Ulcer; or otherwise the stitches may break out, and make new work again.

XXIV. 5. In long Wounds, begin from one of the ends; but in short Wounds, as in the Hair-Lip, begin in the middle; for so you will avoid pursing together the lips of the Wound, which will cause Inequality and Deformity: And in long Wounds, let the stitches be nearly an inch di∣stant one from another, or a∣bove half an inch at least: If they be too thick, they will cause the more pain; if too thin, the Unition will not be so easie and compleat.

XXV. 6. Lastly, In strait Wounds of the Limbs, you may spare stitching; for the lips may be brought together by the Dry

Stitch, and Swathing: But if the Wounds are Transverse, stitch∣ing is always to be used; be∣cause the Flesh, &c. in such Wounds will shrink towards the whole Parts, and so gape very wide.

II. Laqueation, or Dry Stitching.

XXVI. This is done with pieces of Cloth, which are glewed on each side the lips of the Wound; and then being dried, the edges of those Cloths are stitched, and drawn together, instead of stitch∣ing the lips of the Wound it self, whereby the lips of the Wound are also drawn together, as near as you desire.

XXVII. He that knows how to perform this work well, which may be done in almost all Wounds, and that in the very first Dressing, knows very well how to be with∣out the former ways of stitch∣ing with the Needle, which Sennertus says is Cruel, Bloody, and Painful.

XXVIII. And truly (says he) it would be far better, if Chi∣rurgians would accustom them∣selves to this manner of joining the lips of Wounds together; for that in the other ways of stitch∣ing with the Needle after a bar∣barous Fashion, they many times commit many Errors, be∣sides the causing more pain than was caused by the Wound.

XXIX. For sometimes (the Needles being too thick) more or less of the lips is taken up than is necessary, so that the mouth of the Wound is often uneven, purst up, and as it were pleited, whereby the skin is not close joined to the skin, nor flesh to flesh, but the skin is sewed in the midst of the flesh: Or, if they avoid this, they make another fault as great, which is by taking so little hold, that the Wound is left hollow, and the stitches in a short time break out; all which Errors or Faults are totally avoided by this Laqueation, or dry kind of stitching.

XXX. But though this stitch∣ing may be used in almost all sorts of Wounds, and that also for avoid∣ing of new Pain; yet it is chiefly used to the face, and other visible Parts, for the avoiding of Scars, as also because stitches are often∣times broken out before the Agglu∣tination of the Wound; and again in some Persons, who by reason of their fearfulness, will by no means endure stitching.

XXXI. This dry Suture there∣fore is used in three Cases; 1. Where we cannot come conveniently to roul the wounded Part, as in transverse Wounds. 2. When the Beauty is like to be hurt, by making of Scars, as in the Face, and other visible Parts. 3. When the wounded Patient will not ad∣mit of stitching in the Skin and Flesh, as Women, and other timorous Persons.

XXXII. To perform this right∣ly, three things are to be consider∣ed; 1. The Instruments to perform it withal. 2. The sticking Em∣plaster. 3. The manner of doing it.

XXXIII. The Instruments are a Needle and Thread, and pieces of Cloth: The Needle must be one of middle size: The Thread,

an even fine waxed brown Thread, or Silk of the same Magnitude.

XXXIV. The pieces of Cloth must be in number two, one piece for each lip of the Wound: They must be strong, that they may not yield unto the thread, or give way: They must be doubled towards the Wound, and pasted or glew∣ed together with the sticking Medicament, and ravelled at the other ends, which are farthest from the Wound. Lastly, they must one answer another, as to form, magnitude and situation.

XXXV. As to their form, they must be indented towards the lips of the Wound, and backwards, as much as may be, of the form of the wounded Part. If the Part will admit it, they may be Qua∣drangular, Triangular, or O∣val; but the form ought to be such, as is fittest to draw the wounded Parts together. See the Figures here annexed.

[illustration] depiction of various forms of bandages

XXXVI. The next thing to be considered is the sticking Empla∣ster, of which we shall give you several Recipes. 1. Emplastrum Glutinosum Sculteti; which see in Lib. 1. cap. 20. sect. 10. afore∣going of this Work.

XXXVII. 2. Sennertus pre∣scribes this: ℞ fine Bole, Ma∣stick, Sanguis Draconis, sat Fran∣kincense, A. ʒi. make the three first into fine Pouder: Tacama∣hacca, ʒij. mix them with a hot Pestel, which spread upon the Cloth.

XXXVIII. 3. ℞ white Starch, Mastick, Gipsum, fine Bole, Aloes, Gum Tragacanth, and Arabick, A. ʒij. make all into a Pouder,

which mix with the white of an Egg, to the consistence of Honey.

XXXIX. 4. ℞ fine Bole, Sar∣cocol, Mastick, Sanguis Draconis, A. ʒij. make all into a Pouder, and mix them with the white of an Egg.

XL. 5. ℞ Olibanum ℥ss. Frank∣incense, Bitumen Judaicum, Am∣ber, Mastick, Rosin, A. ʒi. Gum of Juniper ʒss. mix, and make a hard Emplaster; which is to be melted at the Fire when it is to be used.

XLI. 6. ℞ white Starch, or fine Flower, Frankincense, Ma∣stick, A. ʒij. fine Bole, Chalk, Sarcocol, Singuis Draconis, A. ʒiv. all being in fine Pouder, mix them with the white of an Egg.

XLII. 7. ℞ Beat white of Eggs into a clear Glare, then gradually sprinkle in unslak'd Lime in very fine Pouder, q.s. which stir very well together, till the Whites of the Eggs cease to appear.

XLIII. 8. ℞ fine Bole, San∣guis Draconis, Frankincense, Ma∣stick, Pine-Rosin, A. q.s. make them into Pouder, and mix them with whites of Eggs.

XLIV. 9. Others dissolve Ich∣thyocolla, or Ising-glass in Vine∣gar, and by boiling bring it to the consistence of Glue, which they spread upon the Cloth: but being dissolved in Sp. Vini, either this or Joiners Glue, it is much more tenacious and strong, and will not be dissolved by the Humidities of the Wound.

XLV. 10. ℞ Mastick, San∣guis Draconis, white Starch, O∣libanum, Gypsum, Frankincense, (all in fine Pouder) Turpentine, Pitch, A. ʒi. Whites of Eggs, q.s. mix, and make an Emplaster.

XLVI. 11. Paraeus prescribes this: ℞ Aloes, Wheat-flower, Mastick, Rosin, (all in fine Pou∣der) Ship Pitch, Turpentine, A. q.s. mix and make an Empla∣ster.

XLVII. 12. ℞ fine Wheat-flower, Whites of Eggs, A. ℥ij. Ichthyocolla ℥iss. Birdlime, Tra∣gacanth, Frankincense in Pouder, A. ʒ vi. Rose-water q.s. mix them.

XLVIII. This being said, we now come to the manner or way how the work is to be performed. The double Linen Cloths are first to be glewed together, and then they are to be spread over with the said glewing Emplaster (some one of the aforegoing) on that side which is to lie upon the skin; af∣ter which they are immediately to be applied to the part, and they are there to be left so long, till the Glue or Emplaster is dri∣ed up, and the Cloths stick fast to the skin, which is commonly in the space of four, five or six hours.

XLIX. The Cloths now stick∣ing fast, the Indentures as to be sewed, or tied together, with ae needle and thread; and they are to be drawn so close, and then tied fast one to another, that the lips of the Wound may be rightly united.

L. And by this means, without any Pain at all, and without any Scar or Deformity (such as is wont to caused by the needles) the lips of the Wound will be drawn together, and agglutinated; and being thus brought together, they will be so kept and pre∣served

a longer time, than they can be with sewing or stitching with the needle.

LI. This dry stitching has but one Objection against it, viz. that it is but of little use till 6 or 7 hours after; for sooner it will scarcely be dried, so as to stick fast to the Skin; (for which reason some sew with the needle first, and then apply the dry stitch:) But this delay can bring no damage a∣long with it. For which reason, if any danger should be feared, such an Emplaster may be used, as may stick immediately upon the Application: Of which kind is that at Sect. 37. aforegoing, and some others, among the aforegoing Prescriptions.

CHAP. VII. Of BINDING up WOUNDS.

I. TO the well binding up of Wounds, two things are necessary, 1. The preparatory Mat∣ters for the Dressing; which are vulnerary Lotions, Balsams, Ce∣rots, Emplasters, &c. 2. The preparatory Matters for the bind∣ing up; which, are Splenia, Bol∣sters, Ferulae, swathing Bands, or Roulers.

II. The Vulneraries, or prepa∣rative Matters for the Dressing, are twofold; I. Simple Vulneraries, which are taken, 1. From Vege∣tables: 2. From Minerals: 3. From Animals. II. Compound Vulneraries, made of the former into Lotions, Oils, Balsams, Oint∣ments, Cerots, and Emplasters.

III. And these are of three spe∣cial kinds, 1. Digestives, which generate a well digested and lau∣dable Pus. 2. Sarcoticks, or Incarnatives, which generate and fill the Wound up with Flesh. 3. Epuloticks, which pro∣duce the Cicatrice, dry up, and over the Wound with skin: of all which we have spoken at large in the second Chapter of this present Book. As to the particular Virtues of the Simples, you may see an explicite and compleat Discourse of them in Our Seplasium, or Druggists Shop, lately Published, to which you are referred.

IV. A Breviate of the binding up Wounds, we have given in Cap. 1. Sect. 132, ad 139. We shall here deliver the Method of doing it more at large. Now to this work belongs, 1. The covering Em∣plaster, or Cerecloth. 2. Splenia. 3. Ferulae. 4. Swathes or Roulers.

V. 1. The covering Emplaster ought to agree to the Indication of Healing; but for want of such a one, this following may serve in many Cases. ℞ Juices of To∣bacco and Melilot, Frankincense, Fir-Rosin, A. lbij. Bees Wax lbi. Sheeps Suet, Turpentine, Gum-Elemi, A. lbss. Pouder of Virgi∣nia Tobacco ℥viij. mix, and with a gentle heat evaporate the Juices,

and bring it to the consistency of an Emplaster. Or you may use the Empl. Diapalma, è Bolo, Cae∣saris, or the like, if need re∣quire.

VI. 2. Splenia: These are Lin∣nen-Cloths folded together, and so termed from their Figure, being almost in the form of the Spleen. The Ancients called them Pul∣villi, from the Resemblance they have to Bolsters: also Pluma∣ceoli, or little Pillows, because they were sometimes made of Feathers.

VII. But as to the Figures or Form they many times differ, ac∣cording to the end for which they are intended; for sometimes they are laid upon the part long-ways, sometimes obliquely, and some∣times transversly.

VIII. Sometimes they are laid single or double; sometimes treble or quadruple; and sometimes more of them, according to their Ʋse, for what they are design'd to do, whether for interception of Hu∣mours, drinking up of Sanies, or filling up of empty, and hol∣low places; that there by the whole Bandage may become e∣qual and smooth.

IX. They are sometimes imposed dry, but most commonly they are soaked or moistned, with some sort of Liquor, whether Lotion, Decoction, Infusion, or Spirit, which may be proper for the dis∣ease of the part affected. See Hip∣pocrates de Vuln. lib. 3. Text. 1, 2. and, de Fract. lib. 1. Text. 32. & lib. 3. Text. 21.

X. 3. Ferulae, or, Splinters. These are for the more convenient binding up of Wounds or Fractures; they ought to be long and smooth, and fitted unto the Bones that are broken, or out of Joint, after such times as they are set again, and reduced to their proper places.

XI. Hippocrates, and other of the Ancients, made them of the Li∣gneous Bark of the Ferula (from whence came the name:) but we, for want of that, make them of thin Splinters of Wood, or Barks of Trees, or Paste-boards, either fingle, or glued together.

XII. But Guil. Fabricius Hil∣danus, Cent. 4. Obs. 98. is a∣gainst the green Barks of Trees; for that when they are through∣ly dried about a Fracture, they are apt to excite pain, and put the bones out of their places.

XIII. Hippocrates says, They ought to be smooth, equal, plain, and a little sloaping at the ends, and something shorter than the swa∣thing they lie under, that the part may not be prest too much be∣yond the Bandage; and impo∣sed (in Fractures) about an inch distant one from another.

XIV. They are to be so placed and fitted, that their ends are not to reach above the heads of the Joints which stick forth; nor that they touch upon the naked Skin, or hurt the Nerves or Tendons nigh unto the Joints. See Hippoc. de Vuln. Tit. 11. & de fract. lib. 1. Text. 4••. & lib. 2. Text. 5, 7, 11, 64, 69, 71. also P. Aegineta, Lib. ••. Cap. 99.

XV. 4. Swathing Bands, or Roulers. These are Bands long and broad, which being rouled up, are afterwards to be swathed about the wounded part. This

the Latins call Fasciatio, or deliga∣tio per fascias; by means of which we endeavour to keep the lips of Wounds together, that they may be the sooner, and the more firmly conglutinated.

XVI. Herein we are to consider, 1. The Matter of Roulers. 2. The Kinds of Rouling or binding up. 3. The way or manner of doing it. 4. The Ʋses thereof.

XVII. As to the Matter of which Roulers are made, they ought to be of Linen-Cloth, somewhat worn, clean, smooth, and without seams or knots, that they may be soft and pliable, but so strong that they may not be broken: It is true, they may be made of Woolen, or Leather, if necessity require it; but otherwise Woolen is not to be chosen, because it is apt to stretch, and cause itch∣ing, whereby it cannot bind so fast; and by irritating, may cause an attraction of Humours: Nor Leather, because it is not only apt to stretch, being dry, but much more, if by accident it should be moistned with the Humor, and withal, when foul, is not to be washed, but must then be cast away.

XVIII. The Roulers are then to be made of Linnen-cloth, not too new, lest they be stiff and hard; nor too old, lest they be too weak: The Cloth must not be too thick, lest it is cumbersom, nor too thin, lest it falls into wrinkles: nor too course, lest its unequal Threads should hurt, or press too much upon the Part: nor too fine, lest by the closeness of the Threads it stops the Pores; which being foul, it is also apt to do; so that perspiration being hindred, an Inflammation may be induced.

XIX. As to the length of the Rouler, it is to be provided, ac∣cording to the thickness of the part it is applied to, and the number of Circumvolutions, which the Artist shall think convenient, whereby some are longer, some shorter.

XX. As to their breadth; those for the Trunk of the Body ought to be the broadest; then those pro∣vided for the Thighs; next those which are for the brawny part of the Arms: The narrower are for the small part of the Arms, and lower part of the legs; and the narrowest those which are fitted for binding up of Fingers and Toes. See Cap. 1. Sect. 138. aforegoing.

XXI. The kinds of Rouling are manifold, as Galen says in's Book of those things which are to be done in the Curing of Wounds, Com. 2. Text. 7. But those which serve for Our purpose in this place, are chiefly four: 1. Fascia In∣carnativa: 2. Fascia Retentiva: 3. Fascia Expulsiva: 4. Fascia Aequans.

XXII. Fascia Incarnativa, is performed with a Rouler, having two ends, wherein you must begin to roul in the sound part, opposite to the Wound, and roul upwards, and so return to the wounded Part with one end; with the other end you must roul down∣wards, crossing the former, that the lips of the Wound may be neatly brought together.

XXIII. In this kind of Rouling, the Rouler ought to be about half

the breadth of the Wound, for thereby it will draw the lips of the Wound together twice; once rouling upwards, and once roul∣ing downwards.

XXIV. Authors make another kind of this Fascia Incarnativa, which is performed with one Rouler, which must be broader than the Wound: The middle of it is ap∣plied to the sound Part, that the sides of it may meet about the Wound; after which the sides are sewed together with a transverse stitch: But this way is not so ready and convenient as the former, because at every dressing, it requires new sewing.

XXV. Fascia Retentiva, is a kind of Rouling, which is chiefly used to keep the Dressing, as Pled∣gets, Emplasters, Cerots, Bolsters, &c. close to the Wound; for which purpose a single Rouler will serve the turn; and this ought to be done no stricter, than what may be enough to stay the Applications in their proper places; for otherwise it may hinder the Protrusion of the Nutriment to the Part, and so produce either a Mortification, or an Atrophy, at least, of the Part.

XXVI. Fascia Expulsiva, is chiefly to press out of the Cavity of the Wound any Humour, or Matter lodging in it; and also to stop the Influx of Humours, which many times invade the depending Part: For which reason we begin the Rouling in the sound Parts be∣low the Wound, and then pro∣ceed to the wounded Part; after which, you may use more or fewer Circumvolutions, as in reason you shall see fit, and so ascend to the sound part above the Wound, where you may use a more close Bandage, to hinder the Defluxion of any Humour: Thus you press out the Matter already in the Wound, and hinder the Afflux of new.

XXVII. Fascia Aequans, ae swathing Bandage; is that which reduces unequal Parts, some of which are high, some low, to a ne∣cessary equality; which is done by applying of Bolsters, with a single Rouler.

XXVIII. There are also other kinds of Bandages, (but proper to other Parts of Chirurgery;) as, 1. Fascia prohibitiva Aposte∣matis, a Bandage which hinders Apostems, wherein we begin the Rouling about the Wound, and go upwards to the Joint of the sound Part. 2. Fascia Aposte∣matis factiva, which is a Band∣age that causes Apostemation, and is just opposite to the for∣mer. 3. Fascia Disjunctiva, a Bandage which keeps Parts asun∣der. 4. Fascia Directiva, a Bandage which reduces Distort∣ed and Crooked Members to their natural Figure.

XXIX. The Way and Manner of Binding or Rouling. This is in part declared in the several kinds; but we have these things to add: 1. That the Swathing is to be begun at one end of the Rouler, and sometimes from the middle thereof.

XXX. 2. Care is to be taken, that the Rouler may not bind or press together the Part too hard, lest by its over-great Compression,

it occasion Pain and Inflammation: And on the contrary, that it be not over-loose; for then it will not sufficiently keep the Parts together.

XXXI. 3. As to the Artist himself, 1. That he carries a light and gentle hand, so as not to hurt the Patient. 2. That he be nimble and quick in the Dis∣patch, that the Patient be not wearied. 3. That he does his work cleverly and handsomly, so that it may look pleasingly to the eye.

XXXII. 4. If it is a long Wound, the Bandage is best per∣formed by a narrow Rouler of a∣bout three inches broad, and having two heads, viz. that has a double beginning. And in Wounds that are not very long, the middle of the Rouler is first imposed upon the opposite part of the Wound; and the rouling of it about is begun from it, and drawn towards the Wound, and above the Wound it is straitned or strained, whereby the lips of the Wound are rightly drawn together: And then after this, both heads of the Rouler are rouled this way, and that way, that so the lower part thereof may be drawn about the lower part of the Member, and the higher part about the higher part of the same; to the end that the Humours may the bet∣ter flow out, and be pressed forth, from the part affected.

XXXIII. 5. In Winter-time the Roulings ought to be the more, by reason of the coldness of the Weather: But in Summer time lesser, lest the Part affected should grow hot and inflamed.

XXXIV. 6. The knot is to be tied a good distance from the Wound; or rather the heads of the Swath or Rouler may be pinned or sewed together.

XXXV. 7. That in the Band∣age of the greater sort of Wounds, the drawing together of the lips may be made easier by imposing the Plumaceolus, a little Pillow or Boulster, or Linnen Cloths many times doubled, which are called Splenia, (of which we have spo∣ken before:) But in the Opinion of Avicen, lib. 4. sect. 4. Tr. 1. cap. 8. the Triangular Bolsters are the most convenient, two of them being used together, one on each side the lips, accord∣ing to the length of the Wound, (and therefore they ought to exceed the length thereof) and answer each other; for so the Swath or Rouler being drawn upon the Angle of the Trian∣gular Boster, it forces it for∣wards, together with the lip ly∣ing underneath, to the contra∣ry part, and so puts a force up∣on the Fissure or Mouth of the Wound, which would not be so effectual if the Bolsters were four square.

XXXVI. The Ʋses of Swa∣thing are either Essential, or Acci∣dental. Essentially they contri∣bute to the Cure of the Wound, by bringing and holding toge∣ther the Parts disjoined, con∣contracting Parts dilated, and reducing Parts distorted; re∣pelling Humors flowing into the Wound, and pressing them forth which are already in.

XXXVII. And accidentally they conduce to the Cure, when they are so applied or imposed, that they contain or hold to the Medica∣ments designed for the Cure; as Hippocrates has signified, where he speaks of Curing VVounds, Lib. 2. Text. 30.31.32.33. & de Fracturis, Com. 1. Text. 21.

CHAP. VIII. Of a FLƲX of HƲMORS.

I. WOunds often happen to Persons of a Scorbutick, or Cacochymick Habit of Body; and in such People there is great cause to fear, (from the abundance of vitious Humors, which have been long in heaping up) a flux of those Humors to the wounded Part; which may induce great Pain, In∣flammation, Apostemation, and many other evil Symptoms: for which reason, we are to do our utmost endeavour, to hinder and prevent this afflux of Hu∣mors; and so to strengthen the Part, as to make it able to resist it.

II. Now such a Flux is more especially prevented, by taking care to hinder or remove all those Causes, which may any ways in∣duce the said Flux: as also all those things which may very much, and preternaturally heat the wounded Part, excite Pain therein, or render the same soft and loose, whereby it is made the more apt to receive the Flux: or may over-heat and rarify the Humors, or make them thin, whereby they are made more fit for motion and fluxion.

III. The Diet also of the wounded Part is to be considered, that it be such as may not gene∣rate too much Nutriment, nor a great abundance of bad and corrupt Humors.

IV. And withal, we must assist and comfort the wounded and weak Parts; with things which corroborate and strengthen, by easing of Pain, abating the vehemency of Heat in the Body, lessening the quantity of Blood, if need require, and due eva∣cuation of the vitious Humors.

V. As to Bleeding, we are to consider the strength of the Pa∣tient, and whether Blood enough was permitted at making of the Wound. Celsus, lib. 5. cap. 16. says, If the Blood flows not forth sufficiently, let a Vein be opened as soon as may be; provided that the Patient has strength enough to bear this loss of Blood.

VI. But this is to be done, 1. In great Wounds chiefly, in which there may be cause to fear an Hemorrhage, and the Patient is strong. 2. If a great Inflammation has seized the Part, or a Fever invades the Sick. 3. If a sufficient quan∣tity

of Blood did not flow out of the Wound, when it was first made.

VII. But now that this Bleed∣ing may be effectual, ancient Phy∣sicians advise that a Vein should be opened, at a good distance from the Part affected, and on the con∣trary side: but modern Physi∣cians say, you are to open the Veins on the same side; and those must be either of the Arm, or some Vein near to the wounded Part.

VIII. As if the Head is wounded, they advise to a Vein in the Forehead, or Veins of the Temples, and those under the Tongue; of which Paraeus has written, Lib. 9. cap. 14.

IX. As to the quantity of Blood, it ought to be according to the plenty of it, which is in the Body, and strength of the Pa∣tient: and therefore if much Blood was lost upon making of the Wound, it ought wholly to be omitted; but if little was lost, then you may take away, according to the strength of the Patient, and not other∣wise: which you may know by the ••age of the Patient, habit of the Body, time of the Year, and other Circumstances intervening.

X. The next Intention is Purging, which is either by Vomit, or Purge, or Clyster. If the Stomach is Foul, and the Body full of ill Humors, gentle Vomiting is best, for it makes the greatest of all Revulsions; and it is to be continued every third day, so long till the Stomach is very clear, and easy, and the Humors carried off which may cause a Fluxion.

XI. For this purpose we com∣mend Vinegar or Wine of Squills, Oxymel of Squills; but in the more strong constitutions, Vinum Antimoniale, Vinum Benedictum, Taertarum Emeticum, Infusion of Crocus Metallorum, and other Antimonial Vomits; to be given and repeated, according to the age, strength, and condition of the Patient: for these things carry off vast quantities of vi∣tious Humors, which may not only endanger a Fluxion, but also keep the Wound from a speedy Healing.

XII. If the Patient is weak, and not able to bear Vomiting, the Body must be emptied of the Morbifick-matter, either by Cath∣articks or Clysters: for the Wound will be so much the more successfully and speedily cured; by how much the ill constitution of the wounded Part is prevented, and the vitious Humors apt to flow unto the same, are carried off another way.

XIII. And this is to be done, 1. In great Wounds, where, by reason of Pain, a fluxion of de∣praved Humors may be feared. 2. In those Wounds where any kind of cutting or dilating is used. 3. Where any Bones are to be made bare of Flesh. 4. And in all Wounds whatsoever, where the pain is more violent than ordinary.

XIV. But if the Wounds are small, and not affected with any such vehement Pain, they may be cured without any Vomiting or

Purging: but then in this case, if the Belly is bound, you are to loosen and open it with Clysters or Suppositories.

XV. Catharticks are to be used also if any pain or heaviness afflict the Head, or if a Tumor or In∣flammation appear, or the Body is Scorbutick or Cacochymick; and that timely, in the beginning of a Wound, whilst there is strength, absence of a Fever, and before the Humors are in motion, if possible.

XVI. As to the kinds of Pur∣gers, they oughtnot to be vehemently strong, but gentle, or else to be gradually taken: Cholagogues are said to be most fit for Wounds of the Head; for that Inflam∣mations and Fevers (the Sym∣ptoms of Wounds) are said to be the effects of Choler. Our Family Pills may be given, every Night one or two small Pills; because they work very gently the next day, and carry off the Humors with much ease.

XVII. Pulvis Cornachini is an admirable Cathartick, given twice a Week, à ℈i. ad ʒss. also a Decoction of Myrobalans, mixed with Elect. Lenitivum, or de Succo Rosarum, or some other Solutive Purge. You may also give the Infusion of Rhubarb, Sena, and Myrobalans, sweetned with Syrup of Roses, or Manna.

XVIII. Sennertus says, that Hot, Cholerick, and Serous Hu∣mors are to be evacuated; because they are more apt for motion and flowing, and make much for ge∣nerating Inflammations, Erysipe∣la's, and Fevers; and therefore are to be evacuated at first, before any Fluxion is excited, or Fever induced: for if a Fever is present, Purging can∣not be permitted, but with some kind of danger.

XIX. If the Humors are very hot and thin, so as that they cannot be well carried off with Purging, you must come to the use of Opiates; because they thicken the Juices of the whole Body, and so, not only make them fit for an After-expulsion, but also by making them thick, do in a very great measure prevent the Fluxion, which otherwise might fall on the wounded Part.

XX. The Air ought to be tem∣perate and thick; for a hot and thin Air does thin and melt the Humors, and so make them the more apt for Fluxion; and a cold Air is hurtful for the Brain, Nerves, Bones, &c. and hinders the Healing of the Wound.

XXI. The Diet is also to be moderate; Wine is not permitted before 12 or 14 days are past, unless fainting or swooning is present. In those Countrys where neither VVine nor Beer are to be had, the White Liquor, made of burnt Harts-horn, made pleasant with juice of Limons and white Sugar, may be of good use: also Barley-Water, made pleasant with Oxy∣saccharum, or Syrup of Limons, or Citrons, or Syrup of Violets with juice of Limons, &c.

XXII. If the Wound is with a Fracture, Flesh nor Fish, are scarcely permitted for the first 8 or 10 days; because they breed

plenty of Nourishment, and conse∣quently of Humors, from whence a Fluxion is induced: and there∣fore Panada and Ptisans are advised, as also some other things according to the Season of the Year, as Asparagus, young Pease, Cabbage, Lettice, Endive, Succory, stewed Prunes, Raisons; and after Meals things which strengthen and close the Mouth of the Stomach; as Mar∣malade of Quinces, codled Ap∣ples, baked Apples, Pears baked or stewed, Conserve of Bar∣berries, preserved Damsens, &c. Caraway-comfits, &c.

XXIII. When Flesh is permit∣ted to be eaten, it ought to be of Chickens, young Pigeons, Veal, Lamb, Kids, Mutton, young Rab∣bets, Wild-fowl, Partridges, Phea∣sants, Turtle-Doves, Blackbirds, Thrushes, Larks, &c. with Sawces made of things cooling and moistning; as Sorrel, Spinage, Succory, Lettice, Purslane, &c. or else of Verjuice, juices of Sor∣rel, Mints, Oranges, Limons, Citrons, Pomgranates, &c.

XXIV. Sleep is to be procured in the Night-time, and avoided by Day: and much Watching is to be avoided, because it induces crudity of Humors, heaviness, pain of the Head, disturbance of the Mind, and other ill Symptoms: in this case Opi∣ates prudently given, are pro∣per, and to anoint the Forehead and Temples with Oil of Pop∣pies, Henbane, or Mandrakes, p. 2. mixed with Vinegar p. 1. inwardly you may give Syrup of white Poppies ℥jss. mixt with Syrup of Limons, Lettice-water, A. ℥i. for a Dose.

XXV. Lastly, as to the excretion of Excrements, the Belly ought to be kept soluble, that there may be a continual sinking away of corrupt and vitious Humors: and if Na∣ture is dull, or the Body costive, Evacuation is to be made by Clysters, Suppositories, and the like; and sometimes by a gen∣tle Solutive Medicine taken by the Mouth: but Venery above all things is to be avoided; (especially in Wounds of the Head) because great store of Spirits are contained in a small quantity of Seed; and thereby all the Faculties, but chiefly the Animal, are weakned and enervated.

CHAP. IX. Of the SYMPTOMS of WOƲNDS.

I. SYmptoms which happen to Wounded Persons are mani∣fold, but the twelve following are chief; viz. 1. Hemorrhage. 2. Pain. 3. Inflammation. 4. An Erysi∣pelas. 5. Indigestion of Humors. 6. Fever. 7. Fainting and Swooning. 8. Convulsions. 9 De∣lirium. 10. Palsies. 11. Gan∣grene, or Sphacelus of the Part.

12. Proud Flesh; which we hinted at in part, in Chap. 1. Sect. 39. of this Book afore∣going.

II. 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, Haemorrha∣gia; is either Essential, which happens upon the first wounding, before binding up; of which we have discoursed at large in Ch. 4. aforegoing: or Symptomical, which is when it breaks forth again some day, or days after the first applications: this is also to be cured after the same manner, and with the same Medica∣ments, and therefore we shall say no more of it in this place.

III. 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉. Dolor, Pain; Galen defines or describes Pain to be, Sensatio tristis, a sad or grievous Feeling; but this shews rather how pain is caused, than what it is: Cicero, Tusc. 2. says, Dolor est motus asper in Corpore, à Sensibus alienus: Pain is a sharp com∣motion or passion in a Body, hurtful to, or disagreeing from the Senses.

IV. These Descriptions or De∣finitions answer not exactly the thing: however, it is an uneasy Feeling, or something disagreea∣ble in the Instrument of Feel∣ing, caused by that which makes a Solution of Unity; or like Lightning, penetrates thro' Nervous and Sensible Bodies.

V. Pain is eased by two sorts of Medicaments, 1. By Ano∣dyns, which the Greeks call 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, & 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉. As∣swagers, or Easers of Pain. 2. By Narcoticks, which the Greeks call 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, (〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, à Stupore) things which give ease by stupifying the Part.

VI. Anodyns, are such Medica∣ments as are temperate, and do restore, at least maintain the natu∣ral temper of the Body or Part, open the Pores, and by their sub∣tilty enter into them, resolve the Humors, and make the Parts soft and loose, and so less apt to retain the Matter paining: if they exceed a little in heat, they more ef∣fectually open the Pores, and discuss the thinner part of the peccant matter, by which the pain is abated.

VII. These things are not to be applied where the Pain is tolera∣ble, but where it is intolerable; which happens more especially when the Nerves or Nervous Parts are wounded: but they are some∣times excited by Errors com∣mitted by the Patient in the course of his Diet; by eating all manner of bad and corrupt Food, as Cabbage, Coleworts, salt Fish, and other salt and pickled Meats: as also by ex∣posing the wounded Part to the cold Air, or over-much Exer∣cise, &c. Or by the carelesness or unskilfulness of the Chirur∣geon, applying things too hot, sharp, or corrosive; too long Tents, too hard Bandage, or leaving pieces of Bones, or Pus, too long in the Wound: and without any of these Causes, the Pain may sometimes be excited, thro' an internal afflux of Hu∣mors.

VIII. If the pain is induced suddenly, with unwonted coldness and chilness, it is an ill sign, and

shews an Inflammation imme∣diately to follow, or a Gangren nigh at hand: these Pains are also the cause of restlesness, want of Sleep, dejection of strength, and an afflux of Hu∣mors to the wounded Part; from whence comes oftentimes Inflammations, Fevers, and some∣times a Gangren or Sphacelus it self.

IX. In order therefore to the Cure, you must make a diligent search into the Causes, which are all to be removed, before any thing else is done: as things extra∣neous are presently to be re∣moved; abundance of Pus re∣tained, is to be brought sorth, &c. but if it proceeds from an over-great afflux of Humors, then Medicaments ano∣dyn and rarifying are to be applied, among which the fol∣lowing are accounted.

X. Of simple Anodynes, the chief are; Roots, of Lillies, Onions, Garlick, Leeks: Herbs, as Camo∣mil, Dill, Elder, Fennel, Mal∣lows common and marsh, Peni∣royal, Walwort: Seeds, Barley, Beans, Wheat, Oatmeal, Fenu∣greek, Linseed: Oils, of Olives, Almouds, Ben, new Butter: Grease, of Capons, Dueks, Geese, Hogs, Mankind, Vipers: Marrow, of Beef, Lamb, Mutton, Veal: Milk, of Cows, Goats, Women∣kind: Gums, Camphir, Ro∣sin, &c. Flowers, Roses, Saffron.

XI. Out of these, several compound Anodyns may be composed; as, ℞ Oil of Ben, Capons-grease, A.℥ss. Oils of Dill and Camomil, A.ʒii. Beef-marrow ℥i, Camphir ʒi. mix them. ℞ Unguentum album camphora∣tum ℥i. Oil of Elder ℥ss. Cam∣phir ℈i. mix them. ℞ Roots of Lillies, Onions boiled soft in Wa∣ter, A.℥ii. Oil of Dill ℥i. White∣bread, q.s. mix, and make a Cataplasm, &c.

XII. Among Anodyns, Senner∣tus commends Oils of Roses, of Earthworms, and of Elder, Pa∣raeus Oil of Whelps; a Cata∣plasm of leaves of Mallows, roots of Althea, Barley-meal, Bean-meal, and Bran. ℞ Oil of sweet Almonds, of Roses, of Camo∣mil, A.℥i. yolk of one Egg, Saffron ℈i. mix them. ℞ Roots of Al∣thea ℥ss. Mallow-leaves, Elder-flowers, A. M.i. boil to softness, and pulp them thro' a Hair-sieve; to which add pouder of Camomil-flowers ℥ss. Barley-meal ℥i. meals of Beans and Linseed, A. ℥ss. mix, and make a Cataplasm; to which you may add (if you please) Oil of Camomil, Earth∣worms, or Roses, q.s. But in extream Pains, Oils of Poppies and Water-lillies are commen∣ded; also a Cataplasm of leaves or roots of Nightshade, made up with Oil of Poppies, or Hogs∣lard.

XIII. Narcoticks take not away the cause of the Pain, but are said to give ease thro' stupefaction, and these Medicaments are generally cold in third and fourth degree: of which kind are Apple of Peru, Darnel, Hemlock, Henbane, Nightshade the deadly, Man∣drake, Opium, Poppies, the black chiefly, Water-lilles, Poplar-buds, English Tobacco, &c. of which you may make Oils, Ointments, Cataplasms, &c. ℞ Ʋnguentum

Populeon & Album, ana ℥i. Oil of Henbane, or English Tobacco ℥ss. Tincture of Opium as thick as new Honey ʒijss. mix them.

XIV. 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, Inflamma∣tio, an Inflammation often follows upon Wounds, more especially if the Nerves, or Nervous Parts are wounded; or that the Pain excites an afflux of Hnmors and Blood unto the Part affected; which, when it cannot sufficiently flow forth, putrifies, and easily causes an Inflammation.

XV. Of this Hippocrates has hinted something in Lib. de Ʋl∣ceribus: Si statim pro Valetudine Sanguis plus minusve è plaga flu∣xerit, & ipsum Vulnus, & quae juxtà sunt, minus Inflammatione praemuntur. If Blood flows forth of the Wound, whether more or less, so it be in proportion to the strength of the Patient; then both the Wound it self, and parts adjacent to it, will be the less troubled and affected with any Inflammation that may possibly follow thereupon.

XVI. If therefore there is any cause to fear an Inflammation, from the Blood not sufficiently flow∣ing out, then bleeding is to be pro∣posed, which is to be in proportion to the strength of the Sick. But if an Inflammation is already pre∣sent, then Authors advise Bleed∣ing and Purging too, as the Ne∣cessity shall require.

XVII. If the Inflammation is excited through Pain, that Pain is to be removed by Application of A∣nodyns or Narcoticks, such as we have enumerated at Sect. 10, 11, 12, and 13. afore-going: And the Afflux of Humors are to be repressed, according as we have directed in the former Chapter.

XVIII. Avicen commends a Cataplasm made of a Pomgranate boiled in red or astringent Wine, then beaten in a Mortar, and made up into a Consistency. Or a Cata∣plasm may be made of Flower of Barley, Sea Lentiles, and Mouse∣ear in pouder, with Oil of Roses or Lilies: But if these things do not, you must pursue the Cure as we have taught, Lib. 3. Cap. 5. aforegoing; where we have de∣livered what is necessary to be known in this Matter.

XIX. 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, Erysipelas, A cuticular Heat, and pustular Eruption upon the Skin, sometimes follows upon the Wounds; which you may know by the Signs of an Erpsipelas, delivered in the former Book.

XX. Hippocrates, Lib. de Ʋl∣ceribus, teaches us, Ʋbicunque Ʋlceri supervenerit Erysipelas, pur∣gandum Corpus esse. That when∣soever an Erysipelas shall follow upon an Ulcer, that then the Body is to be Purged.

XXI. If Choler therefore does so much abound, as to endanger an Afflux of Humors to the Wound, it ought wholly to be evacuated with Cholagogues, yet gently, and by degrees.

XXII. But because many times an Erysipelas has its O••i inal from very thin Blood, either Simple, or mixed with some Choler, Cathar∣ticks are to be very mode a ely used, and sometimes not at all; but Sudorificks are to be chosen, as being most useful to open the Pores, and exhale the super-a∣bounding hot Humidity of the Blood.

XXIII. Hippocrates was wont to impose upon the place af∣fected the Leaves of Woad, or the Juice thereof mixt with some proper Earth, as Terra Sigillata, Chalk, &c. You may also ap∣ply a Cataplasm made of Elder-water, or Juice of Elder, with Barley-meal, &c. and other things which we have directed, Lib. 3. Cap. 17. of this Work aforegoing.

XXIV. But Authors leave this Prognostick to go along with us, That an Erysipelas (if it is not induced from the Application of too hot external Medicines) coming upon Wounds, Ulcers, Fractures, and Dislocations, is for the most part mortal.

XXV. 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, Cruditas, In∣digestion in Wounds: This is another thing which hinders heal∣ing of Wounds. Now a Wound is said to be Crude or Indigested, when it does not afford a lau∣dable Pus or Quittor, viz. white, smooth, uniform, and not ill scented.

XXVI. The Cause of this is manifold; 1. Want of Applica∣tion of fit Medicaments in due time. 2. Being exposed too long in the Cold, or cold Air. 3. From imposing unfit Medi∣caments, as things cold, and Heterogene to the Parts wound∣ed. 4. By reason of a great Flux of Blood continuing. 5. From the Nature of the Parts, as Nerves, Tendons, deep Wounds in the Joints. 6. From the Instrument making the Wound, whereby it becomes Contused, as Gun-shot, &c. 7. From Malignity or Poison. 8. By reason of too strict Ban∣dage.

XXVII. As to the Cure; That which is the Cause of the Crudity is to be removed; the wounded Parts are to be strengthened, and Digestives are to be applied, accordiug to the Nature of the Parts hurt.

XXVIII. If there is an He∣morrhage, it is to be stop'd, as we have taught in Cap. 4. aforego∣ing. If the Joints are wounded, Medicaments drying (but not bi∣ting) are to be applied to preserve their Temperature. The coldness of the Air is to be corrected; fit Medicaments are to be appli∣ed to the wounded Part; an equal and mean Bandage is to be used; Things Comforting and Easing the Nerves and Tendons are to be imposed; and the Con∣tused Flesh, if any be, is to be reduced to Pus.

XXIX. The Part wounded is to be strengthned and fortified with Repulsives, or Interceptives; and with such things as preserve (in a mean) the Natural Heat.

XXX. Lastly, the Wound it self is to be brought to Digestion, by the help of Digestives, reason∣ably applied; an enumeration of which, both Simple and Compound, you have at large.

XXXI. 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, Febres; Fe∣vers happening upon Wounds are of many kinds: As, 1. From Di∣sturbance of Humours. 2. From Generating of the Pus, 3. From an Inflammation. 4. From Pu∣tridness of Humours. 5. From an ill Preparedness of Humours.

XXXII. 1. Fevers from Di∣sturbance of Humours, invade

from the very beginning, arising from the Motion of the Body, Passion of the Mind, and Di∣sturbance of the Blood and Spi∣rits thereupon: As also from vehement Pain disturbing the Humors, which causing restles∣ness, sets those Humors on fire.

XXXIII. They are known from their invading the Patient instant∣ly upon insticting the Wound, and together with it: But a putrid Fever may invade the Patient at the same moment, as well as one of these Ephemerae, which you are to distinguish by their proper Signs.

XXXIV. These Ephemerae bring with them no danger at all, yet neither can ye promise Safety; for that the time of Fluxion and Inflammation that are wont to follow on the Wound, is not yet past over.

XXXV. This Fever requires no special Cure; but if the Sick will submit to the strict Rules of Diet, will vanish of its own accord: But all its Causes (if present, or there is fear of their returning) are to be removed, lest danger ensue. For otherwise about the fourth day Fluxions and Inflam∣mations may happen, and so endanger other Symptoms; in these Cases, this is good, ℞ of Our Aqua Bezoartica ℥i. Guttae Vitae. ℥ss. Aqua Elementaria ℥iij. mix: Dose, one spoonful Morn∣ing and Evening.

XXXVI. 2. Fevers from ge∣nerating the Pus, arise when there is a great abundance of Pus ge∣nerated, as Hippocrates, Sect. 2. Aph. 47. seems to inculcate: For whatsoever abounds in the wounded Part, and cannot be changed into the substance thereof, putrifies, and causes an Effervescency of the putrid Mat∣ter; yet Nature does whatever she can, to convert as much of the superfluous matter into Pus. Now from this Ebullition a heat is engendred in the Blood in the Vessels, which being commu∣nicated to the Heart, excites a Fever, which is more like to an Ephemera plurium dierum, rather than to Febris putrida, properly so called.

XXXVII. It is known, because the Signs of Putridness are ab∣sent, and appear not, nor yet the Signs of an Inflammation: And it invades at the time in which the Pus is wont to be generated, which is chiefly about the fourth day: The Heat is much, but easie; Pulse great, swift, and frequent; Urine like that in time of Health, and is always alone, or without any other Symptom joined with it.

XXXVIII. It is without any danger at all in it self, and soon after ceases many times of its own accord.

XXXIX. The Cure is effected by making a passage forth for the Pus, as soon as may be: And if the Pus is contained in a more noble Part, or in a Part that has consent with a more noble Part, the sooner it is let out, the bet∣ter it is, and the sooner the Fe∣ver ends; and withal, you ought to endeavour to hinder the future afflux of any more Hu∣mours.

XL. 3. Fevers from an Inflam∣mation, are caused from the

Matter heaped up, and causing the Phlegmon; and they arise from the Spirits growing hot, and communicating this heat to the Heart through the Arteries and Veins, by which the putrid Vapours are transfused, and do penetrate: And these Fevers are sometimes Quotidians, and some∣times Putrid, according to the Matter by which they are indu∣ced.

XLI. They are known, because an Inflammation is always present; the Signs of which we have given you in its proper place: And whe∣ther it is a Quotidian, or truly Putrid Fever, you may know by the Signs of them both, as we have declared them in Our Synop∣sis Medicinae, Lib. 7. to which we refer you. If it is a Quoti∣dian, the Signs of Putridness ap∣pear not in the Urine, whereas in Putrid Futrid Fevers they do appear: And the heat in Putrid Fevers is far greater and sharper than in Quotidians; so also the Symptoms are more vehement, and withal there is a greater de∣jection of Spirits, and of the strength of the Body.

XLII. They are greater or les∣ser, according to the Magnitude of the Inflammation, on which they depend; and so likewise they are more or less dangerous.

XLIII. They are Cured by re∣moval of the Cause, viz. of the Phlegmon, like as all other symp∣tomatick Fevers are: And there∣fore you must by cooling Alte∣ratives endeavour the abatement of the Heat, lest that otherwise a Putridness of the Humours be induced. And if any Putridness is present, you must repress and restrain it with all the speed imaginable.

XLIV. 4. Fevers from Putrid∣ness of Humours, are caused from the Heat which induces the Pu∣trefaction, which are kindled, and increase gradually as the Putridness encreases; and this Putridness is in the Wound it self, having an affinity with the Pus, or thick purulent Matter.

XLV. They are known from the Quantity and Quality of the Ex∣crements flowing out of the Wound, as a great quantity of Sanies, which is rather Putrid or Stinking, than laudable or good Pus, and of a various and evil Colour, and very offensive Smell: And though the Sanies may sometimes be but little, yet it is corrupt and stinking: If the Colour of the, Part is changed, and there is pain and heaviness, it is a Sign of a present vitious Matter, not cast forth, which stirring of a heat with in, causes this Fe∣ver to appear, with Signs of Pu∣tridness in the Urine.

XLVI. They are more or less dangerous, according as the Pu∣tridness is greater or lesser, and in a Part more or less noble, and accompanied with more grie∣vous or gentle Symptoms; and as the passage for the vitious and putrid Matter is more difficult or easie for its flowing forth.

XLVII. The Cure consists in re∣sisting the Putridness, and restrain∣ing the Putrid Matter, and that an easie way and passage be made with all speed for its flowing out: For the Putridness being resist∣ed and destroyed, and the pu∣trid

Matter removed, the Fe∣ver then vanishes of its own ac∣cord.

XLVIII. 5. Fevers from an ill Preparation of the Humours thro' the whole Body, are easily kindled upon the occasion of a Wound; for if the wounded Body is im∣pure, a Fever, through pain of the Wound, is easily then in∣duced. This may rather be cal∣led a Cacochymick Fever, because of the great provision of Viti∣ous and Scorbutick Humours heaped up in all places; and it is caused either from those Hu∣mours through the whole Body being inflamed, through the Commotion or Disturbance of the Spirits after receiving of the Wound, or from a Putrid∣ness engendred in the wounded Parts, from whence depraved Vapours are communicated to the Veins, where meeting with vitious Humours, a Fever is in∣duced thereupon.

XLIX. These Fevers are some∣times continued, sometimes inter∣mitting, but for the most part Ter∣tians of either kind, either single or double; very rarely Quotidians, and more seldom Quartans: And they are known by the Heat, by the Urine, and by the Pulse, all shewing a Putridness and Caco∣chymy: If they are caused by a Disturbance and Commotion of the Spirits of the Humours, it is known by its immediately in∣vading the Patient in the be∣ginning, when there is no Pu∣tridness in the Wound. But if it is caused from any Putrid∣ness in the Wound, then the Fever is not at beginning; but after a short time, when Signs and Tokens of Putridness begin to appear in the Wound. Lastly, The Nature and Quality of the Fever is to be known from its own proper Signs.

L. The continual are the more dangerous; the intermitting are of themselves altogether void of Danger: But continual Fevers falling upon Wounds, have all of them some danger, more or less, according to the Quality or Condition of the Putridness; for that a Fluxion may be exci∣ted upon the Part affected: Or by weakening of the Heat of the Part, many Excrements may be generated therein, from whence many other evil Symp∣toms may be excited.

LI. As to the Cure of these Fe∣vers, the Putridness must be re∣sisted, by giving internally Our Tinctura Bezoartica, à gut. xxv. ad lx. in some proper Vehicle; and in the Remission, part of the Mor∣bifick Cause is to be carried off with Purging, by giving several Doses of Sal Mirabile; and then cool∣ing the Blood with Juice of Ci∣trons, or Oil of Sulphur, or Sal Vitriolatum. The Intermitting are to be Purged in the Inter∣mission; 1. Ʋpwards, with Pul∣vis Antimonii, or some small Dose of Tartar Emeticum. 2. Downwards, with Pulvis Cathar∣ticus, or Pulvis Cornachini, or an Infusion of Sena and Rhubarb, that the Cacochymy may in a good measure be carried off: After which the Fever is to be cured with Pulvis Antifebriticus, or with the Pouder, Infusion, or Tincture of Cortex Peruanus.

LII. 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, Lipothymia & Syncope, Fainting and Swooning: These differ only in degrees. In Lipothymia, or Fainting, the Sick loses not al∣together the sense of Feeling, but the Spirits seems to fail, with a cold Sweat breaking forth, chiefly about the Face, Fore∣head and Temples.

LIII. Whereas in a Syncope, or Swooning, Motion and Feeling are taken away together from the Body, so that it lies for a time, seemingly as if it were dead. In handling this Article, we will only treat of a Syncope, as being the greater Disaffection; for that the Cure of it being known; the other cannot be unknown, since that those things, which are beneficial in a Syncope, or the greater evil, must be much more prevalent in a Lipothymia, or the lesser.

LIV. A Syncope may be caused, 1. From Fear, or over great Joy. 2. From Suffocation of the Spirits, from Crude Humours, or Sul∣phureous Vapours, as those of Charcole. 3. From the Sensi∣bility of a Part, as a Nerve, Ten∣don, Membrane wounded. 4. From the Constitution of the Heart being altered, by the Malignity of some Disease, as the Plague, &c. 5. From a malign Vapor sent to the Heart from some other Part, as from the Womb, in Fits of the Mother. 6. From a ma∣lign Matter communicated to the Heart, as in a Sphacelus, or dead∣ly Mortification. 7. From a de∣ficiency of Spirits, there being not matter enough for their ge∣neration, as in Famine, great Thirst. 8. From the Spirits be∣ing spent by too great Heat, Watch∣ing, Grief, Travel, or immode∣rate Evacuations. 9. By Anti∣pathy to some particular thing, as smelling to sweet Bryar, or Wall-flower, seeing or tasting of Shoulder of Mutton, Cheese, &c.

LV. The Signs of a Syncope are, Paleness of the face, with some∣times cold Sweats; small, slow, and unequal Pulse, dimness of Sight, coldness of Hands and Feet; at last the Pulse wholly ceases, and the Speech, Moving, and Feeling are taken away, the Body lying for a while as though it was dead.

LVI. As to the Prognosticks, you must know, 1. A Syncope proceeding from an inward Cause, is more dangerous than that which proceeds from an outward; and that which seizes one which was before feeble and weak, is ac∣counted dangerous.

LVII. 2. A Syncope which proceeds from an Oppression of the Spirits, is more easily cured, and less dangerous, than that which proceeds from a Dissipation of the same, through Inanition: But where Swooning is often repeat∣ed without manifest Cause, the Sick dies at last suddenly, as Hippocrates affirms, Sect. 2. Aph. 41.

LVIII. 3. In a Syncope, if the Sick comes, or revives not a∣gain, by casting cold Water on the face, rubbing them with Rose-water, or Spirit of Wine, or ha∣ving Wine or strong Waters put into their mouth, or strong snee∣zing Medicines blown up their Nostrils, or strong Spirit of Sal

Armoniack held thereto, it may be accounted mortal.

LIX. 4. A Syncope caused by immoderate Evacuation of Blood in Wounds (if it is not too great) is not very dangerous, especially if the Sick is of a good Habit of Body; for that by good Diet new Blood may be genera∣ted again.

LX. 5. The Sick coming to themselves again after a Fit; yet if the Pulse and good Colour of the Face returns not, they will immediately relapse again, or fall into another Fit.

LXI. 6. Lastly, The Syncope, which is the primary Diasaffection of the Heart, is more dangerous than that which happens by con∣sent of other Parts.

LXII. As to Cure: The means proper in this Case, are either Ex∣ternal or Internal.

LXIII. Externally, Cast in their Faces fair Water, Damask-Rose Water, Orange-flower Water, Mint Water, &c. And let the Temples and Nostrils be bathed or moistned with Spirit of An∣gelica or Bawm, or Powers of Oranges, Limons, Lavender, Rosemary, or Amber.

LXIV. But if it is a Woman, and possibly may be subject to Fits, you must avoid sweet Scents, but cause the Fumes of Spirit or Salt of Hartshorn to go up the No∣strils, Spirit or Tincture of Ca∣stor, Volatile Salt, or Spirit of Sal Armoniack, of Urine, or of Blood, &c.

LXV. Then you must use sha∣king of the Body, rubbing of the extream Parts, hollowing in their ears, and pressing the Parts ad∣jacent to the Joints of the lower Jaw, under the Lobes of the Ears; and force into their mouth gr. x. of Our Theriaca Chymica, mixed with a little Spiritus Cor∣dialis, or a drop or two of Oil of Limons or Lavender.

LXVI. Internally, you may give a Toast well sop'd in Choice Canary, drinking the Wine with the Toast: Or you may dissolve a lit∣tle choice Juice of Alkermes in Our Spiritus Cordialis, or gr. xvi. of Theriaca Chymica in Our Aqua Bezoartica ℥i. where these things are not at hand, Angelica, Bawm, Cinnamon, and Mint Waters, may be of use, more especially if mix'd with an equal quantity of mull'd Brandy.

LXVII. Or you may give this Composition. ℞ Spiritus Cor∣dialis ℥i. Tinctura Cordialis ℥ ss. Potestates Anisi, Caryophyllorum, Lavendule, Limonum, Pulegii, Rosmarini, A. ʒi. Cinnamon-water, Mint-water, A. ℥ij. Syrup of the Juice of Limons and Citrons, A. ℥i. Juice of Alkermes ℥ss. mix them. Dose, one or two Spoonfuls, now and then, as you see occasion.

LXVIII. 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, Convulsio, a Convulsion, or pluck∣ing or shrinking up of the Nerves, Tendons, and Muscles, or parts ap∣pointed for voluntary Motion to∣wards their Original, viz. the Brain, or Spinal Marrow, which happens now and then to wound∣ed Persons; this is a vehement and dangerous Symptom, and of which we should be large here, but that we have treated thereof very explicitely in the third Edition of Our Synopsis Medicinae, Lib. 2. Cap. 3. &

Lib. 3. Cap. 18. We shall here therefore give you only those things which are proper to be said upon those Convulsions, which are wont to follow upon Wounds.

LXiX. A Convulsion in wounded Persons, is two-fold; either Na∣tural or Ʋnnatural: That which is Natural happens when one of two Muscles appointed for Motion is contracted, the other being Trans∣ve sly ••ounded; and this may be seen in Wounds of the Head, when one of the Temporal Mu∣scles is cut asunder; and in Wounds of the Fingers: For if the inner Muscle of a Finger is cut asunder transversly, the out∣ward Muscle will be contract∣ed.

LXX. An Ʋnnatural Convul∣sion is that which happens, not because one of two Muscles, ordain∣ed to perform the same Function or Action, is transversly wounded, but is otherwise hurt, cut in part, or prick'd, and this is either Mo∣tus Convulsivus, or Convulsio Vera.

LXXI. Motus Convulsivus is caused from a thin, or vaporous Matter moving up and down, and disturbing the Nerve: Which con∣tinues not long; for the Matter be∣ing kept in the Part effected, the Brain, and Original of the Nerve are so affected, that they lose their Action; from whence a Palsie is in∣duced on that side: Then a ma∣lign Vapor being raised from hence, and passing to the Neu∣rotick Root of the sound Part, not wholly spoiled, the Nerves are shaken; whence comes this Motus Convulsivus, and differs from a true Convulsion only in this, That the Matter is less sharp, and the Contraction con∣tinues not so long.

LXXII. A true Convulsion is that which is caused from an a∣bounding Oily Matter stopping the Nerves; or from a Driness shrinking them up; or by Con∣sent, from an evil or malign Vapor, sent to the Original of the Nerves of the Muscles, and contracting them.

LXXIII. Convulsions are either General or Particular: The Gene∣ral are three-fold, 1. 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, Emprosthotonos, when not only the Neck, but the rest of the Body also is drawn or con∣tracted forwards, that the Sick cannot stand upright; the Nerves of the Neck and rest of the Spine, which move the Body forwards, being disaffected.

LXXIV. 2. 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, Opi∣sthotonos, when the whole Body is bent backwards, so that it cannot be bent forwards; which is caused from the hurt of the Muscles which bend the Body backwards.

LXXV. 3. 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, when all the Muscles of the fore and back Parts are equally Convulsed, or Contracted, and kept so, where∣by the Body remains stiff, that it cannot be bended any way.

LXXVI. Particular Convulsions are twofold, 1. 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, Spasmus Cynicus seu Oris distortio; which, as Celsus, Lib. 4. Cap. 2. says, Is when the mouth is pulled awry. Now the chief Muscles of the Face are those of the No∣strils, Cheeks, Lips, and lower Jaw, which have Nerves, for

the most part, from the third Conjugation.

LXXVII. 2. 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, Spas∣mus flatuosus, seu Flatu abundans; The Cramp, in any other par∣ticular Part of the Body, caused from a thin windy Vapor, con∣tracting the Muscles or Nerves, making a hard knotty Tumor, with vehement Pain.

LXXVIII. Now the Causes of Convulsions upon Wounds are either Essential, or by Consent.

LXXIX. The Essential Causes are either from a pricking of the Nerves, and a vehement Pain thence arising; or else from some malign or sharp Humor or Va∣por twitching some nervous Part, or the Membranes of the Brain; for the Expulsion of which, Nature, by labouring, excites this Contraction, or Con∣vulsive Motions.

LXXX. Hippocrates, Sect. 5. Aph. 65. saith, Those that with their Wounds have manifest Tu∣mors, are not much troubled with Convulsion Fits, but they are sei∣zed with a sort of Madness: But if these Tumors suddenly vanish, (they happening on the hinder Part) then Cramps and Convulsions happen thereupon.

LXXXI. And Galen, Arte Medica, Cap. 92. says, That the pricking of a Nerve or Tendon (by reason of the exquisiteness of their Sense, and because they are conti∣nued from the Brain) is very apt to excite a Convulsion of the Nerves; but then more especially, when nothing breaths forth out∣wardly, the wound of the Skin be∣ing shut up or closed.

LXXXII. The Causes of a Con∣vulsion by Consent are threefold, 1. From a malign Vapor offending the Original of the Nerves, as in Poisoned Wounds. 2. When the Nerves draw themselves towards their Original, by reason of the great pain which is felt in the wounded Part. 3. From vehe∣ment or immoderate Cold, or cold things making the Nerves stiff.

LXXXIII. The Signs of a Con∣vulsion, are a Contraction of the Muscles and Nerves towards their Original, against the will of the Sick, and the Member which they move follows this depraved Motion. But in a convulsive Motion, this is not performed at once, and so continuing, but it comes, ceases, and returns often, draw∣ing the flesh several ways.

LXXXIV. As to the Progno∣sticks: Convulsions or convulsive Motions are very dangerous in Wounds; for Hippocrates, Sect. 5. Aph. 2. says, If a Convulsion fol∣lows upon a Wound, it is mortal; and this is because sharp Humors smite the Nerves and inflame them. And in Sect. 5. Aph. 3. If a Convulsion follows upon an immoderate Flux of Blood, or a Raving, or Sighing, and Sob∣bing upon the same occasion, it is very evil and dangerous.

LXXXV. Whoever is taken with a Tetanos, dies generally within four days; but if they es∣cape these, they recover. Hippo∣crates, Sect. 5. Aph. 6. The reason is, because the Disease is perperacute, or very acute, and Nature is not able to endure that horrible pain any longer, caused by the strong Tension of the Nerves, both forward and back∣ward.

LXXXVI. They who die of a Convulsion, continue hot a long time, because they die stifled, the Mu∣scles appointed for respiration being also contracted or shrunk up: For the Muscles of the Neck distend∣ed, the Septum transversum, or Diaphragma, must also be hurt. For Nerves arising from the fourth Vertebra of the Neck are inserted into the Midriff, and so the Neck being convulsed, Re∣spiration is hindred.

LXXXVII. The Cure of Con∣vulsions we have taught at large in the Third Edition of Our Synop∣sis Medicinae, Lib. 3. Cap. 18. Sect. 21. ad 28. But in Con∣vulsions and convulsive Motions which happen upon Wounds, (whether it is of themselves, or by Consent of some other Part) this is particular, that you must have great regard to the Brain, and Spinal Marrow, and the Nerves which proceed from them.

LXXXVIII. For which reason you are to anoint the Neck, both before and behind, as also the whole Spinal Marrow, with some pow∣erful Neurotick, such as this: ℞ Cil of Peter, Chymical Oil of Amber, Angelica, Anise, Caraways, Camomil, Cloves, Fennel, Juni∣per, Lavender, Limons, Mace, Nutmegs, Rosemary, Sage, Sassa∣frass, Savin, Turpentine, A. ʒi. liquid Amber, liquid Storax, Bal∣sams of Chili, Peru and Tolu, A. ʒij. mix them; with which a∣nont two or three times a day.

LXXXIX. If the Convulsion happens from the Retention of the Pus, or other Recrements, a Pas∣sage must be made as soon as may be, for the Excrements both thin and thick to come forth; and by which some Neurotick Oil or Liquor is be drop'd into the Wound, that has a power to cleanse and give ease.

XC. And outwardly, things which have a power to draw from the depth of the Wound are to be applied; which must be Medi∣caments of an attractive force, and yet Neuroticks withal; of which kind are all sorts of natu∣ral Balsams, Turpentines, and the like.

XCI. The Body, if Costive, is to be kept soluble with Clysters. ℞ fat Broths lbi. Tincture of Sena ℥ss. brown Sugar ℥iv. mix them, and exhibit warm. Or you may Purge with a Dose or two of Pul∣vis Cornachini à gr. xx. ad ʒss. given in a little Syrup of Roses solutive, which works pleasantly and gently.

XCII. After Purging, Speci∣ficks are to be given; as morning and evening Our Theriaca Chymi∣ca, Laudanum Specificum, Elixir Antepilepticum, Spiritus Opii, Po∣testates Lavendulae, Limonum, Pulegii, Rosmarini, Succini, & Virtutum, Guttae Vitae, Sal & Spiritus Cornu Cervi, and other things of like kind, with which also outwardly, the Parts affected may sometimes be bath∣ed.

XCIII. If the Convulsion arises from poisoned Wounds, whether with poisoned Weapons, or bitings of poisonous Creatures, &c. you must then dilate the mouth of the Wouud, that the venomous Matter may have free vent; and Cupping-Glasses are to be appli∣ed, to stop the ascending of the Vapors.

XCIV. The Medicines also which you apply to such poisoned Wounds, must be of a thin or liquid substance, that it may the more easily pass to the bottom of the Wound, and they must be of a drying and digestive quality, to resolve and draw out the virulency or poison of the Matter.

XCV. Such are Ointment of To∣bacco, made thin with Oil of To∣bacco, Our Theriaca Chymica, or Mithridate dissolved in Spiritus Cordialis: And in this case a little of the Princes Pouder (to be added with the former mix∣tures, whether of the Ointment or Treacle) will be found of ex∣traordinary use.

XCVI. If the Convulsion is cau∣sed from extremity of Pain, Ano∣dyns are to be applied; as Oil made by expression, out of the Seeds of Hypericon, in which the Flowers of the same Herb are often to be infused, which is commended by Heurnius; also other Anodyns, and Narcoticks, store of which you may find in their proper places.

XCVII. If the Convulsion is caused through external Cold, or cold things, or Applications; you must then keep the Sick in a warm Room, and anoint with warming or heating Medicaments, such as this: ℞ Ox Gall ℥ii. Oils of Amber, Anise, Sassafrass, and Li∣mons, A. ʒii. mix them, to a∣noint withal: Also you may a∣noint with the Compositum, at Sect. 89. aforegoing.

XCVIII. 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, Deli∣rium, Dotage, or symptomatical Madness. This Symptom hap∣pening upon a Wound, is dan∣gerous; for the mind not be∣ing well, it shews the Brain is not well, neither its Membranes, nor the whole nervous System; and therefore it is always a bad Sign.

XCIX. And if it is accompa∣nied with a continual Fever, and Difficulty of Breathing, it is mor∣tal. Hippocrates, Sect. 4. Aph. 50. And if it follows a great ef∣fusion of Blood, it many times shews a Gangrene is present, and that the Patient will infal∣libly die.

C. If a Delirium happens in the beginning of a Wound, it shews that some noble Part is hurt, and is more dangerous than if it hap∣pens afterwards; for it demon∣strates the vehemency of the affect contending with Nature.

CI. Since where-ever this Sym∣pton appears in Wounds, it is for the most part mortal, and declares imminent Death; we shall not say much of the Cure of it: But if notwithstanding that any hope shall appear, 1. Revulsion is to be made with proper Clysters. 2. Deriva∣tion is to be made by the Nostrils with proper Errhines, such as Juice of Sweet Marjoram, Beets, Primrose Roots, &c. 3. You must cause them to smell often to volatile Salts and Spirits, as of Sal Armoniack, &c. 4. Ap∣ply Hypnoticks to the Forehead and Temples. 5. Endeavour as much as may be, to remove any present evil Symptom in the Wound it self. 6. Give Spiritus Opii Compositus in some proper Vehicle, as oft as need requires, to compose the Spirits, and bring the Pa∣tient to rest; or in place there∣of

of, you may give a small Dose, as gr. i. or ii. or iii. of Our Spe∣cifick Laudanum, or of Our Vo∣latile Laudanum, or Dr. Gar∣dener's Laudanum Tartarizatum; all which see in their proper Places. See more hereof in the Third Edition of Our Synopsis Medicinae, Lib. 3. Cap. 6.

CII. 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, Paralysis (à 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, which is to be re∣solved) The Palsie, or Resolution of the Nerves; that is, a resol∣ving or loosening of the Nerve, and Muscle into which the Nerve is inserted, so that they become weak∣ned, and useless for the performing of voluntary Motion. Or, it is a privation of Motion, and some∣times of Motion and Feeling, both from an Obstruction of the Nerves, which puts a stop to the Course of the Animal Spi∣rits, the efficient Causes of vo∣luntary Motion and Feeling.

CIII. Several Conjugations of Nerves have several Offices, some serve for Motion, some for Feeling, some for Tasting, some for Smelling, some for Seeing, and some for Hearing: Now if the Nerves ap∣pointed for Motion only are af∣fected, voluntary Motion only is hurt, not the Feeling: But if the Nerves appointed for Feel∣ing are only hurt, then the Feel∣ing is lost, the Motion remain∣ing. If the Nerves of both kinds are hurt, then both voluntary Motion, and sense of Feeling are hurt together: But if the same Nerve does serve both for Mo∣tion and Feeling together, then both are lost together.

CIV. Thus, in the Tongue, if the third and forth Conjugations of Nerves of the Brain are hurt, the 7th pair being safe, the Taste is hurt, the motion of the Tongue con∣tinuing; and contrariwise. In the eye, if the Optick Nerves, the first pair be hurt, the Moto∣ry or second pair being safe, the sight will be lost, but the motion of the eye will remain, & è contra.

CV. Now the proximate Cause of a Palsie is some disaffection of the Nerves inserted into the Parts destinate to Voluntary Motion; because from the Nerve every Muscle has the Faculty of mo∣ving, for that it conveys to it the Animal Spirits, the princi∣pal efficient Causes of Motion: And this Disaffection is gene∣rally a cold and moist distem∣perature, which relaxes the Nerve, and makes it wholly un∣capable to receive, and convey the said Animal Spirits.

CVI. The Nerves are re∣solved either by external Cold and Moisture, as cold Weather, wet Clothes, lying in the Snow, or wet Places, immoderate Ve∣nery, cold and narcotick Applica∣tions; or by Internal Defluxions of cold and moist Humours, too much moistning and cooling the Nerves, and so relaxing them, altering their natural Tempera∣ture, and making them unfit to receive and convey the Animal Spirits to the Parts ordained for motion, as aforesaid, viz. the Muscles.

CVII. Now the Nerve being re∣laxed, and the Spirits not flowing, but a flux of cold moist Humors filling up and extending in breadth or thickness the Muscle, the Nerves

themselves become compressed, and so the passages of the Animal Spirits are made narrower, or closed up; or otherwise they are obstructed with the same flowing Humour, and so they are stop'd.

CVIII. And this may be effected either by Compression, Contusion, Laxation, Luxation, too strict Li∣gature, Mortification through Cold, or Solution of Continuity, when the Nerve which conveys the said Spirits to the Muscle or Part, is either cut a-sunder, cut tranversly, obliquely, torn, brui∣sed, or eroded with some cor∣rosive or sharp Humor.

CIX. The Signs by which a Palsie is known, are the hùrt of Motion, and sometimes of Feel∣ing, and sometimes of both: But the Part primarily affected, is found out by that which is ma∣nifest.

CX. If one side of the face is Paralytick, the rest of the Body being well, the Brain is originally affected: But if the Speech is hindred also, and one side of the Body hurt withal; both the Brain and Medulla Spinalis are grieved.

CXI. If either side is Para∣lytick, all the Parts of the Head being well, the Cause is in the same side of the Spinal Marrow; but if both sides are Paraly∣tick, the Head being well, both sides of the Spinal Marrow are hurt.

CXII. If the Arms only are Paralytick, the fifth, sixth, and seventh Vertebrae of the Neck are affected: If the Thighs, Legs and Feet are affected, then the Cause is in the Vertebrae of the Loins, and Os Sacrum.

CXIII. If any particular Part is Paralytick only, then the rooted Cause is neither in the Brain, nor Spinal Marrow, but in some Branch or Sprig of a Nerve in∣serted into that Part. If both sides of the Body are affected, it is then an universal Palsie; but if one side only, it is an Hemiplegia, or Half Palsie.

XIV. As to the Prognosticks; It is manifest, if the Paralytick Member is actually hot, there is hopes of Cure: So also if a Fe∣ver follows after a Palsie, because it warms, discusses and drys the morbifick Matter. Or if a Diar∣rhaea happens naturally, because it discharges the Matter impact∣ed in the Nerves: Or if a Trem∣bling comes after the Palsie, because it shews the Passages for the Spirits are made a little per∣vious or open.

CXV. If a Palsie happens af∣ter an Apoplexy, it is scarcely cu∣red, for it shews the Vehemency of the Cause: It is scarcely cured if it happens in old Age in the Winter time, because their natural Heat is weak, and Diseases in Winter-are more rebellous: So also if the Paralytick Member is extenuate, and its fresh colour lost, because the Spirits are few, and the na∣tural Heat weak: Or if the eye of the Paralytick side is weak, for it argues a defect both of the natural Heat, and Animal Spi∣rits.

CXVI. A strong Palsie from an inward Cause, is hard to be cured, because it proceeds from cold, vis∣cous and gross Humors: If both

Motion and Feeling are abolished, it is more dangerous than when one of the Symptons only happens: If the Paralysis follows after a vehe∣ment Luxation of the Spina Dor∣si, or Back-bone, it is dange∣rous, because the Nerves are generally much bruised, and by reason of Inflammation, are scarcely to be reduced. If it happens from a Nerve being transversly cut asunder, it is in∣curable. Hippoc. Sect. 6. Aph. 19.

CXVII. The Cure has respect to, 1. Diet: 2. Internals: 3. Ex∣ternals; all which are to be re∣gulated according to the Con∣stitution of the Patient, and Quality of the Wound afflict∣ing.

CXVIII. 1. As to Diet: Let their bread be Biscake; their meat, the Flesh of Land, and Mountain wild Foul, as Partidges, Larks, Starlings, Blackbirds, Pheasants, Chickens, rosted with good Sawce: Their Drink, a Decocti∣on of Guajacum, used ordinari∣ly; or Wine in which Cepha∣lick and Neurotick Herbs have been infused.

CXIX. 2. As to Internals, keep the Body soluble either with proper Clysters; such as the Tur∣pentine Clyster with brown Su∣gar, or fat Broth, in which Co∣locynthis has been infused, or a Tincture of Colocynthis, or Scammony, or Aloes has been mix'd; then Purge with Tinctu∣ra Cathartica, Sal Mirabile, Sy∣rupus Catharticus, Pulvis Anti∣monii, Pulvis Catharticus, Pulvis Cornachini, Electuarium Cathar∣ticum, or Pilulae Catharticae, which of these agree most with the Habit and Constitution of the Body.

CXX. And in the Intervals of Purging, let the Patient take morning, noon and night 60 or 80 drops of the following mixture in a Glass of Wine. ℞ Potestates Lavendulae, Limonum, Pulegii, Rosmarini, Virtutum, A. ʒj. Spi∣ritus salis Armoniaci ʒ ss. mix them.

CXXI. 3. As to Externals or Topicks, Bleeding must be avoided, as a thing most pernicious. The Vertebrae, and Parts affected, may be bathed with this: ℞ Powers of Turpentine ℥iv. Powers of Am∣ber ℥ij. Powers of Juniper ℥j. mix them. Or this, ℞ Oil of Peter, Oil of Amber, Oil of Turpentine, A. ℥i. Oil of Limons and Cara∣ways, A. ℥ss. mix them. And after some days time, for anoint∣ing, you may apply this Em∣plaster, to attract Heat and Spi∣rits; ℞ Frankincense ℥viij. Ship Pitch ℥iv. Balsam Capivii, of Pe∣ru, and Turpentine, A. ℥ii. Wax ℥i. melt, mix, and make an Em∣plaster.

CXXII. 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, Gangraena & Sphacelus, a Gangrene and Mortification. We shall not say much of these here, because we have very largely dis∣coursed of them in Lib. 3. cap. 11. aforegoing of this Work; yet a short Observation or two we shall give you. If a Gangrene appears, bath the Part affected with Camphorated Spirit of Wine, simple, or mixed with some Wa∣ter: Water of Crabs alone is said to be singular; so also Sac∣charum Saturni infused in Lime-water;

Fomenting also with Wine mix'd with S.V. and Saf∣fron.

CXXIII. If there is a Mortifi∣cation, a Fomentation with Wine, in which Wormwood, Rosemary, Hypericon and Aloes have be boiled, and then mixed with Spirit of Wine, and a little Spirit of Sal Armoniack, is commended; so also the Tinctures of Aloes, Euphor∣bium, and Myrrh made with Cam∣phorated Spirit of Wine, in which Saffron has been infused: Or those Tinctures impregnated with Spi∣rit of Sal Armoniack.

CXXIV. 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, Hy∣persarcosis, Carnis Excrescentia, Proud Flesh. This is whenever the Flesh grows forth beyond its due measure, whereby it hinders the Production of the Cicatrize for covering the Wound, or o∣therwise causes it to be unplea∣sing to the sight, or deformed.

CXXV. It is caused mostly for want of Care in the Physician, not applying Medicaments sufficiently drying, and then the Flesh will not be sound and solid, but lose and spungy.

CXXVI. Or from abundance of Blood flowing unto the Part affect∣ed, and then the Flesh will be in a right temper, only there will be too much of it.

CXXVII. The Cure is by taking away the superfluous-Flesh, that so the Wound may be shut up with a Cicatrize; which that this may be done, the Medicaments must be sufficiently powerful in dry∣ing and cleansing, and, if need require, somewhat corroding likewise.

CXXVIII. If it proceeds from the first Cause, strong Detersives, and such as may produce a Cica∣trize, are to be chosen, as Spunge burnt, Galls, Aloes, Tutty, burnt Alum, dry Lint; sometimes burnt Alum alone will do, or Pulvis ad Hypersarcosm, Red Pre∣cipitate, &c.

CXXIX. This is commended, ℞ Galls, Pomgranate Peels, Spunge burnt, A. ℥ss. burnt Alum ʒii. make all into a Pouder, to strew thereon. Or, ℞ Galls, Pom∣granate Peels, Myrrh, burnt Alum, dried Blood, A. ʒii. Dragons-blood, Ceruse, Verdigrise, A. ʒi. Red Precipitate ʒss. make a Pouder.

CXXX. This Pouder is beyond all, which is called Pulvis Ange∣licus: ℞ burnt Alum, red Preci∣pitate ground fine, Ana, mix them. Or the Aqua Viridis, Green Water of Sennertus, which takes away the Flesh without any pain at all, and generates the Cicatrize: ℞ Crude Roch-alum, Verdigrise, A. ʒij. Wine ℥xviij. boil till a quarter is wasted, then filter thro' brown Paper, and add to it Camphir ʒi. dissolved in Spi∣rit of Wine ℥i. dip Cloths in this, and lay it on the proud Flesh.

CXXXI. If it proceds from the Second Cause, or abundance of Blood, you may apply some of the former drying Medicaments, and withal, the Patient must use fasting, and a spare Diet.

CHAP. X. Of Curing by the SECOND INTENTION.

I. 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉. Syssarcosis, Concarnatio; Curing of Wounds by the second Intention, is next to be taught, which is the Ʋnition of Parts disjoined by some proper Medium, or middle Sub∣stance; which in Wounds of the fleshy Parts is a like substance, or Flesh: but in Wounds of a Bone, it is a Callus, &c.

II. Now when a Wound is to be cured by the second Intention, you may discover by these following Directions: 1. If there is con∣tused Flesh, or loss of substance; whether it is of Flesh, Mem∣brane, Ligament, Cartilage, or Bone. 2. When you cannot conveniently or easily bring the lips of the Wound together, by stitching or rowling; as in Wounds of the Joints, when the great Ligaments are cut asunder. 3. When without it there would be a great and dangerous He∣morrhage; as in Wounds of the Neck, where the internal Jugu∣lar Veins, and Soporal Arteries are divided. 4. When we ex∣pect the scaling of a Bone, or separation of a piece of a Liga∣ment, or Cartilage. 5. When great store of Pus or Quittor is like to flow to the wounded Part: which you may know,

III. 1. By your not being able to hinder the afflux of Humors by Swathing, as in Wounds of the Armpits and Joints. 2. By the Patient's having a Scirrhus of the Liver or Spleen. 3. By the Bo∣dies repletion with cacochymical Humors. 4. By the Patient's having some contagious Diseases; as the Leprosy, French-pox, Itch, &c. In all which cases, the Cure ought to be attempted rather by the second, than by the first Intention.

IV. Where there is loss of Sub∣stance, the Reasons hindring the Cure by the first Intention, are, 1. Pain and Inflammation; which may ensue, by reason of the forcible bringing of the lips of the Wound together. 2. Be∣cause of a great Deformity, which may be in the wounded Part, after the Cure is per∣formed. 3. By reason of evil Symptoms which are apt to follow, after the Wound shall seem to be healed; as Pain, Inflammation, Tumor, and a fresh breaking out again.

V. Now to cure a Wound after the second Intention, there are several Indications; as, 1. To stop the Hemorrhage, if any be, and procure Digestion. 2. To cleanse the Wound of the di∣gested Matter by Abstersives. 3. To fill up the Wound with new Flesh, or some other Me∣dium of Unition, by Sarcoticks. 4. To abate or take away the Flesh, if it is proud or super∣fluous. 5. When the place, if

filled up with Flesh, &c. to produce the Cicatrice, with proper Stypticks and Epulo∣ticks.

VI. 1. How the Hemorrhage is to be stopt, we have taught in Chapter 4. aforegoing: some time after which, the Wound is to be brought to yield a Quittor of a white, smooth, equal, and thick substance, which is called Digestion, and is performed with Digestives; which, what they are, see in Chap. 2. aforgoing, of this Book.

VII. 2. If the Wound is foul, with any ill or stinking Matter, looks black, or ill coloured, it is to be cleansed with Medicamenta detergentia, Mundificatives, or Abstersives; and these Medica∣ments ought to be according to Galen, Meth. Med. lib. 1. cap. 12. of a drying and penetrating faculty, and are said to be the strongest kind of Sarcoticks.

VIII. For the slough, or foulness which is united to the Flesh, &c. in a Wound, is united by moisture: wherefore drying Medicines spending the humidity, the evil matter is separated; as in things glewed together, if the Glew is too much dried, it loses its strength and hold.

IX. 3. The filling up of the Wound with Flesh. To do this, four things are required: First, To reduce the whole Body, and especially the Part affected, to a natural Temperament, and to cause it to incline to driness; which if it is, it is to be pre∣served; if it is not, it is to be induced, by Purging, Vomiting, and Clysters, (according as Na∣ture indicates) and the regulati∣on of the course of living, in the right ordering of the seven Non-naturals; as we intimate in the Third Edition of Our Synopsis Medicinae, lib. 1. cap. 9. and cap. 19. sect. 1. to which places we refer you.

X. Secondly; the generating of new Blood, agreeable to the tem∣per of the Part wounded: if a Spermatick Part is wounded, the Blood generated ought to be cool, thick, and dry; which is to generate a Medium, for the unition of the Parts sepa∣rated: but if a fleshy Part is wounded, the Blood is to be hotter, moister, and thinner: this is done by the power or effects of inward Medicines.

XI. Thirdly, the Chirurgeon ought to be skilful and hardy: he ought to dress his Patient with as much ease as may be; and he ought to be careful that his Applications be neat, soft and smooth, which things add much to the Cure: and he ought to be diligent in dressing the Patient in due time, not neglecting or delaying his duty.

XII. Fourthly, you ought to have fit Topical Medicaments, called Sarcoticks, or Incarnatives; which what they are, we refer you to Chap. 2. Sect. 31. ad 40. aforegoing. These Sarcoticks, or Flesh-breeders, are drying, yet void of a sharp and biting quality.

XIII. Now the Differences of these Sarcoticks are taken, 1. From their several degrees, as they respect the first Quali∣ties

of Medicines. 2. From their Kinds.

XIV. As they respect their first Qualities, they are threefold: 1. Of a mean Operation or Tem∣perature; which are of use when the Pus is laudable, as white, smooth, thick, and equal. 2. Stronger; when the Quittor or Matter flowing from the Wound is thin and ichorous; for then the Desiccatives ought to be stronger, so as to incras∣sate or thicken the thin Matter. 3. Strongest; when a slough or filth appears in Wounds, and these are truly Abstersives.

XV. As to their Kinds, they are twofold; 1. Simple. 2. Com∣pound. Which what they are, you may see at large in Chap. 2. aforementioned.

XVI. The Simple are such as are, 1. Dry in the first degree; as, Meals of Barley, Beans, Spelt-corn, Rice, Mastich, Frank∣incense, Olibanum, &c. which are to be used to soft and ten∣der constitutions, as Children, young Ladies, &c. 2. Dry in the second degree; as Honey, Gum Elemi, Capivii, all sorts of Rosin, Ship-Pitch, Meal of Cicers, Minium, Litharge, burnt Lead, &c. washed. 3. Dry in the third degree; as Meals of Orobus, Lupins, Orrice, both sorts of Birthworts, pouder of Tobacco, Myrrh, Sarcocolla, Lapis Calaminaris, Tutia, Aes ustum, &c. These are fit for Sailers, Rusticks, Mechanicks, and such as are of a hardy, strong, and firm constitution of Body.

XVII. Besides, the differing degrees of these Medicaments, are to be applied to several Parts of the Body, according to the nature and quality of the Wound. The lips of Wounds, because they are soft, or softest, may admit of the first degree; the Nerves and Membranes will admit of Medicines of the second degree: and Cartilages and Bones re∣quire Medicaments of the third degree.

XVIII. Out of the simple Sar∣coticks, Compounds may be framed, of which we have given you many Examples in the Chapter afore∣cited, so that we need say no more of them here: but one thing is to be noted, that sometimes Cathereticks (as burnt Alum, Verdigrise, calcin'd Vitriol) may become the strongest kind of Sarcoticks, if they be mixed in a small quantity, with Sar∣cotick Compositions.

XIX. 4. The abating or taking away of Proud-flesh. Tho' in a vacancy or loss, we are to pro∣cure the growing of new Flesh, yet we must take heed, that it does not over-grow, or grow too fast, or too much; the cause of which is, too much Blood sent unto the Part.

XX. This is abated, 1. By strict or short Diet, and eating Food which nourishes not too much. 2. By strait Ligature, hindring the flux of Blood to the Wound. 3. By cooling and astringent Medicaments, ap∣plied to the sound Parts adja∣cent to the Wound.

XXI. It is taken away, 1. By Instrument, as Incision-knife, Scissers, or Razor. 2. By rub∣bing

it with a rough linnen Cloth, or applying dry Lint to it. 3. By application of Cathereticks.

XXII. Such are, burnt Alum, calcin'd Vitriol, and red Pre∣cipitate: if the Patient is of a tender habit of Body apply this. ℞ Ʋnguentum Basilicon minus ℥i. red Precipitate grownd and washt, à ʒi. ad ʒii. mix them. But if the Patient is of a rustick constitution. ℞ Ʋng. Basilicon ℥i. red Precipitate levi∣gated, burnt Alum, A. ℈iv. mix them. See more of this matter in Chap. 9. Sect. 125. ad 132. aforegoing.

XXIII. 5. To produce the Ci∣catrice. This is not to be done 'till so much Flesh is generated, as it seems to be somewhat higher than the natural Skin; for otherwise the healing up would be hollow, which is a deformity to be avoided.

XXIV. The Causes of making Skin are threefold: 1. Efficient, which is a faculty resident in the sound Skin, adjacent to the Wound; for that Skinning al∣ways begins from the edges of the natural Skin. 2. Material, which is a Membranous Flesh dried. 3. Adjuvant, which are Epuloticks, or Skinning Medi∣caments.

XXV. The Faculty of these Medicines is to dry strongly, in the third or fourth degree, that they may consume the present hu∣midity, and stop the influx of more Blood, which might engender yet more flesh: and therefore they ought to be very astrin∣gent, so as to be manifestly felt by the Tongue, yet without acrimony, that they might not erode.

XXVI. These are of two sorts: 1. Stypticks. 2. Epuloticks, purely so called. As to Sty∣pticks, you may find many of them in Our Pharmacopaeia Ba∣teana, as also in Our Pharmaco∣paeia Chirurgica in this Work; to which add. Dr. Gardner the King's chief Chirurgeon's Sty∣ptick Water, described in Cap. 11. Sect. 13. following: or this, ℞ Colcothar, or Vitriol calcin'd to redness, after the Spirit and Oil have been drawn off, ℥i. burnt Alum, Sugarcandy, A. ʒvi. Red-wine, Smiths-forge-water, A. ℥xxx. mix them well; digest in a warm Balneo for a Week, shaking the Glass every day, then letting the Mixture settle; let the Water be kept upon the Ingre∣dients, pouring off the clear, as you have occasion to use it.

XXVII. Epuloticks are either simple or compound, both which you may see in Chap. 2. often aforenamed: if the wounded Person is of a soft and tender habit of Body, you may use Frankincense, Olibanum, Ma∣stich, bark of the Pine or Frank∣incense-tree, Oister-shells cal∣cin'd and levigated, burnt Lead washt, &c.

XXVIII. If the Patient is of a mean habit of Body, you may use things drying in the third degree; as Balaustians, Pom∣granate-peels, unripe Grapes, Myrle-berries, Sumach, Catechu, Sanguis Draconis, Cortex Pe∣ruanus, Henbane-seeds, Terra Ʋmbra, red Oker, Terra sigillata, fine B••le, &c.

XXIX. If the Patient is of a very rustick and hard habit of Body; you may use burnt Alum, burnt Brass, Caput mortuum of Vitriol, and other things of like na∣tures.

XXX. Of Compound Epuloticks, some also are for tender Bodies, as Ʋngnentum de Minio, Ceratum de Minio, Ʋnguentum de Tutia. Some are for Bodies of a stronger habit, as Ʋnguent. Tutiae Nostr. Ʋnguent. Album, Emplastr. Dia∣palmae, Empl. Album, de Mi∣nio, &c. And some are for rustick Bodies, as Ʋnguentum de Bolo, Emplastrum de Bolo, Caesa∣ris, &c. or this, ℞ Ʋng. Tutiae Nost. ℥i. Colcothar of Vitriol, or burnt Brass ʒjss. mix them.

CHAP. XI. Of WOƲNDS of ARTERIES, and VEINS.

I. THEY are called in Greek, 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉. in Latin, Vulnera Arteriarum & Vena∣rum; in English, Wounds of the Arteries and Veins.

II. The Signs. Wounds of the greater Arteries and Veins have this peculiar unto them, that there is always a very great Hemorrhage present, which of∣tentimes causes Faintings and Swoonings.

III. Now either a large Ar∣tery may be wounded alone, or a large Vein, or they may be both wounded together: and either a great Vein may be wounded, or a lesser; and sometimes one alone, and sometimes many.

IV. These Wounds are known by sight: for if an Artery is wounded, the Blood comes forth by leaping, and with violence: but if a Vein, it comes forth by an equal flowing, and not by leaping. See Chap. 4. Sect. 8, 9, 10. aforegoing.

V. But now what Artery or Vein it is which is wounded, or whether only one, or more, is to be known by the Anatomy of the Part; which we suppose no experienced Artist to be igno∣rant of.

VI. The Kinds. The Wound of the Artery or Veins is made either longways, or obliquely, or transversly; and the Vessel is either only wounded, or it is cut quite thro': and the Ves∣sels wounded are either inter∣nal or external, or lye very deep, or are more superficial.

VII. The Prognosticks. Wounds of the Arteries are more dan∣gerous than Wounds of the Veins; and Wounds of the great Vessels, are more dangerous than Wounds of the less: but those Vessels, whether Arteries or Veins, which are cut transversly quite thro' are less dangerous than those which are otherwise wounded, and not cut quite thro'.

VIII. The greater the Hemor∣rhage,

the more danger; the lesser, the less danger: but if a Convulsion or Delirium be joined with it, or both, the danger is yet so much the greater.

IX. If the Vessel wounded is internal, or lies deep, it is so much the worse; but if it is internal, or superficiary, so as it may easily be come at, the danger is the less.

X. If an Artery is cut long∣ways, or obliquely, or is wholly cut asunder any otherwise than trans∣versly, since that it is moved with a continual Motion of Dilatation and Contraction: by this Motion (especially by the Distention) the Wound is more dilated, and in every Diastole it gapes; by which means the Blood is poured out, and leaps forth with violence and rushing. See Chap. 4. Sect. 11. ad 18. aforegoing.

XI. The Cure. There are two Intentions of Cure; 1. To stop the Hemorrhage; because the Life and well-doing of the Pa∣tient depends immediately up∣on it; which, how that is to be done, we have taught at large in Chap. 4. Sect. 19. to the end of the Chapter: so that no more need be said thereof here. 2. To unite and agglutinate the Vessels; which is the pre∣sent matter of discourse in this Chapter.

XII. In the consideration of this Article, we must see whether the Wound is Simple, or Compound: if it is Simple, many times the things stopping the flux of Blood do the Cure also, as to Agglutination; more especially if it is an excellent Styptick, such as that of Dr. Gardner the the King's Chirurgeon, made out of the Colcothar of Vitriol, thus:

XIII. ℞ Colcothar of Vitriol, or Vitriol calcin'd to redness, q.v. calcine it again till it comes to blackness, or a reddish black; then extract the Salt by boiling it in fair Water; decant the clear Water, and evaporate it to dri∣ness, which then calcine again with a red-hot heat. This stops the Blood upon the spot, tho' the Hemorrhage is never so great, and agglutinates a simple Wound, to a Miracle.

XIV. Where this Medicament is not to be had, the Agglutina∣tion is performed commonly at one dressing, with some Artificial Bal∣sam; made of Frankincense, Turpentine, Gum Elemi, Capi∣vii, Wax, Oil-olive, and Oil of Spike or Juniper-berries: or else with some Natural Balsam, as those of Capivii, Chili, Gi∣lead, Peru, or Tolu; which scarcely ever admit of being twice applied.

XV. If the Wound is compli∣cated with several accidents, as Contusion, Broken Bones, Loss of Substance, &c. you must first stop the Hemorrhage by the Method delivered in Chap. 4. Sect. 19. &c. aforegoing, let∣ting it so remain for two, three, or four days, as the nature of the Wounds, and Symptoms, if any, will permit.

XVI. Then opening of it, you must apply Digestives, such as we have enumerated and descrbed in Chap. 2. aforegoing: after

which you must cleanse it with Abstersives, to keep the Wound and extravasated Blood (if any be) from putrifying.

XVII. This done, you must fill up the Wound with Flesh (if it is wanting) by the help of Sarcoticks and Incarnatives; and then lastly, you must produce the Cicatrice with Stypticks or Epuloticks, or both, as in rea∣son you shall see fit.

XVIII. If the Wound is without loss of substance, or bruised lips, bring the lips and mouths of the Arteries both together and keep them so by suture; passing the Needle with a strong waxed Thread thro' both of them, making the Glovers-stitch, and apply this. ℞ Fine Bole ℥iv. fine Aloes, Frankincense, Dragons-blood, Gum-tragacanth in pouder, A. ℥i. Gypsum, white Starch, A. ʒi. Acatia, Hypocistis, Sumach, Catechu, A. ℥ss. mix, and with the white of an Egg, bring it to the thickness of Honey; which apply, with a Compress over it, squeezed out of Oxycrate, or Red-wine.

XIX. Then rowl it up with the Agglutinative Rowler, beginning on the opposite part, bringing both the heads over the Wound, and taking a turn or two there, rowl upwards and downwards, so as to press the Blood up∣wards, and restrain the Inflam∣mation above: let the Bandage be made for the ease of the Patient, and the Position such as may prevent Pain.

XX. Wounds of the Arteries are not to be drest oftner than needs must; once in five or six days (whilst there is danger of an He∣morrhage) may be enough: but if the Blood makes its way thro' all the Dressings, then you must take them off; and if the Stitches are broken, and the lips are not capable of being stitcht again, the bleeding Ar∣tery is either to be taken up, and tied, and then to be cured by Sarcoticks.

XXI. Or if it lyes so deep that it cannot be tied, then Escaroticks are to be applied to the Vessel, or the Actual Cautery: if Escaro∣ticks, the Wound is to be cleansed of its clotted Blood, and Dos∣sels may be dipt in this Mix∣ture following. ℞ Calcanthum ustum, Gypsum, A. ℥iii. Frank∣incense in pouder ℥ii. Aloes, Gum-Arabick in pouder, A. ℥i. mix them. Apply this with Lint on the bleeding Artery, and over it Dossels of Lint dipt in the white of an Egg, mixt with the Pulvis Galeni, and so dress up the Wound as before directed; and at next dressing, leave the Esca∣rotick sticking on the Artery, and incarnate with all the speed that may be.

XXII. But if after all these Endeavours the Artery continues to bleed, you must use the Actual Cautery; which may be con∣veyed down to the Artery thro' a Cannula or Pipe, the outside of which may be covered with a Plaster, or a rag dipt in the white of an Egg, that it may not burn through.

XXIII. Then dress the caute∣riz'd Part with Dossels dipt in Mucilage of Quince-seeds, or in the white of an Egg, or some such like

thing; and embrocate the Parts about with Oil of Roses, ap∣plying Diapalma with juice of Plantan over all: the heat being allayed, you must digest, in∣carnate, and cicatrize the Wound, as before directed.

XXIV. An Observation. One wounded in the Artery, between the Thumb and Forefinger, had been drest three or four days by a Chir∣urgeon, yet continued to bleed: he came to me late one Night, with Dossels crowded in it; I threw them out, and with a Needle and Thread stitcht up the Artery, and the Wound with it: then sprinkling some of my Agglutinative Pouders upon the Suture, I drest it with a Restrictive Plaster and Ban∣dage, and in three or four times dressing he was cured. But afterwards some vehement pul∣sation appearing under the Cica∣trice, from a too loose healing up of the Wound: he was drest with a Pledget, dipt in a dulcified Tincture of Vitriol, with good Compress and Bandage: at the next dressing it was contracted, so that no more pulsation was observed. Wiseman.

XXV. Another. One had an Aneurism in the Palm of his Hand, reaching to third and fourth Fingers, which at last broke out, and bled at times for eight or ten days. He was drest with Tin∣cture of Vitriol aforementioned, once in four or five days; so the Bleeding was stopt, and the Wound firmly cicatrized, that the least pulsation appeared not under it. Wiseman, Lib. 2. cap. 2. Observ. 3. & 4.

CHAP. XII. Of WOƲNDS of NERVES and TENDONS.

I. THEY are called in Greek, 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉. in Latin Wounds of the Nerves and Tendons.

II. Nerves and Tendons maybe wounded many ways, as by bruising, rending, tearing, or cutting, or by puncture; and the Cures of them both are performed by one and the same Method: 'tis true, they are of another nature than Flesh, and therefore require other Medicaments than woun∣ded Flesh doth.

III. The Signs. They have also an ex quisit and quick sense; and therefore if they be hurt they bring great Pains, and many times Con∣vulsions; and these Wounds are known, 1. From the Part hurt; if it has many and great Nerves, &c. passing thro' it. 2. By the Symptoms; because there will be vehement Pain, Pulsation, Inflammation, and many times Convulsion or Ra∣ving.

IV. If they are cut thro', they occasion no new Considerations in

Chirurgery, because they wholly cease from Action, and are irreco∣verable; but if they are prickt by a sharp-pointed Weapon, it is called a Puncture, and this is not to be slighted: but this is to be understood of the great great Nerves and Tendons, and their main bodies, not the small Fibres of them, which are in every Wound of the fleshy Parts.

V. Consider the Place wounded, viz. whether near the Joint, in the inside of the Arm or Leg, or near the end of the Muscle, or in the tendinous parts of the Hand or Foot.

VI. Whether the Wound is in the heads of the Muscles, or in the ends of them; whether above the Joint, or in the Joint it self: for if it is in the head of the Muscle, it shews that the Nerve is wounded; but if in the ends, or near the Joints, it is a sign that the Tendon is wounded.

VII. If the Nerve or Tendon is cut transversly thro', the pain is less; but if they are only prickt, there is instantly a vehement Pain, and an Inflammation; by which the Brain being drawn into consent, Convulsions and Deli∣rium's are also excited; yet the sense of a Tendon is not altoge∣ther so exquisite, as that of a Nerve.

VIII. The Prognosticks. All Wounds of the Nerves or Tendons are dangerous, but more or less, according as they are of use: but whether it be Nerve or Tendon, the transverse Wound is most dangerous, and difficult of cure.

IX. They are dangerous, be∣cause of their exquisite sense, and their consent with the Brain: and yet notwithanding a Wound by pricking, is more dangerous than that which is made by cutting: and the Wounds of the Tendons, are less dangerous than those of the Nerves.

X. Hippocrates, Sect. 5. Aph. 2. says, that Convulsion which hap∣pens upon a Wound, is mortal. This is to be understood with∣out doubt of Wounds of the Nerves and Nervous Parts; and signifies not, that it always and of necessity causes Death, but that it is very dangerous, and oftentimes is the forerunner of Death; especially after too great an effusion of Blood.

XI. And tho' commonly a Flu∣xion and Tumor happens in these kinds of Wounds, unless it is driven back to some more inward, deep, and remote Parts, which is generally dangerous: yet there is always a ground of hope, if even to the seventh or Cri∣tical-day, no evil Symptoms shall follow thereupon.

XII. For so says Galen, de Comp. Med. lib. 3. cap. 2. If to the fifth, or even to the seventh day of the Disease, there is no ap∣pearance of a Phlegmon or Inflam∣mation, and that the sick is altogether free from pain; as also that they feel no extension, or stretching in the Part affected, the Patient will always be safe and secure. For it is a sign that Nature has quieted the impe∣tuous motion and violence of the Humors.

XIII. In Wounds of the Nerves, a putridness is also easily generated,

for they contain in themselves but a weak heat, and are of a very dry nature; so that they are easily hurt by things which are cold and moist, as by Water and Oil, which are enemies to the Nerves.

XIV. Nor does this putridness contain it self in the wounded Part alone, but communicates it self unto the next adjacent Parts, and sometimes to Parts that are more remote: as if the Hand, or the Finger only were wounded, the pain may ascend to the Arm and Shoulder: or if the Leg or Foot were hurt, the pain may reach to the Thigh or Hip; and not only Pains, but Apo∣stems may happen in those Parts also: and sometimes the malign Symptoms may extend themselves to other Parts also, yea to the opposit side, and sometimes to whole Body, cor∣rupting all the Humors, whence Rheusmatisms, Fevers, Dysen∣teries, &c. may be excited.

XV. And yet this you are to take special notice of, that tho' an Inflammation or Putridness is, or or may be induced, yet that many times no signs of their coming do appear before-hand; and often∣times there are present no ve∣hement Pains; but that very often they secretly and sudden∣ly (as also Convulsions) invade the wounded Person.

XVI. The reason is, because the depraved and vitious Matter is thin, and is hiddenly conveyed thro' the Nerves unto the Brain; as is manifest in the Epilepsy, in which a malign, poisonous Va∣pour ascends to the Cerebrum from the extream parts of the Nerves, without any sense of Dolour in those Parts thro' which it passes; but only a seeming coldness, like that of cold Water, rising up gradually to the Head.

XVII. And therefore in Wounds of the Nerves, tho' there shall be no Pain felt, nor any Inflammation appear: yet you are not to trust to this, but you must manage the Cure with all the care, cir∣cumspection, diligence, and skill imaginable.

XVIII. Now the Wounds of the Nerves are truly dangerous, as, 1. Because the Membrane with which they are covered, proceeds from the Meninges of the Brain, and that they are filled with plenty of Animal Spirits. 2. Because they act by consent with the Brain and Spinal-Marrow; which as Galen says, De Ʋsu Partium, lib. 12. cap. 11. are the great Fountain and River, from whence the Nerves as Rivulets only run. 3. By reason of the dreadful Symptoms, (before enumerated) which are apt to ensue.

XIX. The Cure. Seeing then that in all Wounds of the Nerves, pain and Inflammation are easily induced, we must endeavour that the pain may be mitigated, and the Inflammation prevented: These Authors do, 1. By bleeding and purging out sharp and thin hu∣mors. 2. By keeping the Wound also open, that the excrements may the more freely flow forth.

XX. The chiefest cause of pain in these Wounds, is the excrementi∣tious humor shut up, which being too long kept, degenerates into

a malign, or at least acrimonious quality, by which it bites the Nerves, and at length putrifies them.

XXI. Hippocrates, Sect. 5. Aph. 18. says, that every thing that is cold, is an Enemy to the Nerves, Brain, and Spinal Mar∣row; but that which is warm, is a Friend to them: and the rea∣son is, because the Nerves, &c. are Parts void of Blood, and have in them but little natural and innate heat; so that they are soon, and easily offended with any thing which is cold, it causing Pain.

XXII. And Galen, de Comp. Med. lib. 6. cap. 2. says, Let the Oil with which we cherish the Wound be sufficiently hot, lest that it offend the Wounded Part; for as that which is cold is most of all contrary to these kind of Affects, so that which is but blood-warm, does them but little good: for this reason, (says he) I my self chuse rather to make use of a Fomentation of Oil which is suf∣ficiently hot, always shunning that which is but lukewarm; but wholly refusing that which is quite cold.

XXIII. Yet Galen, in Meth. Med. lib. 6. cap. 6. seems to say, that if a Nerve is discovered, or made bare, then such things as are but tepid, or lukewarm, are rather to be applied, than such things that are very hot.

XXIV. Now as to asswaging of the Pain, things hot and somewhat moist, are most fit; yet because those things which moisten the Nerves, do easily putrify them; therefore such Medicaments as are heating, and drying withal, are rather to be chosen, being also of thin parts, and strength∣ning the weak heat of the Nerves, by consuming and dry∣ing up the Excrements.

XXV. Galen, de Comp. Med. lib. 3. cap. 2. and Meth. Med. lib. 6. cap. 2. says, The faculty of the Medicines to be applied to wounded Nerves, ought to be both thin, and also moderately heating, and such as may dry without any sharpness or pain; for that this alone can draw the Sanies from the bottom of the Wound, without either contracting or biting. And a little after he says, The wounded Nerves require such Medi∣cines, which may excite a gentle heat, but may dry strongly; and which from the nature of their own substance, may have the power of Attraction, and be also of thin parts.

XXVI. Also regard is to be had to the strength of the Patient, and habit of Body: for the stronger Medicines are to be applied to hard and strong Bodies, the weaker Medicines to the more soft and tender Bodies: so also you must consider the Matter to be dried up, and according to the store of Humidities, you are to chuse the more drying Medicaments: for the Medicine ought to an∣swer in driness to the quantity of humidity offending.

XXVII. Also Medicaments which are drying, but of thin parts, and carry with them a notable heat, with a kind of biting, (which is apt to excite Pain, and a Flux of Humors;) as distilled Spirits, Oils and Balsams,

are many times to be mitigated by mixing them with other things of a milder temper. What Me∣dicaments are necessary in this case, we shall shew anon, when we come to treat of Punctures, or Prickings of the Nerves.

XXVIII. Now to ease the Pain, preserve the Temperament of the Part, hinder the Afflux of Hu∣mors, and prevent the Inflamma∣tion, Medicaments are to be applied upon the Part affected; as also on all the Parts that lye in the midst, from the Wound to the original of the Nerves: and they are to be anointed and cherished with hot Oils, as Oil of Earthworms, of Foxes, of Whelps, of Castor, of Costus, and the like; using these of themselves, or mixing them with Oil of Turpentine.

XXIX. If the Nerves affected are those of the Neck, then the Arm, from the Wound even to the Armholes and the Neck, is to be anointed: if the Nerves affected are those of the Leg, then the Groins must be anointed, and we must ascend from them by the Back-bone, all along up to the Neck and Head.

XXX. The incision of a Nerve is either streight and direct, or transverse; if it is transverse, it is cut either quite asunder, or but in part: now a Nerve quite divided, is less dangerous than that which is only cut in part; as Galen, Meth. Med. lib. 6. cap. 2. and Guido, Magn. Chir. Tract. 4. doct. 1. cap. 4. affirms: the rea∣son is, because a Nerve quite cut asunder, cannot cause any hurt in the Brain.

XXXI. Yet being cut quite asunder, it can never be consoli∣dated again, according to the first Intention; as we have hinted at Sect. 4. aforegoing: and so says Hippocrates, Sect. 6. Aph. 19. When the Bone is wounded, or the Cartilages, or a Nerve, or the thin part of the Cheek, or the Praepu∣tium, it does not unite, or grow together again.

XXXII. As to the Cure of these Wounds, Galen, de Comp. Med. lib. 3. cap. 2. & Meth. Med. lib. 6. cap. 3. advises to Topicks which dry with little biting; as Ʋng. de Calce lota, Ʋng. Dia∣pompholigos, and the like.

XXXIII. If the whole Nerve is cut asunder, no Convulsion can ensue, because both ends give way: this kind is cured by Sarcoticks, of which we have wrote abun∣dantly before, in Cap. 2. Sect. 31. ad 46. now in this kind of Wound, the motion of the Part into which the Nerve is im∣planted to move, is abolished.

XXXIV. If the Nerve is cut asunder, but in part, it is first to be dressed with the Medicaments afore prescribed: but if Pain, Inflammation, Putrefaction, Fe∣ver, or Convulsion are like to ensue; the best course is to cut the Nerve or Tendon asunder, rather than by deferring the Incision, to hazard the Life of the Patient.

XXXV. This being done, you must apply anodyn and drying Me∣dicaments, and the Wound being dressed, apply over the Dossels or Pledgets, Diapalma, or Dia∣chylon simplex, softned with Oil of Myrtles, Quinces or Roses;

because the tenderness of the Part will scarcely admit of any stiff Emplaster.

XXXVI. Then rowl up the Part with the Fascia Expulsiva, of which we have treated before in its proper place; that thereby, the Sanies which does gather in the place, and a new afflux of Humors may be prevented.

XXXVII. If a Nerve, &c. is contused without a Wound, foment it with hot Oil-olive, applying over a Sheeps or Lambs Skin, new taken off: but if it is with a Solution of Unity, then Medicaments anodyn, drying, and congluti∣nating are to be imposed; as Ceratum Album, Emplast. Cata∣gmaticum, malaxed with Oil of Hypericon.

XXXVIII. If the Nerve is dis∣torted by a Fall, or the like, which may hinder the motion of the Part, you may apply Emplastrum Album mixed with Gum Ammo∣niacum, or Diachylon simplex, or cum Gummis.

XXXIX. If afterwards a hardness shall remain, which may cause a numbness of the Part, you must mollify with Oil of white Lillys, of Hypericon; or with Goose, or Capons, or Vipers Grease, mixt with Ammoniacum or Bdellium; also with Oil of Sheeps-Trotters, or of Neats-Feet, mixed with Mucilage of Fenugreek-seed, Lin-seed, or Marshmallow-roots; the Part may also be embrocated with emollient Oils hot; but nothing exceeds golden-coloured Palm-Oil mixt with Oil of Aniseeds, ana: which resolves to a Mira∣cle, so also Spiritus Mirabilis: lastly, you may lay over all Dia∣chylon cum Gummis, mixed with a quarter-part of liquid Storax.

XL. How the Pain is to be eased, we have already shewn at Sect. 28. and 29 aforegoing; we come to shew how to resist the Inflammation. This is done by imposing things cooling and drying; for they both abate the Inflammation, and correct the Putrifaction: of which kind are, Barley and Bean flower, meals of Vetches, Chick-Pease, and Indian Maize, boiled with Oxymel q.s. to the consistence of a Cataplasm; which is to be applied after Embrocating with Oil of Elder, mixed with Rose-Vinegar.

XLI. If a Convulsion affects the Patient, tho' it is many times mortal, yet something (whilst there is Life) is to be done; you must Embrocate all the Spinal Marrow, from the Head to the Coccyx, with this Mixture, hot: ℞ Oil of Ben ℥vi. Chymical Oils of Lavender, Limons, Juniper, Rosemary, Sage, and Savin, A. ʒvi. mix them; upon which apply a Sheep-skin newly drawn off, to the Part.

XLII. Then the Part wounded is to be dressed; and if the Wound is in the Hand, you must Embro∣cate upwards to the Armpits by which the Nerves pass, and so proceed to the Vertebrae of the Neck and Thorax: but if the Foot is wounded, you must Embrocate upwards from the Wound to the Leg, Thigh, and Os Sacrum, even to the Vertebrae of the Loins; giving inwardly in the mean season this Mix∣ture: ℞ Our Aqua Bezoartica,

or Spiritus Cordialis ʒvi. Spiritus Opii compositus, à ʒss. ad ʒi. mix for a Dose.

XLIII. These things, as to Me∣dicines, whether Topicals or Inter∣nals, we have said in short upon the Cure of a Nerve or Tendon cut, or other wounded than by Pricking: we shall next treat of the Cure of a Wound of the Nerves, &c. made by Puncture; out of which, those things which in general seem necessary to be said, concerning the Wounds of the Nerves and Tendons, (of what kind soever) will be plain∣ly and evidently seen.

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

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,

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,

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,

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.

III. Contusion of the Nerves, &c.

LXXXVIII. This is often by a

Fall or Blow, the Skin suffering a solution of Ʋnity; whence comes an Ulcer, and many other Sym∣ptoms, from the afflux of Hu∣mors.

LXXXIX. If the contused Nerve is not bare, which may be discerned from the more continual Pain, than is usual in a simple Contusion of the Flesh; great care must be taken to resolve the coagulated Blood, as soon as may be.

XC. For should it suppurate, the Nerve would easily putrify, and other ill Symptoms ensue; so as to force you to cut the Nerve asunder, or do something worse.

XCI. In such a Contusion of a Nerve therefore let a Cloth be dipt in Oil of Castor, or of Worms, or of Whelps, or of Foxes, of Dill, of Rue, of Camomil, or of Rosemary.

XCII. Or you may foment the Part very hot with Sponges, dipt in this Fomentation: ℞ Roots of Orrice, Zedoary, A. ℥i. Hyssop, Fetherfew, Marjoram, Mint, Southernwood, Tansy, Savery, A. M.ss. White-wine q.s. boil, and make a Fomentation; to every Pint of which add S.V. ℥jss.

XCIII. Or you may apply this Emplaster: ℞ Propolis, Turpen∣tine, Caranna, Opopanax, roots of Sowbread in pouder, A. ʒiv. Oil of Castoreum, of Hypericon, A. q.s. mix, and make a Plaster. And if Convulsions happen, give in∣wardly Chymical Oil of Laven∣der, à gut. ii. ad vi. dropt into white Sugar, in a glass of white Port-wine, or Canary.

CHAP. XIII. Of WOUNDS of the LIGAMENTS.

I. THey are called in Greek, 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, pl. 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉: In Latin, Vulnera Li∣gamenti pl. Ligamentorum: And in English, Wounds of a Liga∣ment, or Ligaments.

II. The Signs. If they be wounded, it is known by the place or part hurt, which is near some Joint: Besides, the Pain is in no respect to be compared with a Wound of the Nerves or Ten∣dons, for when these are wound∣ed, they produce neither Pain, nor Convulsion.

III. And in regard they are void of Sense, at least-wise not so sensible as are the Nerves or Ten∣dons, so they never commu∣nicate their Affects to the Brain.

IV. The Prognosticks. The wound of that Ligament which goes from one Bone unto another, is most of all free from danger.

V. That Ligament which is in∣serted into a Muscle, if it is not well or rightly Cured, may bring a great deal more of danger with it;

because it is able to draw the Nerves and Tendons into a con∣sent with it.

VI. Because the Ligaments have but a very weak heat in themselves, therefore they do not easily bear Wounds, but are very apt and ready to heap up Excrements, which may contract and induce a putridness, that may excite other Symptoms and Evils.

VII. The Cure. By reason of the natural coldness, and dryness of the Ligaments, those Medi∣cines which are useful in the Wounds of the Nerves and Ten∣dons, are also useful here, espe∣cially those that are most dry∣ing.

VIII. And truly you may safely enough, make use of the strongest of them, for that this part is void of Sense, and therefore will not be offended with the Acrimony or sharpness of those drying Medi∣caments.

IX. And tho' Medicaments not too hot are to be used to consume the Sanies, lest the Ligament rot; yet in respect that those Medi∣cines must not only dry, but al∣so cherish the weak heat of the Part, and strengthen the same, they ought to have so much heat, as to be able to Corrobo∣rate it; which they can scarcely do, unless they be hot in the se∣cond or third degree.

X. In this case you may use the Oil of Mastich, all the kinds of Natural Balsams, Artificial Bal∣sams, of themselves, or mixed with drying Pouders; and over all you may apply, Emplastrum de Minio, or Catagmaticum, ma∣laxed with Oil of Mastick.

XI. Wiseman says, That Wounds of the Ligaments require much one and the same Method with the Tendons, only the Me∣dicaments here are to be more drying, as Euphorbium, Sulphur Vive, Calx lota, or slaked Lime well washed, Lapis Tutia, &c.

XII. Barbette commends the Restaurative Pouder, thus made, ℞ Roots of Comfrey, fine Aloes, Calx Viva, Red Precipitate, a. ℥ijs Mastich, Myrrh, Mummy, a. ʒij. make each into a fine Pouder, and mix them.

XIII. And at first dressing, the weak heat of the Ligament is much to be considered, because it is apt to give occasion to a plentiful Collection of Humors, and other Vehement Symptoms.

CHAP. XIV. Of WOƲNDS of the LIMBS.

I. THey are called in Greek, 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉 pl. 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉. in Latin, Vul∣nera Membri, pl. Membrorum: in English, Wounds of a Limb or Limbs.

II. By Limbs here, we under∣stand the Brawny Parts of the Arms, as also the Hands; also the Thighs, Legs, and Feet.

III. The Kinds. They are Threefold, 1. From the Part, either Superior, as the Arm, Hand; or Depending, as the Leg, and Foot. 2. From the nature of the Wound, viz. it is either Simple, or Complicate, where as well as the Skin and Flesh, the Arteries, Veins, Nerves, Tendons, and Liga∣ments, or Bones may be wound∣ed. 3. From the kind of the Weapon wounding, according to which, the Wound is either Con∣tused, a Cut only, or a Pun∣cture. 4. From its being either without or with loss of Substance.

IV. The Signs. The Part wounded is known by sight: but whether it is Simple or Compli∣cate, must be known by their proper Symptoms.

V. A simple Wound is for the most part made by Cutting, and it is known by being void of any vehement Pain, a soft and gentle Bleeding, the Capillary Vessels be∣ing only hurt, in the Musculous Flesh only, and without any evil Symptoms.

VI. A Complicate Wound, is discovered by the proper Signs of the similar Parts hurt: so if any considerable Vein is wounded, there is a great flux of Blood, but it comes forth easily, smoothly, of a Red Colour, and more thick Substance.

VII. If an Artery is wounded, the flux of Blood is more considera∣ble, and it comes forth by leaping, as the Pulse beats, of a more yellow Colour, and thinner Substance than that which comes forth from a Vein, and many times with fainting Fits, ac∣cording to the greatness of the Flux.

VIII. If both Arteries and Veins are wounded, the flux is yet greater, and the Blood flows vari∣ously, and seems to be of two Co∣lours and Substances, like diffe∣rent things not well mixed toge∣ther; the Pulses grow weak, and if the flux is vehement, or has been of any continuance, faint∣ing and swooning Fits attend the Patient.

IX. If a Nerve is wounded by Cutting, and not cut asunder, there is vehement Pain felt, which ma∣ny times induces Inflamation, Fe∣vers, and other dangerous Symp∣toms: but if the Nerve is cut a∣sunder, there is no pain at all felt, yet the Sense of feeling remains; but the motion of the Part into which the Nerve is in∣serted, is lost, or taken away.

X. If a Nerve is prick'd, vehe∣ment Pains and Convulsions are apt to ensue, with Inflammation, and other Symptoms, because the Brain is drawn into consent.

XI. If a Tendon is not cut asunder, the pain is like that of a Nerve, but something less: but if cut asunder, as it is without pain, so also the motion of the Member, which it is to move, is lost.

XII. If with the Skin and Musculous Flesh, the Arteries, Veins, and Nerves are all wound∣ed together, then all the Sym∣ptoms afore enumerated, are manifest together, which en∣danger

an immediate flux of Humors.

XIII. If with the Wound, there is a Fracture of the Bone, it is known by feeling, together with the weakness, or falling down of the Part, as being un∣able to lift it self up.

XIV. If there is loss of Sub∣stance, it is known by the great∣ness of the mouth of the Wound, Cavity, or Hollowness, and many times by finding the Matter which is cut out.

XV. If a Wound is Contused, it is generally made with a blunt Instrument, or with Stones, or a Bullet, or by a Fall: If it is an edged Instrument, it is general∣ly a Cut; but if a pointed In∣strument, a Puncture or Prick∣ing.

XVI. The Prognosticks. A Simple Wound is without danger: a Complicate Wound is dangerous, according to the degree of the Complication.

XVII. If an Artery is wounded, it is more dangerous than if a Vein is wounded; and the greater the Vessel, the greater the danger: if they both be wounded, the danger is yet more; but most of all, if with the Wounds of these Vessels, a Nerve is also hurt by cutting or pricking.

XVIII. And if withall a Nerve is wounded, and it is long-ways, there is no fear of a Convulsion, for that the Fibres are not so much af∣fected: but if it is wounded transversly, and not cut in two, it may then induce vehement Pains, Inflammations, Convul∣sions, and Delirium, or Doting, which the pricking of a Nerve also doth: because from the Fi∣bres that are cut asunder, the pain is communicated to those which are not cut in two, where∣by the Evil is communicated to the Brain it self.

XIX. If the Nerve is wholly cut asunder, it brings not with it so much danger, nor is there any fear of a Convulsion: but yet an incurable disaffection follows it, viz. a debility both in Sense and Motion of that Part into which the Nerve is inserted, for that the Animal Spirit can be no more conveyed by the said Nerve into those Parts.

XX. If a Tendon shall be wound∣ed, but not cut through, it causes a debility in the motion of that Part it usually moved: if it is cut asunder, then the motion of the same Part is wholly taken away, or lost.

XXI. If there comes forth great store of Sanies, or thin Ex∣crements, it is a sign of the ill Constitution of the Part, and of the Wound, and that it is infla∣med, and in very great danger; for the Sanies which flows, is always according to the disposi∣tion of the Part affected, some∣times like Water, sometimes like Whey, and sometimes white and milky; but that which flows from the Tendons, is more glutinous, like to the white of an Egg.

XXII. The Cure. If it is a simple Wound, and made by cut∣ting and priching, it may be Cu∣red by the first Intention; and here Stypticks or Balsamicks do the Work, and commonly at one dressing.

XXIII. But if the Wound is complicate, the Indications of healing must be according to the number of Complications, whe∣ther it is a hurt of any of the Vessels, or of the Nerves and Tendons, or a Contusion, or with loss of Substance, or all of these together.

XXIV. In any of these Cases, if any Extraneous thing is in the Wound, it is (if possible) to be taken forth, and the Hemorrhage (if any be) to be stopt, then the Lips of the Wounds are to be stitch'd up, according to the nature of the Wound, and to be drest up with proper Ano∣dyns (if the pain is vehement) and digestively, as we have in the proper places of this present Book, before declared.

XXV. If the Nerves are wounded by a downright cut, whereby they are commonly left naked and bare of Skin, you must preserve them as much as may be from the external Air, which is always an Enemy to the Nerves, and endeavour as much as may be, to cover them with their own proper covering, and the Skin which lyes upon it.

XXVI. If the Nerve is wound∣ed, according to its length you must with a Swath or Rowler draw the Lips of the Wound together, that they may be conjoined: but if the Wound is transverse, and ne∣cessity so require, then the con∣joining of the Lips is to be done by Suture or Stitching, taking great Care, that in sowing you touch not the Nerve with the Needle; because by the prick of the Needle the same Sym∣ptoms may arise, that are o∣therwise wont to happen in a Puncture of the Nerves.

XXVII. The Wound then is so to be drawn together, that there may be a free passage for the Sa∣nies to run out, which if need so require, may be kept open with a Tent, for that, if the Sanies should be retained or kept in, it might corrupt and putrefie the Nerve.

XXVIII. And because the Nerves when wounded, do not well bear the stronger Medicines, as Euphorbium, &c. Galen in these kind of Wounds was wont to use unslack'd Lime often washed, with much Oil of Roses mixed therewith; also Pom∣pholix mixed with the same Oil.

XXIX. But Modern Physicians have found out better Medicines than these, invented by the means of the Chymical Art, an Enumera∣tion of many of which we have gi∣ven you in Cap. 12. Sect. 61, 62, and 64. a little aforegoing: and over all, the Wound it self may be covered, with Diacalciteos, or Diapalma, or our Emplastrum Album.

XXX. And to preserve the natural heat, that thereby a good Suppuration may be made, and the Putridness and Corruption of the Humors may be resisted, as al∣so the Nerve defended from the Cold of the ambient Air, this following Cataplasm may be ve∣ry useful.

XXXI. ℞ Flower or Meal of Barley, Beans, and Orobus, Pou∣der of Red Roses and Camomil Flowers, A. ℥ij. Oil of Turpentine,

ʒx. Oxymel simple, Oil of Whelps, or Earthworms, A. q.s. mix, and make a Cataplasm.

XXXII. Where the Nerves are transversly wounded, and not cut asunder, if by the Fibres that are whole, the Brain is drawn into Consent, so that a Convulsion may be excited; you must do all that may be to prevent it, by using the Medicines which we have propounded in Cap. 9. Sect. 89. ad 98. aforegoing, if those things suffice not, the whole Nerve is to be cut asunder, that the Convulsion may be remo∣ved, as we have admonished in Cap. 12. Sect. 86. above.

XXXIII. A Wound made by running of a Sword through the Arm or Leg, is not to be stitch'd up, (because it is apt to be painful, inflamed, and generate a putrid Sanies) but to be drest up with Astringents or Stypticks, Compress and Bandage: by this means such Wounds in a good habit of Bo∣dy, do easily agglutinate in a few days; whereas if they be drest with Tents, they are of longer continuance, and at last become very difficult to be heal∣ed.

XXXIV. In such a Wound, if the Weapon passes not quite thro', but you find by probing it, that it wants not much of passing thro', if the contrary side is more depending, it will be good to open it on that side, by passing a Seton-needle, or some such like Instrument through it, then to apply Digestives, and to dilate the hole with a Tent for a few Days, that the Matter may pass thro' and down∣wards, letting the upper part of the Wound heal up: but the Application of Digestives will be needless, if Stypticks be imme∣diately applied, upon the first making the Wound.

XXXV. If a Person is run thro' the Arm, Thigh, or Leg, with a broad Sword, you may dress the Wounds with Stypticks, or some Astringent Pouders mixt with the white of an Egg, and Pledgets spread with Sarcoticks, making the Application upon both Ori∣fices, and then bring the Lips of the Wound close with Com∣presses and good Bandage, so will the Wound heal by agglu∣tination, without Pain, Matter, or Tumor, (there being no Nerve hurt) and that in four or five Days.

XXXVI. But if thro' some Cause which you could not know, there should be Inflammation with Pain, or Tumor, you must dilate the Orifice most distempered, and keep them both open, especial∣ly the more depending, with small short Tents, spread with the common Digestives, and then proceed as in a Body Ca∣cochymick.

XXXVII. If a Wound is made in the Arm, Thigh, or Leg, by a Sword passing slantingly thro', both Orifices ought to be drest with Astringents, or Stypticks, and good Bandage, so by the help of the Balsam of the Blood, the Wound will be healed in few Days.

XXXVIII. But if thro' the Ig∣norance of the Chyrurgion, being at first ill managed, with Tents, &c. the Patient should be in great pain, the Limb or Member swell'd,

and the Wound disturbed, whereby it shall seem not to be Cured but by Suppuration: in this Case you may foment the Member with Discutients, keep both Orifices open with small Tents dipt in the common Digestive, Embro∣cate the Parts about with Oil of Roses mixt with a little Vinegar, and apply over all Empl. è Bolo, or some such like: The third dressing, if need require, apply red Precipitate upon a Dosil, and dress up the Wound as be∣fore, &c.

XXXIX. If a Wound in Arm or Leg by long ill dressing is be∣come Sinuous, with a Flux of Humors, Inflammation, and Tu∣mor; so that the whole Member becomes Oedematous, or is so weakned that it cannot assimulate its Nutriment, nor yet resist the Crudities which attend it: in this Case the Sinus may be laid open by Incision, and the Wound de∣terged with Mundificatives, as that of Paracelsus, mixt with Red Precipitate; the Parts a∣bout may be Embrocated with Oil of Roses mixt with Vinegar, and Ceratum Galeni, may be ap∣plied over the inflamed Tumor.

XL. The Oedematous Tumor may also be fomented with a De∣coction of Wormwood, Scordium, Elder and Camomil Flowers, Red Roses, Balaustians, and Myrtle∣berries in Red Wine; and a mix∣ture of Emplast. Album, with Sticticum Paracelsi, may be ap∣plied over the Swelling with good Bandage, not renewing this dressing above once a Week to give a breathing to it.

XLI. And where-ever you find the Sinus to have penetrated, you must open it, and deterge it with Abstersives, as the former, and with Ʋng. Diapompholigos, or o∣ther Epuloticks, produce the Cicatrize, helping forward the Cure by the use of a Laced Stock∣ing or Compress.

XLII. An Observation from Wiseman. A Gentleman wound∣ed in the Thigh with a Tuck, was drest by a young Chyrur∣gion with Tents reaching to the bottom of the Wound, by which it was much inflamed. I threw out the Tents (says he) and drest the Wound with a Pledgit of Ʋng. Basilicon, Embrocated with Oil of Roses, applied over Empl. è Bolo, and then let him Blood. Being Feverish, I also prescribed him a Clyster, and gave him an Anodyn Draught to dispose him to Rest that Night. The next Day, I found him in good Temper, and his Wound inclined to heal; I dressed it, as the Day before, and advised him to keep his Bed three or four Days: about two Days af∣ter I visited him again, and ta∣king off the Dressings, saw his Wound perfectly Cured; it con∣tinued so, and he walked a∣broad the next Day.

CHAP. XV. Of WOƲNDS of the JOINTS.

I. THey are called in Greek, 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉 pl. 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉. in Latin, Vulnera Artus vel Articuli, pl. Artuum, vel Articulorum: in English, Wounds of a Joint or Joints.

II. These Wounds are made ei∣ther by a Puncture, or by an Inci∣sion or Cut, and they are either in the upper compassing Parts, or else they pierce to the Cavity of the Joint.

III. Wounds of the Joints are much of the same nature with Wounds of the Nerves, and are either without Luxation, or with it: and these are such as happen in the Elbow, Wrist, Knee, Ancle, or Joints of the Fingers and Toes.

IV. The Prognosticks. All Wounds of the Joints are dange∣rous, 1. For that they are of an Exquisite Sense, by reason of the Nerves, Tendons, and Membranes, whence sharp Pains do ensue, with an afflux of Humors, In∣flammations, Fevers, Watch∣ings, loathing of Food, Thirst, Weakness, Convulsions, Gan∣grenes, and sometimes Death.

V. 2. If they are great, where∣by they are the more grievous; for great Wounds piercing to the Ca∣vity, are most dangerous, and if they happen in the great Joints, are of Evil Consequence, more especially if that they call the Aqua Articularis, or Joint-water, issues out from them. Of this Water, Celsus, Lib. 5. Cap. 26. has wrote something; also Pa∣raeus, Lib. 9. Cap. 39. Plater. prax. Tom. 2. Cap. 17. Lang. Epist. Lib. 1. Epist. 3. and Sen∣nertus prax. Med. Lib. 5. par. 4. Ch. 15.

VI. This Humor being let out, there follows another Excremen∣titious Humor, which Celsus says, is either a thin whitish Ichor, or a glutinous Honey-like Humor, which he calls Meliceria: Pa∣raeus says, this Excrement is sometimes thick and white, and sometimes thin: Platerus will have it to be a waterish thin Ichor: Langius likens it to Whey: and Sennertus calls it Sanies, which, says he, our Chirurgions call the Joint-water, the flux of which Humor can no ways be stopped, but by resto∣ring the wounded Part to its own natural Temper.

VII. This Humor is cold and moist, and is caused of the Alimen∣tary Juice which is sent to nourish the Joint; its diversity is from the various Temperatures of the Bodies wounded; and it is cor∣rupted by the weakness and di∣stemperature of the wounded Joint.

VIII. Wounds of the Joints are very hard to Cure, because being Parts void of Flesh, and hollow, they are apt to receive fluxions:

and Galen, Meth. Med. Lib. 4. Cap. 6. says, That they easily de∣generate into Ʋlcers of an ill and dangerous nature.

IX. And they are yet more dan∣gerous in an Internal Part, be∣cause in those Places the greater Vessels and the Nerves are con∣tained; for which cause more considerable Haemorrhagies and Convulsions are easily excited.

X. Hippocrates also saith, That in Wounds of the Joints, if the Nerve is perfectly cut asunder, the Patient will without doubt be Lame.

XI. Wounds of the Joints with Luxation, or a loosening of the Joint, are yet more dangerous, for that the Joint cannot be redu∣ced, without apparent danger of the Patients Life; for that vehement Pains do always ac∣company these kinds of Wounds.

XII. So that the Physician by heeding this Prognostick, will do well to save his Credit; for if the Joint being reduced, continue so, it induces Death to the Sick, and that in few Days, which is often seen, even upon a very small Wound.

XIII. The reason is, because the Nervous Parts about the Joint suffer cruel Pains, whence Fluxi∣ons, &c. now if the Joint is brought back again unto its place, the same Parts are again extended, from whence of ne∣cessity there is a new afflux of Humors, with Inflammations and Convulsions, which being communicated to the Brain, bring unavoidable Death.

XIV. Sometimes also from the afflux of Humors, proceeding from the Pain and Extension, the natu∣ral heat is suffocated, from whence there follows a Gan∣grene and Sphacelus.

XV. In such a Case therefore the Physician is to acquaint the By-standers, that if the Joint is reduced, a Fever will succeed, and after that a Convulsion, which will induce the Death of the Pa∣tient, as we have hinted at Sect. 12. above; there being but few that live beyond the Seventh Day after the Reduction.

XVI. And this Hippocrates, Lib. de Articul. Text. 74, 76, and 77, positively affirms in Wounds of the Ancles, Elbows, Wrists, and Knees, where the Bones of the Leg, Arm, Cubit, and Thigh are dislocated, or seem to stick forth, or are fallen out, whether towards the Interior or Exterior Parts, &c. whatsoever they be of these, says he, that upon a Wound are dislocated or loosned, and hereupon stick out, if they shall be put back again into their places, they certainly cause Death.

XVII. But Sennertus is of the Opinion, that the lesser Joints, as those of Fingers, &c. if they be reduced, they do not necessarily bring Death, but many over∣come the Pain, and Live: yet Hippocrates, Lib. de Articul. Text. 78. will have it, that they will be in danger of a Convulsion.

XVIII. And Galen de Fract. Lib. 3. Text. 16. saith, Si verò parvi articuli, quemadmodum cir∣ca digites reperiuntur, neque tunc quoque res periculo vacabit, qui tamen, si evadant, plerique ob di∣ligentiam magnam in Cura adhi∣bitam,

id consequuntur, viz. If the small Joints, to wit, such as are those of the Fingers, shall happen to be wounded and dis∣located, they will not be alto∣gether free from danger; but if notwithstanding they escape, and recover, it follows chiefly from the great Diligence and Pains which has been taken in the Cure.

XIX. Now then, as you ought not to reduce the Joint; so that you may not be accused of Ignorance or Ʋnskilfulness by the Vulgar, as to have made the Patient Lame or Maimed; so to preserve your Credit, you must always make use of this Prognostick, fore∣telling unto the Standers-by, the danger of Death, that by such a Reduction, may ensue to the Distressed Patient.

XX. The Cure. If it is with∣out Luxation, the Cure is almost the same, as in Wounds of the Nerves, by drawing the Lips together, and keeping them so closed, excepting an Issue or Passage for the Quitter to run out.

XXI. They are also to be de∣fended from cold Air, or any cold thing, because they have in them∣selves but little heat; for this purpose, such Oils, Balsams, Ointments, Cerots and Empla∣sters, as we have directed in Wounds of the Nerves, are to be applied here.

XXII. If it is a Puncture, it is to be dressed also, as a Puncture of a Nerve or Tendon; the Injuries of cold Air are to be avoided, for Cold nips Wounds, (but these more especially) hardens the Skin, hinders Suppuration, ex∣tinguishes Natural Heat, brings Agues, causes Blackness, Gan∣grenes, Mortification and Con∣vulsions; nor must you use Moi∣stening, Unctuous, or Relaxing Topicks, unless by the vehemen∣cy of the Pain, you are forced to use Anodyns.

XXIII. But if the Wound is made by cutting, then the Lips are pretty near one another, or else they gape much; in which latter Case, you must use stitching first of all, but you must only stitch the Skin, in Persons of ripe Age; in Children, you may stitch the subjacent Parts, because in such they will admit of Uni∣tion.

XXIV. But you ought to leave a small Orifice in the most depend∣ing Part, to be kept open with a Tent, that the Quitter may be discharged.

XXV. If the Wound pierces not to the Cavity of the Joint, you may dress it with some good Natural or Artificial Balsam, mixed with some drying and healing Pouder, as, ℞ Balsam of Chili or Peru ℥ij. Aloes, Cate∣chu, Frankincense, Mastich, Myrrh, Olibanum, Sanguis Draconis, A. ʒiij. Comfrey-root, Borax, Centory the greater, Sarcocol, A. ʒij. make all these things into a fine Pouder, and mix them with the Balsam, and apply it.

XXVI. Over all you may apply Empl. Album, mixed with a lit∣tle Oil of Limons; or this Cata∣plasm; ℞ Barley, and Bean-flower, A. ℥iv. Flowers of Camo∣mil, Wormwood, and Melilot, A. p. ij. the Common Lixivium,

lbi. Vinegar of Roses, ℥iv. boil all to the thickness of a Cataplasm, adding in the end, Oils of Rofes and Myrtles, A. ℥iss. This pre∣vents pain, and asswages it, if present.

XXVII. Now here is to be no∣ted, That all Applications must be actually hot; because actual heat does Concoct, and discuss Ex∣crementitious Humors in the Joints, and strengthens them.

XXVIII. If the Wound pierces to the Cavity of the Joint, your Medicaments must be yet more dry∣ing. 1. Because the Joints are apt to abound with a thin Quit∣ter. 2. Because the Bones and Ligaments have no feeling, and so may endure very strong Me∣dicaments. 3. Because they are in their own Nature very dry, and therefore require the more drying Medicaments.

XXIX. For this purpose then you may use this: ℞ Balsam de Chili, or Linimentum Arcei ℥ij. fine Aloes, Catechu, Mastich, Myrrh, Olibanum, Sanguis Dra∣conis, A. ʒiij. Sarcocol, Hen∣bane-seeds, A. ʒiv. Euphorbium ʒij. all being in Pouder, mix them with the Balsam or Liniment, and apply it.

XXX. The next thing to be done, is to prevent the afflux of Humors, 1. By Purging. 2. By In∣terception. 3. By a good Positi∣on of the Member.

XXXI. As to Purging, you may do it with Diacassia, an In∣fusion of Sena alone, or of Sena and Rhubarb, or Diacatholicon, or Tinctura Purgans, or Sal Mi∣rabile, Syrupus Catharticus; E∣lect. Catharticum, Pulvis Cor∣nachini, or Pilulae Catharticae.

XXXII. For Interception, you may use. Pulvis Astringens, or Stypticum (some distance above the Wound) over which apply Ceratam Nigrum, Empl. Album, Sticticum Paracelsi, or some such like.

XXXIII. In the position of the Member, you must be very careful; for an ill position increases the Symptoms, and causes Distor∣tion, Numbness and Contraction, several ways.

XXXIV. If therefore the Wound is in the upper part of the Shoul∣der, a large Bolster is to be put under the Arm-pit, that so it may bear up the Arm, and drive the top of the Shoulder up higher, also cause the Lips of the Wound the more easily to consolidate.

XXXV. If the Wound is in the Elbow, the Arm is neither to be kept straight, nor yet too much bended, but kept in a mean posture between Exten∣sion and Contraction, viz. in the form of an Obtuse Angle.

XXXVI. When the Lips of the Wound begin to unite, you must cause the Patient to use a mode∣rate motion of his Arm, that it may prove the more pliable af∣ter the Wound is healed.

XXXVII. If the Wrist, or Joints of the Fingers are wounded, the Hand is to be kept half-bended, and the Fingers also, lest the Hand should be hurt ei∣ther by Extension or Contra∣ction.

XXXVIII. If the Joint of the Hip is wounded, the Thigh-bone must be kept in its Cavity, which

may be done by laying the Pa∣tient upon his Back, with Pil∣lows under the Huckle-bone, ap∣plying fit Bolsters and Rowlers: but he must sometimes stir and move his Thigh, this way and that way, lest there should be a hurt of the motion.

XXXIX. If the Knee is wound∣ed, it must be kept extended, if you would not have the Leg Contracted after the Wound is healed, or would prevent Lame∣ness.

XL. If the Joints of the Toes are wounded, they are to be kept in their natural posture, not bending them inwardly or out∣wardly, lest it causes stumbling in going.

XLI. Now that this situation of the Part, may be so preserved, and not altered, either sleeping or wa∣king, it is to be kept in that po∣sture, either by fit and conve∣nient Bandages, or else by wooden Instruments made for that purpose.

XLII. As to the Cure of great Wounds in the Joints, which pass into the Cavity, tho' they be Cu∣red, yet the Member will re∣main stiff.

XLIII. Now a Wound of the Joints is said to be great, in a fourfold respect. 1. From the greatness of the Solution of Con∣tinuity. 2. From the great and vehement Symptoms. 3. From the greatness of the Joint, and nearness thereof to the more principal Parts. 4. From the evil habit of Body in the Person wounded.

XLIV. And it is said to be Mortal, if vehement and deadly Symptoms do follow upon it; as Convulsions, with frequent Fainting and Swooning, Gan∣gren and Sphacelus.

XLV. If the Wound is with a Luxation withal, and in a great Joint, you must not, as we said before, Reduce it; but the Sick is to be told beforehand of the danger, if it is restored; and of an unavoidable Lameness that will follow thereupon, if it is not.

XLVI. These things being consi∣dered, you must stop the Fluxion, as is directed at Sect. 30, 31, 32. &c. aforegoing; and place the Pa∣tient and Member in such a posture, as may be most conve∣nient, and cause least pain to the Patient, as is sufficiently declared in the Sections above: provided always that the Mem∣ber is not depending, or in a hanging posture; because such a position is apt to add to a Flux of Humors, or to in∣duce it.

XLVII. This being said, the Wound is to be cured, like as are other Wounds, with proper Balsams, Sarcoticks, and drying Pouders: but yet it is not to be bound up, in the same manner as other Wounds are; and great care must be taken, that it is not offended with the Injuries of the ambient and cold Air.

XLVIII. Cataplasms are also to be imposed, not upon the Wound it self, but upon the near adja∣cent parts, lest the weight there∣of should hurt it.

XLIX. And in regard that Fluxions are easily excited, the Body ought to be cleansed by mani∣fold

Purgations, and that as oft as need shall require: and like∣wise by Sweating, to be freed from all its vitious and super∣fluous Humors.

CHAP. XVI. Of WOƲNDS with CONTƲSION.

I. THEY are called in Greek, 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, plu. 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉. in Latin, Vulnus contusum, plu. Vulnera contusa; in English, a Wound or Wounds with Contusion, a Contused Wound or Wounds.

II. A Wound with Contusion is generally made with a Weapon or Instrument which is blunt; where∣by, besides the solution of con∣tinuity, there is a bruising of the Flesh, or other parts apper∣taining.

III. The Signs. It is known from the Instrument hurting, the great Pain, and the black and blue colour of the Part.

IV. Now a Contusion is either without a Wound, or with a Wound: if it is without a Wound, we have already discoursed of that at large in Lib. 3. Cap. 7. afore∣going: if it is with a Wound, wherein it is not only bruised within, but is also externally wounded in the Superficies, it is what we intend to treat of here in this Chapter.

V. The Prognosticks. A Wound with a Contusion is more dangerous and difficult to cure, than that without. For the bruised Parts and Blood poured forth, if they be not, or cannot be dis∣cussed, must of necessity be turned into Pus, without which the Wound cannot be healed.

VI. And if the contused Flesh, and extravasated Blood begins to putrefy, it may excite and cause a Gangren, or some other dan∣gerous Symptom.

VII. The Cure. In order there∣fore to the Cure, you must first have respect unto the Contusion; where∣in you must prevent the afflux of Humors, by Revulsion, De∣fensatives, and Repellers.

VIII. Then the Blood which is flowed in, must be changed into Quittor or Pus, by Medicaments, (not too moist) unless you think it may be discussed; and Cata∣plasma Laxativum Schroderi, or Resolutivum Foresti may be ap∣plied round about the Wound, where it is bruised, but not on the Wound it self.

IX. Hippocrates, in Lib. de Ʋlcerib. says, If any of the Flesh shall be battered and bruised by the Weapon or Instrument, we are then to take care, that (as soon as may be) it be converted into Pus: for as it is less dangerous than an Inflammation, so there is also a necessity, that the battered and bruised Flesh should (by being converted into Pus) be wasted and

consumed away, that new Flesh may be bred instead thereof.

X. So that when we shall find that there is no cause to fear an Afflux of Humors, we must en∣deavour to bring the bruised Flesh and Blood to Pus, which is done by Maturatives and Di∣gestives; which what they are, we have shewed, Lib. 3. Cap. 3. Sect. 29, ad 32. Cap. 5. Sect. 105, ad 108. Sect. 134, ad 137. & Sect. 145, ad 149. Cap. 6. Sect. 23, 36, 37. & Lib. 4. Cap. 2. Sect. 16, ad 30.

XI. But because they are gene∣rally hot and moist, you must have a special care in the use of them, that they be not over-moist; for that then they are apt to pro∣duce putridness, and a cor∣ruption of the Part may easily be excited; for which Reason, Discussives may also be mixed with them: as,

XII. ℞ Roots of Althea ℥i. wild Cucumber roots ℥ss. Origa∣num, Dill and Fetherfew tops, A. M. i. fat Figs N^o vi. Raisons stoned ℥i. boil in Water to softness, pulp thro' a Hair-sieve, and add thereto, meal of Lin-seed and Fenu∣greek-seed, pouder of Orrice-root and Camomil-flowers, A. ʒ iv. Sanguis draconis ʒiii. Myrrh in pouder, Galbanum, liquid Storax, liquid Amber, A. ʒii. Saffron ʒi. Oil of Hypericon, golden-coloured Palm-Oil, A. q.s. mix, and make a Cataplasm; which I impose about the Wound, not on the Wound it self.

XIII. For so says Hippocrates, lib. de Ulcer. When it seems needful that the Wound be de∣fended with a Cataplasm, it ought not to be laid on the Wound, but upon the parts adjacent to it; that so those things may be softned or dissolved which are not, and the Pus may pass away.

XIV. The next thing to be con∣sidered, is the Wound it self; upon which you must apply a Di∣gestive, made of Rosin, Turpen∣tine, and the yolks of Eggs; or Triapharmacon, or Ʋnguentum Basilicon, or some such-like, out of the things before-mentioned.

XV. The Pus being fully bred, you must then use Abstersives and Glutinatives; healing it up, as you do other Wounds.

XVI. But if the bruised Flesh will not be converted into Pus, but on the third, fourth, or fifth day, a Tumor arises with Pain, and so increases from day to day, whereby its colour is extin∣guished, and it becomes yel∣lowish, with signs of a Gangren near at hand; then the Part must be scarified, and Ʋnguen∣tum Aegyptiacum is to be applied, ordering the rest of the Cure, as we have taught in Lib. 3. Cap. 7. aforegoing.

XVII. If with the Flesh, the Nerves, Tendons, and Ligaments are bruised, without any contusion of the Skin, they are to be cherished by fomenting the Part with Dis∣cussive Oils made hot; such are Oils of Dill, sweet Marjoram, Orrice, Southernwood, Rue, Tansy, &c.

XVIII. But if the Skin is bruised withal, first lay on the white of an Egg, beaten with Oil of Roses, which will mitigate the pain: and then the pain being somewhat moderated, you may

comfort the Part by fomenting it with red Port-wine, and then apply a Cataplasm, made of Bean-meal and Oxymel; or Elm-leaves boiled in Oil; or the ashes of Vine-branches mixed with yellow Palm-oil and Vin∣egar.

XIX. If there is vehement pain withal, then take Tar, Oxymel, and Bean-meal, which mix, and boil to a Cataplasm; laying it on as hot as it can be endured.

XX. If there is more cause of Drying, mix with the former meal of Orobus, pouder of Flo∣rentine-Orrice root, or root of round Birthwort; anointing the place with Oils of Castor, of Whelps, of Camomil, Dill, Or∣rice, and Rue: or with an Oint∣ment made of Galbanum and Myrrh.

XXI. And give inwardly, an Electuary made of pouders of Centory the less, roots of Birth∣wort, Elecampane, Gentian, and Orrice, mixed with Ammonia∣cum, and Mel Juniperinum, or honey-like Extract of Juniper-berries.

XXII. If at last there remains a hardness on the Nerves or Ten∣don, whereby numbness and stupi∣dity be excited, then Emollients or Digestives are to be laid on; as roots of Althea, of white Lillies, Bdellium, Ammoniacum, Opo∣panax, Sagapenum, Diachylon simple, & cum Gummi; or Palm-Oil, mixed with Chymical Oil of Aniseeds in equal parts, or Balsamum mirabile.

XXIII. If the Ligaments are bruised, you must apply such things as heal, dry, discuss, and strengthen: such are Oils of Mastich, Juni∣per-berries, Oranges, Limons, Caraways, to anoint withal.

XXIV. And then apply this: ℞ Oils of Mastich, Lavender; and Savin, A. ℥i. Oil of Mace by Ex∣pression ʒvj. Bdellium, Ammonia∣cum, Galbanum, A.℥ss. Saffron ʒii. Wax q.s. mix, and make an Ointment, or soft Cerate.

CHAP. XVII. Of WOƲNDS made by Biting of VENEMOƲS BEASTS.

I. THEY are called in Greek, 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, pl. 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉. in Latin, Morsus Bestiae, pl. Morsus Bestiarum; in English, The Biting or Bitings, of a Beast or Beasts.

II. We shall comprehend in this Chapter the Bitings and Stingings of all living Creatures, even the Bitings of Mankind: not that we think every Creature is Poi∣sonous, yet we are apt to be∣lieve, that there is somewhat

of Poison or Malignity, more or less, in the Bitings of all Crea∣tures, Man as well as Beast.

III. And therefore we shall lay down our Considerations in a fivefold order, as they have re∣spect either to Biting or Stinging; the first of which is made by Mankind by Beasts, by Serpents, and by Insects.

IV. These Wounds then are, 1. By the bitings of wild or tamed Beasts and Human∣kind, not esteemed poisonous. 2. By the bitings of Mad-dogs, and Mad-men, which require the same order and method of Cure. 3. By the •…•…ing of Serpents; as the Viper, Rattle-snake, &c. 4. By the biting of the Taran∣tula. 5. By the stinging of Scorpions, Hornets, Wasps, Bees, &c. of all which in their order.

I. Of Biting of Wild-Beasts, and Human-kind.

V. We intend to treat of those Wounds here which are made by the biting of Human-kind, and of Beasts in their own nature not Venemous; as of an Ass, Ape, Baboon, Bear, Cat, Dog, Horse, Leopard, Monkey, Squirrel, Ty∣ger, &c. concerning which, yet Celsus, lib. 5. cap. 27. saith, That all Bitings of wild Beasts whatsoever, have in them some certain kind of Venom.

VI. Moreover, these Creatures when they bite, are for the most part enraged; and Wrath or Rage has in it a great power to disturb the Humors, and cor∣rupt them; which vitiousness of the Humors is easily commu∣nicated into the Spittle, and by the Spittle as easily conveyed into the Wound; which thing is manifestly evident, in such as are bitten by a mad Dog or Man.

VII. But if it is supposed that such Wounds are altogether free from any Virulency whatever, yet the Contusion it self (for Teeth are seldom so sharp as to wound, and not also bruise) renders all Wounds whatsover the more dan∣gerous and grievous, and makes them the more difficult to be cured.

VIII. The Prognosticks. These Wounds are dangerous as well in themselves, by reason of the Contu∣sion, as also because the Spittle of the furious and enraged Animal is supposed to have something of Ma∣lignity joined with it; but much more dangerous, if the Nervous and Tendinous Parts are bitten or wounded withal.

IX. And if they are made by one Man's biting of another, they are not without their danger. Guilielmus Fabricius Hildanus, Cent. 2. Obs. 84. & 85 gives us three Instances. 1. A Mer∣chant, who in his Cups was bitten by another, on the very tip of his right Fore-finger; upon which, his whole right Hand became inflamed, and a Gangren presently began to follow, with Convulsions, a great burning Fever, Swooning, and continual Restlesness. 2. A Physician, who was bit, by put∣ting his Finger to the Mouth of a Woman who had a Frenzy, to feel her Tongue; upon which

biting, he was presently taken with a vehement pain, not only in his Finger, but thro' his whole Arm. 3. Another Man was bitten sorely to the first articu∣lar of his Thumb, by another furious and enraged person; up∣on which he was instantly taken with a vehement pain thro' the whole Arm, and soon after with a Fever, and Swooning-fits.

X. The Cure. If the Wound is made by a Beast that hath blunt Teeth, whereby there is a Contu∣sion, the Blood is to be well squeezed or prest forth, out of the Wound; and Purging-medicines are to be given, (if need so require) to prevent the greater afflux of Humors.

XI. And to prevent the Evil from being communicated to the more superior, or other adjacent Parts, you must apply Defensa∣tives made with Oxycrate, or some other like thing: and to the Wound it self, for easing the Pain, promoting Suppuration, and keeping the Wound open, some proper Anodyn, matura∣tive or digestive.

XII. As, ℞ One Egg, Butter ʒiv. Oils of Violets and Roses, A. ʒij. Saffron ʒss. mix them. Or, ℞ The yolk of one Egg; Turpen∣tine, Honey, A. ℥ss. mix them well together; then add Oil of Roses, or Oil of Ben ʒiii.

XIII. And you may (if need require) apply over this Cata∣plasm. ℞ Althea-roots ℥ j ss. flowers of Camomil and Melilot, A. M.j. Wormwood-tops P.ii. boil all to softness, and beat them to∣gether; to which add the yolk of one Egg, Mithridate ℥i. Oil of Camomil q.s. mix, and make a Cataplasm.

XIV. If you should fear, that there is Virulency in the Wound, you may apply this. ℞ Un∣guentum Basilicon, Strasburgh-Turpentine, A. ℥i. yellow Palm-Oil, or Oil of Ben, Mithridate, A. ʒvi. yolk of one Egg.

XV. And that what is bruised, may be converted into Pus, you must use this Digestive. ℞ Ung. Basilicon, Rosin, Honey of Roses, A.℥i. yolk of one Egg, mix them. Or this: ℞ Strasburgh-Turpentine, Mastich in pouder, A. ℥i. Honey of Roses ℥jss. yolk of one Egg, mix them.

XVI. And if any Malignity is feared, you may apply this: ℞ Strasburgh-Turpentine, Mithri∣date, A.℥i. Aloes, round Birthwort∣root, Myrrh, Orrice-Florentine, A. ℥ss. all in fine pouder, pouder of Zedoary, and Winters Cinnamon, A. ʒi. mix, and with Honey of Roses, q.s. make a Liniment.

XVII. The Wound being di∣gested, and well cleansed, you must fill it up with Flesh, with proper Sarcoticks, and at last with Epu∣loticks produce the Cicatrice.

XVIII. If a Gangren is feared, as approaching, you must pursue the Cure, as we have directed in the Chapter of a Gangren. Or thus: Bathe all the adjacent places with Spirit of Wine Campho∣rated; and upon the Wound apply very hot this following Mixture.

XIX. ℞ Strasburgh-Turpentine Gum Elemi, A. ℥i. yolks of two Eggs; pouder of Earthworms ʒii. Frankincense, Camphir, A. ʒi. mix them.

XX. If the Pain increases, bathe with this: ℞ Powers of Amber, Powers of Juniper, A. ℥i. Spirit of Sal Armoniack ʒii. Guttae Vitae ℥ss. mix them: and over all, apply some proper Anodyn Cataplasm: after which the Pain being something eased, you may apply Empl. Album, and so Cure it as another bruised Wound.

XXI. But mean season, or du∣ring the whole course of this Cure, give inwardly every Night a Dose of Our Theriaca Chymica; and every Morning fasting this mix∣ture: ℞ Aq. Bezoartica, or Spi∣ritus Cordialis ʒvi. Syrup of Li∣mons ʒiii. Spiritus Opii Composi∣tus ʒiss. mix for a Dose.

II. Of the Bitings of Mad-dogs, Mad-men, &c.

XXII. Whether the Patient is bitten by a Mad-dog, or by a Mad∣man whose Madness came thro' the biting of a Mad-dog, the Signs, Symptoms, Prognosticks, and Methods of Cure are all one, and therefore in Treating of the one, we Treat of the other also.

XXIII. This Poison or Venom which causes this Madness, con∣sists not in the first qualities, as Heat, Coldness, Driness, or Moi∣sture, but in a Specifick Proper∣ty peculiar to this kind of Dis∣ease, which is called in Greek, 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, (aquae metus) 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, morbus, quo ali∣quis à Cane rabioso commorsus a∣quam timet; also 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉. in Latin, Hydrophobia, & Rabies; a Malady in which the Patient is always extreamly fear∣ful of Water.

XXIV. Now it is necessary in the first place, to know whether the Dog which gave the Wound be Mad, or no, which you may know by these Signs. He refuses his Food, and his Water also, (be∣cause he is afraid of Water) Slaver or Snivel comes forth from his Mouth and Nostrils, he carries his Tail under his Belly, hangs his Tongue out of his Mouth, which looks either yellow, blackish, or reddish, his Eyes are red and fiery, and he looks wild, becomes lean, and barks but little, and that hoarsly; sometimes he runs swiftly, sometimes he stands still, he knows not his Owner, but runs fiercely upon all Crea∣tures, and oftentimes in run∣ning strikes his Head against Posts or Trees, and when in this Condition, other Dogs will shun him.

XXV. The Signs. If the Madness is beginning, the Patient becomes discontented and angry without any just Cause; he feels a gnawing and heaviness in his Stomach, complains of unrea∣sonable Weather, tho' it is fair, his Body also becomes heavy and lumpish.

XXVI. If he sleeps, his sleep is very troublesom, and he is full of fears without any cause; he drinks less than usually, and be∣gins to murmur and speak to himself, and desires Candle∣light in the Day-time.

XXVII. In the place wounded, tho' it is healed, a pain is felt, which ascends towards the Head,

whither when it is come, a Ver∣tigo is caused, so that he cannot walk steadily forwards; now when these last Signs appear, you may be sure that Madness is at hand, or not far off.

XXVIII. If the Madness is present or manifest, the Face then and Body become red, he looks wildly, is very trouble∣som, and foams at the Mouth, and spits upon those that stand by.

XXIX. Sometimes they snarl and bark like Dogs, and many times offer to bite; they vehe∣mently hate or are afraid of Water, and all Liquid things, which if proffered to them, or they come near them, they be∣come more fierce, and are more offended.

XXX. Their Pulses are small and inordinate, their Ʋrine comes away by drops; and the Madness increasing, they Vomit either yellow or black Choler, and become Costive.

XXXI. Their Limbs become more and more lumpish and heavy, their Voice becomes hoarse, and they are troubled with difficulty of breathing, putting out their Tongues as if they wanted Breath, or Air, or were vehe∣mently hot.

XXXII. A Day or two before they Die, some of them are trou∣bled with the Hiccough; and a little before Death with Con∣vulsions, and a dreadful gnash∣ing of the Teeth.

XXXIII. The Prognosticks. The Patient being bitten by the Mad-dog, the Poison is received; but it manifests its self in Madness in some sooner, in others later: some grow Mad in a few Days space, as in a Week, more or less; some in a longer time.

XXXIV. But its general time of manifesting it self, is upon the Revolution of the Moon to the same place of the Zodiack, where she was when the Wound was made, which is a Months time.

XXXV. Yet if the Wound was great or deep, or manifold, and the Dog vehemently Mad, the Pa∣tient may possibly become Mad, upon the next New or Full Moon; or if they escape the New, upon the next Full; or if they escape the Full, upon the next Change.

XXXVI. Sometimes the Poi∣son lyes dormant for a much longer time, as for a Year or two, before it manifests it self in Madness; but this is caused from the weak∣ness of the Poyson first received, or the shallow, remoteness, or hard place where it is lodged; and therefore if it manifests not it self in a Month or two, the Pa∣tient is generally supposed se∣cure or perfectly well, more especially if the proper means both Internal and External have been used beforehand.

XXXVII. If the Wound is not deep, nor has offended a Nerve, Artery, or Vein, there is great hope of Cure, and that the Pa∣tient may do well.

XXXVIII. But if the Person who is bitten, begins to have the fear of Water before him, and be∣comes Mad, the hope of Reco∣very is very small; nor did I ever know one such to escape.

XXXIX. The Cure. There are three Intentions of Cure;

1. To draw forth the Poyson out of the Wound, that it may not get deeper into the Body. 2. To strengthen the principal Parts, that they may be able to resist and repel the Poyson. 3. To destroy the power of the Poyson it self.

XL. The first intention is an∣swered in some measure by applying a Ligature, three or four Inches above the Wound: but Celsus, lib. 5. cap. 27. advises, that it be not too strait, lest the Part be∣comes benummed.

XLI. If it is in a place which will not admit of Ligature, then you must apply a Defensative, made of fine Bole, Terra Sigillata, Catechu, Sanguis Draconis, mix∣ed with Whites of Eggs.

XLII. Then you must scarifie the Wound, if it is not large e∣nough already; or apply Cup∣ping-glasses with much Flame and Scarification, to make the stronger Attraction.

XLIII. If the place is such as cannot be Cupped, yet it is always to be scarified, and the Blood to be drawn by a dry Sponge, not wet in Water: after which you may ap∣ply hot Pigeons or Chickens, being first cut asunder.

XLIV. After these things are done at the first, you must apply other Topicks of a very strong At∣tractive quality, as Cataplasms made of Garlick, Shelots, Leeks, Onions, Mustard-seed, Cresses, Rue, Salt, Leven, Honey, Mi∣thridate, Pigeons-dung, Tur∣pentine, Burgundy-Pitch, &c.

XLV. Galen, de Antidot. lib. 2. cap. 1. very much commends an Emplaster made of Opopanax, Pitch, and Vinegar; and he af∣firms that he never knew any that died, upon whom this Em∣plaster was applied: the Com∣position is this. ℞ Pitch lbi. which melt, and add thereto Opo∣panax dissolved in the sharpest Vinegar, strained, and reduced to a just consistency ℥iii. mix, and make a Plaster.

XLVI. Now these Attractive Medicines are to be applied in three or four Days after the Wound is made, otherwise they will be unprofitably used.

XLVII. Bleeding in this Case is very pernicious, for it strongly draws the Poyson into the Blood, and so corrupts the whole Mass, whereby, at length, it seizes both Heart and Brain: Purging, in like manner, is also as delete∣rious, especially in the begin∣ning, because it draws the Poy∣son from the outward Parts, to the inward.

XLVIII. But if the Poyson has already possessed the inward Parts, Purging will then be necessary, for the evacuating of the empoisoned Humors, or morbifick Matter, and it ought often to be repeated, and that with the strongest Eme∣ticks, or Catharticks, or both by turns, which ought to be begun after the 20th Day, and before the 40th Day, with Tartarum Emeticum, Vinum Antimoniale, Infusion of Crocus Metallorum, Wine or Vinegar of Squills, Our Family Pills, Pilulae Panchyma∣goge, Pil. Catharticae, Pulvis Cornachini, Sal Mirabile, &c.

XLIX. The second Intention is performed, by giving inwardly Mi∣thridate or Venice Treacle, mixt

especially with a proportionable Dose of Volatile Sal Armoniack, or Salt of Hartshorn, or Salt of Amber, giving ʒiss. every Morn∣ing fasting, and every Evening at bed-time; but for this pur∣pose Our Theriaca Chymica al∣most a Thousand times exceeds them, which you may give eve∣ry Night going to Bed; and every Morning a Dose of Our Tinctura Cordialis, in a Glass of Canary, both which are to be continued for Forty Days at least together.

L. In this Case, Galen, de Antidot. lib. 2. cap. 11. and Dioscorides, lib. 6. cap. 37. commends the Antidotus de Can∣cris fluviatilibus, thus made. ℞ Ashes of River Crabs ʒii. Gen∣tian in Pouder ʒi. generous Wine half a Pint: mix them for a Draught; which is to be taken every Morning for Eleven Days. Galen affirms that none ever died, who rightly used this Pouder of Crabs.

LI. The third and last Intention is to destroy the power and force of the Poyson it self; and this is done chiefly by the help of Volatile Alkalies: Volatile Salt of Beans is an Admirable Thing in this Case, so also the Volatile Salts of Hartshorn and Sal Armo∣niack, also the Volatile Salt of Vipers: but that which exceeds all other things, is the Volatile Salt of the Livers of Mad-dogs, which radically destroys the Poison, and may be given daily a gr. x. ad ℈i. in any fit Ve∣hicle.

LII. But because every one can∣not attain this, or it is not ready at hand, you may make use of the substances of the Liver and Spleen, by drying them, and re∣ducing them to Pouder; of which Pouder you may give à ℈ii. ad ℈iv. in a Glass of Choice Cana∣ry in the Morning at Ten a Clock, and in the Afternoon a∣bout Five a Clock; this is known to be a Specifick.

LIII. As to the Volatile Salt of the Livers and Spleens of Mad∣dogs, because it will be difficult to be gotten in any considerable quan∣tity; you may make it of the Flesh of the Dog, joined with them, which is to be cut into very thin slices, and then dried in the Sun, or an Oven, till they are perfectly dry, and being cut into bits, is to be put into a Glass Retort, and distilled in all respects as you distil Volatile Salt of Vipers.

LIV. Guil. Fabricius Hildanus, Cent. 1. Observ. 78. has this fol∣lowing Cure. A Young Man was on the 30th of July, 1602. wounded in the Arm by the Bite of a Mad-dog. On the first of Au∣gust (says he) he came to me; I scarified the Bite, applied a Cupping-glass with much Flame, and extracted as much Blood as I could, then I washed the Arm in Posca, in which Venice-Trea∣cle and a little Sea-sait were dis∣solved; for the slaver of a Mad∣dog, if it dries upon any part of the Skin, unless it is quickly and diligently washed and wi∣ped off, may cause Madness; and after this he cauteriz'd the Bite all over, very deep, with an actual Cautery.

LV. And by the way he advised

Young Chirurgions, that they take special Care, that they cauterize not such Bites superficially, but ra∣ther to err in the excess of their depth, than in the defect, because as it is a dangerous and desperate Disease, it must have a severe and desperate Cure; and he knew one who had no Benefit by an actual Cautery, because it was not made to enter deep e∣nough.

LVI. After the Cauterizing, he was not careful to asswage the Pain, because unctuous things, as Butter, Oil, &c. which relax the Eschar, he approved not of, in such Ʋlcers, they hindering the evaporation of the Poison, and re∣pelling the Blood, and with it the Venom to the Noble Parts: And since Pain, as Galen says, at∣tracts the Blood and Humors, out of the Body to it self, it is probable that if it is moderate, it may do good in such a Case as this is; therefore after the Burning, he applied Cotton dipt in Aqua Vitae, in which Theriatae Andromachi was dissolved, to the Ulcer.

LVII. Afterwards he laid to it the following Plaster spread upon Cloth. ℞ Onions a little boiled, Leven, Mustard-see, A. ℥ii. Theriaca Andromachi ℥ss. Rue, Scordium, A. Mss. beat them to∣gether in a Mortar, with a little Honey. The next Day he cut the Eschar every where, as much as he could, and repeated the Ap∣plications of the aforesaid Medi∣cines, and so proceeded till the Eschar fell off: afterwards, lest the Lips of the Ulcer should close, he put Pease into it twice a Day, applying the prescribed Plaster, keeping the Ulcer thus open for three Months.

LVIII. But in the interim, he strewed twice or thrice a Week, the following Pouder upon the Ʋlcer: ℞ Red Precipitate levigated, Pouder of Bezoar-stone, and of Angelica-root, A. ʒi. mix them: This, says he, wonderfully at∣tracts the malignity from with∣in to it self: and inwardly he gave Alexipharmicks, as Venice-Treacle, Mithridate, Bezoar, Burnt Harts-horn, and the fol∣lowing Pouder in Borage and Bugloss Water. ℞ Ashes of River Crabs ℥v. Gentian-root in Pouder ℥iiss. Olibanum in Pouder ℥ss. mix them. He neither bled, or purged him, lest he should have drawn the Poison inwards, but by this means he was per∣fectly Cured. See the Third Edition of Our Synopsis Medicinae, lib. 3. cap. 21.

III. Of the Bitings of Serpents, as Vipers, Rattle-snakes, &c.

LIX. The Signs. When one is bitten by an Adder, Viper, Rat∣tle-snake, or Slow-worm, &c. the Part becomes of a leaden Colour, sometimes reddish, or of a reddish black, and very painful; and if it is not pre∣sently Cured, much black and fetid Pus does come forth from the Sore, like as from a filthy Ulcer.

LX. What we shall say on this Subject, we shall chiefly deli∣ver from Monsieur Charas out of his new Experiments upon Vipers. 1. A Dog was bitten in his upper Lip by

an angry Viper; he was not much moved at it at first, but by little and little grew sad, and his Jaw began to swell; a little while after he vomited up the last Food he had eaten, and dis∣charged by Stool: He refused his Food, and would touch none of it, and lay in a prostrate manner without complaining: the place prickt grew livid, and the lividness extended to the Neck and Breast, as also the Swellings, and at length after Forty Hours he died; without nothing was observed but the Tumor and lividness in the Part prickt, and places adjacent; but being opened, in the Trunk of the Vena Cava, a little Blood was found coagulated, and the rest of the Blood in this place, in the Heart, and in all other places, was of a dark Colour, and of an ill Consistence, like Blood in part dissolved and corrupted; the Stomach was of a darkish Colour, but the Me∣sentery and Guts were darker: The Heart, Liver, Lungs, and Spleen were not altered at all, but of a good Colour, and re∣main'd in their natural Condi∣tion.

LXI. A Dog bitten at the Ear. He howled when he felt the bi∣ting, and continued howling for half an Hour, then was quiet. The place prickt grew livid, and swell'd, as also the Parts ad∣jacent, he vomited not, but voided some Excrements, would neither eat or drink, and died ••n 24 Hours after he was bitten: Outwardly nothing was seen but the lividness and swelling. Be∣ing opened, all the inward Parts were in the same Condition with those of the former Dog, save there was found in the Ves∣sels no coagulated Blood, but only it was of an obscure Co∣lour, of an odd consistency, and in a disposition to coagulate.

LXII. 3. A Dog bitten on the tip of his Nose by an enraged Viper. He howled when he felt himself bitten, but was soon appeased, fell to licking the place prickt, and to seratching it with his Feet or Paws. He lay not down, but continued that exercise for some time. The place bitten became somewhat black and blue, but swell'd not; and a little while after the Dog cat and drank, as if nothing ailed him, gradually the lividness disappeared, and he grew as well as ever. In this Case, I suppose the biting of the Viper scarcely pierced thro' the Cutis, which was the principal reason of the Dog's recovery.

LXIII. 4. A Puppy seven or eight Days old, bitten on the Leg by an enraged Viper. He howled as soon as bitten, and so conti∣nued till he died, which was a∣bout an Hour after. The place prickt was swell'd and livid; and being opened, nothing was found but some lividness in the Stomach and Guts, and some blackishness and ill-consistency in the Blood, but all the other inward Parts appeared sound.

LXIV. 5. A Dog bitten on the Belly by an angred Viper. He cri∣ed presently, but not long. The place bitten was very livid, and swell'd much, the Tumor and

lividness reaching over all the Natural Parts: he drank often, but would eat nothing, and was always for two Days in this Con∣dition, without growing worse. (I suppose the Skin was scarcely penetrated). Then he was bitten again, and that twice, near the same place; he howled much, and the Swelling increased, and extended it self over the whole Belly, as also the livid Colour, but it went no farther: The Dog often lickt his Wounds, and drank store of Water, and at length fell to eating, and in five or six Days was Cured per∣fectly, without any other Reme∣dy than that of his Tongue lick∣ing the Wound. (Either the Skin was not perfectly penetrated, or else the Attractive Virtue of the Tongue by often licking, drew forth the Poison).

LXV. 6. A Dog deeply bitten on the Tongue by an inraged Viper. He cried vehemently, so as to be heard a great way, and conti∣nued tossing and vexing him∣self for half an Hour together, and then died. He was open∣ed, his Heart, Liver, Lungs, and Spleen, were found and well; but his Tongue was ex∣ceedingly livid: his Mesente∣ry covered all over with black Spots, some of which were blacker than Lentils, under which there was coagulated Blood; the Stomach and Guts were also grown blacker; the Blood very black, and beginning to coagu∣late in the Heart, and in the Vena Cava, being like Blood curdled and corrupted.

LXVI. 7. A Pigeon and a Pullet were bitten by an angry Vi∣per, almost at the same time, in the most fleshy Part, viz. under the Breast. Soon after in both there was observed a very swift and extraordinary beating of the Heart, which continued, still increasing, so much, that in less than half an Hour they were both dead. They were opened, and in both there was found a little Blood coagulated in the Heart, and Vena Cava, and all the rest of the Blood blackest, and ready to be coagulated, and as it were, to be corrupted; but the Heart, Liver, and all the inward and outward Parts were of a very good Colour, and in a very good Condition, ex∣cept the lividness which appear∣ed only upon the place bitten.

LXVII. 8. Another Pigeon bit∣ten on the Leg twice, a little The∣riaca being given it beforehand. Upon the first bite, it went too and fro in the room, and shew∣ed not any sign of Illness: but upon the second bite, it grew Sick by little and little, and died in half an Hour after. The Place which was first hitten, was much more livid than the Place which was bitten the second time.

LXVIII. When I was in Caro∣lina, I had a Dog bitten by a Rat∣tle-snake upon his Throat. The Dog cried out immediately, presently grew Sick, Vomited up all that was in him, and re∣fused his Food, and then ran home, and laid himself down. He would sometimes cry, some∣times whine, and sometimes groan bitterly; outwardly the

place bitten was livid, his whole Neck was extreamly swelled, as also his Head, and Eye-brows, which seemed to hang over his Eyes. He died in the space of 24 Hours, but at times, to the last moment groaned vehement∣ly, as if he had been Heart-sick, and with frequent Convulsions wonderful to behold: Being o∣pened, the Heart, Liver, Lungs and Spleen seemed to be well, the Stomach, Mesentery, and Guts were spotted all over with livid and blackish Spots; and the whole Mass of Blood both in the Heart, Arteries, and Veins was every where coagulated, and looked almost of a black Colour.

LXiX. The Causes. From what has been observed, it appears, that in the biting of a Viper, Rat∣tle-snake, &c. the Poison goes not directly to the Noble Parts, for that no alteration was ever ob∣served therein, but the Cause of Death is from the Poison imme∣diately entering into and work∣ing upon the Blood, coagulates it, and corrupting it, separa∣ting its Parts, and disturbing its Circulation, thereby hindering the Communication of the Spi∣rits thro' the whole Body, de∣priving the Noble Parts of them, and destroying or contamina∣ting them, with its deleterious Gas.

LXX. The progress of the Poison is from the place bitten; and the swiftness of its motion from the magnitude of the Arteries or Veins, which receive it, or which the Teeth did light on. As in the Tongue of the Dog which was bitten; the Tongue being full of Veins and Arteries, 'tis no wonder that the Poison meeting with them, and finding a large way, and very short, should so soon produce its Effects, and cause Death so much the more speedi∣ly, than that which meets with small, slender, long and wind∣ing Branches, tho' in this latter Case, it will not fail to do the Work at last.

LXXI. The Vomiting and ex∣tream Pains in any Part, chiefly in the Viscera, proceed either from the coagulated Blood, or its dispo∣sition to Coagulation, hindering it in its course of Circulation, for that the Spirits contained in the Circulating Blood, finding their passages stopt by the Congela∣tion, and endeavouring to make way for themselves, do Vio∣lence to the Viscera and lateral Parts, and so excite those ex∣tream Pains which the Patient reels; as also Vomitings, by weakening the Tone of the Sto∣mach, &c.

LXXII. And the Cold Sweats, Faintings, Swoonings, and Con∣vulsions with which such Patients are assaulted, are caused from no∣thing else, but the defect and di∣minution of the Spirits, and the obstruction of their concourse to the more Noble Parts, with the weakness and putridness of the Blood, which is destinated as their Vehicle to convey them.

LXXIII. The Prognosticks. The biting of any Poisonous Serpent, as the Viper, Slow Worm, Rattle-snake, &c. is always dangerous; and if it is not immediately pro∣vided for, is for the most part Mortal.

LXXIV. Our Common Vulgar Snake is without danger, tho' it bites never so deeply: and the biting of the Chicken-snake, or long black Snake of Carolina, is also safe, my self was bitten in the Night-time upon two of my Fingers, by one of those large black Snakes, making in all five Wounds, which bled, and were sore, but healed of their own accord, without any more than the first pain or trouble.

LXXV. If the biting of a Viper or Rattle-snake is deep, and in a considerable place, if no Remedy is presently applied, they Kill in a few Hours time. A Rattle-snake bit a young Man in the Woods in Carolina upon one of his Legs, and no Remedy being ready, he was Dead in about half an Hours space.

LXXVI. If Remedies be appli∣ed both outwardly and inwardly, and not almost immediately upon the receiving of the Wound, they oftentimes prove abortive: and if timely used, yet many times the hazard of Life is not small: and where the Patient recovers, it is sometimes three or four Days before he is fully out of danger.

LXXVII. The Cure. The An∣cients bound Ligatures three or four Inches above the Wound, held up the Member as high as might be, scarified, and if they could, ap∣plied Cupping-glasses with Sca∣rification; where they could not be applied they only scari∣fied, and applied Defensatives about the Part.

LXXVIII. Then they drest the Wound with Antidotes, Electua∣ries and Treacles mixt with Oil of Scorpions, Orvietanum, and the like, mixt with Pouder of Vipers.

LXXIX. And inwardly they gave Simple and Compound Anti∣dotes, as you may find in Dios∣corides, lib. 7. in Nicander in his Theriaca and Alexipharmaca; in Grevinus, de Veneris, lib. 1. cap. 36, and 37. where he has ga∣thered them together. Petrus de Abano, in lib. de Venenis, cap. 4. commends these following, viz. Hypericon, Swallow-root, Elecam∣pane-root, Radish, Dittany, Birth∣wort round and long: and these he affirms to be equal in Power and Virtue with Theriaca Andro∣mach; it self against Poyson.

LXXX. But there are many other particular Simples as good or better for the purpose intended, than those before enumerated, as Angelica, Bawm, Bay, and Bay-berries, Contra-yerva, Camo∣mil, Gentian, Germander, Ju∣niper-berries, Lavender, Master∣wort, Myrrh, Pyrethrum, Rue, Rosemary, Sage, Savory, Scor∣dium, Southernwood, Saffron, Tansy, Time, Wormwood, Marsh and Roman, Virginian Snake-root, Zedoary, &c. of which you make Pouders, Ele∣ctuaries, Tinctures both Spiri∣tuous and Saline, Volatil or Chymical Oils, Spirits and Wa∣ters, &c.

LXXXI. The Ancients, before Mithridate and Treacle were in∣vented, used only the Juices or Pouders of the Herbs and Roots inwardly, and applied the same outwardly to the Sores, as the Native Indians in the Continent

of Florida do at this Day, when they make use of the Virginian Snake-root, with which, in this kind of Cure, they do Won∣ders: After the Invention of Compounds, the Ancient Greeks and Romans used Mithridate, Theriaca Andromachi, Diatessaron, and other the like Composi∣tions.

LXXXII. The Viper-catchers, if they are bitten, they apply to the Wound the Pouder of Vipers, or the Vipers Head beaten to a Mass in a Mortar, and take the same Pou∣der inwardly: others use Tro∣ches of Vipers; and others a∣gain commend the Pouder of Tin as a Specifick in this Case, both, or either of which may be mixed with a little Mithridate, and so taken or applied.

LXXXIII. But after all, the Medicaments that are proposed, I am confident none of them exceeds, nay, comes not up to, the three fol∣lowing Medicaments, with which I have Cured several who have been bitten with Vipers and Rattle-snakes, viz. 1. Our The∣riaca Chymica. 2. Volatil Salt of Vipers. 3. Virginian Snake∣root.

LXXXIV. The Theriaca Chy∣mica you may give from ℈i. to ʒi. either alone, or dissolved in Ange∣lica-water, or some Syrup or other fit Vehicle; it may be given, 1. Upon receiving the Wound. 2. Morning and Evening daily. 3. If Fainting, Swooning, or Convulsions are induced. 4. If there is present a Vomiting, and it is constantly Vomited up, it is to be repeated till it will stay.

LXXXV. The Volatil Salt of Vipers or of Rattle-snakes, which is inferior to no other thing in the World, and may be given from ℈i. ad ʒi. three, four, or six times a Day, or as oft as need shall require; or instead thereof the Volatil Spirit of the Viper, &c. which is the Volatil Salt dissolved in the Flegm, and is made exactly as you make Spirit of Harts-horn. Indeed all Volatil Animal Salts, have a power to resist and de∣stroy the Poison of Serpents of all kinds.

LXXXVI. The Virginia Snake∣root does incredible Cures of this kind: you may give the Pouder à ℈i. ad ʒi. in some fit Vehicles, twice or thrice a Day: or the Tin∣cture thereof extracted with Sp. Vini, à ℥i. ad ℥ii. in a Glass of Wine, twice or thrice a Day: or the Elixir thereof extracted with the Powers of Angelica, Rosemary, or Juniper-berries, in the same proportion. I Cu∣red a Dog which was bitten in the Foot with a Rattle-snake, by giving the Pouder inwardly, in a strong Decoction of it in Milk, and applying the green Root beaten to a Cataplasm outward∣ly to the Wound, in less than three Days the Dog perfectly re∣covered.

LXXXVII. These things being said, we will give you two Histo∣ries or Observations of Cures of this kind, performed by two very knowing Men, viz. Ambrose Pa∣raeus, and Monsieur Charas, which are well worth the reading, and so conclude our Discourse upon this Title.

LXXXVIII. Paraeus, lib. 20.

cap. 23. says, A Man was bitten on the Hand (as he was gathering Hops on a He dge) by an Adder or Viper: He suckt the Wound im∣mediately with his Mouth, thereby to ease the Pain, and draw out the Poison; but as soon as the Tongue touched the Wound, presently it so swell'd, that he could not speak: His Arm swell'd also, even to his Shoulder, and his Pains were so sharp and acute, that he twice Swooned away in the presence of the Chirurgion.

LXXXIX. His Countenance was yellowish and livid, like to a Dead Man, so that his Recovery was despaired of: yet his Mouth was washed with Theriaca dis∣solved in White-wine, adding to it a little Aqua Vitae; the Arm was scarified with many and deep Scarifications, and the Blood which was waterish, and sanious, was suffered to flow forth plentifully from the Parts about the Sore; and the Scari∣fications were washed with Mi∣thridate and Theriaca, dissolved in Aqua Vitae.

XC. The Patient was laid in his warm Bed, and made to sweat, but not suffered to sleep, lest there∣by, the Poison should have been drawn into the inward Parts. These means so prevailed, that the next Day, all the malign Symptoms vanished: wherefore to finish the Cure, I (says he) thought good that the Wound should be kept long open and washed with Theriaca Androma∣chi; nor was I (says he) de∣ceived, for within a few Days after he recovered.

XCI. Charas in his new Expe∣riments upon Vipers, cap. 1. has this Observation. A certain Man by handling an enraged Viper was bitten on the lateral inside of his right Thumb, with one of the great bent Teeth. The pricking was no more than that of a Pin, it seemed not deep, and on the surface there was only a very small hole, with a very little redness, so that it was not dis∣cernable but by its Colour: nor was there either on or about this little hole any sign of the yel∣low Liquor contained in the Bags about the great Teeth, which is wont to be cast upon the Wound when a Viper bites deep.

XCII. Strong Ligatures were made above the place bitten, the Part wounded was scarified, and an Iron Spatula heat red hot, and often repeated, was held very near to the prickt place, to keep the Pores open, and attract back, and draw out some of the Poi∣son: and Theriac. Androm. ʒii. was given in a Glass of Wine.

XCIII. In less than a quarter of an Hour after the biting, the Patient felt some debility, and cal∣led for a Chair, he grew very pale, his Pulse grew quick, low, and almost interrupted: after which followed Convulsive mo∣tions, and a kind of Tetanos, for he had a stiffness of his whole Body, chiefly of his Neck, and Muscles of his Head.

XCIV. He then complained of a great pain about his Navel; he was cold in his extream Parts, and in his Face; which was all over covered with little drops of cold sweat; and his Lips, espe∣cially

the lower, was also swell'd: a while after he went to Stool, and then swooned away.

XCV. At the same time he Vomited the Treacle before given, and all he had eaten at Dinner, undigested; and he became so weak, that he was not able to get up to his Chamber again, from whence he came down.

XCVI. And by reason of the quickness, weakness, lowness and inequality of his Pulse, and his frequent swoonings, as well as his cold sweats, Viper Pouder ʒi. was given him in Treacle-water and Carduus-water; and a great Cataplasm of Theriaca Androm. was applied upon the Heart and Stomach.

XCVII. The Mixture he Vo∣mited up presently; Pouder of Vi∣pers was then given in some Orvie∣tan; this he also Vomited up: during all this time, he had his Senses, and the use of his Reason. This Vomiting not giving time to the Remedies to be resolved, and communicate their Virtues to the Noble Parts, it was thought proper to have recourse to the Volatil Salt of Vipers, be∣cause that being exceeding Sub∣til, and Volatil, and very quick∣ly transmitted to all the Parts, even the most remote, the Pati∣ent might thence feel its Effects with more speed and efficacy, than from all the other gross Medicines, which had been cast up, as soon as they had been taken down, whereby they were made ineffectual, by not im∣parting their Virtue to the Blood, where the necessity re∣quired.

XCVIII. For this Cause-sake then, there was given of Salt of Vipers ʒi. in Treacle and Car∣duus Waters: and about a Quart of this Mixture was given him: he kept it a little while, and then cast up a part of it, mixed with store of Viscous Phlegm. He took another like quantity of the same Mixture, which he also kept for some time, and then Vomited up as much of it as might be remaining in his Sto∣mach, and therewith much Phlegm.

XCIX. More of the same Com∣position was still continued to be gi∣ven him, as fast as he Vomited it up; he had also several Cly∣sters, to mitigate the violent and rebellious Pains, which he felt in his Belly about his Na∣vel.

C. His Lips remained yet swel∣led, his Pulse ill, his Sweats cold, and his Faintings continued very long; but persisting in the use of the Volatil Salt of Vipers, his Vomiting at length ceased, and he kept the Eighth Dose in his Stomach, which was given him about Four Hours after he received the Wound.

CI. From that time the Sym∣ptoms lessened, and the coldness began gradually to retire, and give place to the natural Heat, which was manifestly restored about Five Hours after the biting, his Pulse also returned, and was even and strong, but somewhat high.

CII. I left him not (says Charas) before the Mortal Sym∣ptoms ceased, and then he was carried to his Lodgings, whither I

accompanied him, and he was put to Bed, and there was given him a Mixture made of Confect. Hyacinth, Confect. Alkermes, A. ʒi. Syrup of Limons ℥i. Carduus-water ℥iv. mixt together: it was given him at three times, from Three Hours to Three Honrs.

CIII. He had also Citrons to smell to, and now and then he took some slices of them with Sugar: he took also good Broths, and drank Ptisan made with Roots of Scorzonera, and Raspings of Harts-horn, made pleasant with Syrup of Limons: a little Wine was also given him sometimes: and Confectio Alkermes was dis∣solved sometimes in his Broth, sometimes in his Ptisan.

CIV. During all the great Ac∣cidents or Symptoms, his Finger was not changed, nor any swelling upon it; but that began when those Symptoms ceased: the Pains a∣bout his Navel still continued, but a little abated, for which reason Clysters were prescribed: his Belly was a little stiff, but not swell'd, his Tongue whi∣tish, not dry, his Eyes faint and wan, his looks pale, and his Lips still tumified.

CV. The Tumor of the Finger extended it self that Night over the whole Hand, which was often anointed with Matthiolus his Oil of Scorpions, mixt with Hungary-water: but for all this anoint∣ing, the Tumor went forwards to the Arm the next Day, with pain and redness, and ascended to the Eye.

CVI. Then Fomentations made of the Roots of Angelica, of Ma∣ster-wort, of Carline Thistle, and of Birth-wort, with the Tops of Centory, Calamint, Hypericon, Scordium, and Wormwood, boiled in White-wine, which were con∣tinued for some time, with a∣nointings with Oil of Srorpions between whiles.

CVII. This was done with great Care, but no great Effect succeed∣ed upon it, and he again Vomited up even his Broth; but this Vomi∣ting continued not, yet the Pain in his Belly remained obstinate, and the swelling, and redness of the Hand and Arm still encreased: and from the beginning of the third Day, it seized on the Shoulder of the same side, descending to the Arm-pit, upon the whole Breast, and all the adjacent Parts, even to the whole Region of the Liver, the continual use of the Fomentation, and Oil of Scor∣pions doing nothing.

CVIII. And since the External Remedies proved succesless, we had recourse to Internal Ones: In the Evening of the third Day, Pou∣der of Contra-yerva ad ʒi. was given in Cordial Waters, mixt with as much of Confect. Al∣kermes, for all which, we saw no abatement of the Redness, Tumor, or Pain; but on the contrary, the swelling seemed to seize on the Left side.

CIX. For this reason, we found it necessary to return to the use of our first inward Remedy, the Vo∣latil Salt of Vipers, which had an apparent good Operation, and struck at the Root of the Mischief: Thus in the Morning of the fourth Day there was given Salt of Vipers ʒss. in Carduus-water ℥iv. he was well covered, and made to Sweat.

CX. The Dose wrought accord∣ing to expectation, for the Sick sweat not only abundantly, but found also a great amendment in all the ill Symptoms which remain∣ed. His Pain about his Navel was almost insensible, the swel∣ling of his Lips, and that which was in the Region of the Liver, Breast, and Arm-pits, vanisht; the other also of the Shoulder, Arm, and Hand, was much a∣bated, together with the Red∣ness and Pain.

CXI. Finding the Symptoms thus to abate upon giving the last Dose, the next Morning another like Dose was given him, and all the Symptoms still much more a∣bated, he sweating powerfully with∣al. And tho' the Patient found himself exceedingly amended, yet the next Morning he had such another Dose again, and the Morning following one Dose more, whereby all the Symptoms vanished, and were perfectly taken away.

CXII. In the interim there was applied to the Finger, a little Emplaster to cicatrize the Scarifi∣cations which were at first made, and were healed in a few Days af∣ter. Thus in about a Weeks time, the Patient went abroad, and did his usual Business, and was as well as if he had never been bitten of the Viper at all.

CXIII. From this Observation, which deserves to be kept ad per∣petuam rei memoriam, and writ∣ten in Letters of Gold, the mighty Virtues, Power, and Force of the Volatil Salt of Vipers is manifest, in overcoming the Poison which so violently exercised its fury over the Natural Heat, and all the Noble Parts: and its activity and pe∣netration is manifest, in pursu∣ing the Poison, and expelling it from the remotest parts of the Body, where it had fortified it self, and endeavoured to regain the place it had lost, and where, in the mean time it seemed to despise and profligate, all other the most generous and power∣ful Remedies.

CXIV. And now we are speak∣ing of the Volatil Salt of Vipers, (tho' it is forreign to this present Discourse, yet) we will give you one other Observation of the same Charas, of a certain Man who had such a vehement and continual pain of the Head, upon the Forehead near the Temples, which was even so doubled and redoubled, that he could not chew, nor so much as open his Mouth to swallow a little Broth, but with extream Pain and Anguish: and tho' all things were done to him that could be imagined, as Bleeding in the Arm and Foot, Purging often, Frictions of Neck and Shoul∣ders, Vesicatories and Attra∣ctives behind the Ears, opening the Temporal Artery, exhibiti∣on of powerful Sudorificks, which were continued Morning and Evening for many Days to∣gether, by which he sweat very plentifully, pulling out one of his upper Teeth which was sound, thinking thereby to give some vent to the Humor, &c. yet these means were used in vain, and left the Patient as bad as they found him.

CXV. At length it was resol∣ved, that a Dose of the Volatil

Salt of Vipers should be given him, in Wine: this one Dose presently removed all the Pain, which caused as great a wonder in the Assistants and Standers by, as satisfaction to the Patient. And by this so surprizing an Effect, with what hath been said afore∣going, the power, forces, effi∣cacy, and virtue of this Salt is better demonstrated, than by all the Rhetorick and powerful Reason imaginable to be offered in the World. Action demon∣strates better than Words; and the Effects of things, more than the most florid Harangues.

IV. Of the Biting of the Tarantula.

CXVI. The Tarantula is a great over-grown Spider, very frequent in Apulia, called in Greek 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉. and in Latin Phalan∣gium and Tarantula, from Taran∣ta, an ancient City of Apulia; but they are inhabitants of other places besides Apulia, for I saw several of them in Caro∣lina, a Province of Florida.

CXVII. The effects of the Biting of the Tarantula might almost seem fabulous, if it were not attested by great Autho∣rities, as Matthiolus and Epipha∣nius; besides whom Ferdinandus, Kircherus, and the most faithful Gassendus, declare themselvee to be Eye-witnesses thereof: be∣sides, it is a thing not only known, but common in Apulia.

CXVIII. This kind of Insect is most frequent in Summer-time, and many times bites the Country-man, leaving a Venom or Poison behind it: and the Biting is known by sickness at Stomach, a pain immediately coming upon the the bitten Part; with swelling, and itching, which in a little time will be in various parts of the Body.

CXIX. Presently after the Bite, there will be also in various places a numbness and trembling, Con∣vulsions, a loosning of the Members, with other Convulsive Symptoms; a great diminution of strength, and other wonderful effects, as Matthiolus and Ferdinandus have related.

CXX. These Authors have not reported it to be of any great dan∣ger, being more troublesom than any thing else: but I have been informed from one who has been an Eye-witness of the Distem∣per, that one of his Acquain∣tance, who had been bitten, and had too long neglected the Cure, was afterwards affected with an incurable Trembling and Palsy, which no means that for several Years had been con∣tinually tried, could either take off, or relieve.

CXXI. The Cause. Without controversy, there is a poisonous Infection given with the Bite; which affects not only the Bloody Mass and Vital Spirit, but passes withal into the Lym∣pha and Nervous Juice; thereby disturbing the Animal Spirits, by which it is presently con∣veyed thro' the whole Human Body, affecting all parts.

CXXII. This Venom multi∣plying it self (like Leven in the lump) and flowing every where, the Animal Spirits are presently

brought into Confusion; and being irregularly and inordinately moved, they induce Convul∣sions, or Convulsive Motions; which are accompanied with Pain and Languishing, sometimes with Contractures, and some∣times with Resolutions, or Loosning of the contained Parts, and other Paralytick Disaf∣fections.

CXXIII. The Cure. In the Country where this is common, the People have an admirable and wonderful Remedy which never fails, and this is by Musick. Those who are bitten by a Ta∣rantula, tho' they are very sick, yet as soon as they hear pleasing Musick, they are eased of their Pain and Sickness.

CXXIV. For upon the hearing of the Musick, says Matthiolus, they fall a leaping, and begin to dance and jump about; and con∣tinue it for a long time, as if they ailed nothing; but if it happens that the Musick gives over never so little a time, they immediately fall to the Ground, and return to their former Pains and Sickness, unless by the in∣cessant Musick, they dance and leap, 'till the Poison is wholly shaken off, and vanished.

CXXV. For this end there∣fore many Musicians are hired, and they continually play, taking their course by turns; one being weary, another beginning to play; that the noise and Musick may be without intermission, and that those who are bitten may Dance so long, 'till they are perfectly cured.

CXXVI. And, says Ferdinan∣dus, poor People do waste almost all they have in hiring these Mu∣sicians, who scatter themselves up and down all the Country; for this only purpose, to play to such as are thus bitten, where the People leap and dance about the Villages, in publick Streets and Fields, for a Day, two, three, or more, yea a Week or more together, 'till the Cure succeeds; which 'tis proba∣ble, may be sooner and better accomplished with some Tunes, than with other-some; as Kir∣cherus and Gassendus have inti∣mated from their own Observa∣tion.

CXXVII. For they assert, that these distempered People are not affected or excited, indifferently with any Musick; but with some particular and certain kinds of Tunes; and that they leap and dance more to some Measures, than to several others.

CXXVIII. And truly good Mu∣sick, by its Harmony and Sweet∣ness, does congregate and ease, or quiet the dissipated and disturbed, or restless Spirits, (witness that of David to King Saul;) and disposes them in such an order, that instead of tumultuating, whereby Convulsions are indu∣ced, they move harmoniously, and give liberty to the poi∣sonous Gas to evaporate and transpire: for by the length and continuity of the motion of the Body, and all its parts, the fury and rage of the Poison is worn out; and the Spirits being much wearied, at length rest themselves, and the Patient wholly shakes off his Madness.

CXXIX. As to the Medical

Cure, you may, as to Externals, use strait Ligature two or three Inches above the Wound if it may be, and Scarification, or Cupping-giasses therewith: also Vesicatories, or red-hot Irons held very near, are useful for extracting the Venom: so also to anoint the Spot with Oils of Vitriol or Sulphur, and Medicaments which are of a vehement, strong, and attractive force, are immediate∣ly, and with all speed to be applied.

CXXX. A Cataplasm made of Phalangium, or Spiderwort, and presently applied upon the Bite, is said to be a Specifick, and to attract or draw forth the Poison, after an admirable manner: and Authors say, that this Plant is found to be an effectual Cure for the Poison of that kind of Spider called Phalangium, or Tarantula.

CXXXI. You must avoid Bleed∣ing and Purging, and only give inwardly Sudorificks and volatil Alcalies; as Spirit and volatil Salt of Harts-horn, of Ox and Sheeps Blood, of Urine, of Sal Armoniack, of Ox-horns, and of Vipers; giving à ʒss. ad ʒi. and Sweating well upon it, and repeating the Dose twice a day, 'till the Patient is well.

CXXXII. ℞ Volatil Salt of Harts-horn, or of any other Crea∣ture ℈ii. Mithridate ʒjss. Saffron gr. xii. mix, and make a Dose, to be given in a Glass of Wine. Where note, that the Salt of Vipers in this case, is beyond compare; and all things which move Sweat, open the Pores, and are Neurotick, are proper to be exhibited.

V. Of the Stinging of Scor∣pions, Hornets, &c.

CXXXIII. This Title does not properly belong to this Chapter, yet because it has some affinity with it, in respect to the Malignity that a Sting infuses into a Wound, we thought good to add it by way of Appendix, and to treat of it in this place.

CXXXIV. The Signs. Stinging may be known by the Sense of Feeling, and the Creature that stings, by the Sight. There is exquisite Pain, more especially if it is done by a Scorpion or Hornet, and the Pain is some∣times so great as to cause In∣flammation, Tumor, Apostema∣tion, Convulsion, Gangren, and Mortification, according to the place which may be unhappily stung, and carelesness of looking after it.

CXXXV. The Prognosticks. If a Nerve or Tendon is stung, the pain is the greater, and Convulsions are presently excited, with In∣flammation and Tumor, Trem∣bling over the whole Body, Fainting and Swooning, cold Sweats, &c.

CXXXVI. If an Artery is struck by a Scorpion, it infuses Poison into the Blood; the place looks livid, and without a speedy course is taken, an universal conge∣lation of the Blood follows, and the Patient dies in a few days, sometimes in a few hours. Pa∣raeus says the stinging of a Scorpion is mortal, unless Re∣medies are applied in time.

CXXXVII. And this I believe

was the case of one whom I knew, who was wounded by the sting of a Scorpion, just upon the Pulse of of the right Wrist: the pain was not extream at first, but after∣wards the Hand and Arm swel∣led, grew livid and full of pain, which was extended to the Shoulder, Armpit, and Brest, with a vehement Colick, or pain of the Belly. There being no body near which had Skill, no∣thing was done 'till the next day; at which time Fainting, cold Sweats, and Convulsions seized the Patient; the Chir∣urgeon being come, he endea∣voured to let the Sick Blood, but in vain; for the Blood was so coagulated, that he could not bleed: he lay in this con∣dition, without any help, (for the same things were applied outwardly, and given inwardly: yet as they were advised with∣out skill, so they were without effect) the Patient continued growing worse and worse, and on the third day in the morning died; being dead, the Body was opened, and all the Blood in the Heart, Vena Cava, and other Vessels was found coagu∣lated, and of a blackish co∣lour, &c.

CXXXVIII. But this is not general or universal, for many stung with Scorpions live and do well, and it is rare that any one stung by them dies: but it is true, that many great and evil Sym∣ptoms oftentimes follow upon their stinging, and sometimes very hazardous accidents ensue.

CXXXIX. The stinging of a Hornet is less dangerous, and yet less dangerous are the stingings of Wasps or Bees: to these, if any reasonable means are applied, they recover upon the spot al∣most, the vehemency of the pain being upon the first making the Wound.

CXL. The Cause. The Cause of this exquisit Pain and evil Sym∣ptoms, arises from the Poison or Malignity contained in the Sting; for the Sting is a kind of hollow Pipe, filled with a malign and acrimonious Liquor, the small end of which seems to be stopt or covered with a small thin Cuticle; or a congelation of its internal Juice; this Sting entring into the Flesh of any Creature, the venomous Juice contained within it, or in the Parts adjacent to it, is ejected thro' into the place where the Sting enters, and there left in the substance of the Flesh, Nerves, Tendons, Membranes, Arteries or Veins, whence come the Accidents which ensue.

CXLI. And so according to the dignity and sensibility of the Parts stung, such are the Symptoms, either more or less, in number; or greater or lesser in magnitude, sen∣sibility, and danger: if a Nerve or Tendon is hurt, the pain is more acute; if an Artery or Vein, the Blood may be in dan∣ger of coagulation, especially if the mischief was done by a Scorpion.

CXLII. The Cure. If one is stung by a Scorpion, inwardly Su∣dorificks and Alexipharmicks are to be given; Volatil Animal Salts, as Volatil Salt of Serpents, Vi∣pers, Rattle-snakes, or of the

Blood of Beasts, &c. mixt with Mithridate, Our Theriaca Chy∣mica, Juice of Alkermes, Saf∣fron, and other the like things; and Sweating ought frequently to be provoked.

CXLIII. Outwardly, Anodyns and strong Attractives are to be applied, and Cupping-glasses, with Scarification: the Pain is eased, and the Stinging cured by taking a Scorpion or Scorpions, beating them, and applying them to the place stung, as Dioscorides saith. The Oil of Scorpions is both an usual and certain Remedy, being anointed upon the place. Snails beaten with their Shells, and laid there∣on, presently allay the Pain. Sulphur vive in pouder mixed with Yurpentine and applied, is extraordinary good: so also a Cataplasm of Rue-leaves laid thereto. The Milky Juice of the Figtree-leaves, or unripe Figs may be laid upon the Wound: or a Cataplasm of Calamint, with juice of Rue and Barley-flower. A Cataplasm made of Briony-roots boiled, and mixed with Sulphur and old Oil, is approved; or made of the Herb Scorpioides, with juice of the same Herb, Mithri∣date and Barley-flower, than which few things are more commended.

CLXIV. The Cure of the Sting∣ing of Hornets, Wasps and Bees, is more easy: the Sting if it remains in, is to be taken forth; and the Place stung, is to be suckt hard with the Mouth; or Pot-ashes may be mixt with Leven and Oil-olive, and ap∣plied: and if it can be conve∣niently, the Part may be put into Water, as hot as can be endured, for an Hour together, and at last washed with Vinegar, or Salt-brine. The milky juice of unripe Figs mixed with Ho∣ney, or Mithridate, is approved of; so also a Cataplasm made of Hornets, Wasps or Bees, beaten in a Mortar, and applied.

CXLV. A Cataplasm of Cres∣ses, eases the Pain, and discusses the Tumor: so also a Mixture of Ox or Cow dung mixed with Oil, Vinegar, Honey, Mithridate, and Salt, and applied very hot. An Emplaster made with Tur∣pentine, Frankincense, Wax, A. ℥i. Oil of Hornets, Wasps, or Bees, q.s. is a famous thing: and not inferior is a Mixture of Turpentine, Mithridate, and pouder of Sulphur vive: Cloths also also dipt in a Mixture and and Dissolution of Honey, Salt, and Vinegar, and applied ex∣ceeding hot, not only ease the pain, and discuss the Tumor, but also perfects the Cure.

CXLVI. An Observation of the Biting of a Viper, made by James Wass, a Chirurgeon of the City of London. One Samuel Hilden, of Charlton near Greenwich, of about 25 years of age was bit∣ten by a Viper on the eighth of July 1695, it was on the upper part of the Forefingers end. Coming to me (says he) about 3 hours after the Bit was given, I found an Escar upon the place of the Wound, so hard as I could scarcely make an Incision upon it with an Incision-knife: it was opened

about an Inch an half, or nearly two Inches in length, from the root of the Nail to the middle Joint; to which I applied a Digestive mixed with a little Venice-Treacle; his Hand and Arm were mightily swelled, as big as the Skin could hold, of a dark purple or livid colour: the Pain was vehement, and general over his whole Body, and the Poison withal mightily affected his Head; his whole Hand and Arm, even above the Shoul∣der, were well bathed with Camphorated Spirit of Wine; and inwardly a very strong Tin∣cture of Radix Serpentaria was given, a full Spoonful at a time, in a Glass of Canary; which being repeated every four hours, for about forty-eight hours, in∣duced a violent Sweating, by which the Malignity was fully cast out, so that the very Sheets were stained yellow with the Humor sweat forth; and in a weeks time after, he was seen well upon the Exchange, Lon∣don.

CHAP. XVIII. Of POISONED WOƲNDS.

I. BY Poisoned Wounds, we here only understand, Wounds made with Poisoned Weapons or Instruments; and they are called in Greek, 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, plur. 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉. in Latin, Vulnus venenatum, pl. Vulnera venenata: and in Eng∣lish, Poisoned Wound or Wounds, or, Wounds made with Poisoned Weapons.

II. The Signs. There is an extream great sense of Pain, or sharp Pricking in the wounded place, and a strange kind of Swelling, with Acrimony and Inflammation.

III. The natural colour of the Part is much altered, and becomes of a livid or blackish colour; and instantly thereupon grievous Symptoms (for which no other Reason can be given, than that of Poison) do succeed upon the Wound.

IV. Thro' the whole Body also, there is perceived and felt a vehe∣ment Heat and Burning; some∣times a kind of Stupidity, and straitness of Breathing, and sometimes a Palpitation of the Heart, Trembling, Fainting, Swooning, Vomiting of Choler, and the Hiccup.

V. And as the Poison takes a deeper possession of the Vitals, the Pulse grows weak, there is a Retention of Urine, Sickness at Heart; and a little before Death, cold Sweats, Coldness of the whole Body, Vomiting, Pain in the Stomach and Bowels, and a frequency of Convulsions.

VI. For immediately upon the Poison being received in, by the Veins and Arteries, it presently

diffuses or spreads it self thro' all the Body, coagulates the Blood and Lympha, and if not stopt in its career, contaminates the whole Humane Frame.

VII. The Prognosticks. If the Patient is not tender and fearful, and the Poison has not passed farther than the Part wounded, and it is remote from any prin∣cipal Part, or great Vessels, there is the greater hope of Cure.

VIII. But no Wound made by a poisoned Weapon, let it be in what part of the Body soever, can be absolutely secure, or free from dan∣ger: for Poison in its own pro∣per nature, is such an absolute Enemy to the nature of Man, that it always threatens de∣struction.

IX. A small Wound thus poi∣•…•…, oftentimes br•…•… Death; 〈◊〉〈◊〉 otherwi•…•… great Wounds 〈◊〉〈◊〉 •…•…oisoned, may be healed.

X. So much the Wound is nearer to the Heart, or Brain, so much the more dangerous it is; the far∣ther off, the less danger.

XI. By so much as the Sym∣ptoms are more in number, greater in effects, and more contumacious in not yielding to Remedies, by so much the more dangerous they are, and for the most part mortal.

XII. But if the Symptoms are few, and those not grievous, but yielding to Remedies, there is so much the greater hopes of Recovery and Safety.

XIII. If Remedies prevail no∣thing, but the Symptoms continue; as cold Sweats, Fainting, Swoon∣ing, Coldness of the Body, Convulsions, Failing of the Pulse, &c. the hopes of Reco∣very are past, for Death it self comes galloping.

XIV. If after the using of pro∣per Means, and taking of Anti∣dotes, the Patient has ease, and the Symptoms begin to abate, there is hopes that the Poison will be overcome, and that the Sick will recover.

XV. The Cure. The first In∣tention of the Cure of Poisoned Wounds is, to hinder the Poison from penetrating inwardly to the the more interior parts. The se∣cond Intention is, that its power and strength may be weakned and destroyed by Ale∣xipharmicks; which being done The Third Intention is the Healing it up, as another ordi∣nary Wound.

XVI. We ought then first care∣fully to see if any part of the poisoned Weapon remains yet in the Wound; for if so, you must hasten with all possible speed to take it forth by Manual Ope∣ration; otherwise all our At∣tempts of Curing will be in vain.

XVII. If it cannot be so taken forth, you must apply Attractive Emplasters, Cerats, or Cataplasms mixed; which things have a power in them of drawing forth the Poison, with the extraneous Bodies themselves.

XVIII. And that the Poison may not penetrate to the more inward parts, especially to the Heart; you must follow the Advice of Celsus, lib. 5. cap. 27. viz. Supra Vulnus id Membrum deligandum est, non tamen nimis vehementer, ne Membrum torpeat.

That Member is to be bound up above the Wound, yet notwith∣standing it is not to be over∣hard bound, lest the Part should become numbed, or lose all its sense of Feeling; or that it should be seized with a Gan∣gren, which many times comes from the unskilfulness of the Artist. After which, you must by Alexipharmick Attractives draw out the Poison to the more external Parts.

XIX. The Ancients to draw out the Venom, used to cause the Wound to be sucked; of which Celsus in the place afore-cited thus writes: Si ne id quidem est, (hoc est, si desit Cucurbitula, vel simile quid) Homo adhibendus est, qui Vulnus exsugat. If indeed that is not done, (to wit, if a Cupping-glass, or some such∣like thing is wanting) then a Man is to be gotten, that may suck the Poison out of the Wound.

XX. But indeed Cupping-glasses with Scarification, draw out the Poison more powerfully: after which, the Wound may be washed with warm Vinegar or Wine, in which Mithridate has been dissolved.

XXI. If the Poison has not passed farther than the Part wounded, and if the Patient will admit of it, and that it is not Nervous, or in a Nervous Part; the most effectual Remedy is the Actual Cautery: for Fire does by its potency both destroy the Poison, and hinder its pene∣tration into the more internal parts.

XXII. If the Poison has pene∣trated deeply into the Body, the Actual Cautery is not to be used; for that would be to add Sorrow to Grief.

XXIII. If where the Actual Cautery might be applied, the Patient will not admit of it, then the Potential Cautery, or Caustick Medicaments, are to be applied.

XXIV. These things being done, care is to be taken that the Escar may be made to fall off as soon as may be; which that it may speedily do, you must make deep Scarifications, which may reach even to the sound Part; then you must apply Medicines which may procure the fall thereof, that the Poison may have a Vent to come forth.

XXV. After which, the Wound is not presently to be healed: but an Onion beaten with Salt, or wild Garlick, or Rue, are to be applied upon the Wound; or Ʋnguentum Nicotianae, of it it self, or Ʋng. Basilicon mixed with a sixth or quarter-part of red Precipitate, or Turbith-mineral, and a little of Our Theriaca Chymica, or Mithri∣date.

XXVI. To the adjacent Parts, you may apply Oxycroceum; and other Attractive Emplasters made of Gum Elemi, Opopa∣nax and Sagapenum, as Diachylon cum Gummi, &c.

XXVII. Let the Sick sleep spa∣ringly, and use a slender Diet; eating such Food as is easy of digestion, and yield a good Juice.

XXVIII. But if the Patient will not admit of Caustick Medi∣caments,

these following things as are to be applied; as Onions, wild Garlick, Rue, Doves-dung, Walnuts, with Garlick, Salt, and Honey; which whether in∣wardly taken, or outwardly ap∣plied, are able to free the Body from Poison.

XXIX. And to the former things you may add, Angelica-root, root of Masterwort, of Contrayerva, and Virginia Snake-root; roots of Elecampane, Radish, and Birthwort long and round; Hypericon, Swallowort, Dittany, Carduus ben. Scabious, Gentian, Vipers-grass; and all other Sim∣ples whatsoever, that have a power and faculty of attracting Poison.

XXX. It is also to be observed, that Medicaments that are very sharp, are not to be used to Ner∣vous Parts, lest they excite Pain and Convulsions: and therefore such things are to be applied, which only draw forth Poison by the simple property of their substance.

XXXI. And where sharp Me∣dicines are or may be used, yet they are not to be continued long; but after they have been applied for a day or two, then others more mild are to be chosen. Mithridate, and Theriaca Andromachi, also Our Theriaca Chymica, either alone of them∣selves, or mixt with Oil of Scorpions, juice of Rue, or juice of Vipers-grass, are of singular use to be applied.

XXXII. This Ointment or Cataplasm is commended by some. ℞ Oil-olive, Honey, A. ℥ ii. Quicklime in fine pouder, roots of round Birthwort, Rue dried, Angelica-root, Zedoary, all in fine pouder, A.℥i. mix them, and apply it.

XXXIII. Or this. ℞ Onions, Garlick, Leeks, A. ℥ii. boil to softness, and beat them together; to which add Oil of Scorpions, Mithridate, A. ℥i. roots of Dra∣gons, of Masterwort, of round Birthwort, and of Florentine-Orrice, A. ʒii. mix them.

XXXIV. Or this of Guido. ℞ Assa foetida, Galbanum, Opopa∣nax, Sagapenum, Myrrh, Pepper, Subphur, A. ℥jss. Doves-dung, Ducks-dung, A. ℥ii. Calamint, Horse-mint, A. ℥i. dissolve the Gums in Wine, then add the Oil and Honey, with the other things in pouder, and make an Emplaster.

XXXV. Or, ℞ Roots of Dragons, of round Birthwort, A.℥i. Rue, Scor∣dium, Tobacco, all in fine pouder, A. ℥ii. roots of Angelica, and of white Dittany, Dittany of Creet, A. ℥iii. Oil of Turpentine ℥ii. Frankincense, Myrrh, Sulphur vive, A. ℥ss. Ship-Pitch, Wax, A. q.s. mix, and make an Em∣plaster.

XXXVI. Or, ℞ Potashes, Quicklime in fine pouder, A. ℥ii. pulp of xx Figs, Rue, Tobacco, Wormwood, Southernwood; roots of Angelica, round Birthwort, Ze∣doary, Garlick, Onions, A. ℥i. in fine pouder; Goats-dung in fine pouder, Oil of Euphorbium, Oil of Scorpions, A. ℥iii. Wine-vinegar lbi. Honey lbjss. mix, and make an Emplaster.

XXXVII. Or, ℞ Propolis, Tur∣pentine, juices of Swallowort and Scordium, A. ℥ii. Tobacco in pou∣der, Zedoary, Orrice, Birthwort,

all in fine Pouder, red Precipitate, A. ʒii. Oil of Hypericon, of Scor∣pions, of Turpentine, A. ℥ss. mix, and make an Ointment.

XXXVIII. Or, ℞ Tops of Hypericon, Rue, A. Mii. Car∣duus Ben. Scordium, Swallow∣wort, Tobacco, A. Mj. roots of Dragons, of Angelica, and Bryony, A. ℥ii. beat all well together in a Mortar, and make a Cataplasm, applying it very hot.

XXXIX. Or, ℞ Ammonia∣cum, Bdellium, Gum Elemi, Gal∣banum, Liquid Storax, A. ℥ss. Myrrh, Sulphur Vive, Oil of Hy∣pericon, Oil of Scorpions, A. ʒii. Euphorbium, red Precipitate, A. ℥i. Pitch, Propolis, Turpentine, A. q.s. mix, and make a Cerat.

XL. The second Intention, is the destreying the Poison by Alexi∣pharmicks, or Counter-poisons which may fortifie and defend the Heart; such are the Bezoar-stone, Ani∣mal Bezoar, and Bezoar Mine∣rale, Mithridate, Venice Trea∣cle, but chiefly Our Theriaca Chymica, all Volatil Animal Salts, the chief of which are Salt of Man's Blood, and Salt of Vi∣pers, than which last, nothing is yet known of greater force; these things may be given in their due Dose in some proper Syrup, or Cordial-water, such as are Our Aqua Bezoartica, or Spir. Cordialis.

XLI. And outwardly the Heart may be guarded, by bathing it with Powers of Amber, of Juniper-ber∣ries, of Camomil, of Sage, of Limons, or of Rosemary, laying over it a Plaster of Theriaca Chy∣mica, or Mithridate.

XLII. The third and last In∣tention, is the healing up of the Wound, which you may do with this Ointment. ℞ Gum Elemi, Tobacco in Pouder, A. ℥iii. Beef Suet, Oil Olive, Wax, Frank∣incense, Turpentine, A. ℥iv. Juice of Tobacco ℥viii. mix, and make an Ointment, S.A. The rest of the Cure, you must perform ac∣cording to the general Rules.

XLIII. But if you find from the continuance of the dangerous Sym∣ptoms, as Cold Sweats, Faint∣ings, Swoonings, &c. that the Poison has already penetrated to the more inward Parts, especially to the Heart, the wounded Part is not much to be medled with, but the Cure is by Internal A∣lexipharmicks and Sudorificks, to defend and save the whole from the Power of the Malig∣nity.

CHAP. XIX. Of WOƲNDS by GƲN-SHOT in General.

I. THese kinds of Wounds were wholly unknown to the An∣cient Greeks and Latins, and therefore they have no proper Names by which we can call them: The Moderns who have wrote

in the Latin Tongue, call them Vulnus vel Vulnera Sclopetarum globuli; and we in English, Gun-shot Wounds.

II. There has been a great Con∣tention among Authors concerning Gun-shot Wounds, and many the Arguments pro and con, whether they are Poisonous, or have any de∣gree of Fire or Burning in them, or not; some maintaining the Af∣firmative, others the Negative, which the Learned Sennertus in his Med. Pract. lib. 5. par. 4. cap. 20. has Excellently sum∣med up, and given the Deci∣sive Judgment concerning it, ad∣hering to the Negative Voice: The whole Discourse is too long to be here inserted, they that desire to read it, may have re∣course to the Author himself, where they may have much Sa∣tisfaction.

III. That (says Wiseman) which might be the occasion of their suspecting a Burning and a Poi∣sonous Quality, was the deadly Colour of these Wounds, which in those early Days, when the Invention of Guns was Novel, surprized them, they looking not unlike Poisoned and Burnt Wounds.

IV. Where the Bullet pierces (says he) it extinguishes the Na∣tural Heat, and the Lips of the Wound are livid or blackish; and if they be not rationally drest, they inflame, and are accom∣panied with a Tumor; and Bli∣sters frequently rise about them: in this Condition the Wound is commonly the first Day, and so to the seventh; and if not succoured, it Gangrens, and so the Patient commonly Dies.

V. In former Times Artists were deceived by the appearance of the Wounds, and so drest them as Poisonous Wounds, which occa∣sioned them so to write of them, and in their way of managing of them, it was no wonder that they were so difficult to digest and Cure.

VI. And in Our Times (says Wiseman) tho' they are not cal∣led Poisoned Wounds, yet it is a difficult thing to disswade many of Our Chirurgions, from dressing them with Tinctures of Myrrh, and Honey of Roses, and thrust∣ing in of great Tents; by which way of dressing, these kinds of Wounds have been found undi∣gested on the tenth day.

VII. These lesser fleshy Wounds being undigested, at last Gangren, and it is not to be wondred at: I will (says he) shew you the Experiment every Day in a Fonta∣nel or Issue made with a Caustick: If you cut thro' the Escar, and put a Pea in the middle of it, with Tincture of Myrrh, and Honey of Roses, as some dress Gun-shot Wounds, and the next two or three days after, when you dress it again, it will be to your sight not unlike a Gun-shot Wound: if you continue your dressing with a Pea, and your Tincture of Myrrh, if it does not Gangren, yet it will be inflamed, and slow in digestion; which is from the improper Ap∣plications.

VIII. For if this Escar had been drest with Emollients and Digestives, as ought to be done, it would separate with Digestion in

the worst habit of Body; and so it will in Gun-shot Wounds with little distemper or difficulty, if the Extraneous Bodies be but timely Extracted.

IX. If therefore Gun-shot Wounds be rightly drest, they will as easily digest and heal, as any Complicated Wound; and what is said of Gun-shot Wounds is to be understood, when at Sea, of a Wound by a Splinter; which tho' it may not have force enough to make a Wound, yet oft-times bruises the Skin to the Flesh, so forcibly as to extinguish the Natural Heat, and make it black.

X. In this Case, if it is drest with Spir. Vini, & Ung. Aegyptia∣cum, or lapt up with a warm Stuph, it will grow black, dry, and parcht, and become an Escar; and the Humors which flow plentifully to it will cause an In∣flammation, with Tumor; and an Apostemation is the best which can be expected under∣neath the Escar, and conse∣quently it will terminate in a hollow Ulcer; but for the most part it Corrupts and Gan∣grens.

XI. Whereas if this Contused Escar is dressed with Lenients, according to that Aphorism of Hip∣pocrates, Omne quod contusum, necesse est ut putrescat & in Pus vertatur: viz. All that which is bruised must putrefie, and be con∣verted into Matter: as with Ʋng. Basilicon cum Oleo Liliorum, &c. and the Parts about Embroca∣ted with Oil of Roses mixt with the white of an Egg and Vinegar, and a Defensative applied over all to prevent defluxion, the Escar would separate as easily as those made by a Caustick in an Issue, and afterwards be in∣carnated and cicatrized with a great deal of Ease to the Pa∣tient.

XII. By what has been said, it appears what the Nature of these Wounds is, to wit, that they are only with very great Contusion, and Tearing of those Parts thro' which the Bullet passes. And tho' the Part at a near distance may be burnt by the Flame of the Gunpowder, yet this belongs not unto the Wound it self, nor is the Part burnt within: and tho' it is granted, that Bul∣lets may possibly be Poisoned, yet this is no ways Essential un∣to these Wounds, but meerly Accidental.

XIII. Wounds then made by Gun-shot, are the most Complicate sort of Wounds; for there is not only a solution of Continuity, but there is conjoined with them, Con∣tusion, Rubbing, Tearing in a ve∣hement manner, and sometimes Fractures of the Bones: to which may be added, sometimes vari∣ous Accidents, as Hemorrhage, vehement Pain, Inflammation, Erysipelas, Convulsion, Fever, Delirium, Palsie, Fainting and Swooning, Sinuous Ulcers, Gan∣grens, and Sphacelus.

XIV. The Differences. They are taken, 1. From the magni∣tude of the Wound, as it is either great or small, deep or superficial.

XV. 2. From the Part affect∣ed, the Skin and Flesh being some∣times only wounded; sometimes the Nerves and Tendons, some∣times

the Arteries and Veins, and sometimes the Bones are broken. Or thus; The Wound is made either in the fleshy Parts, or in the fleshy and Spermatick Parts both: The Spermatick Parts as they are called, are either soft or hard, the soft are the Mem∣branes, Nerves, Tendons, and Ligaments; the hard are only Cartilages and Bones. The Membranes may be divided and bruised. The Nerves, Tendons, and Ligaments may be contused and torn. The Bones may be fractured, by being broken trans∣verse, or by fissure, or into bits; which last is that which Gun-shot most produces.

XVI. 3. From the Modus or Manner; sometimes the whole Body is wounded, sometimes a part only: sometimes the Bullet sticks in the Wound, sometimes it passes quite through: sometimes it pene∣trates into the Body, sometimes it carries into the Body with it some Extraneous Matter.

XVII. The Signs. What Parts are wounded, are to be discovered by putting in the Probe, or else from the site of the Wound by Ana∣tomical Deductions: If the Ner∣vous or Tendinous Parts are hurt, there will be manifest and vehe∣ment pain: If the great Arteries and Veins, a mighty Hemor∣rhage; yet sometimes the Part being much contused, the Lips afterwards quickly swell, and oftentimes so much, as to stop in a great measure the flowing of the Blood.

XVIII. These Wounds are gene∣rally Orbicular, and either of a blue or livid Colour, or of a blue mixed with green, or of a Violet Colour: Sometimes the Wound it self is black, and the Parts adjacent to it livid.

XIX. There is a heat sometimes in the Part, which arises from the quick and vehement passing of the Bullet, making a great Contu∣sion of the wounded Parts.

XX. There is also a feeling of the Blow, as if a Stone, or some other heavy thing was flung a∣gainst, or entering into the Part.

XXI. If the Wound was made by a Poisoned Bullet, the Colour of the Flesh is more wan and livid, than otherwise it would be; there will be a heaviness and sluggish∣ness of the whole Body, a Trem∣bling, a Palpitation of the Heart, Faintings, Swoonings, and sometimes Convulsions, and o∣ther like Symptoms to these.

XXII. The Colour of the Wound and Parts adjacent will be ill, as if tending to Mortification, the pain will be vehement and prick∣ing, there will be Inflammati∣on, and a Fever of the whole Body, and sometimes dotage and raving withal.

XXIII. If such a Poisoned Wound is slow in maturation, or generating of Pus, if there be an extinguishing of the fresh Co∣lour of the Part, and its incli∣ning to a yellow or livid Co∣lour, if the Pain remits, with∣out any manifest Cause; and if the Part ceases beating, and a stupidity is present, &c. the Wound will degenerate into a Gungren.

XXIV. The Symptoms. If it is an ordinary Wound, they are

chiefly these, Contusion, Pain, In∣flammation, Convulsion, Heat, Palsie, Lividness, and (if the Wound is great, in or near a Joint) sometimes a Gangren and Mortification.

XXV. If the Bullet is Poison∣ed, all these Symptoms will appear, but sooner, and more vehement than if it were not.

XXVI. The Prognosticks. These Wounds for that they are al∣ways made with a considerable Contusion, are much more dange∣rous than those that are made with Sword or Dart, supposing the place to be the same: As to instance, many have recovered of Wounds made with a Sword in the Belly, Guts, and Bladder, whereas scarcely ever any one was Cured of Wounds made in those Parts by Gun-shot.

XXVII. If in a healthful ha∣bit of Body, a fleshy Part is only wounded, and in a good Air, the Wound may be Cured without any great hazard or difficulty.

XXVIII. But if in a Cacochy∣mick habit of Body, the Sperma∣tick Parts are very much lacera∣ted or torn, and it is in a hot and moist Air, viz. the Wind being South, and Signs of Poison do appear, a Gangren, &c. is to be feared.

XXIX. Tho' a Wound seems desperate, yet it is not to be given over while there is Life; for it has been oft-times observ'd, that Nature many times works Mira∣cles, as it were, and that very many, who have seemed to be near to the Grave, have yet notwithstanding recovered and done well.

XXX. If there are many, and those the more Noble Parts, that are wounded, bruised, and torn, and if withal, any Bones are broken or hurt, the Wound is so much the more dangerous, and the Cure the more diffi∣cult.

XXXI. If the Parts are much torn, the Wound then yields a stinking Sanies; and if a flux of Humors then follows, an extin∣guishing of the Natural Heat is to be feared.

XXXII. If these Wounds hap∣pen in such Parts, as can easily draw the principal Parts into con∣sent with them, there is much danger. And such are the Joints and great Vessels, from which many times there arises not on∣ly Vapours, but corrupt and vi∣tious Humors, which being re∣ceived and communicated to the Heart, do easily induce Fe∣vers, Fluxes, as Diarrhaea's, Lienteria's, Dysenteria's, Faint∣ings, Swoonings, Convulsions, and the like.

XXXIII. If such Wounds hap∣pen to a Cacochymical Body, they are much more dangerous, than if they happen to a Body of a good Ha∣bit; from whence it is, that in Armies and Camps in which Epi∣demical Diseases rage, most of these that are thus wounded, die of their Wounds. For in Camps the Air is for the most part in∣fected with the nastiness of the Camp; and the Souldiers for want many times of wholesom Meat and Drink, drink filthy and corrupt Waters, and eat bad and corrupt Food coming next to hand, so that 'tis no

wonder that such a Constitution is induced, as may render Gun-shot Wounds in such Bodies ve∣ry dangerous.

XXXIV. These Wounds come more slowly to Suppuration than others do; not only because the natural heat is much abated; but also because the Spirits are much wasted and dissipated, by reason of the Contusion.

XXXV. Lastly, If these kind of Wounds are made by a Poisoned Bullet, they are then indeed very dangerous, and for the most part Mortal, and this more especial∣ly, if they penetrate into the interior Parts: and sometimes these Wounds, tho' they are but small to see to, yet they many times destroy and kill the Patient.

XXXVI. The Cure. The In∣dications of Cure (I mean of Wounds not Poisoned, for as to the Cure of them we shall refer you to the for∣mer Chapter) are chiefly three, 1. The drawing forth of the Bullet, if it yet sticks in the wounded Part. 2. The con∣verting the bruised Flesh into Pus, or Matter. 3. The Incar∣nating, or filling the Wound up with Flesh, and then at length cicatrizing it, which is common with all other Wounds.

I. Of Extracting the Bullet.

XXXVII. The Bullet, or any other Extraneous thing carried in∣to the Wound with the Bullet, is first to be taken forth, and this is to be done either at first dressing; but if it is not then fit to be done, you must do it at some other fit time, during the Cure.

XXXVIII. The Bullet is to be drawn forth, either the way it went in, or the opposite way, if it lyes very deep, is much nearer to the opposite place, and may be felt there thro' the Skin and Flesh.

XXXIX. If the Bullet pierces not so deep, then having found it out, by searching with the Probe, &c. being put into the Wound the same way it went in, you must attempt the drawing it out with some fit Instrument.

XL. Now to take the Bullet out the way it went in, you must place the Patient as near as may be in the posture he was in when he received the shot; or if thro' weakness he cannot be so posi∣ted, let him be placed in a po∣sition as near to it as may be, lest some Muscle, Nerve, Ten∣don or Ligament, lye in the way of its passage; the Sick be∣ing thus placed, then search for the Bullet, &c.

XLI. The largeness of the Wound will in some measure shew you the largeness of the Bullet, by which means you may make choice of a fit Instrument for the Extra∣ction.

XLII. Now in Extracting the Bullet, 1. The way must be sufficiently opened by Instru∣ment. 2. That the Bullet be laid hold of. 3. And being laid hold of, that it be drawn forth by the Chirurgion's Hand.

XLIII. The Instrument takes hold of the Bullet as a pair of Scissars, or as it fastens it self into the Bullet, either by com∣prehending it in its Cavity, or

by laying hold of it by its Bill, being made like a Saw.

XLIV. For which reason there is great variety of Instruments; some lay hold on the Bullet and draw it out, as they are fast∣ned into it: Others compre∣hend the Bullet, having a glo∣bular Cavity at the end: Others are nocht like Saws, of which some are straight, some crook∣ed, according as the Wound is either straight or oblique.

XLV. You must endeavour to find out the Bullet; if you fail of it by searching with the Probe, you must try if you can find it by feeling with your Hands a∣bout the wounded Part; for sometimes a Bullet takes such a circular course, that its way is impossible to be followed.

XLVI. Wiseman gives us Examples of this kind: One who being shot in the Cheek, he cut out the Bullet behind in his Neck. Another (says he) was shot in the outside of the small of one of his Legs, the whole Member swel∣led, and was inflamed, and no possibility of finding out the Bullet, at last by chance he felt it, in the inside of the Thigh above the Knee. Another wound∣ed in the outside of the Arm, he cut the Bullet out below the Scapula; and in some Cases the Parts extreamly pained with In∣flammation and Tumor, do sometimes discover the place where the Bullet lyes; and sometimes the pain alone will do it, tho' there be no Tu∣mor, &c.

XLVII. In the very work of Extracting, you must be cautious that you lay not hold of some Nerve or Tendon, and so pluck them a∣long with the Bullet, for then you will cause intolerable Pain, and grievous Accidents; for which reason you must not open or di∣late your Instrument, till you take hold of the Bullet there∣with, without any of the cir∣cumjacent Parts.

XLVIII. Moreover, if the Bul∣let can be found, it will be best, to attempt the drawing it forth whilst the Sick is warm (if in heat of Battel) and the Wound fresh, not being altered much by Air or Accidents, by which means less pain will follow upon the Extraction; for after the first and second Day the Wound swells, and the adjacent Parts are inflamed, and so changed in their Temperament, that they will hide from your fight the Bullet, and what accompa∣nied it, if any thing, so that the place they lye in will be dif∣ficult to be known; or being known, will not be extracted without great hazard, pain, and trouble to the Patient; so that then it may be needful to defer that Work to another time, and by Leniments to hasten the Di∣gestion.

XLIX. To omit the present drawing forth of a Bullet when lodged in a Joint, may hazard a Mortification, because it is lodg'd among the Tendons, and will cause much pain which will not cease; for which reason, the Wound will not digest.

L. If the Bullet is lodged in a less Noble Part, as in the Muscu∣lous Flesh, and it has not been

drawn out at first dressing; in this Case you may more safely stay the Extraction till the seventh Day; or till the vehemency of the Accidents are over, and the Wound digested; but then you must be more careful, for the Wound will be the more pain∣ful, and the more slow in dige∣stion: If the Bullet carries any Rags with it, so long as they remain in the Wound, it will be very painful, inflamed and ve∣xatious, nor will it digest well, or be cured.

LI. But if the Bullet cannot be found out, by the Probe, or other∣wise, as it chances sometimes when Wounds are very deep or oblique; then the Wound is to be kept open for a long time, and sup∣purating Medicines are to be made use of; and if possible, the Member is to be so placed, that the Bullet may fall forth by its own weight, or may be expelled by Nature; and there∣fore in this Case, unto Nature the whole Business is to be com∣mitted.

LII. And tho' Leaden Bullets may lye long, and be carried about in the Body, yet Iron or Brass Bul∣lets must be taken forth in some considerable time, because the first swells mightily, by its rust∣ing; and the other yields Ver∣digrease, both which are very painful, and inimical to the healing.

LIII. If the Bullet is lodg'd in any Noble Part, or a Part that may easily draw the Noble Parts into consent with it, and that by reason of the Wound it self, the Patient's Life is in any dan∣ger; in this Case you ought not to attempt the Extraction, since thereby the Sick can have no Benefit, but that you may pro∣bably hasten on that Death, which otherwise the Wound would have infallibly induced, but in a larger space of time.

II. Of Proper Digestive Me∣dicaments.

LIV. Our first and great Care here must be, that the Contused Substance may be brought to Ma∣turation, and separated from the sound Flesh, and sound Parts; for the bruised Matter easily be∣comes putrid, and Gangrens; so that our ordinary and com∣mon Digestives and suppurating Medicines, which are made use of in other Wounds and Tu∣mors, have simply here no place; more especially if the Nervous Parts are hurt or bruised, which do not well admit of such kind of moist and simply Oily Medi∣caments, but require those that are drier.

LV. Those Medicines then which we are to make use of in these Wounds, must be of that Nature and Quality, that tho' they will bring the contused Flesh into Pus, yet they will not produce any putridness, but by their Anodyn Property ease and alle∣viate the Pain.

LVI. To accomplish this Inten∣tion, Quercetan does to every Ounce of any Digestive or Suppura∣tive add ʒi. of red Precipitate: Yet this is not to be done rash∣ly, but with some caution, as where there is a present putrio∣ness,

and fear of a Gangren nigh at hand; for in most other Cases, these kind of Wounds may be Cured without any kind of Mercury whatsoever: and in Nervous Places, if Precipitate is used, it may be the cause of very much Pain.

LVII. Paraeus commends high∣ly his Oil of Whelps thus made: ℞ Oil of white Lillies lbiv. two young Whelps, which kill, and boil them in the Oil till the Flesh falls from the Bones: add to them Earthworms (washed in Wine) lbii. boil them together, and let them be strained without any strong pressing; then to that which is strained, add of Venice Turpentine ℥vi. Spirit of Wine ℥ii. mix, and make an Oil or Balsam. It has an admirable Virtue to ease Pain, and maturate the Pus. If you apply it to Joints or Ner∣vous Parts, there ought to be more of the Turpentine than of the Oil, because these Parts re∣quire more drying than the fleshy Parts do.

LVIII. Barbett commends this: ℞ Venice Turpentine ℥iv. Calves Marrow, Oil of Hypericon A. ℥ii. Galbanum ℥i. Venice Treacle ℥ss. Roots of Scordium, of Scorzonera, A. ʒiii. yolks of four Eggs: mix, and make an Oint∣ment.

LIX. Sennertus commends this as a thing singularly useful: ℞ Ʋng. Basilicon ℥i. Oil of Lin∣seed, and of white Lillies, A. ℥iii. mix them.

LX. Or this: ℞ Oils of Lin∣seed and of Hempseed, A. ℥iv. Ho∣ney ℥i. Allum ℥ss. mix them.

LXI. Joubertus commends this: ℞ Hogs Lard, or fresh Butter ℥viii. red Precipitate washt and levigated ℥i. Camphir ʒii. dissolved in Aqua Vitae; mix them well together. Now if in∣stead of Lard you take Arcaeus his Liniment, the Medicine will be much more effectual. The Lard, or Butter, or Liniment, are Suppurative; the Precipi∣tate adds to the force of the Suppuration, causing very little pain, and the Camphir helps Penetration, and resists Putre∣faction.

LXII. ℞ Oil of Hemp ℥viii. Linseed Oil ℥ii. Juices of Plantane and Night-shade, A. q.s. boil them till the Juices are consumed.

LXIII. Another of Barbett, more effectual: ℞ Yolks of Eggs-N^o iv. Turpentine, Ung. Aegy∣ptiacum, A. ℥ii. Amber, Euphor∣bium, Mastich, Mummy, A. ℥ss. round Birthwort Roots in Pouder ʒii. Oil of Elder, q.s. mix, and make an Ointment.

LXIV. Sennertus has this: ℞ Oils of Linseed and Hempseed, A. ℥vi. Sal Armoniack, white Vitriol, A. ℥iii. Mithridate, The∣riaca Andromachi, A. ℥iss. mix them together over the Fire: This is of use, when a putridness is supposed near at hand.

LXV. If Putridness and a Gangren is feared, then add some Precipitate, as, ℞ Ung. Basili∣con ℥i. fresh Butter ℥i. red Pre∣cipitate levigated ʒii. mix them together.

LXVI. Another of Barbett's, more Excellent than any of the former, which also resists Putre∣faction: ℞ Oils of Linseed and Roses, (Hempseed I think is bet∣ter)

Tar, Turpentine, Galbanum, A. ℥ ii. Mastich, Frankincese, Nitre, Sal Armoniack, A.℥i. Oils of Worms, and of Turpentine, Verdigrise, white Vitriol, Camphir, pouder of Earthworms, A. ʒi. Alum ʒss. mix them together over a gentle Fire. If the Part is not Nervous, in a great Putrefa∣ction, you may add some red Precipitate.

LXVII. ℞ Turpentine, Honey, A. ℥iii. yolks of Eggs N^o vj. boil them with a gentle Fire, to the thickness of a Liniment.

LXVIII. ℞ Oils of Linseed and Hempseed, A.℥iii. Oils of Roses and Mastich, A.℥i. Oil of Camphir ʒi. mix them well together by boiling, and use it warm.

LXiX. ℞ Turpentine, Honey, A. ℥ iv. round Birthwort root, Aloes, both in fine pouder, A. ℥ss. Allum, Crocus Martis, A. ʒii. mix them.

LXX. ℞ Unguent. Nicotianae, Ung. Basilicon, A.℥iii. Gum Elemi, pouder of Virginia Tobacco, A. ℥i. mix them.

LXXI. ℞ Oils of Linseed and Hempseed A. ℥iv. Ung. Nicotianae ℥iii. Ung. Basilicon ℥ii. Oil of Turpentine ℥i. mix, and melt them together.

LXXII. ℞ Yolks of Eggs N^o.ii. Turpentine ℥iv. Oil of Hypericon ℥ii. Frankincense, Mastich, Oils of Linseed, Eempseed, and of Eggs, pouder of Tobacco, A. ℥i. mix them.

LXXIII. If any Putridness is feared near at hand, then you may use some of the following Compositions. ℞ Oils of Hemp∣seed and Linseed, A. ℥ vi. Sal Armoniack, white Vitriol A. ʒii. Gum Sandrach ℥j ss. mix them over the Fire. Or you may use the Compositions at Sect. 63, 64, 65, and 66 aforegoing.

LXXIV. Or this. ℞ Oils of Linseed and Hempseed, A. ℥iii. Tar, Turpentine, A. ℥ii. Frankin∣cense, Galbanum, Mastich, Sal Nitre, Sal Armoniack, A. ℥i. Oil of Earthworms ℥ss. Oil of Turpen∣tine ʒii. Alum, pouder of Earth∣worms, Camphir, white Vitriol, Verdigrise, Tobacco, A. ʒi. mix, and melt them over the Fire.

LXXV. And to prevent the Afflux of Humors, this following Defensative is to be applied. ℞ Fine Bole, Catechu, Dragons∣blood, pouder of dried Ox-blood, A. ℥i. Nut-galls in pouder, Frank∣incense, Rosin, Crocus Martis, A. ℥ss. Vinegar of Roses ʒiii. whites of Eggs q.s. mix them, and apply it over the Wound.

LXXVI. Or: ℞ Oils of Roses, of Elder-bark, and of Mastich, A. ℥i. fine Bole, Rosin, Catechu, all in fine pouder, A. ℥ss. Vinegar of Roses, q.s. mix, and make an Ointment.

LXXVII. Or this of Barbett: ℞ Pouder of red Roses, of Scor∣dium, A. ℥iii. Bean-meal, crumbs of Rye-bread, A. ℥j. (these two boiled in a little Milk) yolks of Eggs N^o.vj. Oils of Roses and Violets, A. ℥ii. Wax, q.s. mix, melt over a gentle Fire, and make an Emplaster.

LXXVIII. And over the Wounded Part it self, it will be good to lay the following Cataplasm; which cherishes the Heat of the Part, prevents Putridness, and facili∣tates the Suppuration. ℞ Roots of Althea, of Comfrey, A. ℥i.

flowers of Camomil, of Hypericon, tops of Wormwood, A. M. ss. boil in Milk to softness, then mash them together, and add of Barley-slower, or else meal of Althea-roots and of Beans, A.℥jss. Wine q.s. mix, and make a Cataplasm.

III. Of Abstersives, or Cleansers.

LXXIX. If the Wound pierces quite thro', some use the Flamula, or Seton; but this both Senner∣tus and Barbett disapprove of, as not safe, and advise to the use of Tents put into both Ori∣fices; which Penecilli or Tents ought not to be over-thick, lest they hinder the coming forth of the Pus, and cause Pain.

LXXX. At first, dressing the Wound once a day will be enough; because in Gunshot-Wounds, there is scarcely any thing which requires Evacuation, sel∣dom before the third or fourth day: but when-ever the Pus begins to flow, it is then to be opened and drest twice a day; and when it flows in such abundance, that unless it is often emptied or cleansed, it may cause grief and pain, then you must open it, and cleanse it from the Pus or Purulent-matter thrice a day; but the Acrimony of the Matter will direct you best, whether it is to be drest and cleansed once, twice, or thrice a day.

LXXXI. But when the Pus begins much to diminish, twice a a day will be enough to open and cleanse the Wound: and when it flows forth very little, and be∣gins to be filled up with Flesh, once a day will be enough, as at first.

LXXXII. At first we admit Tents, to open a passage for the Sanies; at length Splenia, made of Linnen-rags, four, six, or eight times doubled, or rather Bolsters may be used, and ap∣plied to the bottom of the Sinus, (if possible;) that by their means, thro' a harder Binding, the Sanies may be pressed forth, which will much advance the Cleansing.

LXXXIII. But if there is a vast quantity of Sanies, and the Sinus is deep and winding, that it cannot all flow or be pressed forth; in this case, the Sinus is to be cut or laid open, that the Wound or Ulcer may be the better cleansed.

LXXXIV. And whether the Wound or Ʋlcer seems contuma∣cious or not, Vulnerary-Potions, or Wound-Drinks, are of extraor∣dinary Ʋse in the Cure; for they cleanse the Ulcers, and free them from the filth of the Excre∣mentitious Humors, causing all things in the Wound which are Heterogeneous to be easily, and the sooner cast forth, assisting Nature therein: if they are useful in any other kind of Wounds, then certainly they are most of all necessary in these; variety of which you may see Cap. 3. Sect. 28. ad Sect. 43. aforegoing.

LXXXV. After Concoction or Digestion begins to appear in the Wound, which is scarcely before the third or fourth day; for that by reason of the Contusion, the native Heat was much weakned, and the

Spirits exhausted; and that there is neither much Pain, nor any Inflammation; but that the greatest part of the bruised substance is turned into Pus, then the Wound is to be cleansed, and after filled with Flesh; which with what things it is best to be done, we now come to shew you.

LXXXVI. Among the number of Cleansers, that which first offers it self is Ʋnguentum de Apio, or Ointment of Smallage, both the simple and the com∣pound; nor have Authors com∣mended them in vain.

LXXXVII. Sennertus has this: ℞ Decoction of Barley, juices of Smallage, Plantan, Agrimony, Centory the less, A.℥iii. boil them, and at the end add Venice Turpen∣tine ℥ix. Honey of Roses ℥vi. Frankincense, Mastich, A. ℥ss. Saffron ʒi. mix them.

LXXXVIII. Mindererus his Ʋnguentum Decameron. ℞ fuices of Arsmart, Celandine, Century, Dock sharp-pointed, D•…•…es-foot, Groundsel, Hypericon, Plantan, To∣bacco, Yarrow, A.lbi. mix, and digest for some days, for the Mix∣ture to settle: decant the clear, and add thereto fresh Butter lbiii. green Liquorice well bruised, Comfry-roots, Tormentil-roots, Hounds∣tongne, all well bruised; Oil of Myrrh, Deers-suet, A.lbj. boil them all well'till the crackling ceases, and the consumption of the Humi∣dity, then strain hot by Pressing thro' a strong Canvas-bag; and to the strained Matter add Venice-Turpentine, Gum Elemi, A. ℥ix. Wax q.s. melted, so as to bring the whole to the consistence of an Ointment, or very soft Cerat; adding after all to every Ounce of the Ointment ℈i. or ʒss. of pure refined Verdigrise.

LXXXIX. Or, ℞ Meal of Orobus ℥ii. Myrrh, Frankincense, A.℥i. juice of Smallage, Turpentine, A. ℥iv. Ung. Aegyptiacum ℥ i. mix, and make an Ʋnguent.

XC. Or, ℞ Ung. Nicotianae ℥iii. pouder of Tobacco ℥i. Gum Elemi ℥ss. mix, and make an Ointment.

XCI. Among the number of the Abstersives, nothing has yet been found to exceed Ʋng. Fuscum Wurizii; the Composition and Preparation of which, see in its proper place.

XCII. Ʋnguentum Apostolorum is commended by some, but this may be trusted to: ℞ Aegyptiacum, Apostolorum, A. ℥jss. Gum Elemi ʒvi. pouder of Tobacco ʒii. mix them.

XCIII. Or this: ℞ Ung. Ni∣cotianae ℥iii. pouder of Scammony, Tobacco, A. ℥. Gum Elemi ʒvi. Honey q.s. mix over a gentle Sand-heat, and make an Ointment.

XCIV. ℞ Meal of Orobus ℥iii. pouder of Florentine Orrice, Frank∣incense, A. ℥jss. juice of Smallage ℥viii. Honey, q.s. mix, and make an Ointment over a gentle Fire, or a gentle Sand-heat.

XCIV. An Abstersive Pouder. ℞ Scammony ℥iv. fine Aloes ℥ii. Tobacco in fine pouder ℥i. round Birthwort-root in pouder ℥ss. mix them, and keep it for use.

XCVI. ℞ Fine flower or meal of Barley and of Lupins, Honey, A. ℥ii. Turpentine ℥iv. juices of Smal∣lage and of Wormwood, A. ℥vi. fine Aloes, Frankincense, Myrrh,

Orrice-root in fine pouders, A. ℥i. mix, and boil gently to the con∣sumption of the Juices: to which you may add Ʋng. Aegyptiacum ℥ii. if you use it in a Wound which is very foul.

XCVII. ℞ Ung. Nicotianae ℥iv. Unguent. Aegyptiacum ℥i. pouders of Aloes, Scammony, To∣bacco, A. ʒvi. mix, and make an Ointment; which is inferior to none of all the foregoing Com∣positions.

IV. Of Incarnatives, or Flesh-breeders.

XCVIII. When the Wound is become clean, it is then very ne∣cessary that Flesh should be gene∣rated or bred: because that when all the bruised Flesh is converted into Pus, the Wound will become empty or hollow, and therefore it ought to be filled up again.

XCIX. This following Sen∣nertus commends, as useful in these kinds of Wounds. ℞ Betony, Comfrey, Horsetail, Hype∣ricon, Plantan, Tormentil, A. M.ss. Earthworms (washt in Wine,) Oil of Mastich, A. ℥ii. Pine-Rosin, Manna Thuris, or the finest white Frankincense, A. ℥ss. Wine q.s. boil'till the Wine is consumed, then Strain out by a strong Expression; and add thereto Wax, Goats or Sheeps suet, A.℥iv. Aloes, Frank∣incense, Mastich, Myrrh, A. ℥ss. mix, and make an Ointment.

C. We will not trouble you with any more Sarcoticks in this place, having already given you an ample number and Variety of them in Cap. 2. Sect. 31. ad 46. aforegoing; in the forms of Oils, Ointments, Balsams, and Emplasters. The Sarcotick or Incarnative being laid upon the Wound or Ulcer, you may cover all with Empl Diapalmae, or Our Empl. Album.

V. Of Gunshot-Wounds, with Fracture of the Bone.

CI. If with a Wound, there be a Fracture of the Bone, which sometimes is broken into many pieces, wherein for the most part, the Nervous Parts are hurt; when these I say, are to be cleared from these Fragments of Bones, there will be many times sharp and acute Pains, Convulsions, and sometimes a Gangren it self: which makes some Artists come to Amputa∣tion with all the speed that may be; which yet ought not to be done, so long as there is any hopes of a Cure without it; for that Nature oftentimes even in these Wounds, is wont to work Miracles as it were.

CII. The Way of Curing these is the same, as in curing Fractures with a Wound; of which we shall speak more largely, in Lib. 6. Cap. 5, 6, 7, 8 following: and in Cap. 23. of this present Fourth Book: however, we think it fit to say something thereof in general terms in this place.

CIII. In the first place there∣fore, it is necessary that the great Fragments of the Bones be restored again into their places, that they may be joined together by a Cal∣lus: but in the application of

Splinters, you must use great caution, lest by them you excite more pain than otherwise would be; and so cause Convulsions, Inflammation or Gangren, which otherwise by due care, might not have happened.

CIV. Some apply Glutinating Cataplasms, (which here indeed have no place) which stick so close and fast unto the Part, and bind it so straitly together, as to cause very much pain, and many times other ill Symptoms: those are not rashly and inconsi∣derately to be made use of, but in their due time and ap∣pointment.

CV. After therefore that the Bones are set again, or composed, or conjoined; the Member is to be placed either in a thin Plate of Lead, or in a Skin moistned with Wine; or in the hollows of those Chips which are bored out of Pumps and Water-Pipes in making, being first moistned with warm Water.

CVI. For all these things, as they hold the broken Parts toge∣ther; so they do it in such a manner, and so easily, that they may notwithstanding them, be be bent as much as you please, and prevent any new access, or cause of Pain: but instead of these things, you may lay on some of the following Cerats or Emplasters.

CVII. ℞ Mucilage of Comfrey-roots, Cherry-tree or Plum-tree Gum, or Gum-Arabick, A. ℥vi. juice of Comfrey, fine Bole, Terra Sigillata, A. ℥iii. juice of Doves-foot, pouder of Catechu, A. ℥ iv. Turpentine lbj. Oil of Earthworms ℥vj. yolks of Eggs N^o xxx. or more: mix them.

CVIII. ℞ Fine Bole, Catechu, A. ℥iij. Turpentine, juice of Doves-foot, or of Comfrey A. ℥iijss. Rosin, Wax, A. ℥viij. mix, and make a Cerate.

VI. Of Dressing Gunshot-Wounds.

CIX. The Bullet, and other extraneous things, as Splinters, Rags, &c. being extracted, you must come to the Dressing up of the Wound; which is to be per∣formed as a Contused Wound, with Oleum Catellorum Paraei; the Recipe of which you have at Sect. 57. aforegoing, which is to be applied hot, as the Part will bear.

CX. In this case, you are not to heed what any shall say to the the contrary, who object against it, as a Greasy Medicine; no tho' it be near a Bone (says Wiseman,) for the Gleet (says he) will foul it much more than Greasy Medi∣caments.

CXI. If you have not the Oleum Catellorum, you may use this. ℞ Oils of Hempseed and Linseed, A.℥iv. Oils of Lillies and Camomil, A. ℥ij. Turpentine ℥j. mix them. Or this: ℞ Stras∣burgh Turpentine ℥iv. Gum Elemi, Frankincense, A.℥ij. Oils of Hemp∣seed and Linseed, and of Earth∣worms, A. ℥iij. Oil of Elder ℥jss. Mastich, Olibanum, A. ℥ss. mix them.

CXII. Or you may use this: ℞ Linseed-oil, Oil-olive, Turpen∣tine, A. lbss. Gum Elemi ℥iij. purified Verdigrise ʒij. mix them.

Or this: Take Turpentine, Balsam Capivii, Oils of Linseed and of Hypericon, Spirit of Wine, A.lbss. Sanguis Draconis in very subtil pouder ℥j. mix them.

CXIII. Quercetan commends this. Take juices of Coltsfoot and Sorrel, A. ℥iv. fresh Butter lbss. Oleum Visci Pomorum com∣positum, (which see in Querce∣tan. rediviv. Tom. 3. pag. 259.) lbj. Larch-Rosin ℥ ij ss. Frankin∣cense, Hens and Goose grease, A. ℥ij. pulp of xx. fat Figs: put all into a Vessel, which stop close; and boil on a gentle Fire for six hours, then strain out hot, and evaporate to a consistence. Where note, if you cannot get the Oleum Visci, &c. you may use in the place thereof Oils of Lin∣seed, of Earthworms, and of Hypericon, A. ℥iv.

CXIV. Or this, of the same Quercetan. Take Oil-olive, or Linseed-oil lbj. new Wax, Rosin, Ship-Pitch, A. ℥iv. Goats-suet, Veal-marrow, A. ℥ij. Oesopus ℥j. melt all together, and strain, keeping the Ointment for use; to every Ounce of which he adds ʒi. of Precipitate: yet in recent Wounds the Precipitate is not necessary; for by experience we know, that these Wounds will digest and suppurate without it, which frees them from pu∣tridness.

CXV. Now to these Wounds you ought to use a soft Tent, and Pledgets dipt in some Digestive pretty hot, but not so hot as to seald them: the Parts about you may Embrocate with Oils of Earthworms, of Roses and Myr∣cles, A.℥iij.mix'd with Vinegar ℥i.

CXVI. Let the Applications over the Wound be of that nature or quality, as to refist Defluxions of Humors, and such as may strengthen the weakned Parts. As, Take Bean and Barley flower, A. ℥vj. Catechu ℥iij. mu∣cilage of Gum-tragacanth ℥j. which boil in Posca, or Water and red Wine to a Cataplasm, adding at last Eggs N^o ij. Oocymel ℥iij. or you may add Oil of Roses, and Wax, A. q.s. and make it into the form of a Cerat.

CXVII. Above the Wound lay this Defensative. Take Terra Sigillata ℥vj. Catechu ℥iij. Lith∣arge, Sanguis draconis, juice of Sloes or Acacia in ponder, Comfrey-roots in pouder, A. ℥ij. Oil of Myrtles, Vinegar, A. ℥xij. mix, and boil to the consistence of a Cerat.

CXVIII. Or, Take fine Bole, Ceruse, A. ℥vj. Catechu, Litharge, A. ℥iij. Oil of Roses omphacin ℥xij. Vinegar ℥vj. juice of Plan∣tan and Nightshade, A. ℥ij. Wax q.s. mix them: apply the Compress dipt in Vinegar, and let the Bandage be equal and gentle, to keep on the Dres∣sings, and hinder the Afflux of Humors.

CXIX. If much Blood has not been lost, Revulsion may be made on the same side, as Galen advises, otherwise not: the Bowels may be emptied with a Clyster made of Mutton-broth or Posset-drink lbj. and brown Sugar or Molosses ℥iv. giving inwardly now and then a dram or two of Our Aqua Bezoartica, or Spiritus Cordialis.

CXX. The Air ought to be

temperate, because Cold is an Enemy to Wounds; the Diet ought to be spare, as thin Mutton-broth, Barley-broth, Water-gruel, Pa∣nado, potched Eggs, &c. because it prevents Inflammations; and he ought to rest quietly, for which purpose you may give this this Dose. Take Poppy-water ℥iij. Angelica-water compound ℥j. Syrupus de Meconio ʒvj. mix them. Or this: Take Guttae Vitae Nostrae ʒj. Spiritus Cor∣dialis ℥ss. Syrup of Limons ℥j. mix them.

CXXI. The second Dressing is next to be considered, where∣in a Fomentation is to be pro∣vided, made thus. Red Port-Wine lbij. Spirit of Wine ℥iij. Powers of Wormwood, Juniper, and Angelica, A. ℥ ss. Scurvy∣grass-water lbj. mix: and being very hot, wring Stuphs out of it, and apply them, which will defend the Wound from the Air.

CXXII. If the Wound is in a good condition, continue the use of Digestives; but if it is affected with vehement Pain, foment it with this. Take white Port-Wine, Decoction of Althea-roots, A. lbj. Spiritus Anodynus ℥j.ss. Broth of a Sheeps Head lbss. mix them: and afterwards apply over all this Cataplasm. Take Barley and Bean flower, A. ℥iv. Orrice-root in pouder ℥ij. Ung. Basilicon, & Nicotianae, A.℥jss. Eggs N^o iv. yellow Palm-Oil q.s. mix, and make a Cata∣plasm: it promotes the Suppu∣ration and is Anodyne.

CXXIII. This being done, it is to be bound up, as before; and this course may be continued to the eighth or tenth day, 'till the Sloughs are separated, the Wound digested, and a good sort of Pus, (which is white, equal, smooth, and not stinking) is generated.

CXXIV. If the Pus is wanting in any of these Qualities, you may mix a little Precipitate with your Digestive or Suppurative, or Ʋng. Apostolorum.

CXXV. You may cleanse by an Injection, made of the Juices of Smallage, the lesser Centory, Plantan and Agrimony, mixt with Barley-broth and Honey, in which you may dissolve a little Venice-Turpentine; first well mixt with the yolk of an Egg.

CXXVI. Or you may apply this Unguent. Take juices of Adders-tongue, Agrimony, Centory, Wormwood, Parsley, Plantan, and Smallage, A. ℥j. mucilage of hull'd Barley ℥iij. boil them together, to nearly the consumption of the juice or humidity; then add Venice or Strasburgh Turpentine ℥iij. Oney ℥ij. Barley-flower ℥j. Saffron ʒss. mix, and make an Abstersive.

CHAP. XX. Of ACCIDENTS of Gun shot WOƲNDS.

I. NOW from the first begin∣ning of the Wound to the eleventh or twelfth Day, these kinds of Wounds may be subject to many and various Accidents or Symptoms, which not only hinder the Cure, but oftentimes destroy the Patient; as, 1. Vehement Pain. 2. Inflammation. 3. Gan∣gren. 4. Hemorrhage. 5. Fe∣vers. 6. Delirium. 7. Faint∣ing and Swooning. 8. Convulsi∣ons. 9. Palsies. 10. A Sinuous Ʋlcer; of all which we shall discourse briefly, (as these Sym∣ptoms may have relation to these kinds of Wounds, having said otherwise enough of them in Chap. 9. aforegoing) that we may lead our young Artist, as it were, by the Hand, thro' the intricate Labyrinths of the Art of Curing.

I. Vehement Pain.

II. If the Pain is vehement, you must outwardly foment with and apply Anodyns, with which you may sometimes mix Spiritus Opii Compositus, and sometimes a small quantity of the Tincture of Opium, Extracted with equal Parts of Night-shade Water, and Spirit of Wine.

III. And Inwardly give Our Spiritus Opii Compositus in some proper Vehicle, or this follow∣ing Mixture: ℞ Poppy-water ℥ii. Syrup of Limons ℥i. Spiritus Opii Compositus ʒiii. mix them. Or, you may give a Dose of Our Theriaca Chymica, which will not fail of giving the due Ease; or Dr. Gardner's Laudanum Tar∣tarizatum, or Our Laudanum Specificum; taking which of them is first at hand.

II. Inflammation.

IV. This proceeds either from an ill habit of Body, or from an ill handling of the Wound in the begin∣ning, which to prevent, you ought to hinder the afflux of Humors, evacuating that which already disaffects the Wound.

V. First, you ought to Purge, and if the habit of the Body, and condition of the Sick will permit it, to bleed, which is in some measure the first Days Work, and if then neglected, to be performed now. Secondly, by Topicks; you must ease the pain by Anodyns, which may re∣press the heat, as is directed in Chap. 9. aforegoing, according as it may be either Phlegmon, or Erysipelas.

VI. In the beginning use Repel∣lers and Refrigeratives; in their state, use moderate Calefactives and Discutients; and lastly, Digestives, which may concoct, or suppurate the Matter.

III. Gangren.

VII. This is an attendant upon an Inflammation, and is much to be feared, when the Phlegmon yields not to Discussives, or Sup∣puratives; for then the natural heat of the Part is suffocated, either thro' the great afflux of Humors, or application of To∣picks too Refrigerative, and Repercussive, which obstructed the motion of the Spirit into the Part.

VIII. It is known by the Gleet and change of Colour, it beginning to look livid; as also by the ab∣ating of the Tumor, &c.

IX. When you see these Sym∣ptoms coming on, you must imme∣diately scarify, not only till the Blood comes, but you must cut deep thro' the Escar to the quick, making it bleed freely, till the Part becomes sensible in its feeling; that thereby you may evacuate that which would suffocate the Natural Heat, and Vital Spirits.

X. Having thus made way for the enterance of your Medicaments, foment the Part with a good Lixi∣vium of Pot-ashes, mixed with Salt and Vinegar: Or you may make a Decoction of Worm∣wood, Southernwood, Centory, and Colocynthis in the said Lixivium.

XI. Bathe also all the places both above and below the Wound, or Mortification with Spirit of Wine Camphorated, and lay double Cloths dipt in the same over them.

XII. The Gaugren it self being fomented with the Lixivium, &c. wash the Scarifications, and ap∣ply to the Wound, Ʋng. Aegy∣ptiacum mixed with Venice Trea∣cle, dissolved in a little Wine Vinegar, adding also a little calcin'd Vitriol; and apply a Cataplasm made of the Flower or Meals of Orobus, of Lupins, of Beans, and of Barley, boiled up with some of the afore-mentioned Lixivium, adding at the end of the boiling a little Oxymel, either simple, or that of Squills, which is better.

XIII. If in making the Scari∣fication you should cut some Vessel, whereby there should be a flux of Blood, you must be wary not to choak the heat of the Part, by crouding in Dosils, for so the Gan∣gren may be increased: In this Case, the better way is to use the Actual Cautery, for thereby you not only stop the bleeding, but also resist the Putrefaction; af∣ter which, you must dress up the Wound, as if it was made by burning.

XIV. You must also be wary in this Work, that while you are ae Curing one Gangren, you make not another, by the too long use of sharp Medicines; therefore when the Ulcer grows warm, and it ceases gleeting, forbear their use, and then dress it with warm Dige∣stives, as Ʋng. Basilicon, with Oil of Turpentine hot; after Di∣gestion cleanse it with Abster∣sives, as Mundificativum ex Apio, &c. according as the removal of the Sloughs require, and then with Sarcoticks and Epuloticks compleat the Cure. See more hereof of lib. 3. cap. 11. and

cap. 9. of this Book, afore∣going.

IV. An Hemorrhage.

XV. It oftentimes happens that in separating of the Contused Parts, that great Hemorrhages succeed, as also after the separating of an Escar: in this Case you must stop the Orifices, by applying some Astringent Pouder; some use that of Galen, made of Aloes, Frankincense, and Hares-wooll.

XVI. Others use Dr. Gardner's Styptick, rouling up the Wound with a good Compress, dipt in some Styptick Liquor, such as this: ℞ Colcothar, Burnt Allum, Su∣gar-candy, A. ℥i. Ʋrine of a young Person, Rose-water, A.℥xvi. Plantan-water ℥xxxii. mix, and stir the Liquor for a long time, then let it settle, keeping it upon the Faeces, and pour off the clear by Inclination, when you have occasion to use it.

XVII. Bolsters, or double Cloths, &c. may be dipt in this Water, and laid upon an open Artery, and held close with the Hand, till the Blood stops; also a small Tent, (according as the Wound may be, may be dipt or soak'd in it, and put into the Part) this Li∣quor taken inwardly, stops also the Bloody-flux, and all Hemor∣rhodial and Menstrual Fluxes, being given à ʒss. ad ʒii. in Knot-grass, or Comfrey water.

XVIII. Lastly, over all some common Defensive may be laid, and the Wound is not to be o∣pened till three or four Days af∣ter. See lib. 3. cap. 15, and 16. and cap. 4. and 9. of this fourth Book.

V. Of a Fever.

XIX. The Fever is either Con∣tinent or Remitting, seldom Inter∣mitting: If it is Continent, such things must be given, as may upon the spot repress the preternatural heat, and hinder the farther pu∣trefaction of Humors, of which kind is Our Tinctura Cordialis, Elixir Proprietatis, Spiritus Sul∣phuratus, Spiritus Nitratus, Spi∣ritus Vini Basilii, Spiritus Mira∣bilis, Spiritus Opiatus composi∣tus, Sal Absinthii, Sal Cornu Ceryi Succinatum, Sal Mirabile, Sal Nitrum Nitratum, & Vi∣triolatum, Sal Vitriolatum, & Sal Prunellae, Antihecticum Po∣terii, &c.

XX. If the Fever is Remit∣ting, it is to be considered as in the Fit, and as in the Remission of the Paroxysm: as in the Fit, you may exhibit any of the Medica∣ments in the aforegoing Section, but chiefly those which are Sa∣line.

XXI. As in the Remission of the Paroxysm, the great Medicine which is to be exhibited, is either the Pouder, Tincture, or Ex∣tract of the Cortex Peruanus: give a Dose of it immediately upon the remission of the Fit, and repeat the Dose every four or six Hours, till the Fit re∣turns, and then forbear it, till the Remission; after which re∣peat it again as before, conti∣nuing its use, till you are sensi∣ble the Fever is utterly destroy∣ed by the use thereof.

VI. Of a Delirium.

XXII. If the Body is Costive, it ought to be opened with Sal Mi∣rabile, Syrupus Catharticus, Pulvis Cornachini, or some other proper Purge; and afterwards it is to be kept open with Our Laudanum Catharticum, giving two or three Doses of it every Night at Bed-time.

XXIII. Outwardly let the Head, Forehead, Temples, and Nostrils, be bathed with Spiritus Anodynus, or with Tinctura Opii; and let Cloths dipt in the same, be laid or bound upon his Temples and Forehead.

XXIV. And inwardly give this Julep oftentimes in the Day∣time: ℞ Poppy-water 〈◊〉〈◊〉 Damask Rose-water, Angelica-•…•…ater, A. ℥iii. 〈◊〉〈◊〉 of Limons ℥iiss. Spi∣ritus Opii compositus ℥ii. mix them; of which give new and then two or three Spoonfuls at a time.

XXV. And at Bed-time (if you find the Patient does 〈…〉〈…〉 to 〈◊〉〈◊〉 by what has 〈◊〉〈◊〉 been given) give•• •…•…node•…•…re Dose of Tinctura Op•…•… S••rupus de Mae∣conio, which may 〈◊〉〈◊〉 ••ixed with a little of Our The•…•…a••a Chymica; I have constantly used this Me∣thod for many Years past, and never without Success, in two or three Days times at most; and sometimes, it recovered my Patient from his Dotage in 24 Hours.

VII. Fainting and Swooning.

XXVI. You may give the Pa∣tient Our Aqua Bezoartica, ad ℥i. or Spiritus Cordialis, or An∣gelica-water Compound, mixt with a little Syrup of Limons, and of∣ten repeated, till the Fainting or Swooning goes quite away.

XXVII. If the Fainting or Swooning Fits follow thick, and that the former Prescription will do no good, you must give this: ℞ Spiritus Cordialis ℥ss. Aqua Angelicae simplex ℥iii. vola∣til Salt of Harts-horn ℈i. Tin∣cture of Saffron ʒss. mix for a Dose, which repeat as oft as you see occasion.

XXVIII. If this yet prevails not, take this: ℞ Spiritus Cor∣dialis ℥i. volatil Salt of Harts-horn fixed with Spirit of Salt, and evaporated to driness ℈i. vo∣latil Salt of Amber ℈i. mix, for a Dose, which repeat as oft as need requires.

VIII. Convulsions.

XXIX. Convulsions in this Case are said to arise from Putrid Vapours, or Acrid Humors offend∣ing the Nerves, with which Humors these Wounds do often abound.

XXX. The Parts affected are frimarily the Nerves in loco; secundarily their Original, or the Brain, by consent, which being irritated, causes an involuntary Contraction or Convulsion, in the Parts affected, as near the Knee or Shoulder, where the Convulsion is only to be discern∣ed by a Trembling, which is the more manifest, the nearer it is to the Joint.

XXXI. It sometimes follows

great Inflammations, especially in the Nervous Parts, and is here for the most part Fatal; a Con∣vulsion upon a Wound, being generally the Prodromos, or Forerunner of Death.

XXXII. If you will attempt any thing, give inwardly this Mixture: ℞ Potestat. Virtutum ʒi. Spiritus Gordialis ʒiv. Syrup of Citron-peels ℥i. mix them; and at Bed-time give ʒi. of Our Theriaca Chymica.

XXXIII. Outwardly bathe the Parts with this Mixture: ℞ Powers of Rosemary, Limons, Ju∣niper, and Turpentine, A. ʒii. Tinctura Opii, Spiritus Vini Camphorati, A. ʒi. mix them; and apply to the Wound it self this: ℞ Linimentum Arcaei, Ung. Basilicon, Balsam de Chi∣li, Peru, & Tolu, A. ʒii. mix them.

IX. Palsies.

XXXIV. Palsies which arise from Wounds, immediately affect the Nerves of that place only; they do not simply take away the Life of the Patient, but do sometimes threaten a Gangren or Mortification, thro' a defect of Natural Heat in the Member.

XXXV. Inwardly give Spirit of Harts-horn, or of Sal Armo∣niack in some proper Vehicle; and outwardly, foment the Part with this Mixture: ℞ Oil Olive ℥iii. Oils of Amber ℥ii. of Turpentine ℥iv. mix them, and Embrocate therewith, and round about the adjacent Parts, apply this: ℞ Balsam de Chili, Capivi, Peru, Tolu, A. ℥i. Camphir ʒii. mix them, and apply the Mixture with Lint.

XXXVI. After those things have been applied for ten or twelve Days, or longer, as you see oc∣casion, then apply an Emplaster made of Burgundy Pitch, Ship Pitch, Gum Elemi, Frankincense, A. ℥i. Turpentine, q.s. which will stir up heat in the Member, and attract Life and Spirits into the Part.

X. Sinuous Ʋlcers.

XXXVII. Sometimes after the Separation of the Escar, the Ʋlcer becomes Sinuous, especially after a great afflux of Humors; and where Bandage cannot be used to preserve the Tone of the Parts, as in the upper Parts of the Thigh and Hip, &c. or from the large∣ness of the Wound, Contusion of the Flesh, &c. or Laceration of Parts, whereby there is a great loss of Substance, and an Acrid Matter, inducing such a like Ulcer.

XXXVIII. Sometimes also it becomes Sinuous from a Cacochy∣mical or Scorbutick habit of Body, or may be induced from Lues Venerea being joined with it; in which Cases, you will scarce∣ly ever Cure the Patient, with∣out exhibiting Antifcorbaticks or Antivenereals, &c.

XXXIX. If the Wound is in∣flicted on the higher part of a Mem∣ber, whereby the Pus cannot dis∣charge it self, but may be apt to lye and create a Sinus, you must perforate it thro' the bottom, ei∣ther with a Syringotomus, or with a Seton-Needle, retaining a

twisted Thread or Silk in the Ulcer, till the lower Orifice is digested, and then drawing out the Silk, to keep it open by a Tent for some time, 'till the upper part is healed; and then as the Matter diminishes its flow∣ing out of the depending Ori∣fice, the Tents may at length be removed, and the Wound heal∣ed up.

XL. But to prevent Sinuosi∣ties, you will do well to enlarge the Orifice at first, and to keep it so wide open, that the Pus may have a free passage out; which if it cannot be by the way the Bul∣let went in, you must then con∣sider so as to find out the best place to open it, so as it may be discharged, as we have before directed.

XLI. But before you do this, it would be also well to consider, whether it cannot be done without such an Apertion; as by altering the position of the Part, Com∣pression, Bandage, hollow Tents, &c. and therefore you must endeavour by Stuphs, Sponges, Compresses, and good Bandage to force out the Matter, that the hollow sides may ag∣glutinate.

XLII. These Stuphs, Sponges, &c. may be dipt and wrung out of an Infusion or Decoction of Baiau∣stians, red Roses, Sumach, Pom∣granate-peels and Catechu, made in red Wine, and that the Mat∣ter may the better discharge between whiles, you ought to dress it the oftner.

XLIII. And Injections are to be made with a Decoction or Infusion of Roots of round Birthwort, Flo∣rentine, Orrice, of Zedoary, Ca∣techu, Aloes, Myrrh, Sarcocolla, and Allum in Aqua Calcis, to which Spirit of Wine and Ho∣ney of Roses may be added.

XLIV. If the Orifice is small, and the Sinus lyes shallow, as un∣der the Skin, and in a place where it may be safely opened; you may widen it with Crepitus Lupi, Gentian-roots, Elder Pith, or prepared Sponge, and after∣wards cut it open with a pair of Probe-Scissars, or with an Inci∣sion-knife, the Director being placed within; or you may lay it open by a Caustick.

XLV. The Sinus being thus di∣vided or opened, you may digest it with Turpentine mixed with yolks of Eggs; or cleanse with some proper Abstersive, variety of which you may see when we come to Treat of Ulcers in General: Af∣terwards Sarcoticks are to be used, which that they may be made the more drying, Pouders of Frankincense, Myrrh, Rosin, and Orrice-roots with Honey, may be added.

XLVI. If the Sinus runs trans∣verse Arteries, Veins, Nerves, Tendons, &c. the best way will be to make the position of the Part, so as its Orifice may be depending, (for Cutting will there be dange∣rous) and by Digestive, and Ab∣stersive Injections to dress it for some time, and afterwards by Sarcotick and Styptick Injecti∣ons, with good Bolsters, Com∣press, and Bandage, keeping the Orifice open with a Tent, and so compleat the rest of the Cure according to Art: But if after all your Endeavours the

Ulcer grows Fistulous, you must then Cure it, as we shall here∣after teach in lib. 5. cap. 10, 12, and 20.

CHAP. XXI. Of GƲN-SHOT WOƲNDS of the THORAX.

I. THE Wounds of the Tho∣rax have relation to the Brest, Ribs, and Parts contained within them, as Heart, Lungs, Mediastinum, Aorta, and other Vessels: Sometimes the External Parts are only hurt or wounded, sometimes they pierce thro' the Ribs and Pleura, in which Case many times the Principal are wounded.

II. If the Wound penetrates not into the Cavity of the Brest, but is only in the Musculous Flesh, it is to be Cured as a Wound in the fleshy Parts.

III. If there is a Fracture of the Ribs, &c. with it, it must be Cured as a Wound with a Fracture; the broken Bones (if any) are also to be taken forth, lest they prick the Pleura, and cause In∣flammation.

IV. The Signs. If there is a deep penetration into the Cavity, it may be discerned by the coming forth of the Air, with noise, also a Flux of Blood following by the Wound, or by the Mouth, or by both; unless the Blood fall down upon the Diaphragmd, and then the difficulty of breathing, and other like Symptoms, will ensue.

V. If the Diaphragma is wounded, besides the difficulty of breathing, there will be a Hoars∣ness, the Diaphragma will be drawn upwards; the Back-bone will be affected, and there will be a great pain about the Ba∣stard-Ribs.

VI. If the Lungs are wounded, there will be a Cough, with dif∣ficulty of Breathing, and often sighing: If there is an Effusion of Blood, it will (as it is much or little) flow forth of the Wound, or be cough'd up, or both, and the Sick will be much inclin'd to lye upon the Wound.

VII. If the Medulla Spinalis is hurt, the Nerves are resolved, and a Palsie ensues; but more especially in the Part under the Wound.

VIII. If the Aorta, or Vena Cava, or Portae, a very great Hemorrhage follows: If it flows from the Right side, the Vena Cava is hurt; but if from the Left, it is mostly the Artery, which may be known by its leaping and florid Colour.

IX. If the Heart is wounded, the Blood flows vehemently, and is as it were boiling-hot, there are cold Sweats, with fainting and sinking of the Spirits.

X. The Prognosticks. If the Vena Portae is wounded, the Pa∣tient dies immediately; and so

he does of most of the Wounds made in the other Vessels.

XI. If the Heart is wounded, the Patient dies, but he lives longer, being wounded in the Right Ventricle than in the Left: If shot into the Lungs, it is present Death.

XII. And tho' almost all these Wounds made by Gun-shot are Mortal; yet such as are so wound∣ed, ought not to be left without help; but the Artist ought to use a Courage and Boldness to attempt something, for that he may sometimes happily prolong Life, and sometimes Cure that, which to the Eye may seem uncurable.

XIII. The Cure. First, the Bullet, or any Extraneous Matter, if present, must be extracted, to give way for the discharge of Blood and Matter contained in the Cavity of the Thorax.

XIV. Then the Wound is to be drest with a Tent dipt in this mixture: ℞ Fine Bole, burnt Harts-horn, A. ℥jss. fine Flower ℥i. one whole Egg, Oils of Roses and Elder, A. q.s. mix them. Or this: ℞ Catechu, white Starch, A. ℥jss. Dragons Blood, Terra Sigillata, A. ℥ss. Mastich, Olibanum, A. ʒiii. two whole Eggs, Linseed Oil, q.s. mix them: Spread the Compress with one of these, and apply it over the Wound.

XV. If the Blood stop not by this, apply the following Mix∣ture: ℞ Catechu ℥jss. fine Bole ℥i. Allum ℥ss. Salt extracted out of the Caput mort. of Vitriol ʒii. Eggs N^o i. or ii. fine Flower, q.s. mix them.

XVI. Or you may inject the following Mixture: ℞ of the Styptick Liquor described in Cap. 20. Sect. 16. afore-going ℥vi. Syrup of Comfrey ℥jss. Spirit of Wine, or rather red Wine ℥i. sweet Caput mort. of Vitriol ℥ss. mix them.

XVII. This Method is good, because the Orifice of the Wound is large enough for the Injection to re∣turn out again; and here is need not only of Stypticks, but also of Detersives, where for the pre∣sent Occasion, if the former Mixture is not at hand, Red-Wine it self is an Admirable thing in such bleeding Wounds, being given inwardly by the Mouth, or Injected with a Sy∣ringe; but much more, if it is impregnated with the Tincture of Catechu; then it will exceed most things in the World.

XVIII. Or inwardly you may give Our Tinctura Mirabilis in a Glass of Port-wine, or this fol∣lowing Styptick, which stops bleeding upon the spot. Take Oil of Vitriol ℥iiss. Oil of Turpen∣tine ℥i. mix perfectly till you have a blackish or purple Colour; being intimately mixed, add to them Spirit of Wine rectified ℥viii. and keep it for Ʋse. Dose à gut. xx. ad xi. in a Glass of Red-wine. These things will stop bleeding upon the spot.

XIX. The Blood being stopt, the Wound is to be digested with this, or some such like: Take Stras∣burgh Turpentine, Balsam of Chili, or Peru, A. ℥i. Pouders of Frank∣incense, Olibanum, of Fenugreek-seed, A. ʒi. Oil of Hypericon q.s. mix them: dip short Tents in it,

and apply them; and apply o∣ver a Pledget spread with some of the same, or with such other Suppuratives as are used in sim∣ple Gun-shot Wounds.

XX. Embrocate the Brest with this Mixture: Take Oils of Whelps, and of Earthworms, A. ℥ii. Oil of Ben, yellow Palm-Oil A. ℥i. mix them; and apply o∣ver all Diapalma, or Empl. Al∣bum, or Diachylon simplex, ma∣laxed with some of the same Oil.

XXI. After Digestion you must deterge by Abstersives, either with an Injection (if the Matter is so disposed) such as this: Take Extract of Scordium ℥i. White∣wine ℥xii. mix, and dissolve. Or, Take Extract of Wormwood ℥i. Juice of Smallage ʒvi. round Birthwort-root, Orrice-root in fine pouder, Scammony in fine pouder, A. ℥ss. mix, and dissolve in Red∣wine lbii. over a gentle heat, adding Honey of Roses ℥iii. If it is too strong, you may weaken it, by adding thereto Damask or Red Rose-water lbss. more or less.

XXII. Or you may deterge with an Ointment, such as this: Take Turpentine ℥iii. Barley-flower, Pouders of Frankincense, Orrice-root, Olibanum and Scam∣mony, A. ℥ss. Aloes ʒii. Honey of Roses ℥iv. mix them, with which dress the Wound in the fleshy Parts.

XXIII. The Wound being thus cleansed, you must fill up the hollow Parts with Incarnatives; and lastly, finish the Cure with Sty∣pticks and Epuloticks.

XXIV. But this is to be noted in dressing these kinds of Wounds, that you be careful to remove the Sloughs without, lest a stinking Gleet falls from them, upon the Viscera within.

XXV. Also in order to the Cure, the Body is to be kept open with proper lenient Clysters; and Pectorals are to be given inward∣ly, to prevent the harshness of the Aspera Arteria; their Diet ought to be sparing, and their Drink medicated Ale or Hydromel; and after the Accidents are o∣ver, the Patient may enter into a Milk Diet, drinking either Cows Milk alone, or Milk sweet∣ned with white Sugar-candy, or Sugar of Roses.

CHAP. XXII. Of GƲN-SHOT WOƲNDS of the BELLY.

I. THE Abdomen, or Belly, is divided into three Re∣gions, 1. Epigastrium, the up∣per Region, the sides of which are called Hypochondria: The Right Hypochondrium possesses all the Liver; the Left, the Spleen; between which the Stomach is placed. 2. Regio Ʋmbilicalis, the Middle Region, in which is

the Navel, and round about which dyes the Guts; and be∣hind on each side the Reins or Kidneys. 3. Hypogastrium, the Lowermost or Inferior Region; the sides of which are the Illia, and in the middle the Pecten or Pubes, under which lyes the Ve∣sica, or Bladder.

II. The Abdomen consists also of Parts containing and contained.

III. The containing are, 1. Com∣mon, which cover the whole Bo∣dy, as, 1. The Cuticula. 2. Cu∣tis. 3. Pinguedo. 4. Membra∣na Carnosa. 2. Particular, or peculiar to the Belly, as, 1. The Muscles of the Belly. 2. The Pe∣ritonaeum. 3. The Omentum, which has a special relation to the Guts.

IV. The contained Parts, are, 1. For Nutrition, as Stomach, Small-guts, Mesentery, Vena Portae, Vena Cava, Arteria ma∣gna, Coeliaca magna, Liver and Spleen. 2. For Expurgation, as the Gall, Pancreas, all the Guts, but chiefly the great ones, Reins, Ureters, and Piss-bladder, also the Ʋterus, or Womb in Wo∣men. 3. For Procreation, as the Vasa praeparantia, & deferentia, Prostatae, & Ʋterus in wo∣men.

V. These Parts both containing and contained are liable to Gun∣shot, from whence various kinds of Wounds arise, which occa∣sion various Accidents: Some penetrate into the Cavity of the Abdomen, wounding the con∣tained Parts; others pierce not, but only wound or bruise the containing Parts.

VI. If the Bullet penetrates not, but only bruises or scratches a lit∣tle, yet such a slight hurt may be subject to a Tumor, and therefore lenient Embrocations, as with Oils of Whelps, Earth-worms, Hypericon, &c. are to be used, applying over them Empl. de Bolo, or Caesaris.

VII. If the Skin and Flesh is wounded, and no farther, it is Cured as Gun-shot Wounds in fleshy Parts, and all those things may be used, which are applied in simple Gun-shot Wounds. But these Wounds, if they happen in a Cacochymical or Scorbutick Ha∣bit of Body, because we cannot bind them up, as we can other Parts, by reason of their Fi∣gure, Site, and continual Mo∣tion, are subject to great de∣fluxions, and the Matter is apt to insinuate it self amongst the circumjacent Muscles, and raise them up, so making sinuous Ul∣cers, difficult to Cure.

VIII. If the Bullet penetrates thro' the Peritonaeum, and wounds the internal Viscera, you are to consider what Parts are hurt, which you may discern from the Place and the Accidents accom∣panying such Wounds, as also by the proper Symptoms of each Part.

IX. The Signs. Celsus, lib. 5. cap. 26. says, If the Liver is wounded, there is forthwith an effusion of gross Blood: If the Vena Cava, or Portae, are wounded, the Right Hypochondrium is in pain.

X. If the Artery is wounded, the Blood is florid, and comes forth impetuously, and the Patient makes his exit therewith.

XI. If the Stomach is wound∣ed,

a Singultus, or Hiccough follows, with Vomiting and Nau∣seousness; the Food with the Chyle comes forth of the Wound; there is also a cold Sweat, with Fainting and Languishing.

XII. If the Wound is in the Left Hypochondrium, under the short Ribs, the Spleen is wound∣ed, the Blood which flows forth is black, and there is also Ten∣sion, and difficulty of Breath∣ing.

XIII. If the lesser Guts are wounded, there will be Vomiting of greenish Matter, and the Food will come out of the Wound in less than half an Hour, and will continue so to do as long as Life lasts: If the great Guts are wounded, the Excrements and stinking Smell will shew it.

XIV. If a Kidney is hurt, the Wound is in the Region of the Loins, near the Vertebra, under the Diaphragma: There is also a pain going to the Groins and Testicles, with a difficulty in ma∣king Water; and what is pist forth, is either pure Blood, or Urine mixt with Blood: If the Ureters are wounded, the Urine comes forth at the Wound.

XV. If the Bladder is wound∣ed, there is great pain in the Groin, and the Ʋrine comes forth by the Wound; the Stomach suf∣fers also by consent, and the Part wounded indicates it.

XVI. If the Womb is wounded, the Groins and Coxa are pained, and the Blood flows not only by the Wound, but per Vulvam, and are sometimes Frantick, with other Symptoms of Death.

XVII. The Prognosticks. Tho' Physicians say, That if the Belly is so wounded that the Excrements come out of the Colon on the Left side, the recovery of such a one is rather a Miracle than a Work of Art; yet this I can say by Ex∣perience, that when I was in the West-Indies, I had a stout Ne∣gro so wounded by a shot, that his Excrements daily came forth thro' the Wound; yet notwith∣standing that I despaired of his Life, by the Care and Pains I took with him, I perfectly Cu∣red him in a Months time.

XVIII. Wounds of the Stomach are sometimes Mortal; but I have lived to see such Wounds Cured, and the Patient to live many Years after them.

XIX. Celsus determined such like Wounds made with sharp or cutting Weapons, Mortal, how much more then may we judge them so, which are made by Gun-shot? Tho' it is also true, that sometimes Nature does wonders of this kind.

XX. If the Wound is only in the Region of the Belly, it is not with∣out danger, more especially if it is in the middle, or Linea Alba: But if it penetrates, there is much more danger, for these Parts once broken seldom re∣cover.

XXI. The Cure. You must first begin with the Extraction of the Bullet, or any other extrane∣ous Matter which may be carried in with it, lest they induce putridness: then you must reduce the In∣testines and Omentum, lest they Inflate and Corrupt. Lastly, you must abate the Inflamma∣tion, and hasten Digestion.

I. Gun-shot VVounds of Stomach and Guts.

XXII. To dispose the Guts and Omentum to reduction, you must foment with warm Discutients; and if the Orifice is not large enough, you must make it wi∣der.

XXIII. If the Omentum is cor∣rupted, make a Ligature beyond the corrupt Part, and cut it off, leaving the ends of the Liga∣ture hanging out, till it is cast off by Digestion.

XXIV. If there is an Hemor∣rhage, inject Red-wine mixed with Syrup of dried Roses, fine Bole, Terra Sigillata, Catechu, Aloes, Frankincense, and Sanguis Dra∣conis, all in subtil Pouder: Or mix the Styptick Liquor (descri∣bed Cap. 20. Sect. 16.) with Red-wine and Frog-spawn-water, Ana; and inject with it, being indifferent hot.

XXV. Or you may use the In∣jection mentioned in Cap. 21. Sect. 16. which is an admirable thing, being cast into the Wound Blood-warm.

XXVI. This done, make a Mixture of the subtil Pouder of fine Bole, Catechu, Terra Sigil∣lata, Aloes, Frankincense, San∣guis Draconis, and dried blood, a new-laid Egg, and Oils of Ma∣stich and VVhelps, which apply upon a Tent fastned to a Thread: Then spreading the rest upon a Stuph, lay it over all: But if there is no Hemorrhage, you ought to digest as fast as you can.

XXVII. And inwardly give this: ℞ Dr. Gardner's Lauda∣num Tartarizatum, or Our Lau∣danum Specificum, gr. iii. or iv. Tinctura Mirabilis ʒss. or ʒi. of the Styptick (described cap. 21. sect. 18.) gut. xx. Red-wine, red Rose-water, A. q.s. mix, dissolve, and give it for a Dose.

XXVIII. Fallopius commends this in Wounds of the Stomach and Guts: ℞ Mouse-ear, Plan∣tane, roots of Comfrey and Tormen∣til, flowers of Hypericon, which boil in Red-wine, strain out, and add thereto Manna, Frankincense, Rosin of the Fir-tree, Cypress, Tur∣pentine, Saffron, Earth-worms in Pouder, Oil of Mastich, A. q.s. mix, and make a Sarcotick.

II. Gun-shot Wounds of the Reins or Kidneys.

XXIX. In Wounds of the Reins you must make an Injection with such things as are abstersive and drying; as, ℞ roots of Aristo∣lochia rotunda, of Comfrey and Orrice, A. ℥ii. Catechu ℥jss. Red-wine, Chalybeat-water, A. q.s. boil, strain out, and after∣wards add Powers of Turpentine ℥ss. Syrupof dried Roses ℥iv. mix for an Injection.

XXX. Or: ℞ Tinctura Mi∣rabilis ℥i. Red-wine ℥vi. Smith's Forge-water ℥viii. in which ʒi. of the Vitriol of Mars is dissolved, Ho∣ney of Roses ℥iii. mix for an In∣jection.

XXXI. Embrocate with Ole∣um Hyperici mixt with Oleum Catellorum, Ana; and dress up the Wound with a Digestive made of Turpentine, and one whole Egg, mixed with fine Bole, Mastich and

Frankincense in pouder; applying over all, Our Emplastrum Album, malaxt with Oil of Hypericon, yel∣low Palm-Oil, or Oil of Hempseed. Or this Cataplasm: Take Barley, Bean, and Orobus flower, A. ℥iii. Eggs, N^o ii. mix them, adding Oxymel ℥vi. boil to a Consistence, and add Oil of Hypericon, or of Whelps, q.s. mix them, and ap∣plyit.

III. Gun-shot Wounds of Li∣ver and Spleen.

XXXII. In these Wounds there is generally a great Hemorrhage, and therefore you may inject with the Mixture described in Cap. 21. Sect. 16. or those at Sect. 29, and 30. aforegoing, which will cleanse and heal.

XXXIII. Wiseman gives us this: Take Plantane, Cinkfoil, Knotgrass, Yarrow, Myrtles, red Roses, boil all in Chalybeat, or Smith's Forge-water, and sweeten with Syrup of dried Roses, then use it Blood-warm for an In∣jection.

XXXIV. Or you may add to it (says he) Acacia, fine Bole, Dragons Blood, and Frankincense in Pouders, and make it up into the consistency of a Liniment, and apply it upon Tents or Pledgets.

IV. Gun-shot Wounds of the Womb.

XXXV. Tho' these are accoun∣ted deadly, yet the Vagina, which some are pleased to call the Womb, being Gangrened, was cut out of the Body of a Butcher's Wife by Dr. Gardner the King's Chyrur∣geon, without any hazard of Life, and the Woman is yet alive at the writing hereof, tho' it is many Years since the Operation was done.

XXXVI. If there is an Hemor∣rhage, you must endeavour to stop it with Injections, such as we have described at Sect. 24, 25, 29, and 30, aforegoing, or some other proper Styptick Liquor.

XXXVII. Then Apply Embro∣cations and Digestives, observing the universal Method of Curing Wounds, application of good Vulne∣raries and Sarcoticks, keeping the Body cool and empty with Clysters, and giving inwardly proper Traumatick Drinks, such as we have in other places de∣scribed; together with the Mixture mentioned at Sect. 27. aforegoing.

CHAP. XXIII. Of GƲN-SHOT WOƲNDS in the LIMBS and JOINTS.

I. THese kinds of Wounds sel∣dom go without Fracture of the Bone; nor is there any of the five various kinds of Fra∣ctures which will not be made by Gun-shot.

II. The Signs. Now to disco∣ver a Fracture of a Bone, it will be well, as Hippocrates advises, to compare the sound Parts with the Parts affected, and to see whe∣ther there is any inequality, or not; for if broken, you will feel a Cavity, if you touch or press upon the Parts above or below.

III. There will be a vehemency of Pain, because of the divulsion of the Nerves, and distortion of the Tendinous Bodies, also a prick∣ing pain in the fleshy Parts by the pointed ends, or shivers of the Bone.

IV. The asperity and inequality of the Bone, also searching with your Probe, and handling the Fra∣ctured Member, wherein is per∣ceived a crashing of the Bones one against another: these, with the Impotency of the wounded Member, so that the Patient cannot lean or stand upon it, are all demonstrations that the Bone is broken.

V. The Prognosticks. Those Fractures are most dangerous, which are made so deep in the Flesh, that we cannot well come at them with our Hands, to extract the shivered Bones, and place the others right, and retain them so by Bandage, as those of the Pubes, Os Ilion, Os Sacrum, &c.

VI. Those Wounds in which there are many Splinters of Bones, wherein the Bone is generally shat∣tered to pieces, are extreamly dangerous, because their sharp points are apt to prick the Nerves, Tendons, &c. where∣by vehement Pain, Inflammati∣on, and Convulsions are excited, and many times Death follows, unless the Member is immedi∣ately Amputated.

VII. Tho' Amputation is not to be used upon every slight account, yet when the Case is so desperate, that the Cure cannot be done with∣out it, or when it is necessary to be done for preserving the Patient's Lise, it ought to be done at first, even upon the receiving of the Wound, whilst the Patient is heated, furious, and in Mettle, before his Courage decays, Spi∣rits languish, or Pain, flux of Humors, Inflammations, Fevers, or Convulsions, seize him, and not defer it to the next Day, at which time the Patient will chuse rather to Die, than to endure the Cruelty of the Ope∣ration.

VIII. If the Bone is broken in the middle, it is less dangerous than near the Joint, where it is

more hard to be restored; and being restored, more difficult to be kept in its place; besides the great number of Symptoms, which are apt to ensue, which cannot be cured without much difficulty.

IX. The Agglutination of Bones is more easily, and sooner per∣formed in young Persons, than in such as are old: so also in such as are of a Sanguin Complexion, rather than in such as are Cho∣lerick, Melancholick, or of a Cacochymick, or Scorbutick Habit of Body; because the former has much better Juices, Lympha, and Serum, for the generating of a Callus, than the latter have.

I. The Cure of Gunshot-Wounds in the Limbs.

X. Clear the Wound from all extraneous things; as Bullets, Rags, Splinters, Weapons, pieces of Bones, &c. and if need be, enlarge the Orifice of it; then dress it with Digestives and lenient Embrocations, after∣wards deterge it with Mundifi∣cativum Paracelsi; and hasten the Exfoliation of the Bones with Mel Rosarum and Spirit of Wine, or Tincture of Eu∣phorbium, &c.

XI. The Mundificative of Paracelsus. ℞ Honey ℥iv. Tur∣pentine ℥ ii. boil with a gentle heat, to the consistence of a soft Ointment; take it from the Fire, and mix with it the yolk of an Egg, red Precipitate levigated ℥i. stir them 'till they are well in∣corporated. It is said to excel all other Abstersives or Mundifi∣catives.

XII. If the Fracture is near a Joint, there may be many times thro' the violence of the Blow, a dislocation withal: in this case, you must first restore the Joint, before you meddle with the Fracture: you must also first reduce the Fracture, before you meddle with the Wound.

XIII. To reduce the Fracture, you must make Extension, and Coaptation, or Reposition, that the Bone may be restored to its proper place, which ought to be done with much steadiness and care; and not with such a force as is necessary in Fra∣ctures without a Wound, lest the Musculous or Nervous Parts should suffer vehement Pain, In∣flammation, Convulsions, &c.

XIV. When you begin the Work, if the Orifice is not large enough, widen it, for the Extraction of the Bullet, broken Bones, and other Extraneous Bodies; so will the Extension be the easier, and less subject to an Inflam∣mation, and a small extension will serve to restore the Bones to their former place.

XV. And indeed these Wounds require more dilatation than any other; that not only the cor∣rupted Blood, and other Excre∣ments may have a free passage out; but that also the Shivers of Bones, with which these kinds of Wounds usually a∣bound, may with less trouble be extracted by Instrument, or discharged by Nature.

XVI. If this Dilatation is not made at first, you may possibly

be forced to do it when the Part is afflicted with vehement Pain, Defluxion, and Inflamma∣tion; or when the Bones are corrupted by the retention of the Matter; which will be a great disadvantage to the Pa∣tient.

XVII. The Wound being laid open, see whether the Bone is bare, or not; which you may find out either with your Eye, Finger, or Probe: if it is bare, you must apply drying things to it, as dry Lint, pouders of Aloes, Birthwort-roots, Frankincense, Myrrh, Orrice-roots, Euphor∣bium, &c. forbearing all oily and greasy Medicines, because they foul the Bone, and hinder the Callus.

XVIII. But to the Fleshy Parts you must apply Digestives, because they require Digestion, without which no Cure will succeed: and therefore over the dry things laid upon the naked Bone, you may apply warm Suppuratives, such as we direct to in Simple Gunshot-Wounds.

XIX. Then lay over the Fra∣ctured Part Emplastr. Caesar, or E Bolo; or Catagmaticum ma∣laxed with Linseed-Oil, and Oil of Whelps: or this; Take Empl. Album ℥iv. Comfrey-roots in pouder, Terra sigillata, Catechu, Rosin, all in pouder, A. ℥ss. juice of Plantan ℥j. Oils of Myrtles and of Whelps, A. q.s. mix, and make an Emplaster.

XX. Apply over the Wound a Stuph, or double Cloths wrung out of a Decoction of Wormwood-tops, Myrtle-berries, Sumach, red Roses and Catechu made in Red-Wine; which Compress will serve to keep the lips of the Wound smooth, and defend it from the injury of the Bandage.

XXI. The next thing to be considered is the Bandage: for unless that is rightly and well done, no Unition, or Healing can be expected: and tho' in Simple Fractures without a Wound, all kinds of Bandage may be admitted, with ma∣ny circumvolutions about the Part, and once opening them in a Weeks time may be enough: in these Wounds it is not so, for the Bandage is to be daily loosned, and the Wounds to be opened and drest, for the dis∣charge of purulent and excre∣mentitious Matter, and exfo∣liation of carious Bones, which lying, would corrupt those which are sound.

XXII. But the Bandage ought to be such, as may the least shake or hurt the fractured Part: for being every day to be opened, the so often rowling the Wound up would cause much pain, and hinder the Unition; for which Reason, Authors have invented many kinds of Bandage, to answer all the Intentions of Dressing, and yet keep the Member immoveable.

XXIII. And therefore for this purpose, it ought to be made of soft Linnen Cloths; (broader than those we use in simple Fractures;) yet it may compre∣hend, or reach over, both the Fracture and the Wound, keep the Lips down and smooth, and not hurt them by its too hard compression.

XXIV. The Form of the Liga∣ture. Take a soft broad piece of Cloth, folded four times dou∣ble, to give it the more strength and firmness, and so broad as may reach over both the lips of the Wound, and the fractured Parts, and so long as to come once about the Fracture: it must have three slits, from the ends to the middle; which middle must be undivided under∣neath, to bear more equally the Member; and the ends must come over one another, with a Compress between or under them, over the Wound, to press the lips thereof equally down, which otherwise would swell or stick out with great brims.

XXV. The Compress is useful to receive the matter, and fill up the inequality; and the Slits or Straps are to be so fastned, that you may easily open them, and undress and dress the Wound, without disturbing the fractured Member.

XXVI. Now because thro' the great shattering of the Bones, and laceration of the fleshy Parts; as also by reason of the largeness of the Wound and Fracture, causing exceeding pain, the Member is made exceeding weak, that it cannot be kept steady by this Ban∣dange, you ought to make use of Ferulae or Splints; but they are not to be used 'till the Flux of Humors and Inflammation cease, which will be about the seventh day; and 'till then, you may make use of Splenia, which are folded Linnen Cloths four times double, and cut or made in length and bredth like to the Ferulae.

XXVII. These Splenia are to be spread with Galen's Cerat, or any proper Ointment, whereby they may adhere to the Part, 'till you have put the Bandage over it. They strengthen the Part, and make such an equal compression, as to keep the Bones in their pla∣ces, press the Serous Humors out of the Wound, and cause the Member to lie soft.

XXVIII. The Pain and Inflam∣mation being thus gone off, and the Wound digested, you may (if you think fit) use pliable Pastbords cut into like pieces, to lay over these Splenia. Or, having fast∣ned the Splenia, by the broad Bandage with three Slits, or Straps, cut a piece of Pastbord, fit to receive the lower part of the Member, and leave a place large enough for dressing of the Wound: and over the other part of the fractured Member you must lay another piece of Pastbord, to answer to the former; which ought to be wet, that they may be the more pliant.

XXIX. And about the Past-bord make a Bandage with three Ligatures, which you are to fasten in the most fit place for the ease of the Patient: if the Splenia also are made wet with whites of Eggs, and so applied, they will very much strengthen the Member, and also keep it steady without those other.

XXX. You may make the Past-board over the first Bandage, to en∣compass so much of the lower parts, as may support the Fracture, and come within an Inch of the Wound: and over the Wound it self you

may fasten a Splenium of Cloth four times double, or a Ferula∣like piece of Copper, Pewter, Tin, or Pastbord, lined as you see the Part can bear it, which may be taken off at each dressing.

XXXI. The first Bandage next to the Cerate, makes an equal compression, by three Heads, meeting one over another: the lowermost presses the Humors or Recrements from below up∣wards, and with the help of its next fellow, keeps the Bones in their right places, and forces the Pus out of the Wound; and by the help the middle Bracer has from the uppermost, the matter is prest out of the up∣per parts of the Fracture and Wound, to the mouth of the Orifice: it also restrains the Influx of Humors from above, by virtue of the Defensative lying under it.

XXXII. And in the dressing of these Wounds, you are only to undo the middle Binder, to come at the Sore; but in doing it up again, you must take great heed, that you make it not too hard nor too slack, but draw it strait in a mean, that it may not in the least hurt the Patient.

XXXIII. The convenient Position of the Membeer, is next to be con∣sidered; which ought to be so, 1. As it may lye soft and easy; lest the compression should offend the wounded Parts, and cause Pain, or Inflammation. 2. That it may lye equal or smooth; for otherwise the Limb will be distorted, or the Operation ill performed. 3. That it may lye higher than the parts next the Body, especially for the first three or four days: because if it inclines down∣wards, it may be apt to induce an afflux of Humors. Now how this Position is exactly to be per∣formed, we shall teach in Lib. 6. of Fractures, following.

XXXIV. The Bones being thus restored, the Wound digested, and the Inflammation or other Accidents gone off, which is about the se∣venth or ninth day, unloose the Bandage, take off your Astrin∣gent or Restrictive Applica∣tions, and impose Empl. Cata∣gmaticum, or some such like, over the broken Bones.

XXXV. Or this following. Take Frankincense, Wax, A. lbi. Catechu in fine pouder ℥iv. juice of Comfrey, of Doves-foot, A. ℥iij. mix, and melt, reducing it to the consistence of a Cerat.

XXXVI. Or, Take mucilage of Comfrey-roots, birdlime, juice of Doves-foot, or Bistort, of Poplar∣buds, A. ℥iv. mucilage of Traga∣canth, Osteocolla in fine pouder, Catechu in fine pouder, A. ℥ iij. yolks of Eggs N^o xx. Turpentine lbjss. Oil of Whelps ℥iv. mix, and boil all well; adding afterwards Wax, enough to bring it to the consistency of a Cerat.

XXXVII. Some use instead of these, Empl. Sticticum Paracelsi ℥iv. Empl. Album ℥ij. mixing them together; and over this, or one of the former Empla∣sters, apply a double Cloth dipt in Decoction of Wormwood, Southernwood, Sumach, and Red-Roses, made with Red-Wine.

XXXVIII. Which done, fit to

the wounded Part the former Bandage again; and over it ei∣ther some Plates of Tin or Copper, or otherwise Splenia of double Cloths dipt in whites of Eggs, and wrung out hard: these latter will lye close to the Part, and after they are dry will admirably well strengthen the Member.

XXXIX. In about nine days time the Wound will be digested, after which Maturatives or Sup∣puratives are to be forborn, and Abstersives or Cleansers are to be used; as the Mundisicati∣vum Paracelsi, at Sect. 11. afore-going; or Ʋnguentum Nicotianae; or this, Take Tobacco, Perwinkle, A. M. ij. Hypericon Mj. roots of round Birthwort ℥jss. of Floren∣tine-Orrice ʒ vj. Frankincense, Myrrh, Sarcocol, A. ʒiii. White-VVine q.s. boil, and strain out, and dissolve therein Honey of Roses ℥iv, vel vi. Inject this with a Syringe, and it will both cleanse, and breed Flesh.

XL. If there is a caries, or rottenness of the Bone, make a Decoction of Orrice-root, Gen∣tian, Cortex Guajaci, Scordium, Perwinkle, Hog-fennel and Myrrh, in Wine; adding Tin∣cture of Euphorbium to it, Cam∣phorated S.V. or Extract of Scordium.

XLI. If the Caries will not yield to the former Medica∣ment, touch it now and then with this. Take Oil of Myrrh, distilled per descensum, and acuated with S.V. ʒiv. Oil of Cloves ʒi. Oil of Sulphur ʒjss. mix them. Or you may use Tinct. Euphorbii, alone: these will in a short time remove the Cariosity; after which, you may pursue the ordinary Method of Cure.

XLII. While these things are doing outwardly, you may administer inwardly this fol∣lowing Wound-Drink. Take round Birthwort-roots, A. ℥ss. the Herbs, Angelica, Avens, Bistort, Comfrey, Doves-foot, Perwinkle, Self-heal, Scordium, Speedwel, Ladies-mantle, A. M. j. VVine lbxii. boil them in a Vessel close stopt for half an hour, or better; strain out, and let the Patient take ℥iv, ad vi. morning and evening, with Osteocolla ʒi. in fine pouder, every time. Or you may make a Decoction of Perwinkle in Wine, in which you may give Osteocolla, as before directed.

XLIII. Now in Dressing these kinds of VVounds, you are to ob∣serve, that if the Quittor is but little, it is enough to dress them once in 24 hours time: but if much Pus flows forth, or there is great Pain, or the Patient is feverish, they ought to be drest once every 12 hours.

XLIV. Cooling and Astringent Medicines are not to be used in the first Dressing; because the first extinguish the Natural Heat; the latter keep in putrid Vapors, and may induce a Gangren.

XLV. For this cause Anodyns, Emollients, and Suppuratives are convenient; as Oils of Linseed, of Hempseed, of Lillies, of Eggs, of Hypericon, of Elder, of Whelps, of Earthworms, and of Camomil; which may be mixt with yolks of Eggs and

Saffron, 'till the Wound comes to Digestion, which may be about the fourth or fifth day. Or this: Take Crums of Bread ℥iv. Milk ℥xii. Barley and Bean meal, A. ℥j. flowers of Camomil and Melilot, A. P.ij. boil all to the consistence of a Cataplasm, adding at last yolks of Eggs N^o ij. Oil of Whelps and of Hypericon, A. ℥jss. mix them.

XLVI. If Putrifaction is feared, some use Vitriol calcined, and dissolved in Aqua Vitae; tho' it is not suppurative, because it resists Putrifaction.

XLVII. Tents, if any are used, may be at first made greater and longer, that the Wound may be sufficiently dilated: but Escaro∣ticks are not to be used, without great necessity; 1. By reason they cause Pain, Inflammation, and Fevers, &c. 2. Because they hinder Suppuration. 3. Be∣cause the Escar keeps in putrid Vapors, which may pass from the lesser to the greater Vessels, and so to the Principal Parts, and cause a Fever.

XLVIII. If there is any Burn∣ing, then such Medicines which are good against Burning are to be used: as, Take Oils of Linseed and white Lillies, A. ℥ii. Ung. Album ℥jss. Ung. Nico∣tianae ℥i. juices of Housleek, of Plantan, of Elder-leaves, and of green Tobacco, A. ℥ii. Saccharum Saturni ʒiv. boil with a gentle Fire to the consumption of the Juices, and add Oil of Whelps ℥i. purified Verdigrise ʒj.

XLIX. If the Contusion is very great, and possesses much of the adjacent Parts, they are to be Scarified, to discharge part of the coagulated Blood, which is apt to putrify.

L. If by the Signs the Bullet seems to have been poisoned, the brims are to be scarified, Ventoses to be applied, Antidotes are to be inwardly given, and Alexiphar∣micks applied outwardly. In∣wardly give Sal Viperarum, or Our Theriaca Chymica, taking after it a spoonful or two of Our Aqua Bezoartica, or Spiritus Cordialis.

LI. And outwardly apply to the Wound this Mixture. Take juices of Scordium, Tobacco, and Angelica, Vinegar of Roses and of Squills, Honey, A. lbss. Sal Gem, Alum, A. ℥i. Verdigrise purified ℥ss. mix, and boil to a consistence; adding at the end of the boiling, Mithridate, Venice Treacle, A. ℥i. or of Our Theriaca Chymica ℥ii. apply this either upon Tents, or Pledgets, or by way of In∣jection, as you see fit. See more of this Subject in Chap. 18. afore-going.

LII. If the softer Spermatick Parts are lacerated, you may apply this. Take Strasburgh or Cypress Turpentine, Oils of Turpen∣tine and Hypericon, A.℥ii. Tur∣bith-mineral ʒss. Calx vive, Eu∣phorbium, Tutty, all in fine pouder, A. ʒi. mix them.

LIII. But if the harder Sper∣matick Parts, as the Cartilages and Bones are shivered, then, ℞ Of the former Composition ℥ijss. Oils of Hypericon and Juniper-berries, A. ℥ii. pouders of round Birthwort roots, of Cloves, of Tobacco, A. ʒi. mix them, and let it be applied hot: this will

procure the Scaling of the Bone, and preserve the sound Part from Cariosity.

II. Of Gunshot-Wounds in the Joints.

LIV. These Wounds are subject to more grievous and vehement Accidents or Symptoms, than the former: there are Tendons and Ligaments inserted near the Joints, for their motion; and Membranes, to make them of a very exquisit sense: the Trunk of Nerves in every great Joint passes thro' it, for the use of the Member beyond it; and Joints being exsanguous Parts, the Natural Balsam of the Blood and Lympha is more spa∣ringly supplied, for the help of the Cure.

LV. The Prognosticks. Great Wounds in the greater Joints, are accompanied with more vehement pain, than Wounds out of the Joint; and also with Inflam∣mations, Delirium, Convulsions, and Gangren, which are for the most part mortal.

LVI. The Cure. In these, the extraneous Bodies, and Splinters of Bones, are immediatly to be taken forth; for which reason, the Orifice, if it be not large enough, is to be made so: but in doing this, in the lower parts in the hollow of the Ham, Arm, Armpit, or Groin, be cautious, because those Parts are subject to great Hemorrhages.

LVII. The Extraneous Bo∣dies, &c. being removed, you must with all speed hasten Digestion by dropping, or applying warm upon Tents, Dossels, or Pledgets, proper Digestives, such as the following: but Tents are to be used with much caution in these kinds of Wounds.

LVIII. Take Turpentine washed in S.V. ℥iv. Oil of Hypericon ℥ii. yolks of Eggs N^o ii. Frankincense, Mastich, Olibanum, Myrrh, Saf∣fron, A. ʒi. mix them.

LIX. Or, Take Turpentine ℥ii. yolks of Eggs N^o ii. Oils of Scor∣pions, of Castor, of Earthworms, and of Whelps, A. ℥ss. Frankin∣cense, Myrrh, Harts-horn burnt, A. ʒiss. mix them.

LX. But if a stronger Dige∣stive is required; then, Take Oils of Turpentine and of Spike, A. ℥i. Oils of Castor, and of Hype∣ricon with Gums, A.℥jss. Euphor∣bium in pouder ʒjss. mix them: this is to be dropt very hot in∣to the Wound, and one of the afore-mentioned Digestives is to be applied over all.

LXI. Then the Parts adjacent are to be Embrocated with Oils of Whelps and of Hypericon, over which this Cataplasm may be applied. Take Barley and Bean meals, A. lbj. flowers of Camomil and Melilot, red Roses, tops of Wormwood and Scordium, all in pouder, A. ℥i. Broth of a Sheeps-head, (if you would have it Lenitive, otherwise in Oxymel) q.s. boil to a consistency; adding, Oils of Whelps and Linseed, A.q.s.

LXII. Or, Take mucilages of Altbea and Comfrey roots, A. ℥iv. Barley and Bean meals, A. ℥vi. meals of Linseed and Fenugreek-seed, A. ℥iv. Zedoary in pouder ℥jss. Wine, q.s. boil to a consi∣stency: and add, Oils of Hypericon

and Whelps, Honey, A. ℥ii. yolks of Eggs N^o ii. mix them for a Digestive.

LXIII. Then deterge with this Abstersive. Take Turpentine, Ho∣ney, Orobus-meal, A. ℥ii. Orrice-root, Frankincense, round Birth∣wort-root, A. ℥jss. juice of Smal∣lage ℥ iii. mix, and make an Ointment.

LXIV. The Wound being cleansed, Inearnate with Sarco∣ticks: as, Take Beef-suet ℥iv. Earthworms washed, Oil of Ma∣stich, A. ℥ii. roots of Comfrey and Tormentil, A. ℥ ss. tops of Hyperi∣con, Betony, Horse-tail, Plantain, A. M. ss. Wine, q.s. boil to the consumption of the VVine; strain out by strong expression, and add thereto VVax ℥ iv. Pine-Rosin ℥i. Aloes, Frankin∣cense, Mastich, Myrrh, A. ℥ss. mix, and make an Ointment. Wiseman.

LXV. If the pain is violent, and yields not to Anodyns, cut off the affected Tendon, and whatever corrupts, lest it taints the rest: and if the Bone is bare, you must be careful not to foul it by applying greasy Medicines: also in great Wounds of this kind, you ought always to con∣sider first, whether they are curable or not; that by a timely Extirpation, you may save the Life of your Patient.

CHAP. XXIV. Of BƲRNINGS and SCALDINGS.

I. THIS kind of Wound is called in Greek, 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉. in Latin, Ambustio; in English, Burning: also, 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, Pustula, Scalding; 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, Vesicatum Aquis, Scal∣ding with Water; 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, Vesiculatum Oleo, Scalding with Oil; 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, Vesicatum Picis, Scal∣ding with Pitch, &c.

II. Burning or Scalding, is a Solution of Ʋnity; mostly in the fleshy parts, caused by an ex∣ternal burning matter; and always hurting the Cuticula, for the most part the Cutis, and many times the Arteries, Veins, Lymphaducts, Muscles, Nerves, Tendons, and Ligaments.

III. The Differences. The Dif∣ferences are taken, 1. From the Nature and Quality of the Wound. 2. From the Matter or Substance, with which the Burning or Scalding was made.

IV. From the Nature and Qua∣lity of the Wound, it is Fourfold. 1. When heat and pain are only excited in the Wound; and unless that Medicaments are presently applied, the Cuticula will be separated from the Cutis, and so Blisters will be raised, which will contain a clear Water.

V. 2. Sometimes the Cutis it self is burnt; and then a Bli∣ster is raised upon the spot, but no Escar or Crust is pro∣duced or made; tho' many times the Skin is contracted together.

VI. 3. Sometimes the Skin it self, and the Flesh which lies under it is burnt, and an Escar produced; so that the Skin is black, and void of sense, and when the Escar is faln off, a deep Ulcer is left.

VII. 4. Sometimes not only the Skin and Flesh are burnt, but the Vessels, as Arteries and Veins; also Nerves, Tendons, and Ligaments; which are many times shrunk up, contracted, and burnt, so as to break in sunder by force of the Fire.

VIII. 2. The Differences are taken from the Matter or Instru∣ment burning; as, 1. With Wa∣ter, which is called Scalding; which is more or less, as it is more or less hot.

IX. 2. With Straw, Stubble, Flax, Chips; which only scald, and raise Blisters, unless the burning is long continued.

X. 3. With Oils, Fats, Tar, Pitch, Varnish, Honey, Wax; all which scald more than the other things, causing greater Pain, and larger or deeper Blisters.

XI. 4. Burning with melted Lead, Tin, or Iron red-hot, &c. which are more vehement and intense Burners than the former things, and many times cause very deep Ulcers.

XII. 5. Burning with the actual Fire it self, as also with Gun∣powder and Lightning; which cause most vehement Wounds and Ulcers; according to the greatness and length, or time of the Burning.

XIII. The Prognosticks. The lighter the Burning, the more easily it is cured: but by how much the burning is greater, by so much it is harder to cure; and so much the more pernicious Symptoms it brings, as Inflam∣mation, Gangren, Sphacelus, loss of Motion of the Part, and Ulcers very difficult to be cured.

XIV. If the Burn is great and deep, it for the most part leaves a great Deformity, or unseemly Scars behind it.

XV. Burning by Lightning is dangerous, and for the most part mortal; and if that, or any other kind of Burning pene∣trates into the Intestines, it is incurable.

XVI. Burnings in Bodies Caco∣chymical, Scorbutick, or Stru∣matick, are many times accom∣panied with an Afflux of Hu∣mors, whence arise Inflamma∣tions, putrid Ulcers, and other unpleasing Symptoms.

XVII. If one part is burnt, the danger is less than if there were more parts, or the whole surface of the Body burnt: in the latter case, the Patient commonly dies miserably, by the very vio∣lence or vehemency of the Symptoms.

XVIII. If the Burning is so deep, as to reach to the greater Arteries, Veins, and Nerves, it is very dangerous; for the Vessels are contracted and shut up,

whereby the Blood and Spirits cannot flow unto the Parts af∣fected; whence either an Atro∣phy, or loss of Sense and Motion, or a Gangren is in∣duced.

XIX. If the Abdomen is burnt, it is not cured but with much difficulty: so likewise the Burnings of the Groins and Armpits, because those places are moist, and apt to receive an Afflux of Humors.

XX. The Burnings of the Eyes are dangerous; for they produce either Blindness, or a depriva∣tion of Sight; or at least a diminishing thereof.

XXI. If the Hairy Parts are much burnt, they remain bald, and the Hair never grows there again: for in such a Part the Cicatrice is hard, and the Pores shut up, so that Hair can never be gene∣rated there any more; nor if there were Matter for their Generation, would they be able to penetrate thro' the closed Pores.

XXII. The Cure. We shall con∣sider this, as it has relation, 1. To Burning or Scalding in general. 2. To a light or gentle Burning. 3. To Burnings with Gunpowder. 4. To Burnings from Lightning. 5. To Burnings of the second Degree. 6. To Burnings of the third degree. 7. To Burnings of the Eyes. 8. To Burnings of the Joints. 9. To Burnings of the Groin. 10. To the preventing of ugly Scars.

I. Of Burning and Scalding, in general.

XXIII. The First Intention is, to draw out the Fire, which in a light or gentle Burning or Scal∣ding, does preserve the Part from Blistering or Ʋlcerating: and in a great Burning, it preserves from farther danger: and there∣fore what is to be applied, is presently to be laid on.

XXIV. Some Physicians, from that common received Axiom, That Contraries are cured with Con∣traries, will have it; That Cooling things must be applied to Burns and Scalds: whereas in all Burnings and Scaldings, the Particles or Atoms of Fire are communicated to the Part, so that an Empyreuma is pro∣duced: in which case, if cold things be applied, the Particles of the Fire which have pene∣trated into the burnt Part, will be driven farther in: whereas on the contrary, it is the Phy∣sician's Business to draw them wholly forth.

XXV. From hence then, upon the imposing of cold things, the fiery Particles being protruded much lower or deeper into the Flesh; it follows, that the Pain will be very much increased, Inflammations may ensue, a Gangren may be excited, and even a Sphacelus it self in∣duced.

XXVI. It is then Heat, and hot things, which are helpful, and call forth the Empyreuma, or Particles of Fire: and therefore in the more gentle Burnings, it is not unknown even to the Vulgar, that the burnt Part is to be held near the Fire, or Flame of a Candle, or a red-hot Iron; to be Burnt again, (as it were)

that thereby the Fire may be drawn forth: Attractionem facit similitudo, atque Ignis externus, intrinsecum Ignem foràs evocat: Similitude and likeness begets attraction, and the external Fire calls forth the internal Fire, as, Paraeus, lib. 11. cap. 9. and Sennertus, Med. pract. lib. 5. par. 2. cap. 18. have truly told us.

XXVII. Barbett therefore ad∣vises, that the hurt Part be held to the Fire, and fomented with warm Water, hot Ink, Lye, or Salt-brine, or Soot may be ap∣plied upon it, or an Onion bea∣ten up with Salt.

XXVIII. Or these following; Roots of white Lillies, Liquo∣rice, Leaves of Beet, Colewort, Hemp; Onions, Leeks, Gar∣lick, Henbane, Tobacco, Hy∣pericon, Flowers of Camomil, Melilot, Elder, Seeds of Quinces, Flax, Camphir, Myrrh, Oliba∣num, Frankincense, Turpen∣tine, whites of Eggs, Hogs-lard, Oils of Nuts, and of Rape-seed, Sheeps, Pigeons, and Hens Dung, Nitre, Common Salt, Sal Gem, Vitriol, Allum, Ink, Lye, Salt-Brine, Ceruse, Litharge, Sac∣charum Saturni, Ʋng. Album Camphoratum, Empl. de Minio.

XXIX. An Ointment of Bar∣bett's: Take Juice of Onions, Hogs-lard, A. ℥ii. Venice Soap ℥iii. Oil of Rape-seed, Mucilage of Quince-seed, A. ℥i. washt Lime ℥ss. Common Salt ʒii. Tur∣pentine q.s. mix, and make a Liniment.

XXX. Or this: Take fresh Sage, M. i. Plantane, M. ii. fresh Butter ℥vi. white new Hens-dung ℥iii. mix, and fry them to∣gether a quarter of an Hour, and press out the Ointment, which keep for Ʋse. This Ointment is ad∣mirable in Burnings of all sorts, even in the greatest, the burnt Part being often anointed with it in the Day, and a fresh Beet, Colwort, or Plantane-leaf laid over it: By the use of this only thing, 'tis said a Poor Soldier became Rich.

XXXI. If the Burn is blister∣ed, and yet it is not great, the Blisters ought to be opened the third Day, and not farther to be pro∣longed, lest the Matter becomes Corrosive: but if the Skin is wrinkled and dryed, the Bli∣sters or Pustules are immediate∣ly to be opened, and the fore∣going Ointment applied, or this following.

XXXII. Take Mucilage of Fleawort-seeds, Meal of Althaea-roots, A. ℥jss. Oils of white Lil∣lies, of Violets, of sweet Almonds, fresh Butter, Unguentum Basili∣con, Roping-soot, A. ℥i. Saffron ʒss. mix, and make an Ointment.

XXXIII. If there is an Escar, it ought to be separated the first or second Day, by the help of some of the former Ointments; but if they will not do, Incision is to be made into the sound Flesh; and when it is separated, the Cure must be done as a Common Ul∣cer.

XXXIV. If any tender Part is burnt, you ought to abstain from the use of Onions, Salt, Soap, and such other like sharp Medi∣caments.

II. Of a light or gentle Burning.

XXXV. Here you must do all you can to prevent its blistering, which is by the speedy Application of Medicaments to draw out the Fire, whereby the Patient is freed from all the Pain of the Burning: for which purpose (if the Con∣dition of the Member will ad∣mit of it) it may be held near to the Fire, or a red-hot Iron may be held near to it; or it may be dipt deep, and held therein for some time in very hot Water, so will the Empy∣reuma, by reason of the likeness, be Extracted.

XXXVI. Or, you may apply a Linnen-Cloth dipt in Varnish, or a Cloth dipt in Lye or Water, in which unslaked Lime has been quenched; and then presently a Cataplasm of Garlick and Salt beaten together, is to be ap∣plied.

XXXVII. Or this: Take un∣slaked Lime often washed in Rose-water, and with Oil of Roses or Hypericon, make a Liniment. Or, Take May-butter, Venice or Ca∣stile Soap, Liquid Varnish, Ana, mix them. Or, Take whites of Eggs, N^o iii. Oil of Roses ℥iii. Camphir in pouder ℥ss. mix them.

XXXVIII. Take of raw Onions ℥iii. Castile Soap, Salt, A. ℥i. beat them in a Mortar to a Pultis, and with Oil of Roses, q.s. make an Ointment. Or, Take whites of Eggs, N^o ii. Oils of Linseed, and of Olives, A. ℥jss. Salt ℥ss. mix them. Or, Take green inner Bark of Elder, or young Elder-shoots, q.v. beat them well in a Mortar, then boil in fresh Butter, q.s. and strain out the Oil.

XXXIX. Take Juice of young Elder-shoots ℥ iii. Linseed Oil; VVax, Ana ℥ j ss. Varnish, Rape-seed Oil, Frankincense in pouder, A. ℥i. boil them to the consumption of the Juice.

XL. Take Castile Soap ℥iii. Linseed Oil, Oil of Eggs, A. ℥jss. Oils of Ben and Rapeseed, A. ℥ss. raw Onions, Salt, Mucilage of Quince-seed, A. ℥i. beat all to∣gether, and make an Ointment.

XLI. Take Linseed Oil ℥iv. new Wax ℥ii. whites of Eggs, q.s. mix over a gentle Fire, and make an Ointment. Take Craw-fish, q.v. beat them well in a Mortar, and boil them in new fresh Butter, q.s. till they grow a little red, then strain out by pressing.

XLII. Paraeus his Ointment. Take choice Lard lbi. yolks of new-laid Eggs, N^o iii. mix, and make an Ointment. Or, Take Oil Olive ℥ii. whites of Eggs ℥iv. shake them together till they be∣come a white Ointment, with which the place is oftentimes a Day to be anointed with a Fea∣ther, till it is well.

XLIII. Ferrarius Arte Med-Infant. lib. 4. cap. 25. com∣mends this as a rare Secret, even where the Burn was Blistered. Take Oil of Roses ℥ii. Rose water ℥i. whites of Eggs, N^o ii. mix them well together by shaking; dip a Linnen-cloth therein, and lay it over the Burn, and conti∣nually keep it moist with the same; after the fourth Day is over, instead of whites of Eggs, take yolks of Eggs, and continue the use thereof till it is well.

XLIV. ℞ Juice of the middle rind of Elder ℥iv. Cream ℥xii. boil to a Consistency, then add fresh Butter, Mucilage of Quincè-seeds, Juice of Nightshade, Ceruse, A. ℥j. mix, and make an Ointment. Or, ℞ the inner Bark of Elder, q.v. Oil Olive, q.s. boil till it is crisp, strain out, and add Ceruse, p. ii. Litharge, burnt Lead, A. p. i. mix them well in a Leaden Mortar.

XLV. Quick-lime so often wash∣ed in Water, till it is freed from all its Salt, may be made into an Ointment with fresh Butter, Oils of Ben, of Hypericon, of Linseed, or of Roses, which will be very good against Burnings; and sometimes you may add thereto the Mucilage of Fleawort-seeds, of Quince-seeds, or the white of an Egg, and Bees-wax.

XLVI. Now observe that no Ointment ought to stick too close or fast to the Part, in these kinds of Wounds, for that then they cause much pain; and the Sores are to be cleansed only by putting fine, thin, and soft Linnen-Cloths upon the Part.

XLVII. If Blisters are raised, they are not properly to be opened, because the Skin will be naked or raw, and so pain will be excited, whereby the Cure will be the longer in doing; but at length on the third Day they are to be cut, when a new Cuticula, or Scarf-skin, begins to be formed and bred.

III. Of Burnings with Gun∣pouder.

XLVIII. In the first place, if any of the Grains of Pouder are gotten into the Skin, they are to be pickt out, otherwise the blue marks will always remain: This, says Sennertus, may be done with a Needle, or with some other In∣strument fit for that purpose; if they cannot all be thus pickt out, you must suffer it to blister (if it is not blistered before∣hand) for so by this means ma∣ny more of those Grains will be easily taken forth.

XLIX. If this is not done at first, and if after the burning is quite healed, some of the Grains remain, there is no other way then, but by applying a Vesica∣tory, whereby the Grains which are more superficial will be ta∣ken away, and the Sore is to be washed from its blackness with a Decoction of Fenugreek and Camomil Flowers. But this by the way.

L. If the Burn is only superfi∣cial, the Cuticula is raised into a Blister: if it goes deeper into the Skin, it makes an Escar; if it burns deeper into the Flesh, there is a hard Crust with a Contraction; in all which there is a vehemency of Pain.

LI. Wiseman advises by Re∣frigerants to bathe or anoint the Part, till the heat is off, and the Escar separated; and then to digest and cicatrize; or by Ca∣lefactives to relax the Skin, re∣solve and dissipate, which by Accident will asswage the heat and burning.

LII. Refrigerants are Waters and Juices of Housleek, Henbane, Hemlock, Nightshade, Man∣drake, Stramonium, Plantane,

Adders Tongue, &c. as also all cooling Juices, Oils, Ointments, Balsams and Cerats, Ʋng. Al∣bum, Nutritum, Populeum, Rosa∣tum, &c. where note, that all these potentially cold things must be used actually hot, till the heat and pain cease.

LIII. Calefactives are a red hot Iron, or naked Fire held to the Part, whereby they call forth the Particles of the Fire, and become the Alexiterion: But the Com∣mon Remedy is an Onion bea∣ten with Salt; yet this is not to be applied after Blisters are risen, nor by any means where the Part is raw, for so you will exasperate the Pain, and in∣crease the Inflammation.

LIV. In this Case the Oint∣ment of Sennertus is better. ℞ Gum Elemi ʒi. dissolve it in Oils of Eggs, of Roses, and of white Lillies, A. ʒi. Ung. Basi∣licon ʒiii. unsalted Butter ℥i. mix, and make an Ointment.

LV. For the easing of the Pain he prescribes this: ℞ Oils of sweet Almonds, and of Roses, white Wax, A. ℥i. melt them to∣gether, then add Mucilage of Quince-seeds ℥ss. Camphir ʒi. mix them.

LVI. Horse-dung fried in Oil of Nuts, and applied, does extin∣guish the Fire: There are also recommended, unripe Grapes, Elder Bark, and young shoots, Dwarf Elder boiled in Oil, Lime well washed, and mixed with Ʋnguent. Rosatum to a Consisten∣cy, which are to be applied, and often renewed, till the Fire and Pain are gone.

LVII. If by these things Blisters are not prevented, you may prick or cut them as they arise, lest they erode and make Ulcers, excite sharp Pains, Inflammations, Fe∣vers, &c.

LVIII. But if the Burning is to an Escar, or Crust, you must ha∣sten its falling with Emollients, then digest, incarnate, and ci∣catrize.

LIX. If there is a Cacochy∣mia of Humors, you may purge by Lenitives often, or rather by more powerful Catharticks, u∣sing a spare Diet, rest, quietness and serenity of Mind.

LX. Some dress the Escar with Mel Saponis, and embrocate the Parts with Oil of Roses mixt with whites of Eggs. Or, they anoint the Escar with Honey mix∣ed with Juice of Onions, and pou∣der of Orrice-roots, and foment the Parts about with Decoction or Juices of Henbane, Night∣shade and Plantane, Mallows, Violets, Quince and Fleawort-seeds, adding to it a third part of thick Cream.

LXI. If the Parts be raw, they may be drest with fine thin Linnen, dipt in the aforesaid Decoction, or Juices, or anointed with a Fea∣ther dipt in Ointment of Stra∣monium mixt with Oils of Eggs or Linseed Oil; by which means places superficially burned, are healed.

LXII. Parts deeper burnt, when they cast off their Escars, may be digested with Turpentine washed in Juice of Plantane, mixed with the yolk of an Egg, Oil of Linseed, and some fine Barley-flower.

LXIII. Afterwards you may

apply Ung. Diapompholigos, and anoint the Lips with Ung. Album Camphoratum mixt with the white of an Egg, or with Ung. de Stramonio, as the Intention, Place or Necessity shall require.

LXIV. Or you may dress with this: ℞ Oil of Elder, lbi. Wax ℥iii. Litharge ℥ii. Ceruse, Lime washed, A. ℥i. Frankincense, Sar∣cocol, A. ℥ss. mix, and make an Ointment: and afterwards you may cicatrize with a Decoction of Horse-tail, red Roses, Bram∣ble-tops, Bistort, &c. in which a little white Vitriol or Allum may be dissolved, or with some other Astringent or Styptick, with which you may be provi∣ded.

IV. Of Burning by Lightning.

LXV. Where Burning by Light∣ning does not immediately Kill, and that there is hopes of Life, proper Medicaments are to be ap∣plied, viz. such as have power to dissolve the Congelation of the Humors which causes Suffo∣cation, and resist Malignity or Poyson, for as much as it mani∣festly appears (from the foetid Smell it carries along with it) that there is a malign and poy∣sonous quality joined therewith, for that it has power to hurt the Body, yea, oftentimes to Kill, even when no visible sign of a Wound or external Hurt does appear.

LXVI. Such a Patient then un∣der hopes of Recovery, is presently to be put to Bed, and some Alexi∣pharmick and Sudorifick Dose is to be given, which may resist the Malignity, and dissolve the Con∣gelation, such as volatil Salts of Harts-horn, of Vipers, of Am∣ber, and of Sal Armonick, Spi∣rit of Harts-horn, and Sal Ar∣moniack, Our Aqua Bezoartica, Spiritus Cordialis, Tinctura Be∣zoartica, Bezoar Minerale, The∣riaca Chymica, Mithridate, and Venice Treacle, also Tinctures of Virginia Snake-root, of Saffron, and Cochinele, Spiritus Opii Compositus, &c.

LXVII. The Arteries, Temples, Nose, and Tongue, may be smeared with Our Theriaca Chymica, made thin with Our Spiritus Cordialis; and to the Wrists and Region of the Heart Epithems or Cata∣plasms may be applied, made of Our Theriaca, or the Vulgar Mi∣thridate, mixed with a quarter part of Pouder of Virginia Snake∣root.

LXVIII. Outwardly to the place Burned, a Cataplasm made of Oni∣ons and Mithridate, or Our The∣riaca beaten together in equal quantities: and if an Escar is made, it ought to be as soon as may be, removed with an Inci∣sion-knife, after which you may apply this following Ointment.

LXiX. Take Pouders of the Roots of Angelica, Swallow-wort, Zedoary, and Contra-yerva, A. ℥ss. Winters Cinnamon, Virginia Snake-root, A. ℥i. Rue, Scordium in fine Pouder, A. ʒiii. Our The∣riaca Chymica ℥jss. Honey of Roses ℥iii. Tinctura Bezoartica, q.s. mix them. If this cleanses not enough, add to it Scammo∣ny in fine Pouder ʒvi.

LXX. The Ulcer being clean∣sed, it is to be filled up with

Flesh, with this Sarcotick Pou∣der: Take Virginia Snake-root, Contra-yerva, Roots of Angelica and Swallow-wort, Zedoary, Aloes, Succotrine, Tobacco all in fine Pou∣der, A. ʒii. Pouders of Scordi∣um, Frankincense, Mastich, Oli∣banum, Myrrh, Pine, Rosin, A. ʒjss. Juices of Tobacco raised from Virginia Seed, of Sanicle, A. q.s. mix, and make Troches, which dry in the shade, and reduce into Pouder, as you have occasion for them.

LXXI. If any Bones should be broken, as oftentimes it falls out, you may apply a Cataplasm made of the flower of Barley, of Beans, and of Lupins, with pouders of the roots of Angelica, of Bistort, of Comfrey, of Swallow-wort, and of the leaves of Rue and Scordium, with Catechu, all in fine pouder, mixed with Mithridate, or Our Theriaca, and a little Tinctura Bezoartica, which is to be re∣newed Day by Day, till such time as the Malignity is over∣come, and the Part in some mea∣sure restored to its strength, lay∣ing also Defensatives round a∣bout, to strengthen the same, and defend it from Symptoms.

V. Of Burnings of the second Degree.

LXXII. If the Burning is so great, that not only Blisters are raised, but also the Cutis, or Skin, is contracted or drawn together, then such Medicaments which only draw forth the Empyreuma, or Particles of Fire will not be enough, but such are likewise to be applied which mollifie and soften the Skin; for which rea∣son all the Pustules are immedi∣ately to be opened, that the hot and sharp Humors, may freely flow forth, which done, the following, or some such like Medicine may be imposed.

LXXIII. Take yolks of Eggs, N^o ii. Oils of Hypericon, of Ben, and of white Lillies, A. ℥ss. Ung. Basilicon ℥i. mix them.

LXXIV. Or, Take Oils of Ben, and of Hypericon, A. ℥i. Oil of Roses, Bees-wax, A. ℥ss. Oil of Scorpions, Palm Oil, A. ʒii. mix, and melt, then add Muci∣lage of Fleawort-seeds ℥i. Saffron ʒss. mix them.

LXXV. Or this of Fabricius: Take new fresh Butter ℥iii. Bar∣ley-flower ℥jss. Mucilage of Quince-seeds ℥i. yolks of Eggs, Oils of Violets, and sweet Almonds, A. ℥ss. Saffron ℈i. Wax, q.s. mix, melt, and make an Ointment.

LXXVI. ℞ Pulp of roasted Apples ℥ii. Meals of Barley and Fenugreek seed, A. ℥i. Milk, q.s. mix, and make a Cataplasm, to which add Saffron in Pouder ʒss.

LXXVII. ℞ Litharge, Ceruse, A. q.v. Wine Vinegar, q.s. boil, and pass the Vinegar thro' a filtering Bag; then add Oil of Vio∣lets, or Oil of Eggs, q.s. and mix them together.

LXXVIII. And on the burnt place lay such a Defensative as this: ℞ Catechu, Terra Sigilla∣ta, Nut-Galls, Sanguis Draconis, Bistort, Comfrey-roots, all in Pou∣der, A. ℥i. Oil of Hypericon ℥vi. Wax ℥iii. Vinegar ℥jss. mix, and make an Ointment.

LXXIX. After which, bind up the Member with a Rowler well

wetted in Oxycrate, or a Linnen-cloth dipt in the same, that the Pain may be lessened or eased, and the afflux of Humors hinder∣ed; these things being done, the Wound is to be digested, cleansed and healed, as another Ulcer.

VI. The Cure of Burnings of the Third and Fourth Degrees.

LXXX. If 〈…〉〈…〉 the whole Ra∣dical Humidi•…•… consumed, and the Flesh it 〈◊〉〈◊〉 is burnt; and if therewith 〈◊〉〈◊〉 Arteries, Veins, and Muscles are burnt, making great Pustules, or an Escar, whence a Gangren may be feared, or other ill Symptoms; you must then cut the Pustules, and cleanse them of the Humor contained in them; and you must endeavour to separate the Escar, even the first or second Day, which if it will not be, you are to cut it with an Incision-knife, that a passage may be made for the coming out of the Matter, and intrusion of the Medicines which are to be applied.

LXXXI. The Escar being o∣pened, Fabricius Hildanus ap∣plies some such like as this: ℞ fresh Butter ℥iii. Ung. Basili∣con ℥i. Mucilage of Quince-seeds, Oils of sweet Almonds, and white Lillies, A. ℥ss. yolk of one Egg, mix them.

LXXXII. Or: ℞ Oils of Ben, and of Hypericon, A. ℥jss. yolks of two Eggs, Turpentine ʒss. mix them. Or: ℞ Mucilage of Flea∣wort-seed ℥ii. Oils of Hypericon and Linseed, A. ʒvi. Turpentine, or Gum Elemi ʒiii. yolk of one Egg, Wax q.s. make a Lini∣ment.

LXXXIII. And lay over lin∣nen Cloths dipt in this Emul∣sion: ℞ Melon-seeds hull'd ℥ii. Fleawort-seed, Fenugreek-seed, A. ʒii. Water lbiv. make an E∣mulsion, in which dissolve Castle-Soap ℥ss. Camphir ʒss. first dis∣solved in a little S.V. mix them.

LXXXIV. If the Part begins to swell, or a Gangren is feared, Defensatives are to be avoided, because they hinder Transpiration: but if a Gangren is already in∣duced, it is to be Cured as we have in several other places de∣clared.

LXXXV. When the Escar, or the Matter or Flesh which is quite burnt is separated, (which is timely to be done, lest by its pu∣tridness, it corrupts the sound Parts) then by Abstersives you must cleanse the Ulcer, after∣wards you must Incarnate, and then you must perfect the Cure with Epuloticks, which yet are not to be over dry, lest the Ci∣catrize is rough and deformed.

LXXXVI. To produce the Cicatrize you may use this: ℞ Diapalma, or Empl. Album ℥ii. Palm Oil that is yellow, Oil of Ben, or Hypericon, A. ℥ss. melt them together, and add thereto Allum burnt, Ceruse, Litharge, Lapis Calaminaris, Tutiae, all levigated, A. ʒi. Mucilage of Fleawort-seed, q.s. mix, and make an Ointment, by grinding them in a Leaden Mortar.

LXXXVII. Fabricius Hilda∣nus used sometimes in this Case, Ʋnguent. Alabastrinum, which softens the Part, eases the Pain,

and induces a very fair Cica∣trize.

LXXXVIII. If the Arteries, Veins, and Nerves, are burnt, to prevent an Atrophy, by reason of want of Aliment, and that the Vessels closely shut up by the Fire may be opened, this Oint∣ment following may be used.

LXXXIX. Take Oils of Whelps, and of Earthworms, yellow Palm Oil, Oil of Ben, Bears Oil, A. ℥i. Camphir ℥ss. dissolved in a little S.V. mix, and make an Ointment.

VII. Of Burnings of the Eyes, Face, &c.

XC. If the Eye-lids, Lips, Fingers, &c. which are naturally separated, should be burnt, that they may not grow together, dry Lint, or Linnen, or little thin Plates of Lead, or white Paper, are to be put between, and proper Medicines are to be ap∣plied.

XCI. It is not fit to apply to the Face when burnt Medicaments made of Onions, Salt, soft Soap, Varnish, &c. lest the Eyes there∣by should be hurt; and there∣fore the Ointment of Ferrarius, or some such like, may be ap∣plied, which is thick, and will not spread abroad; as, ℞ Venice or Castile Soap ℥i. Oils of Roses, and of sweet Almonds, A. ℥ss. mix them.

XCII. If the Eyes are burnt, Breast-milk is commended to be dropt immediately into them, or any other Milk Blood-warm, or Milk mixed in equal parts with Water or Juice of Fennel.

XCIII. Or this Collyrium: ℞ Damask Rose-water, Fennel, and Celandine Waters, A. ℥jiss. Fleawort-seeds well bruised ʒii. digest twelve Hours, more or less, in a warm place, and strain out the clear for use.

XCIV. If it is a vehement burning, and with an Escar or Crust, take heed that the Eye-lid is not drawn back, for that will cause a very great Deformity, to Remedy which, you must apply Emollient Fomentations and Unguents, and if need be, the Skin is to be extended often∣times with your Fingers.

XCV. ℞ Roots of Althea, Seeds of common Mallows, A. ℥jss. Lin∣seed, Fenugreek-seed, and Flea∣wort-seeds, A. ℥i. Mallow-leaves M. j. Flowers of Melilot and El∣der, A. M. ss. Milk, Water, A. q.s. mix, and make a Decoction, with which foment warm.

XCVI. Then anoint with this: ℞ Oils of Hypericon, of Eggs, and of Whelps, A. ℥i. Man's Fat ℥iss. Gum Elemi ℥ss. Saf∣fron ʒi. Wax, q.s. mix, and make an Ointment.

XCVII. Or anoint with this: ℞ Vipers-grease, Man's Fat, Oils of Hypericon, and of Whelps, A. ℥i. Oil of Earthworms, Mucilage of Fleawort-seeds, A. ʒvi. Gum Elemi ʒiii. melt, and mix them over a gentle Fire.

VIII. Of Burnings of the Joints.

XCVIII. As these Parts are almost void of Flesh, and Nervous, and so endued with an exquisite Sense, so they are easily offended with a flux of Humors, and other

grievous Symptoms, for which cause sake, Universal Evacuati∣ons ought to be made with Sy∣rupus Catharticus, Pilulae Cathar∣ticae, Pulvis Cornachini, &c.

XCIX. Topicks ought also to be lenient and gentle, mild and ano∣dyn, and not very sharp, as are those of Onions, Garlick, Salts, Soap, Lees of Wine, &c. and such as may be Emollient to hin∣der the Contraction of the Nerves, Tendons, or Liga∣ments.

C. ℞ Oils of Hypericon, of Whelps, of Earthworms, A. ℥i. Mans, Bears, and Vipers Grease, A. ℥ss. Oil of Ben ʒvi. Gum E∣lemi ʒiii. mix, and make an Ointment.

CI. You ought also to fit Feru∣la's, or other easie Instruments, to the Member, to prevent Contra∣ction: but if there is already a Contraction or Incurvation, then (generals being first premised) the Part affected is to be fomen∣ted with an Emollient Decocti∣on, as, ℞ Roots of Althea, of Briony, of white Lillies, A. ℥ii. Leaves of Mallows, of Alehoof, of Hollihocks, and of Hypericon, Flowers of Camomil and Melilot, A. M. j. Seeds of Flax, Flea∣wort, and Fenugreek, A. ℥i. Wa∣ter, Milk, A. q.s. mix, boil, and make a Fomentation.

CII. After fomenting, anoint with this Ointment following: ℞ yellow Palm Oil, Oil of Ben, and Oil of Eggs, Oils of Hypericon, of Whelps, and Earthworms, Beef-suet, A. ℥i. Balsam Capivii, or de Chili, Gum Elemi, A. ℥ss. Balsam de Peru ʒii. Wax, q.s. mix, and make an Ointment.

CIII. And upon the Part you may lay Ceratum Nigrum, Em∣plast. Polychrestum, or Diachy∣lon simplex; extending daily, and by degrees the Contracted Joint, with fit and convenient Instruments.

CIV. Besides the former at Sect. 102. above, there are o∣ther things which are powerful in Resolving Contractions, as, ℞ pure yellow Palm Oil, Oil of Aniseeds, A. ℥jss. mix, and a∣noint therewith; and it will be yet more powerful if Oil of Vi∣triol ℥ss. is added to it; so also Spiritus Mirabilis in lib. 1. cap. 59. sect. 10. which resolves Contractions to a wonder.

IX. Of Burnings in the Groin.

CV. These are Parts which are moist, lax, and apt to receive fluxions of Humors, by reason of the Glandules, so that a Gangren is apt to be induced; for which cause sake, the Medicaments which are to be applied, ought to be of a drier Nature than those which are applied to other Parts.

CVI. If therefore no Blisters arise, these things made of Lillies, Onions, and Soap, are beneficial; but if large Blisters are already raised, then they ought to be speedily and timely opened.

CVII. Which done, this fol∣lowing Ointment may be apply∣ed: Take Ung. Rosatum, Nico∣tianae, Basilicon, A. ℥i. Oils of Hypericon and Eggs, A. ℥ss. A∣loes, Myrrh, Sarcocol, Olibanum, A. ʒi. mix them.

CVIII. And upon the Oint∣ment,

let the whole Part be co∣vered with this Cataplasm: ℞ flowers of Barley, of Beans, and of Orobus, A. ℥jss. pouder of Roses, of Myrtle-berries and Ca∣techu, A. ʒvi. Honey of Roses, or Oxymel, q.s. mix, and make a Cataplasm.

CIX. But if the Wound or Burning is so great, as may give you the fears of a Gangren, then Medicaments proper against Gangrens are to be applied, of which we have spoken already sufficiently in other places.

X. To prevent a deformed Cicatrize.

CX. To do this, you must be careful that no Hypersarcosis, or proud Flesh, grow upon the Wound or Ʋlcer, for thereby the Cicatrice will be deformed; and sometime if great Care be not taken, they will seem to be as it were wenny; and says Wiseman, when they happen upon Womens Breasts, they have sometimes been supposed Can∣cerous. In others from ill hand∣ling; the loose Flesh (says he) has grown so high and callous, that one of them which came into my Hands, required to be burnt again, in order to the Cure.

CXI. In the Face therefore, there is a special Care to be had, as also in the Eyes, Neck, and Breasts of the Female Sex: In the Eyes, that they be not daub∣ed with greasie and nasty Me∣dicines; and that the Lids be not drest with too drying ones, lest they cause Contraction, and make a Blearedness.

CXII. In the Cure of the Eyes then, you may use Breast-milk, or other Milk, Blood-warm, also Pigeons-blood, Waters of Fen∣nel, Dill, Nightshade, Plantane, and Fumitory; also a Mucilage of Fleawort, Fenugreek, or Quince-seed, Trochisci albi Rha∣sis, Tutia, Calaminaris, Frank∣incense, Sarcocol, &c.

CXIII. If the Ear in this Case should grow to the Scalp, or the Fingers to one another, or the Palm should be Contracted with a hard Callus: in that of the Ear, the Callus must be divided by Incision, and soft Rags dipt in Frog-spawn-water, or some proper Balsam or Ointment, must be put between the unequal Callus rubbed with the Caustick-stone; then the Escar is to be separated, and the Sore to be Cicatrized with the Vitriol-stone, Ʋng. desiccativum rubrum, or some such like Medicament.

CXIV. If the Fingers are grown one to another, they are to be cut with Scissars, or an Incision-knife; and then the Cicatrices to be taken off with the Cau∣stick-stone; and afterwards to be healed as another Ulcer.

CXV. If the Fingers and Palm are shrunk up, and joined close, you must cut asunder each Finger, put∣ting between each a very thin plate of Lead, or other fit Matter; and cause a Rowl of Wood to be placed under the crooked Fin∣gers, which is to be carried with Bars to the inward Parts of the Wrist, and fastned by Screws, to thrust the Rowl gradually for∣ward, till it bears all the Fingers before it, and by a compleat

extension, restores them to their pristin form.

CXVI. When therefore after Burning, these deformed Cica∣trices are feared, they are to be prevented by timely applying of Emollients, during all the time of the Cure, not at all making use of those things which are too drying, for the production of the Cicatrice; but in the parti∣cular use of these Matters, your own Judgment ought to direct you.

CXVII. Let the Parts where such fear is, be fomented with an Emollient Decoction, such as we have described at Sect. 60, 95, and 101, aforegoing; and af∣terwards the Part may be anoin∣ted with the following Lini∣ment.

CXVIII. ℞ pure yellow Palm Oil, Oil of Aniseeds, A. ℥i. Oils of Hypericon, of Whelps, of Earth worms, A. ℥ss. Oils of Ben, of Roses, and of Beans, A. ʒii. Oils of Myrrh, and of Eggs, A. ʒi. white Wax, q.s. mix, and make a Liniment.

CHAP. XXV. Of WOƲNDS of the HEAD without the Scull.

I. THese Wounds are called in Greek, 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, pl. 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉. in La∣tin, Vulnus pl. Vulnera Capitis: and in English, a Wound or Wounds of the Head.

II. Differences. These Wounds are manifold, 1. Of the Con∣taining Parts. 2. Of the Con∣tained Parts. Of the Contain∣ing Parts they are also, 1. Wounds of the Hairy Scalp. 2. Wounds of the Temporal Muscles. 3. Wounds of the Cranium; of which last we shall speak when we come to Treat of Fractures.

III. Wounds of the Hairy Scalp are, 1. A Contusion. 2. A Wound. 3. A Wound with a Contusion; of all which we shall Treat in order.

IV. The Parts affected here, are the Hairy Scalp, the Mem∣brana Carnosa, and the Pericra∣nium.

V. The Hairy Scalp is thinnest on the Vertex, or top of the Head; nor is there any Muscle between it and the Skull-in that Part, ex∣cept the Membrana Carnosa, which some of late call a Muscle, because by it many Men move the whole Scalp: if a Fracture is feared there, you may boldly cut into the Hairy Scalp, because it is of an obtuse Sense, and ea∣sily healed again.

VI. But caution ought to be had in making Incision upon the Fore∣head, where a transverse Wound may cause the Eye-brows to fall over the Wound: for which rea∣son,

when we make Incision there, we make it upwards or downwards, according to the running of the Fibres; but upon the Temporal Muscles no Incisi∣on is to be made, because Con∣vulsions, and other ill Symptoms are apt oftentimes to ensue.

VII. Ʋnder the former lies the Pericranium, which you are to cut thro', when you are making your way to the Skull: and the Hairy Scalp, Membrana Carnosa, and Pericranium, are to be all raised together, when the Cranium is made bare, to make way for the Terebra, or Trepan; because the Pericranium arises from the Dura Mater thro' the Sutures; and therefore if that Membrane is lacerated or torn, Inflammation, Fever, and other Symptoms may follow.

I. Of Wounds of the Head in General.

VIII. The Prognosticks. A Contusion, if there is no Fracture or Fissure of the Cranium, is less dangerous than a Wound, or a Wound with Contusion.

IX. Wounds Contused are more difficultly cured, than Wounds made by Incision; because they require Suppuration.

X. Wounds of the fore-part of the Head are more dangerous than those of the hinder parts: 1. Be∣cause the containing parts are thinner in the fore-part. 2. Be∣cause the fore-part has more Sutures than the hinder-part. 3. Because a greater part of the Brain is contained in the fore-part. 4. Because in Mortal Wounds of the Head, if it is in the fore-part, the Patient Dies sooner than if it is in any other Part. 5. Because the Meninges have Sinuosities in the fore-part but not in the hinder-parts, 6. Because more offending Mat∣ter is apt to be gathered in the∣fore-part, which may offend the Brain, than in the hinder∣part.

XI. The smallest VVounds of the Head are not to be neglected tho' without Fracture of the Skull; for sometimes dreadful Sym∣ptoms may ensue, as Fever, Vo∣miting, faltering of the Tongue, Raving, Convulsion, Palsie of one Arm or Leg, &c. which may be from Concussion of the Brain, or some other internal unknown Cause.

XII. In Mortal VVounds, the Patient lives longer in the Winter than in the Summer, because un∣natural Heat is not then so pre¦valent.

XIII. These VVounds in Chil∣dren prove sometimes Rebellious, because they are of a hot and moist habit, which is most apt to pu∣tridness; and because their ha∣bit is thin, whereby they lose more of their Spirits.

XIV. Hippocrates, Sect 7. Aph. 2. says, it is an ill sign, if the Flesh of the Brims look livid; for it is a sign of the decay of Na∣tural Heat.

XV. If the Patient has no Fe∣ver, is in his right Mind, sleeps well, has his Body soluble, finds himself well when he takes any thing, if the Wound looks of a fresh and lively Colour, and it yields a good sort of Pus or

Matter, there is then no fear of danger.

XVI. Hippocrates, Sect. 5. Aph. 66. says, If the brims in these Wounds tumify not a little, it is an ill sign. And in Sect. 3. Aph. 67. If the Tumefaction is soft, it shews Concoction; and if hard, Crudity.

XVII. Evil may be presaged, if there is blackness in parts near the Wound; a Convulsion, Palsy, loss of Appetite, much watching, and coldness of the extream Parts of the Body.

XVIII. If a Fever invades while Suppuration is procuring, viz. before the seventh day, it is less dangerous than that which invades after the seventh day: because about the first Crisis, ill Accidents may ensue.

XIX. A Wound in or upon a Suture is dangerous: 1. Because the Scull is there parted, and so more apt to open, than a solid Bone. 2. Because in the Suture, there is a Ligament by which the Meninges are tied to the Pericranium; whereby a Wound being inflicted there, may easily be communicated to them.

XX. If Reason fail, Speech ceases, Sight is lost, there is a continual Fever, his Tongue is black and dry, the brims of the Wound blackish and dry: if the Patient suffers an Atrophy or Palsy, with an involuntary ex∣cretion of Excrements, or an absolute suppression of them, especially of Urine, or there is a Phrensy, with a Convulsion, 'tis to be feared that Death is near at hand.

XXI. Symptoms appear sooner in Summer, than in Winter; be∣cause in a hot Season, the Hu∣mors are sooner apt to putrify than in a cold, the unnatural Heat being more easily excited: for in Summer-time we expect them at or before the first or second Crisis, viz. the seventh or fourteenth Day.

XXII. If the Patient is Ca∣chectick, Scorbutick, has the Pox, Leprosy, Dropsy, Phthisick, Con∣sumption, or Hectick-Fever, or a Cacochymick Habit of Body; the Wound will be the more diffi∣cult to cure, the Blood being corrupt or deficient, and so unfit for Unition.

XXIII. If a Tumor in these Wounds does suddenly vanish away, it is an ill sign; unless some eva∣cuation has gone before, or some discussive Medicine has been applied.

XXIV. If a Fever, with a previous coldness, does appear on the seventh or fourteenth day, it is dangerous; for it may be feared that a Putridness has possessed the Brain, the Menin∣ges, or the Scull; which you may know by a yellowishness of the Wound, and an Ichor like to Water, in which raw Flesh has been washed.

XXV. The General Cure. It consists in two principal Indica∣tions. 1. By Internals, to avert a Flux of Humors. 2. By To∣picks, to induce the Healing.

XXVI. The Internals are ei∣ther Cathartick or Dietetick: the Cathartick is performed, 1. By things given by the Mouth. 2. By Clysters. 3. By Suppositories.

XXVII. There are three Cases in which Purges are to be given: 1. If the Body is Cacochymical. 2. If a Tumor or Inflammation appears, as Fallopius advises. 3. If there is an Headach, Sleepiness, Drowsiness, or Le∣thargy.

XXVIII. And they are to be given, 1. Lest the Fever increase, to prevent it. 2. To divert the Humors as soon as may be from the Head. 3. Before the strength is prostrated.

XXIX. As to the kind of Purge, it ought to be such as may purge the Humor abounding: yet some Physicians speak abso∣lutely for Chologogues, because Inflammations and Fevers are the Smyptoms most apt to en∣sue upon these Wounds.

XXX. But strong and eradica∣tive Medicaments at first are to be avoided; lest by a too vehement commotion of the Humors the Strength becomes prostrate, or Pain, Inflammation, and Fever be induced.

XXXI. Therefore Infusion or Decoction of Myrobalans are com∣mended, either alone or mixed; Elect. Lenitivum, or De Succo Rosarum, or Diaprunum Soluti∣vum, or Our Syrupus Cathar∣ticus.

XXXII. Some time after the use of these things, you may purge with Pulvis Catharticus, Pulvis Cornachini, Electuarium Catharticum, or Pilulae Cathar∣ticae; which may be repeated twice a Week, or as you see necessity requires. Arcaeus, lib. 5. cap. 4. is of opinion, that no other Cathartick Medicament but Syrup of Roses solutive ought to be used.

XXXIII. As to the Dietetick Course, 1. It consists in the use of the Non-naturals. 2. In the use of proper Wound-Drinks.

XXXIV. As to the Non-naturals, Fallopius in Hippo∣crat. de Vulner. cap. 11. says it ought to be temperate and thick: for a hot and thin Air does melt the Humors, and make them apt for fluxion; and a cold Air is hurtful to the Brain, Bones, Nerves, and Marrow of the Back-bone: and therefore Medicaments ought to be ap∣plied blood-warm.

XXXV. As to Meat and Drink, Flesh nor Fish are to be permitted for the first seven Days, especially if a Fracture; nor Wine, before the second Crisis, or fourteen Days are past; because in this space of time all the Symptoms usually cease: small Beer or Ale may be permitted for Drink; to weak Stomachs, Oxysaccharum, or Syrup of Violets, or Red-Roses simple, or Syrups of the juice of Limons or of Citrons, or Syrup of Vinegar, mixed with Milk-water, &c. And their Food may be Panada, Ptisan, stewed Prunes, Raisons, Aspara∣gus, Lettice, Endive, Succory, or Spinage boiled; and after Meals, Marmalade of Quinces, preserved Quinces, Conserve of Barberries, baked Pears and Apples, Saccharum Violatum, Caraway and Coriander-com∣fits. And when Meat is to be permitted, let it be of Chickens, Pullets, young Pigeons, Veal, Lamb, Mutton, Kid, Partridges,

Pheasants, Turtles, Black-birds, Thrushes, Larks, &c. with Ver∣juice-sawce, or juice of Oran∣ges, Limons, Citrons, Pomgra∣nates, or Sorel and Mint, with white Sugar. If they will eat Fish, let it be of Trouts, Whi∣tings, Soals, with the afore∣named Sawces.

XXXVI. As to Sleep, let it be in the Night-time, and not by Day, unless an Inflation hath seized the Brain or the Meninges, the Signs of which you will have in their proper Chapters: and too much Watching corrupts the Tem∣perature of the Body, causes Crudity, Heaviness and Pain of the Head, and makes the Wounds dry and malign: in which case, you may Embrocate the Forehead, Temples, Ears, and Nostrils, with Oils of Poppy or Poppy seeds, of Henbane-seed, or of Mandrakes, or ra∣ther with Our Spiritus Anodynus, or with Tinct. Opii ℥ss. mixt with Fumitory-water ℥ ii. doing it blood-warm; or rather with the same quantity of Vinegar: and inwardly you may give Tinctura Opii, à gutt. vi. ad xii. or more, in some proper Vehicle: or Syrup of Poppies ℥ss. in Fumi∣tory-water ℥ ii. or in place thereof, you may give Our Guttae Vitae, à gut. xx. ad xl. or Our Specifick Laudanum, à gr. j.ad iii. in some proper Vehicle.

XXXVII. Rest and Quietness is very necessary; immoderate Exer∣cise disturbs the Spirits, weakens the Body, and puts the Humors into motion; for which reason, gentle walking about the Room, when he is able, is enough.

XXXVIII. As to Excretion of Excrements, the Body is to be kept soluble, and if it is not so, Nature is to be provoked with Supposito∣ries, or Clysters: for ordinary use, ℞ Posset-drink, or Mutton-broth lbi. brown Sugar ℥iv. mix, and give it warm; which repeat so oft as you see occasion: if the Body is bound, add to it Tincture of Sena made in Wine ℥ss. or Aloes ʒss. ad ʒi. which may be dissolved therein. But Venery is above all other things to be avoided, chiefly if there is a Fracture withal; for a great store of Spirits are contained in a small quantity of Seed, whereby all the Fa∣culties, but chiefly the Animal, are resolved and weak∣ned, Paraeus, lib. 9. cap. 14. says, that he has known Death to have ensued in small Wounds of the Head, by reason of Venery.

XXXIX. Perturbations or dis∣turbances of the Mind, whether from Sorrow or Joy, are wholly to be avoided; because thereby the Spirits, both Animal and Vital, are either contracted, or too much dilated, or dissipated; whereby a great Indisposition may happen to the Body.

XL. Washing and Bathing, as they ad to cleanliness; so being prudently done, they open the Pores, and cause a dissipation of dark and fuliginous Vapours, and ma∣lign Humors, whose natural course is to the Head; but finding a vent this way, are stopt in their career; whereby the Spirits are cheared and enlivened, and the Matter contributing to evil

and malign Symptoms, is in part taken away.

XLI. The last things which we shall take notice of here, are proper Wound-drinks, of which you have Examples enough in Chap. 3. Sect. 28. ad 43. But two things are to be observed: 1. That the Simples of which this Wound-drink is composed, ought to be chiefly Cephalicks and Neuroticks. 2. That it is not to be given, 'till all the Sym∣ptoms are past; it being mostly used, as an Induction to the Healing.

XLII. The second Indication, is directed to the application of proper Topicks. The first thing is Bleeding, (if so be a sufficient quantity did not flow out of the Wound when it was first inflicted:) which is used chiefly in great Wounds, and where the Patient has a sufficient strength of Body; or where a great Inflammation or Fever has made an invasion.

XLIII. If it is incised only, and not contused, Curing by the first Intention is only requisite, and therefore Agglutination is to be induced with what speed may be; as with Linimentum Arcaei, and other Glutinatives: if there is a Contusion withal, you must use Digestives, 'till the Matter becomes laudable.

XLIV. If an Inflammation is feared, the following Cataplasm of Hippocrates, which Fallopius in Hippoc. de Capitis Vulneribus, cap. 39. commends above all others, is to be applied. Take Barley-flower ℥iv. Posca ℥vi. boil to the consistency of a Cataplasm; adding to it Oil of Roses ℥ii. or instead of Posca, you may use Red-wine ℥iv. Vinegar ℥ii. either simple, or Vinegar of Roses, which is better; which use to the seventh or fourteenth Day, as you see cause.

XLV. Or, ℞ Barley and Bean flower, A.℥ii. Vinegar of Roses ℥ii. boil them to the consistency of a Cataplasm; adding Oil of Roses ℥ij. This cools, drys, repells, eases Pain, allays Inflammations, and hinders the afflux of Blood or hot Humors.

XLVI. Or, ℞ Crums of Bread, white or brown, ℥iv. new Milk ℥vj. boil to the consistency of a Cataplasm; adding Ung. Popul∣neum ℥ii. Saffron in pouder ʒi. These Cataplasms are to be applied above the Agglutinating Emplaster, or other Medica∣ments with which the Wound is drest; the Hair being first shaved off a good compass about the Wound.

II. Of Binding-up Wounds of the Head.

XLVII. In the Dressing of Wounds of the Head, two things are to be considered: 1. The Covering of the Head. 2. The Rowler or Bandage, for Binding it up.

XLVIII. The Covering must be a Cap, made of soft Linnen Cloth, basted with fine soft Tow, but not quilted; so big, as may encompass the white Head: it ought not to be too thick, too heavy, or too hard; for that the Head requires pliable, light, soft, and easy Applications: not

stubborn, as stiff Emplasters, which will cause Pain; nor too viscous, which will not be easily removed.

XLIX. The Rowler is to be made of soft Flaxen Cloth, not of Woollen, because it would be too hot, and cause Itching: it ought not to be new, for then it would be too stiff; nor yet too old, lest it want strength, and be apt to tear: nor yet ought it to be too thick, because then it would not be pliant enough; nor yet too thin, lest it it be too cold.

L. It ought to be about three Inches broad, somewhat more or less, as the necessity may require; and about three Yards long; so as it may be enough to encom∣pass the whole Head, with manifold circumvolutions and rowlings, the better to keep on the Topical Medicaments, and make a gentle constriction about the Wounds.

LI. It ought also to have two ends, that when they meet, they may link together; or so cross one another, as to strengthen the Bandage, and keep every thing from slipping.

LII. It ought to be rowled about, but not too loose, for then it would ill bind the Head, and not hold the Medicaments close: nor ought it to be too strait, for then, 1. The Blood might be driven from the wounded Part to the Meninges and Brain, from the outward to the inward parts; whence vehement Symptoms might en∣sue, as violent Pain, Inflam∣mation, Apostemation, Fever, Convulsion, Palsy, or Apoplexy, and it may be at last Death it self. 2. The Pulsation of the Arteries might be intercepted. 3. And Fuliginous Vapours would be hindred from breaking forth thro' the Sutures and other Pores.

III. Of a Contusion of the Head.

LIII. It is called in Greek, 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉. in Latin, Ecchymosis, seu Contusio Capitis; and in English, A. Bruising of the Head.

LIV. Contusions when alone, do many times produce grievous Sym∣ptoms; sometimes resembling those of Fractures, and some∣times exceeding them.

LV. They are for the most part accompanied with Concussions of the Brain, and sometimes with Fissure or Fracture, of one or both Tables; in which case, the spongy medullary substance that lies between the two Tables, is oftentimes broken into small crums, and squeezed together; whence follows Extravasation of Blood, and other Symptoms: of all which we say nothing here, but refer it to Lib. 6. fol∣lowing, where we treat of Fractures.

LVI. If with the Contusion there is neither Wound nor Tumor, and yet the Patient has a Palsy of any Part, or is stupified, or raving, it is certain that the Membranes of the Brain are hurt.

LVII. All Contusions of the Head are to be suspected, because

from them the greatest Symptoms do arise: and if in laying open the Cranium, the Patient reco∣vers not his Senses, an Extrava∣sation of Blood is to be feared, under the Dura Mater; in which case, Life is in great hazard.

LVIII. The Cure of a Simple Contusion. You are in the first place to shave the Hair off, and then apply this. ℞ The whites of Eggs N^o ii. Oil of Myrtles, pouder of Catechu, A.℥i. mix them. Dress twice a day, and use it, 'till the Part comes to its own temperature.

LIX. But if there is Pain, In∣flammation, or Tumor, you may embrocate the Tumor and Parts about, with Oil of Myrtles mixt with Vinegar, and then apply the former, or this following Cataplasm.

LX. ℞ Barley and Bean flower ℥vi. Oil of Myrtles or Roses ℥vi. whites of Eggs N^o ii. Red-roses in pouder ℥i. Catechu ℥ss. fine Bole, Cypress-nuts, Roch-alum, all in pouder A.ʒii. Vinegar q.s. make a Cataplasm.

LXI. The Patient being thus drest, Wiseman advises to bleed in the Arm or Neck, some hours after to exhibit a Clyster, and at Night to lay him to rest with an Emulsion of the Cold Seeds.

LXII. The next day repeat the former Dressing, 'till you have re∣strained the afflux of Humors; then foment the Tumor in Red-Wine, in which Camomil, Rose∣mary, Southernwood, and Red-Roses have been boiled.

LXIII. Then strengthen the Part with this of Paraeus, lib. 12. cap. 4. ℞ Whites of Eggs N^o iii. Oils of Myrtles and Roses, A. ℥i. fine Bole ℥ss. Sanguis draconis, Cypress-nuts, Galls, burnt Alum; A. ʒii. Vinegar of Roses q.s. make a Liniment.

LXIV. And discuss with this, ℞ Diachylon simple ℥ss. Empl. de Meliloto, & Oxycroccum, A.ʒii. Oil of Camomil ℥ ss. mix, and make a soft Emplaster.

LXV. If the Tumor goes not away, but grows hard and painful, threatning an Apostem, foment it with Decoction of tops of Al∣thea, Mallows, Linseed, and Fenugreek-seed, half Wine, half Water; and make a Cataplasm of the Faeces with Barley-flower. If after this, it suppurates, you must treat it as a Phlegmon, or Inflammation.

LXVI. But if the Pain abates, yet the Tumor continues with Ex∣travasated Blood, you may dis∣cuss with this. ℞ Barley and Bean flower, A. ℥iii. Red-roses. Myrtle-berries, A.℥i. tops of Worm∣wood, Southernwood, Fetherfew, flowers of Elder, of Camomil, A. ℥ss. Fennel and Dill seed, A. ʒi. pouder, and boil in Red-wine; ad∣ding Honey ℥ii. Oil of Camomil q.s. make a Cataplasm.

LXVII. But if by this means the Humor is not wasted, nor the Tumor discussed, because of the effusion of Blood under the Membrana Masculosa, which makes a separation of the upper parts from the Cranium; discerned by the fluctuation of the Tumor, and a fixt pain in the Part; then make incision, or open it; and if the Scull is sound, digest and finish the Cure by Medi∣cines which mundify and dry,

and by a moderate compression; avoiding moist Medicines to the Bones, because they induce cariosity.

LXVIII. You may apply this, in this case. ℞ Syrup of red dried Roses, of Wormwood, A. ℥i. Turpentine, Gum Elemi, A. ʒvi. Aloes, Myrrh, Mastich, Orrice-root, Barley-meal, A. ʒss. mix them.

LXiX. If the Scull is not sound, which you may discern partly by sight, it appearing yellowish, livid, or black; and partly by feeling with you Probe, or Finger: by which you will find it rugged and unequal, whereas it should be smooth and slippery: in this case, you must first smooth it with a Raspatory, then scale the Bone, by applying the following Pouder.

LXX. ℞ Roots of round Birth∣wort, of Gentian, of Orrice, Dit∣tany, Barley-flower, A.℥ss. Aloes Hepatica, Catechu, Sanguis Dra∣conis, Mastich, Myrrh, Sarcocol, A. ʒii. Euphorbium ʒi. make all into a fine pouder, and mix them.

LXXI. In great Contusions some∣times Gangrens are induced, by reason of the extinction of Natural Heat, known by the Part growing of a livid or black colour: in this case, 1. Scarify, with ap∣plication of Cupping-glasses. 2. Make Fomentations, and other Topical Applications; such as we have directed in their proper places, where we have treated of Gangrens, amp;c.

LXXII. If there is a Concus∣sion with the Tumor, first Bleed, and as often as you see occasion; keep the Body soluble by Clysters: and quiet the Ferment in the Blood, by frequent draughts of cooling Emulsions; then shaving off the Hair, embrocate the Head and Neck with Oils of Myrtles and Roses, mixed with Vinegar and whites of Eggs: and apply the Cataplasm at Sect. 66. above, made with Red-Wine, or Oxycrate.

LXXIII. After the Symptoms are remitted, apply this Cata∣plasm: ℞ Barley, Wheat, and Lentil meal, A. ℥ii. flowers of Red-roses, Myrtle-berries, Nut∣galls, Calamus Aromaticus, Cy∣press-nuts, Catechu, Terra sigil∣lata, all in fine pouder, A. ℥i. Orrice-pouder, Zedoary, flowers of Camomil and Melilot, A. ℥ss. all in fine pouder; rough Red-wine q.s. boil all to a Cataplasm: or, with Wax q.s. make it into a Cerat.

LXXIV. If the Concussion does not terminate by the aforesaid means, you must lay open the Part, and proceed as we have directed at Sect. 67. aforegoing.

LXXV. If in a very great Contusion where there is no Wound, the Tumor is large, and feels soft and pappy, and increases, notwith∣standing all your cooling Applica∣tions; it is to be feared, that the quantity of Serum which raises the Tumor, does proceed from within, from some Fissure in the Scull.

LXXVI. In this case, make Incision into the Tumor, propor∣tionably to its magnitude; and if you find or feel no part of the Scull bare or deprest, dress it with Digestives, and do the Cure as before directed, at

Sect. 67. above, if the Humor does abate, and the Wound it self digests.

LXXVII. But if you find there is a depression, and other ill Sym∣ptoms appear, you must lay the Hairy-scalp more open, to make way for a farther inspection, and then proceed to the Cure, as we shall direct in Lib. 6. following.

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.

V. A Wound of the Head, with Contusion.

XCVI. It is called in Greek, 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉. in Latin, Vulnus Capitis contusum; and in Latin, A Wound of the Head, with Con∣tusion.

XCVII. These Wounds are ei∣ther small, or great: the small or ordinary, are such as are not accompanied with any dange∣rous Symptoms, and where the Cranium is but a little naked.

XCVIII. Here you need not stuff in Dossels; for if the contused Flesh is but well digested, the Bone will incarnate underneath, with the Wound, with no great difficulty: and in the very worst habits of Body, they will incarnate by keeping the orifice a little open, by a small Dossel pressed out of S.V. and defending the ad∣jacent parts from fluxion, by proper Medicaments, and good Bandage.

XCIX. To cure therefore these Wounds, first wash and foment the Wound with S.V. or the Tincture of Frankincense and Myrrh; then if the Wound requires it, stitch it with Needles, (by the lesser it may be done with the dry∣suture,) but leave room for the Matter to come forth; for if that should be shut in by your dressing, the Wound would be made more hollow, and the Cure delayed, &c.

C. Let the Wound be drest with Linimentum Arcaei, or for want of it, with Turpentine; whose Praises, Sennertus, Med. Pract. lib. 1. par. 1. cap. 22. has loudly proclaimed in these words.

CI. Et omninò hîc utilissimum Medicamentum est Terebinthina, omnibus Vulneribus commoda, prae∣sertim Partium Nervosarum, qua∣lis Pericranium est: praeservat enim Contusa à corruptione & putridine, ea corroborat, Dolores sedat, Ʋlcera mundat, & si acri∣moniam aliquam prae se ferat, ea facilè tollicur ablutione Aqua Betonicae; & cum in passivis siccae sit, siccitas temperatur humidis, ut Ovi vitellio, & Olei Rosaceo modi∣co adjecto. Now above all things Turpentine is a most excellent Medicine, fit for the Cure of all sorts of Wounds, but more especially of the Nervous Parts, of which kind is the Pericra∣nium: for it preserves contused Wounds from corruption and putridness, strengthens the Parts, eases Pain, cleanses Ulcers, and if there be any acrimony it carries with it, the same is easily taken away by washing it with Betony-water; and tho' it is drying in its passive qualities, it is remedied by mixing it with humid things, as the yolk of an Egg, and a little Oil of Roses.

CII. The same Sennertus pre∣scribes this. ℞ Turpentine, Oil of Roses, A. ℥i. Wax ℥ss. Saf∣fron ℈ss. mix them: but says he, if an Inflammation is feared, let Barley-flower ℥ss. be added; and to make it Sarcotick, Frank∣incense ʒss. may be added.

CIII. If the Wound is deep, a Tent must be kept in the depending

Part, 'till it yields a good sort of Pus, and then it is to be taken out, and an Emplaster, as Dia∣palma, Empl. Al••um, or De Meli∣loto, mixt with Empl. Album, or Diachylon, may be laid on.

CIV. If the Wound is great, or extraordinary, accompanied with strange and unusual Symptoms; or Inflammation of the whole Head, Neck, and Shoulders; Fever, great Swelling of the lips of the Wound, and they of a livid colour; or that it casts forth a virulent, sharp, and black, and stinking Sanies; or it casts off a slough, and leaves the Cranium much naked, tho' it be not fouled, either by the Matter or the Air.

CV. In this case, (by reason the Bone is naturally smooth and slippery, so that the Flesh dif∣ficultly grows upon it) you must (as Galen and others ad∣vise) rasp the Bone, 'till you see the Blood ready to come out of it; whereby it will sooner and better be supplied with the Matter for breeding of Flesh.

CVI. But if the Patient will not admit of Rasping, then you must keep Dossels close to the lips of the Wound, and make exfoliation from the edges, that the sound part may cast off the rotten: for nei∣ther any inward Medicine, nor Wine applied with Lint, or other Medicaments, to the mid∣dle of a Bone, will signify any thing to the Exfoliation of it; that is but trifling; for in the mean time, the Matter from the edges will rot the Bone under∣neath, and in time pierce thro' the first Table, and run down between the two Tables, and do much mischief: so that at length you will be forced to use the Terebra or Trepan.

CVII. The Bone being thus scra∣ped, or exfoliated, dress it with Pledgets dipt in Linimentum Arcaei hot, or some such like Pre∣paration made of Gum Elemi, Bal∣sam Capivii, Cypress-Turpentine, or some of the Natural Balsams: if Digestion is necessary, apply Digestives to the lips; other∣wise apply Pledgets wrung out of S.V. simple, or a Tincture of Birthwort, Orrice, and Hog-Fennel roots, &c.

CVIII. In a Wound made by Incision, where part of the Scull is cut slanting off, or into the second Table; if there are no Symptoms of Concussion, you ought not to lay open the Wound to set on the Trepan; but cleanse and dress it, with a fit Dossel press'd out of S.V. digest the lips of the Wound, and wait for the Exfoliation, and then heal it up: Rasping in this case is needless; for if the Bone be rightly drest, the Flesh will soon arise, and make Exfoliation, and 'twill Incarnate of its own accord.

CIX. If there is any Malignity joined therewith, as being made with a Poisoned Weapon, or from the Bitings of Malign Creatures, whether Men or Beasts; the lips of the Wound are first to be scarified, and either Leeches or Cupping-glasses may be applied; and then the Wound may be washed and fomented with this following Medicine.

CX. ℞ Our Theriaea Chy∣mica,

or in place thereof, Mi∣thridate ℥ ss. common Angelica or Scordium water ℥iv. Spi∣ritus Cordialis, or Spiritus Vini, ℥ i. Spiritus Universalis ʒ ii. mix them.

CXI. And inwardly you may give this. ℞ Our Theriaca Chymica, or Elect. Antipesti∣lentiale, à ℈i. ad ʒi. Spiritus Cordialis ʒ vi. Aqua Angelicae simplex ℥iii. mix, for a Dose.

CHAP. XXVI. Of WOƲNDS of the TEMPORAL MƲSCLES.

I. IT is called in Greek, 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉. in Latin, Vulnus Musculo∣rum Temporum; in English, A Wound of the Temporal Mu∣scles.

II. The Prognosticks. Wounds of the Temples are always dan∣gerous: 1. Because the Passage of Hearing is in the Temples; and the Instruments of the Senses are very sensible. 2. Be∣cause the Temporal Muscles are placed on the Temples, which are casily offended. 3. Because the Motion of the Joints of the lower Jaw (in Speaking, Eating, or Drinking) does hinder uni∣tion. 4. Because considerable Vessels, as the branches of the Jugular Veins, and Soporal Arteries are distributed there.

III. Wounds of the Temporal Muscle, are commonly accompa∣nied with fearful Symptoms; and many times they follow some time after the Wound is made; as Vomitings, deep Slumbering, Convulsions, &c.

IV. If the Wound is made by Puncture, it is to be accounted dangerous; and many times brings with it very evil Sym∣ptoms, as those before named, and other like.

V. If the Temporal Muscle is cut athwart or transversly, it loses its proper action, which is to move and lift up the lower Jaw; then the opposit Temporal Muscle, being whole and sound, and using its strength, the wounded Muscle not being able to act, or make any resistance, it draws the lower Jaw to it; by which the Mouth, and most parts of the Face are drawn awry, and suffer a kind of con∣vulsion towards the sound part, the other being resolved, and falling.

VI. For as oft as the Muscles of one kind are equal in number, magnitude, and strength on each side: the resolution or cutting asunder of the one part, causes a convulsion of the other.

VII. Besides all this, when we

eat, drink, or speak, this Muscle is in perpetual motion; so that being once cut, it will very diffi∣cultly admit of unition: for this reason, if there should be a Fra∣cture in this Muscle, of the Ossa Petrosa, (joined to the Scull by Sutura Squamosa, or the Scaly Suture) you ought not to be too hasty in dilating it, lest Con∣vulsions or other ill accidents should happen.

VIII. The Cure. If therefore in a Wound of the Temporal Mu∣scles there should be a fracture of the Bone without ill Symptoms, let the Hair be shaved off, and the Wound dressed with this. ℞ Oils of Whelps, of Earthworms, and of Hypericon, A. ℥ss. S.V. ʒii. mix them, and use it warm.

IX. Or, ℞ Balsam of Chili, or of Peru ℥ss. Oil of Earthworms ʒi. mix them, and dress the Wound therewith.

X. If the Muscle is cut trans∣versly, then the lips are to be brought together by stitching in the Skin: afterwards it is to be drest with Linimentum Arcaei, or some other Balsam; or those things which are prescribed in Punctures.

X. Or you may apply this Unguent of Sennertus. ℞ Turpen∣tine, Gum Elemi, A. ℥iii. pure Rosin, Oil of Roses, A.℥iv. Wax ℥vi. Ammoniacum ℥ii. make an Oint∣ment.

XII. Or, ℞ Gum Elemi ℥iii. Opopanax ℥ii. Pine-Rosin ℥i. Bdel∣lium ℥ss. Wax q.s. mix, and make an Ointment.

XIII. Gum Elemi is an ad∣mirable thing, as Conciliator, Different. 181. writes, Attrahit, dolorem mitigat, malam intem∣periem, propter familiaritatem quam cum Corpore habet, corrigit, Viz. It attracts or draws, eases pain, and corrects an ill tem∣perature of the Part, from its friendly quality which it has to the Body.

XIV. Above these wounds you may apply Sticticum Paracelsi, or Diachylon cum Gummis, brought to the consistence of a Cerat, by mixing it with some Balsam, either Natural or Artificial.

XV. And tho' there may be danger of Death, Celsus advises, That we should not altogther leave the miserable Patient comfortless, for that it is better to try a doubt∣ful Medicine, than none at all: and we may avoid scandal, and free our selves from blame and reproach, by making the pro∣bable prognosticks to the Friends of the Sick.

XVI. If the Muscle is wounded only according to the length, you must first stop the Hemorrhage, with some proper Styptick, the chief of which is that of Dr. Gardner's Preparation: then you must unite the brims by stitch∣ing them together, cleansing the Wound first from the grumous or clotted Blood, or other extraneous bodies.

XVII. Which done, dress the Head or Wound with some of the former Ointments, or Balsams, Cerats, or Emplasters; and so compose him to rest, raising his Head somewhat high with a Pillow.

XVIII. An Observation, from Wiseman. One wounded trans∣verse the right Temporal Muscle,

was bleeding almost to death; I stitcht (says he) his Wound, taking the Artery up with the lips; and for want of other Remedies, drest it with a little Wheat-flower and the white of an Egg, applying over it a Com∣press, prest out of Vinegar, with convenient Bandage.

XIX. The third day after the Dressings were taken off, and the lips were found new agglutinated: being better provided with Medicines, the lips of the Wound were sprinkled with pouder made of Frankincense and Dragons-blood, and a Pled∣get applied spread with Linimen∣tum Arcaei, and over it Diapalma.

XX. The fifth day, or second after the former Dressing, the Stitches were cut, and Epuloticks applied: so that in two or three Dressings more he was cured. Wiseman, lib. 5. c. 9. pag. 387.

CHAP. XXVII. Of WOƲNDS of the MENINGES of the BRAIN.

I. THEY are called in Greek, 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, pl. 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉. in Latin, Vulnus, pl. Vulnera Meningium Cerebri; in English, A Wound, or Wounds of the Membranes of the Brain.

II. It follows in order of Nature, to treat of Wounds of the Cranium: but by reason they are chiefly Fractures, of which our whole Sixth Book following treats, we shall here pass them over, and come im∣mediately to treat of those parts under the Scull, which are the Meninges of the Brain, and the Brain it self.

III. The Meninges, or Mem∣branes, are the internal containing part of the Head; and they are two, both which compass the Brain; viz. the Dura Mater, and the Pia Mater.

IV. The Dura Mater is the outermost Membrane, and being very strong, is placed under the Cranium; the wounding of which, is very often attended with Pal∣sies; and in time of the hurt or accident, with Convulsions and other ill Symptoms; the which are the greater, if the Wound is in the middle part of the Head, according to its length; there being many Vessels in that place, which if they chance to be cut, will fill the void space between the Cranium and Dura Mater, with Blood.

V. The Pia Mater, lies upon the body or substance of the Brain, so close, that a Wound cannot be made into the Pia Mater, and the Brain escape free: and from its many Veins being cut, or broken, a Flux of Blood inevitably follows.

VI. The Signs. A Wound of this Part is known by sight; and is for the most part accompanied with vehement Pain, Hemorrhage, Inflammation, Apostemation, and Discoloration.

VII. The Prognosticks. If drowsiness and sleepiness seizeth the Patient, Death not long after will ensue.

VIII. If notwithstanding the use of Means there is a Putri∣faction, and it will not cease, but still increases and goes on; or a Tumor shall increase and grow above the opening of the Scull, being immoveable, black, and dry: if the Eyes of the Sick appear of a fiery colour, bunch-out, and are still moving; if they toss and tumble in their Bed, and rave, you may predict Death at hand, and so much the sooner, as these Symptoms continue constant and uniform. And Death must of necessity ensue, because of the extinction of Natural Heat, and the Gan∣gren of a Noble Part.

IX. When the Pia Mater is wounded, (because it is very thin, and sticks fast to the Brain) the Brain also must be offended, and therefore such Wounds are for the most part mortal: for the Brain being laid open to the Air, is presently and easily corrupted by the external cold, which extinguishes the weak heat of that Part; as also by the moi∣sture which is contained in its substance, as by that which comes to it by a flux from other places.

I. Wounds of the Dura Mater.

X. The Cure. In this case presently lay-open the Hairy-scalp, and raise it up with the Bones, that you may in some measure relieve the opprest Membrane; and if there is a great flux of Blood, cleanse the Membrane with a Spunge dipt, and a little squeezed out of hot Red-wine, or Vinegar.

XI. If there is a vehement Hemorrhage, the Membrane being wounded, you must immediately make way to come at the wounded Membrane, if the Instrument or Weapon has not made way enough; and then stop it with Galen's Pouder, made of Aloes, Frank∣incense, Mastich, white of an Egg, and down of an Hare; or Dr. Gardner's Sty∣ptick, or some such like Me∣dicament.

XII. As to the first Dressing, Authors something differ; Celsus would have it drest with Dryers, viz. Cum Aceto acerrimo: his factis, (those things being done, at Sect. 10. above) ea Membrana Aceto acri respergenda est, ut si intus concretus Cruor rema∣net, discutiatur, &c. The Mem∣brane is to be sprinkled with sharp Vinegar, to prevent the bleeding, and to dissolve the coagulated Blood which remains upon the Dura Mater.

XIII. But Avicen, and most of the Ancients were for Lenients, as Oil of Roses, that the extra∣vasated Blood lying upon the Dura Mater might be converted into Matter: in which case,

you are to be something guided by your Eye.

XIV. If there is Sanies or Putrifaction, dress with Mel Rosarum mixed with S.V. and higher Abstersives may be used, as you see the Putrifaction is more or less: if a Hemorrhage is feared, Celsus his way may be proper, or the use of some other Styptick. But if neither an Hemorrhage nor Putrifaction are feared, but that the Membrane is fresh, and of its natural co∣lour; you are not to grieve or exasperate the Pain, with the acrimony of Vinegar, or Deter∣gents: the use of Vinegar, or Mel Rosarum with S.V. are con∣trary to the Indication of Cure, which teaches to digest recent Wounds, before you use Abs∣tersives.

XV. Therefore Lenients, by the Authority both of Ancients and Moderns, are first to be used. Galen used Pigeons-Blood, or the Blood of Turtles, dropt warm from their Wings. Fallo∣pius and Aquapendens use Oil of Roses, mixed with Rosin of the Fir-tree, afterwards increasing the Rosin, and lessening the Oil: these by their Concoctive qua∣lity, perfect the Digestion sooner; and by their Anodyn quality, secure the Part from Inflammation.

XVI. By this simple Medica∣ment, Wiseman says he never failed of good Digestion, and after∣wards by the tempering of it, he has both digested and deterged, never finding the least prejudice the bare Bone received from it: but this you are also to be cautious of, that you use not Digestives unseasonably, because thereby the Parts may be relaxed: there∣fore after Digestion, add more Rosin, and less Oil.

XVII. Or you may mix Mel Rosarum with the Rosin, instead of Oil; which will answer the Intentions, both of deterging, and incarnating.

XVII. Or you may use this, to both purposes. ℞ Balsam Capivii, Gum Elemi, A.ʒii. Stras∣burgh-Turpentine ℥i. Honey of Ro∣ses, Canary, A. ℥iii. Oil of Roses ℥iv. boil to the consumption of the Wine; then add Cochinel in fine pouder ʒiii. Aloes ʒi. Saffron ʒss. mix them.

XIX. This you may apply upon the Dura Mater, and a Button of Lint over, to fill up the hollow in the Bone: and the rest of the Bone may be drest with dry Lint, or Linimentum Arcaei, and the lips of the Wound with a Digestive, with Turpentine, &c. over which apply Diapalma, or Empl. Album, malaxed with Oil of Roses.

XX. Now one thing is to be noted, that in the Directions at Sect. 10. and 11. above, you take not out more Bones than needs must: for recent Fractures of the Cranium, do easily unite, like those in other Parts; if the Pus or Matter has way made, to be discharged from within: so that having raised up the Bones that are loose, the others may be drest dry, with Catagmaticks; taking care, that a Hypersarcosis or Proud-flesh come not upon them; and thus they will easily agglutinate.

XXI. In these Wounds of the Dura Mater, besides those men∣tioned at Sect. 15, 16, 17, and 18. the Oils of Hypericon and Mastich, mixt with Rosin, are commended: and Archigenes, Ga∣len, and Aquapendens sometimes drest these Wounds with juice of Calamint, mixed with the flower of Milium.

XXII. The Ʋnition and Incar∣nating the Lips of the Dura Mater, is performed by a Carneous Sub∣stance arising from the Membrane, which afterwards as it increases, does unite them; and over∣spreading that Part, grows up to the Cranium, and unites with that Callus, (after Exfoliation of the Bone) and becomes one body with it, filling up the vacancy, or place which was perforated, and in some grows more firm than the Bone it self.

XXIII. You must be careful that your Lenients make not the Flesh too lax and soft, lest a troublesom Fungus springs forth; which you may prevent in its beginning, by using Desiccatives, as red Precipitate, mixt with burnt Alum, Aloes, and pouder of Pomgranate-peels, &c. The Vitriol-stone takes this off with little pain, and also disposes the Part to cicatrize, if pru∣dently used and timely. We will have a few words con∣cerning the Accidents or Sym∣ptoms, and so shall conclude this Topick.

II. Symptoms in Wounds of the Dura Mater.

XXIV. 1. Pain. Narcoticks here have no place, for they would stupify the Membrane; nor emol∣lient unctuous Medicines, because they may induce putridness. Oil of Roses, mixed with Gum Elemi a third part, are to be put warm upon the Membrane, 'till the pain ceases, and the Pus ap∣pears; then Honey of Roses may be mixed with Oil of Roses, for better digesting and deter∣ging, &c.

XXV. 2. Inflammation. It is a red Tumor of the Dura Mater, with distention of its Vessels; so great sometimes, that it sills the hole of the Cranium, and grows above it. This Symptom is dan∣gerous, and therefore they first Bleed, and appoint a slender Diet; then they Foment with a Decoction of Althea, Linseed, Fenugreek-seed, Groundsel and Violet leaves, made in Wine, or in Wine and Water; this being done, they anoint with Oils of Roses, Myrtles, or Quinces: if these things prevail not, and that you see it will Apostemate, you are to dilate the Scull, by taking away more of it.

XXVI. 3. Apostemation. It is known by the extraordinary whiteness of some part of it, as in Pustules of the Skin; then you must carefully open it, but so as not to touch the Brain; and drying abstersive Medicaments are to be applied, as Mel Rosa∣rum cum S.V. Syrup of dried Roses mixed with a little Tur∣pentine, or Balsam Capivii, or Gum Elemi, and Spirit of Wine, &c.

XXVII. 4. Discoloration. This may proceed from many Causes; as violence of the Contusion,

coagulated Blood, coldness of the Air, application of unfit Medicines, and from a pu∣tridness.

XVIII. If it comes from the Contusion, it seldom lasts above three or four days: in this case use Oleum Rosaceum, or Mel Ro∣satum, or Oil of Eggs, with a little S.V. mixt with some Cephalick Pouder and Saffron.

XXIX. If it comes from Co∣agulated Blood, ℞ Pouder of Cochenel, of Chermes-berries, A. ʒi. Saffron ʒss. Sarcocol ʒii. S.V. Honey of Roses, A. ℥ii. mix them; and apply it, 'till the blackness goes away.

XXX. If it comes from appli∣cation of Ʋnfit Medicines, as being too moist, unctuous, or sharp, apply such as are in faculty contrary, viz. drying, as Cephalick Pouders mixed with Honey or Oil of Roses: if from sharp things, apply such as are mild and lenient, as Oils of Hypericon, Earthworms, or Whelps, mixed with a little Saffron, and Balsam of Peru.

XXXI. If it proceeds from Putridness, known by the ill smell of the Sanies, then apply this: ℞ S.V. White-wine, A. ℥ii. Syrup of Wormwood, Honey of Roses, A.℥i. Ung. Aegyptiacum ℥ss. Aloes, Myrrh, Sarcocol, Preci∣pitate, A.ʒi. mix.

III. Wounds of the Pia Mater.

XXXII. Wounds of this Part are most times mortal: partly, for that this Membrane is full of Blood-vessels, and so subject to great Hemorrhages; and partly, because the Brain, being exposed to the Air, is thereby over∣cooled; and being corrupted, is apt to be prest forth by the constant Pain they endure from the putrifaction of the Cerebrum, whereby it many times comes forth at the Wound.

XXXIII. You must make clear and open your way to these Wounds, by removing the lacerated Flesh and Bones, if they will submit: otherwise you must leave it to Nature, lest the Patient dies under your hands, which is a disgrace to an Artist.

XXXIV. First stop the Hae∣morrhage with Galen's Pouder, and Hares Fur, mixed with the White of an Egg, which use upon Pledgits, to retain the Brain al∣so within its Bounds.

XXXV. Then the Part is to be cured with Medicaments, dry∣ing, warming, and comforting; such as that described at Sect. 18. aforegoing, and other the like things, dressing up the Wound as those in the Dura Mater.

XXXVI. If any part of the Lips of the Hairy Scalp is lacera∣ted, shattered, or seems to be torn in Rags, cut it off, lest a Gle•…•… drop from them upon the Mem∣branes or Brain, and so increase the Accidents.

XXXVII. If the Brain be kept within its Membranes, viz. the Pia & Dura Mater, and they di∣gest and incarnate, then proceed in the rest of the Cure, as we have before directed in the Di∣scourse of the Wounds of the Dura Meninx.

XXXVIII. Bleeding is also some∣times to be done, as your Prudence shall direct you: And in a Caco∣chymia,

there ought to be due purging to carry off the offend∣ing Humours, and serous Blood, which, by reason of its thinness and heat, is apt to fly to the affected part; but this is to be done, according as the Necessi∣ty requires, and the Patient's Strength will admit.

CHAP. XXVIII. Of WOƲNDS of the BRAIN.

I. THey are called in Greek, 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, pl. 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉. in Latin, Vulnus, pl. Vulnera Cerebri; in English, a Wound, or Wounds of the Brain.

II. The Signs. Hippocrates, lib. 6. aphor. 50. saith, If any have the Brain wounded, they will have a Fever and vomiting of Cho∣ler. And this Celsus, lib. 8. cap. 4. affirms in a very florid Discourse.

III. Hippocrates, Sect. 7. Aph. 58. says, They who have suffered a vehement Concussion of the Brain, immediately became dumb: and in Coacis Prenot. he says, they fall a slumbering.

IV. There is also Senselesness, Giddiness, and Dimness of Sight: For Fernelius, Pathol. lib. 7. cap. 8. says, If the Substance of the Brain is hurt, the Reason be∣comes weak, and all the Symptoms increase; and many times a Por∣tion of the Brain comes out, not without Danger of Life.

V. If the Brain is wounded, the Pus, or Quittor, will be thick, round, and like a marrowy Sub∣stance.

VI. Paraeus, lib. 9. cap. 22. says, If the Meninges are divided, and a Substance like Fat comes out, which will neither swim a∣bove the Water, nor yet melt with Heat, as Fat will, the Brain may then be said to be wound∣ed.

VII. The Symptoms. The Sym∣ptoms are many and dreadful. 1. What respect the natural Pow∣ers, as, foaming at Mouth, dark∣ness of Sight, Vertigo, vomiting of Choler, a Fever, Convulsion, Deafness, and want of Speech.

VIII. 2. What respects the ra∣tional Faculties; as, Stupidity, want of Reason, a Palsie, Le∣thargy, and last of all an Apo∣plexy.

IX. The Prognosticks. All Wounds of the Brain are dangerous at least, 1. Because of the Noble∣ness of its Parts, and the neces∣sary use of its Functions. 2. Be∣cause of its continual motion, con∣sidering a wounded part in cu∣ring requires rest. 3. From the Substance of the Brain, being soft and humid, and so the more apt to Putridness. 4. Because of the Coldness of the Brain, which ge∣nerates many Excrements. 5. Be∣cause of the Consent of the Nerves,

it being their original. 6. Be∣cause Medicaments are not so easi∣ly conveyed to that part, being wounded.

X. But that some have had Wounds of the Brain, and even with loss of its Substance who have escaped With Life, Authors have reported, and for which they give us these Reasons; as, 1. The healthy and strong Constitution of the Patient. 2. The Skilful∣ness of the Artist in dressing of the Wound; for that many re∣cover of great Wounds, being dressed neatly, easily, and ac∣cording to Art; whereas others die of small Wounds, being ne∣gligently or ignorantly dressed. 3. The difference of the part wounded; some parts of the Brain being more dangerous when wounded, than other some.

XI. Authors are not wanting in giving us Histories of such, who having been wounded in the Br••in, have recovered. Galen on Hippo∣crates, lib. 6. Aph. 18. says, He saw one cured, who had a con∣siderable Wound in the Brain: And, De Ʋsu Partium, lib. 10. he tells us of a young Man, who recovered of a Wound received in one of the fore Ventricles of the Brain.

XII. Andreas à Cruce, Chirurg. lib. 1. Tract. 2. cap. 14. says, he cured several whose Brains were wounded, and brings Wit∣ness of the Truth thereof: And Fr. Arcaeus, lib. 1. cap. 6. brings four Examples of the Truth of the same.

XIII. Fallopius de Capitis vul∣neribus, cap. 45. says, A great Portion of the Brain may come forth, and yet Life be saved: Therefore (says he) forsake not the wounded Patient, for I my self have had great Trial of these things. And Fabricius Hildanus, Cent. 4. Observ. 1, 2, 3. gives us four Examples of this kind.

XIV. Christoph. à Vega in Hip∣pocrates, lib. 6. Aph. 15. says, That Wounds of the Brain, if they reach to the Ventricles, are not cured: But we have seen (says he) many others cured, which pierced to the Substance of the Brain, and out of which some Portion of the Brain issued. Carpus de Tractatu in fractura Cranii, affirms, That he saw six Persons who recovered, when a good quantity of the Brain came out of the Wounds.

XV. Theodoricus Chirurg. lib. 2. cap. 2. assures us, That Wounds of the Membrane, and Substance of the Brain and Ventricles, may be cured. And Horatius Augeni∣us, lib. 9. Epist. 2. says, He saw once the whole Substance of the Brain wounded, and a Portion of the Brain to come out of the Wound, yet that the Patient was cured, and did well.

XVI. Brassavola in Hippocratis, lib. 6. Aph. 18. reports, That he saw two who were cured, after their Brains were wounded. And Massa, Tom. 2. Epist. 11. takes God to witness, and many yet alive (says he) can witness, that I have cured several, whose Skull is, Membranes and Brain have been wounded; also naming them.

XVII. Valeriola, lib. 4. Obs. 10. lib. 5. Obs. 9. & lib. 6. Obs. 4. has also several Examples. And

Sennertus, Med. Pract. lib. 1. part. 1. cap. 24. has given us a famous Example, which was brought to him of a Carpen∣ter who was wounded in the Brain, and there fell out of the Substance of the Brain as much almost as the Quantity of a Wal∣nut, who was cured with an Ointment of Fab. Hildanus.

XVIII. Paraeus, lib. 10. cap. 22. tells us of a young Man wound∣ed upon the right Bregma into the Brain, so that the quantity of a Hazel-nut came forth there∣at, which he cut away, and re∣covered him perfectly, excepting that he continued deaf all his Life after. Wiseman, lib. 5. cap. 9. says, That the Brain it self is insensible; and that the Sym∣ptoms which accompany these Wounds proceed from the Pain and Anguish of the Dura and Pia Mater. He tells us of a Patient of his, who was wounded into the Brain, with loss of its Sub∣stance, who lived 17 days after: And, (says he) by what I have seen of them heretofore, their Cure consists in dressing them as Wounds of the Dura Mater, and in keeping the Brain within its Membranes, without which no Incarnation can succeed.

XIX. Cabrolius de periculosissi∣mis Cerebri Vulneribus, Obs. 16, 22, & 24. has some worthy and notable Histories of this kind. And Skenkius, lib. 1. Obs. 40, 42. has collected many, which for their Rarity are worth reading.

XX. These Authorities being thus alledged, I am unwilling to interpose a Judgment against such a Cloud of Witnesses, most of them being Men of Reputation, Honour and Integrity: All that I will say upon the matter is this, That nothing of this nature ever came within my Cognisance; and tho' Wounds of this kind, may be thought by me, with others, ex∣treamly dangerous, yet I think we ought not to judge their Cure impossible; and therefore be∣lieve it the Duty of every Ar∣tist, when such Accidents offer themselves, not only to bind up the wounded Patient, but to do all his Endeavours, and exert his greatest Skill and Abilities, in order to the Performance of the Cure; since Nature many times assists us in our Underta∣kings, even beyond all hope.

XXI. The Causes of the Sym∣ptoms. 1. Dimness of Sight. It is caused from a Dissipation of the Animal Spirits, and a Con∣fusion of the Visive Spirits in the Optick Nerves.

XXII. 2. Loss of Motion. 1. It is caused, 1. By the Violence of that which gives the Wound. 2. By Privation of the Faculty of moving, thro' the wounding the Instruments of Motion.

XXIII. 3. Slumbering, or Sleep∣iness. It is caused from the Dis∣sipation of the Animal Spirits, but greater, and of longer con∣tinuance than in Dimness of Sight.

XXIV. A Fever. It is caused by an Inflammation seizing upon the wounded part, which being communicated to the Heart by the Veins, is from thence by the same Vessels scattered over the whole Body.

XXV. 5. AVertigo. It is cau∣sed from the Circumvolution, or turning round of the Animal Spirits, and from their violent and irregular Motions.

XXVI. 6. A Vomiting. It is caused from a Communication of Vessels: For thé Brain being hurt, the Disaffection is com∣municated by the Nerves of the sixth Conjugation, which pro∣ceeding from the Brain, are di∣spersed through all the Coats of the Stomach.

XXVII. 7. A Convulsion. It is caused from malign, putrid, or sharp thin Humors or Vapors, pricking the Original of the Nerves, and so disposing them to Explosions in various parts.

XXVIII. 8. A Palsy. It is caused by matter obstructed, which piercing the Nerves and musculous Fibres, especially in their Original, as the Brain and Spinal Marrow, causes a Reso∣lution in those Parts to which those Conjugations or Pairs run.

XXIX. 9. Stupidity. It is caused by putrid Vapors or Hu∣mors, abounding in such plenty, as almost to suffocate or put a stop to the Motion of the Ani∣mal Spirits, being obstructed in the Brain.

I. The Cure of Wounds of the Brain.

XXX. Sennertus Med. Pract. lib. 1. par. 1. cap. 24. forbids things cold and moist; also moist Digestives, and all fat, un∣ctious and oily Medicaments; for the Brain being soft and moist, is by them easily cor∣rupted.

XXXI. But things drying are to be used; as, Oil of Turpen∣tine, and all the kinds of natu∣ral Balsams, (which cannot pro∣perly be said to be unctious or greasie.) Andreas à Cruce, Chi∣rurg. lib. 1. cap. 14. will have Oil of Turpentine and Sp. Vi. to be applied till the fourteenth day is past, and then to drop into the Wound this following Li∣quor.

XXXII. ℞ Generous and strông Wine, as Sherry, ℥x, Juyce of Be∣tony ℥ij, Juyce of Calaminth ℥j, inspissate Juyce of Centory, Seeds of Hypericon, Aloes, Myrrh, Dra∣gons Blood, Olibanum, A.℥ss. bruise and digest all in a Vessel close stopt; then boil gently to the consumption of a third part; strain, and add thereto S.V. ℥iij. Oil of Turpentine ℥ij. mix them for use.

XXXIII. Ʋpon the former ap∣ply Pulvis Cephalicus; and cover all with some fit Balsamick Em∣plaster.

XXXIV. Sennertus says, Pi∣geons Blood may be dropt in, or some fine Cloth dipt in Greek (or rather Sherry) Wine, in which Roses and Betony have been infu∣sed: In Winter-time, Aqua Vi∣tae may be used; others use the Juyce of Catmint; others the Pouder of pure Frankincense; even till the 7th day, and till the Flesh begins to grow up.

XXXV. Fabricius ab Aqua∣pendente Chirurg. lib. 2. cap. 20. uses this following, with good Success. ℞ Meal of Milium ℥ss. Mithridate ʒvj. Aqua Vitae ʒv. Balsam of Peru ʒiij. Oleum Hispa∣nicum ℥j. Oil of Vitriol ʒj. ss. mix them.

XXXVI. And upon that he applies this Emplaster. ℞ Bar∣ley-flower ℥viij. Oil of Mastick ℥vj. Oxymel simple ℥v. Pouder of Ca∣momil Flowers ℥iiij. Oil of Roses ℥iij. Spicknard Scaenanth, Stae∣chas, Betony, all in Pouder, A. ℥ss. White-wine q.s. mix, and make an Emplaster.

XXXVII. The Oleum Hispa∣num, which he wonderfully com∣mends for the speedy healing of Wounds, is thus prepared. ℞ Seeds of Hypericon ℥ij, Roots of Carduus Ben. and of Valerian A. ℥j. cut and beat them well, then infuse in Sherry Wine for two days, after which add Oil Olive ℥iij, bruised Wheat ℥jss. boil to the Con∣sumption of the Wine, then strain, and add thereto Venice Turpentine ℥vj. Frankincense in Pouder ℥ij. give it two or three walms more, and so keep it for use.

XXXVIII. Andreas à Cruce commends Oil of Turpentine mixt with Honey of Roses to be applied with fine Linnen dipt therein, and then fills up the Wound with this mixture, ℞ Aloes, Ma∣stick, Myrrh, Sanguis Draconis, A. ʒij. Turpentine ℥ij. S.V. ℥j. mix them.

XXXIX. Or, ℞ Turpentine wash'd in Bugle-water ℥ij. S.V. Syrup of Roses A. ℥j. Pouder of Frankincense, Mastick, Myrrh, A. ʒij. Seeds of Hypericon, Sanguis Draconis, Mummia ex Cranio A. ʒj. mix them.

XL. The same Andreas á Cru∣ce cured a Girl wounded into the Brain, who had lost a considerable portion thereof, by the Method deliver'd at Sect. 31, 32, 33. a∣foregoing, in about fourteen days time.

XLI. Sennertus commends the natural Balsams as of admirable use: Also the distilled artificial Balsam out of the following Composition. ℞ pure Turpentine lbij. Pine-Rosin lbss. Frnnkincense, Mastick, Myrrh, Gum Elemi, A. ℥iij. mix, and distill a Balsam ac∣cording to Art. It is inferiour to no other Medicine for this pur∣pose in the World: But here I have altered the Proportions, having found these Limitations, by experience, to be much the better.

XLII. Fallopius, in his Com∣ment on Hippocrates, de Capitis Vulneribus, cap. 45. pours into the Wound Oil of Roses mixed with Oil of Turpentine; because the Oil of Roses is Anodyn, and the Oil of Turpentine warming and drying; and this he applies till the seventh day is past; a∣bout which time the corrupt part of the Brain separates it self from the sound.

XLIII. If the Bone is carious, and does not readily exfoliate, you must scrape it, and dress it with Linimentum Arcaei: if that is too relaxing, ℞ S.V. ℥x. Aloes ℥jss. Myrrh ℥j. Roots of Birthwort, Hog-Fennel, Catechu, A. ℥ss. mix them, and apply it upon Dos∣sels.

XLIV. In dry Constitutions use this: ℞ Aloes, Pumice-stone, Pompholix, A. ʒij. Oyster-shells burnt ʒss. each being in impalpa∣ble Pouder, mix it with Mel Ro∣sarum and S. Vini, and apply this Emplaster over all. ℞ Lead cal∣cin'd with Sulphur and washed, Litharge A. ℥ij. Ceruse, Antimony calcin'd and levigated, A. ℥j. Oil

of Roses q.s. mix, and boil to an Emplaster. Or, Take Crocus Mar∣tis ℥j. Calx of Egg shells ℥ss. burnt Alum ʒj. mix and make a Pouder, which apply.

XLV. If the Substance of the Brain being wounded, seems to be of a livid Colour, Medicaments which are drying and warming are to be applied. Take Spirit of Wine ℥ij. Honey and Oil of Ro∣ses, A. ℥j. mix them.

XLVI. As it is an evil sign, if the substance of the Brain is of a livid colour; so if the Portion thereof, which must be separa∣ted, look whitish, like to Hail∣stones, and have not a very stinking Smell, it seems that Nature is strong.

XLVII. If the Wound comes to yield a laudable Quittor, then the Oil of Roses may be more especially omitted, and only Honey of Ro∣ses, and Syrup of Red Roses, or Syrup of Myrtles, mixt with A∣qua Vitae, or Spirit of Wine, are to be used. Or this, Take Bal∣sam of Peru, Gum Juniper, red Oil of Hypericon (made by a manifold Infusion of the Flowers) A. ℥ss. mix them. It admirably dries, warms, resists Putrefaction, and the Prejudices of the ambient Air.

II. Of the Cure of the Symptoms.

XLVIII. 1. Apostemation of the Brain. That this may happen, Valeriolus, lib. 3. Obs. 8. Fer∣nelius de Lue, cap. 7. & Paraeus, lib. 9. cap. 8. with others, do affirm. And Sennertus, lib. 1. par. 1. cap. 27. says, an Inflam∣mation may happen to the Brain, and that in time may Aposte∣mate.

XLIX. Authors account this a∣mong the most desperate, if not a∣mong the mortal Symptoms: But Arcaeus, lib. 1. cap. 6. gives us a History of one, who having lain desperate seven days of a Wound of the Brain, had on the eighth day three Apostemes broke out, and yet was perfectly cured in the space of four Months.

L. The Body is to be kept open with Lenients, or Lenitive Cly∣sters are often to be given. Fo∣mentations may be applied to the adjacent parts upon the Head; and, in due time, the Aposte∣mation is to be opened, and cleansed of its Virulency as soon as may be, lest it contaminate the sound parts of the Brain; and then the Cure is to be ab∣solved, according to the usual Method.

LI. 2. Concussion, or Commotion of the Brain. If it is vehement, it is always dangerous, and ma∣ny times mortal. And Hippo∣crates, lib. 7. Aph. 58. says, They who have suffered a strong Con∣cussion of the Brain, must of ne∣cessity become dumb or speech∣less.

LII. It is to be dress'd as a Fracture, when the Cuti Muscu∣losa is whole. Parcus draws Blood out of the Vena Cephalica, according to the Strength of the Patient, then he shaves the Head, and applies a Cataplasin made of Barley Flower, Oil of Ro∣ses and Oxymel: But Astringents are forbidden, because they hin∣der the breathing of the Fuligi∣nous Vapours thro' the Sutures, 〈2 pages missing〉〈2 pages missing〉

VII. There are many Composi∣tions of this Emplaster; the chief of which we have given you in Cap. 6. Sect. 36. ad 47. of this present Book aforegoing. But some Authors commend the fol∣lowing.

VIII. ℞ Rosin, Ship-pitch, Wax, A. ℥ij. Turpentine ℥jss. Tac∣camahac ℥ss. White Starch, Calx Vive, Frankincense, Mastick, O∣libanum, A. ℥ijss. mix, and make an Emplaster.

IX. Or this Pouder. ℞ Fran∣kincense, Mastick, Olibanum, Ro∣sin, Sanguis Draconis, Fine Bole, Terra Sigillata, Alum, Calx Vive, White Starch A. ℥j. make each into a sine Pouder, and mix them. This is to be mixed with the White of an Egg, till it be∣comes of the thickness of Ho∣ney, and then to be applied.

X. If the soft parts are trans∣versely incised, and the Wound is long, the Lips will gape, being far distant asunder. In this case stitching with Needles is requi∣site, to bring them close toge∣ther.

XI. But when you find the Brims of the Wound agglutinated, and that their Swelling and In∣flammation are gone, you must re∣move the Stitches, and apply the dry Suture afore-named, which will be about the third or fourth day; and this must be done to prevent Scars.

XII. If the transverse Wound is not long, fit or convenient rowling, and dry stitching may suffice for the bringing and keeping the Lips of the Wound together.

XIII. As to Medicaments for the Cure of these Wounds, Pouders are not so fit to be applied, when the Lips are brought together: For in some cases, some small di∣stance must be left, which by Sarcoticks you must incarnate; which Pouders, by their Sub∣stance and Quality hinder, by their drying too often and too soon, making an ugly Scar.

XIV. As to the Substance or Consistence therefore of these Me∣dicines, they ought to be humid and soft, and only drying in their Qua∣lities, whereby Nature will have time enough given her to com∣pleat the Agglutination, by which means the Cicatrizing will be the more beneficial.

XV. Such Medicaments are all Natural and Artificial Balsams; Oil of Hypericon mixed with Tur∣pentine, or with Balsam Capivii, or Gum Elemi, and Arcaeus his Liniment; over which, in Sum∣mer-time, Empl. Album, or de Minio, may be laid; but in Win∣ter-time Empl. Sticticum, or some other like it; and if they are too hard or stiff, you may soften them with Oil of Hyperi∣con, or Oil of Ben.

XVI. The Vulnerary Liquor of Schroder is commended, if used by a skilful Hand. Liquor ad Ʋl∣cera Schroderi, in Pharm. Med. Chym. lib. 1. cap. 66. b. ℞ Calx vive, Sal Armoniack, A. q.v. levigate them, and then mix them together, and melt them with a very strong Heat, and it will yield a Water, which decant, beat the mass to Pouder; and add to it as much Salt of Tartar, which place in a Cellar to melt per deliqui∣um.

XVII. He commends it for cu∣ring Tettars, Ringworms, Fistu∣lous Ʋlcers, old, running, and ma∣lign Sores, Cancers, Serpigo, and breakings out of the French Pox, and such other like, cleansing and healing them: but being mixed with Wine, or Spirit of Wine, it is said to cure Wounds im∣mediately.

XVIII. When the Cicatrize or Skinning is almost induced, to pre∣vent the Skarring, Authors ad∣vise to anoint the part with Man's Fat or Grease: Bears Oil is good for this Use, so also Oil of Ben.

XIX. If both the soft parts and the Bones are cut, you must then have more respect for the Se∣curity of the Patient, than for the Beauty of the Face: Here no kind of stitching is to be u∣sed if the Wound is large, and the Bone much hurt.

XX. The Bone is to be scraped with a Raspatory, and the Wound kept open till it scales; after which the Wound is to be in∣carnated with Sarcoticks, and the rest of the Cure performed as we elsewhere teach.

XXI. If there is a Solution of Ʋnity in the Jaw-bone, you must reduce the Bone to its natural Po∣sture, that Bone may answer Bone, and each soft part its fellow; the parts are to be thus kept in their reduced Position with stitching and convenient Ban∣dage, dressing the Wound with such proper Vulneraries, as we have taught in the general Cure of Wounds.

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.

CHAP. XXXI. Of WOƲNDS of the EARS.

I. A Wound of the Ear is called in Greek, 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉. and in Latin, Vulnus Auris.

II. In Wounds of this Part, the Ear is either wholly cut off from the Temporal-part of the Head, or it is but cut in part.

III. If the Ear is totally cut off, you have nothing more to do, but to produce the Cicatrice with strong Epulotick Medicines; such as the Cephalick Pouder, Ʋng. de Bolo, de Minio, and many other: variety of which you may find in Cap. 2. Sect. 47. ad 57. aforegoing.

IV. If the Wound is such, as that it is not quite cut off, or that the separation is but small, the dry-suture only will do: but if the Wound is large, a Needle and Thread must be used, that the divided parts may be brought and kept together.

V. Then because the Part it self is chiefly Cartilaginous, strong drying, and somewhat aggluti∣nating Medicaments are to be applied.

VI. In Stitching, the separa∣ted parts you are to bring together with the Needle and Thread, the parts of the Skin only, on each side of the Ear, without piercing the Cartilage; for that may induce an Inflammation, and a Gan∣gren may follow it, as Aqua∣pendens, in Chirur. part. 2. lib. 2. cap. 33. does testify.

VII. If the Wound reaches to the first Cavity of the Ear, called Meatus Auditorius, you must then keep a Spunge-tent, or some such other like thing in it: which will 1. Prevent spongy or proud Flesh growing in it, which might stop the passage, and so hinder the Hearing. 2. Hinder Pus, Quittor, or Sa∣nies from falling into the Cavity, which if acrimonious, may ex∣ulcerate the internal parts, and corrode the Tympanum, and so cause an incurable Deasness.

VIII. Sennertus, Med. Pract. lib. 1. part. 3. sect. 3. cap. 5. has these words concerning Wounds of the Ears: Vitanda vero in Aurium Vulneribus omnia unctuosa, crassa, gravia, & em∣plastica, & Ligaturia arctiores: But (says he) in Wonds of the Ears, all things which are unctuous, gross or thick, heavy, and emplastick, are to be avoided, as also too strict Bandage or Ligature.

CHAP. XXXII. Of WOƲNDS of the NOSE.

I. THEY are called in Greek, 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉. in Latin, Vulnera Nasi vel Naris; and in English, Wounds of the Nose, or Nos∣trils.

II. The Kinds. A Wound in the Nose, may be made either in the soft part of the Nose, or in the hard: if the hard parts are wounded, it is either in the upper or boney part; and then there is a Wound and a Fra∣cture; or in the lower or carti∣laginous part, and then the Gristle must suffer a solution of continuity.

III. The Cure. If the Wound happens in the soft parts, the Dry-suture will do well enough: but in these kinds of Wounds we must do all our endeavour, to procure a fair Cicatrice, that the Scar may be with as little deformity as may be, because the Nose is the most eminent part in the Face, and a small Scar will be much discerned.

IV. Medicaments dry and astringent are chiefly to be applied; of which kind are, Ʋnguentum Album Camphoratum, Ʋng. de Minio, Desiccativum Rubrum: also Emplastrum de Minio, Dia∣palma, or Emplastrum Album.

V. If the Wound is with fra∣cture of the Bone, then the Bones must first be rightly set: secondly, the Wound must be consolida∣ted with Sarcoticks or Aggluti∣natives.

VI. To Reduce the Bones. You must put into the Nose a piece of Wood, so framed or cut, that it may easily go in, to bear up the Bones: then on the outside, you are with your other Hand to reduce the Bones to the best posture you can.

VII. This done, you must have a Pipe prepared on purpose, made of an Elder-stick, the pith being thrust forth, or of a thin plate of Silver; or for a present neces∣sity, of a Cane, or of a large Goose or Swans Quill; which Pipe is not to be so exactly round, but somewhat narrower above, and broader below, in respect to the natural figure of the Nostril: which Pipe is to be put up into the Nose.

VIII. Now the Pipe, which is to be wrapped up in soft Linnen, is not to be put too far up, lest it causes Sneezing, which will much hinder the agglutination of the Bone, and consolidation of the Wound: and it is to be tied or fastened to the Head with Cloths or Caps, or other Bandage, that it may not drop out.

IX. The Ʋse of the Pipe is, 1. To make way for the Breath∣ing. 2. To make way for the Pus or Quittor, if any comes from the Wound that way. 3. To keep the Bones in their

Reposition. 4. To make way for a Discharge of the Excre∣ments from the Brain.

X. The Bones being thus re∣duced, you must endeavour to bring the soft lips of the Wounds toge∣ther; either by the Dry-suture, or with a Needle and Thread, as the necessity and occasion shall give indication to you.

XI. Then you must apply a desiccative Medicament to the Wound it self, as fine pouders of fine Bole, Terra Sigillata, Cate∣chu, Chalk, Oker, or Sanguis Draconis; which are to be mixed with the white of an Egg well beaten, and brought to the consistence or thickness of Honey.

XII. If the Wound is made transverse, you must apply to each side of the Nose a soft little Bol∣ster, made of soft linnen Cloth, nipt or wrung out of astringent red Wine: which Bolsters are to be staid on with a Rowler or Bandage, having a hole in the middle to give a passage to the Breath, and is to be fastned behind, or sowed on the back parts of the Head.

XIII. But this Bandage is to be no straiter than needs must, for the keeping of all things in their places; for if it be too strait, it will cause the Nose to look upwards.

XIV. And near to the Septum of the Nose, another narrow Rowler is to be applied; which is to be wound about backwards, and brought to the Neck, as you did the other.

XV. If the Wound is in the lower or gristly part, then is that lower part cut quite off, and so requires nothing but cicatri∣zing: or it is only divided.

XVI. And then the Ʋnition is to be induced, 1. By the Dry-suture, or stitching with Needle and Thread, as the necessity shall require. 2. By the help and use of a Pipe. 3. By ap∣plication of Drying Medica∣ments. 4. By proper and fit Bandage, as we have even now directed you in the former.

CHAP. XXXIII. Of WOƲNDS of the MOƲTH.

I. THEY are called in Greek, 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉. in Latin, Vulnera Oris; and in English, Wounds of the Mouth.

II. We consider the Wounds of the Mouth in a threefold respect: 1. As they have respect to the Lips. 2. To the Gums or Jaws. 3. To the Tongue: of all which in order.

I. Wounds of the Lips.

III. These VVounds are called in Greek, 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉.

and in Latin, Vulnera Labri: are either in the Skin only, or in the Musculous Parts, or in the Membrane also which covers the Mouth.

IV. If the Skin is only wounded, ordinary Astringents or Sty∣pticks will do the work alone: and the Cicatrice may be smoothed with the Spanish Bal∣sam, or Oil of Hypericon.

V. If the Musculous Parts be also wounded, then ordinary Stitching is to be made use of, and the application of such Medicaments as are for the con∣solidation of Wounds made in other parts of the Body.

VI. If the whole substance of the Lip is divided, and does gape, then such Wounds are to be drest as a Hare-lip, after that the edges of it are made raw.

VII. You must pierce each side of the divided Lip with a Needle or Pin, having on each side of it a thin, small Plate of Lead; thro' both which pieces of Lead, the Needle or Pin is to pass, and then the Thread is to be wound cross-wise about both ends of the Needle, &c. nipping off the point thereof with a pair of Steel Nippers well hardned.

VIII. The Stitch is to be taken somewhat deep, and about the middle of the Wound, that the lips thereof may be the more surely kept together: and the Leads keep the Needle or Pin from breaking thro' the edges of the Wound.

IX. If the VVound is large, there must be two ordinary Stitches more; one above the Needle or Pin, the other below it.

X. Authors say, the Needle may be taken out the fourth, fifth, or sixth day, as you see the congluti∣nation to be made: but in our time, they have been taken out the third day, and sometimes on the second: and if the Dry-suture be applied, it many times is taken away the very next day.

XI. Then for Consolidation some healing Balsam is to be applied; as Balsam of Peru, de Chili, Balm of Gilead, or Capivii, or some Artificial Balsam. In Win∣ter they may be used alone, but in Summer they may be mixed with the yolk of an Egg: or, Take Oleum Hyperici, Cyperus Turpentine, A. mix them.

XII. The Oleum Hispanicum described in Cap. 28. Sect. 37. aforegoing, mixed with Gum Elemi, orTurpentine è Chio, is an excellent thing, and causes speedy Agglutination: the parts being agglutinated, remove the Stitches, and induce the Cica∣trice by anointing the place with Mans, Bears, or Vipers Grease.

II. Wounds of the Gums or Jaws.

XIII. These VVounds are either of the Gums only, or of the Teeth and Jaw bones: and the Jaw-bones are either laid bare only, or broken: they are called in Greek, 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉. and in Latin, Vulnera Gingivarum.

XIV. If the Teeth be broken out, they are no more to be restored, unless in young Children: if only loosened by Blows, contusion of the Gums, or the like, they are fastened again by use of Astrin∣gents;

the chief of which is a Tincture of Catechu made in common Brandy, and mixed with Red-wine: or by holding Scurvigrass constantly for some time between the Gums and the Cheeks.

XV. If the Gums are wounded, there is commonly a great flux of Blood; this is stopt with Astrin∣gent Pouders, or with Tincture of Catechu, or Dr. Gardner's Styptick, than which there is no better thing yet known: and the Blood being stopt, the same Styptick which stopt the Blood, commonly performs the Cure.

XVI. If there is a Contusion, the Gums then for the most part Apostemate; then they are to be opened with a Lancet, or Inci∣sion-knife, and emptied of the Matter contained in them: af∣terwards, they are to be cleansed with Mel Rosarum mixed with Oxymel, and Red-Rose Water, and healed with this Gargle or Wash.

XVII. Take Red-rose-water, Smiths-forge-water filtred, A.℥iv. Honey of Roses, Syrup of Mulber∣ries, A. ℥jss. S.V. ℥ii. Roch Alum ʒii. mix, dissolve, and keep it for use.

XVIII. If the Jaw-bones are made bare, they ought to be scraped with a Raspatory, and strewed over with a Cephalick Pouder, and the Exfoliation hastned, if need requires: after which, you must Incarnate with Sarcotick Pou∣ders, and then with proper Stypticks induce the Cicatrice.

XIX. If the Jaw-bone is bro∣ken, or shattred, the pieces are to be taken forth, (if possible, at first Dressing) the broken parts are to be reposited, and the lips of the VVound to be brought as much as may be together; then to be drest with Agglutinative Pouders, and a Dossel dipt in astringent Wine to be laid over: also outwardly may be applied Emplastrum Catagmaticum, which is to be bound on, as the nature and disposition of the Part does require.

III. Wounds of the Tongue.

XX. They are called in Greek, 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉. in Latin, Vulnera Linguae; and in English, Wounds of the Tongue.

XXI. If a part of the Tongue is wholly cut off, it is no more to be reunited: but if the Part separated is yet conjoined, tho' by some small portion, it ought not to be cut off, unless you see it will not unite again, but be∣gins to mortify.

XXII. Such VVounds are cured with much difficulty; because neither dry-stitching nor bind∣ing up can be used, nor yet other Topical Means, as Em∣plasters, Balsams, &c.

XXIII. In such a case there∣fore Stitching with Needle and Thread is to be attempted: the Tongue is to be pulled out as far as may be, and so holden by the Hand in a Linnen Cloth; (if it may be) or with a hollow and rugged pair of Forceps armed also with Linnen Cloth; and so many deep Stitches are to be taken, as shall seem ne∣cessary to hold the parts united, cutting off the Thread near the knots.

XXIV. VVe advise to deep Stitches, lest they should break out again, and so make the trou∣ble the more, and the pain the greater: tho' we know that Celsus, lib. 5. cap. 26. says, that the less Flesh the Needle takes hold of, the less will be the Pain or Inflammation.

XXV. This done, you may use Astringents; such as Syrup of Myrtles, or of Red-roses mixt with Plantan or Red-rose-water, in which a little Alum has been dissolved: or Syrup of Quinces mixed with a Decoction of Vulnerary Herbs; and Saccha∣rum Rosatum may be mostly held in the Mouth.

XXVI. Sennertus, Med. Pract. lib. 1. part. 5. sect. 3. saith, Quia verò Emplastra adhiberi commodè non possunt, Linctus & Linimenta ex Syrupo de Rosis siccis, Melle∣rojato colato, Syrupis, vel simili∣bus adhibenda: and he prepares the following Decoction, with which the Mouth is often to be washed.

XXVII. Take bulled Barley M. i. boil it in fair Water 'till it breaks, adding towards the end of the boiling, Myrtle-leaves, tops of Hypericon, Plantan-leaves, Red-roses, A. M ss. Balaustians P.i. boil again and strain out, and dissolve therein a quantity of Honey of Roses.

XXVIII. If it should degene∣rate into an Ulcer, or an Ulcer should happen to the Fauces, you may gargle with this: Take Plantan, Horsetail, A. M.i. Roses, Balaustians, tops of Wormwood, of VVillow, A. P.i. hull'd Barley ℥i. Cypress-nuts, Lentils, Sumach, A. ʒiii. boil all in Water ten parts, mixed with Vinegar one part: then strain, and dissolve therein Honey of Roses, Wine of Pomgra∣nats, and Diamorum, A. ℥ii. mix, and make a Gargarism.

XXIX. Or, Take Plantan and Red-rose-water, A. ℥iii. Diamo∣rum, Honey of Purslan, A.ʒi. Quid∣dony of Currants, Honey of Rosis, A. ℥ss. mix, and make a Garga∣rism.

XXX. Lastly, let the Diet the Liquid things, Almond-milk •• Milk-pottage, yolks of Eggs, thick Milk, Broths, Gellies, strong Watergruel, Barley-Cream, Panada, and other things of like nature.

CHAP. XXXIV. Of WOƲNDS of the NECK.

I. THEY are called in Greek, 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉. in Latin, Vulnera Colli.

II. These Wounds are either in Parts common or proper: the common parts are the Cutis, and the Membrana Carnosa: the Parts proper are the Vertebrae, the Vessels, and the Oesophagus and Aspera Arteria; of the

Wounds of the Parts common and Vertebrae, we shall treat in this Chapter, of the Wounds of the Vessels in the next, and of the Wounds of the Oesophagus and Trachea Arteria, in the Chapter following.

I. Wounds of the Cutis and Membrana Carnosa.

III. The Wounds which happen to these common Parts, require no particular Discourse; being cured by joining the lips of the parts disjoined together, and applying Agglutinative Medicines.

IV. The Wound is either simple, without loss of substance; or com∣plicate, with loss of substance: again, if complicate, it is with loss of but a little of the sub∣stance, or with great loss of substance.

V. If the Wound is simple, it it is cured by the first Intension: by bringing the lips together, (and stitching them if the Wound is large) and applica∣tion of Stypticks or Glutma∣tives: so the work is done in a day, two, three, or four at most.

VI. If the Wound is with loss of substance, and the loss is but small; seeing these Parts are loose and flaggy, you may not∣witstanding stitch them, and perform the Cure by the first Intention.

VII. But if the Wound is with great loss of substance, you must then according to the general Precepts, 1. Stop the Hemor∣rhage, if it is violent. 2. Bring the Wound to Digestion, by good Digestiives. 3. Then cleanse by Abstersives, such as Mundifi∣cativum Paracelsi. 4. Incarnate with Sarcoticks. 5. And lastly, produce the Cicatrice with Epuloticks.

II. Wounds of the Vertebrae of the Neck.

VIII. Sometimes the Wound only divides Museles, and does not pass to the Spinalis Medulla; and then the Wound is to be drest, and the Cure to be per∣formed, as those Wounds which happen in the fleshy parts.

IX. If the Bone is also hurt, the Wound is to be drest as Wounds of the Head, in which there is a Fracture of the Cra∣nium.

X. If the Spinal Marrow is wounded, it is wholly cut asunder, or but in part only. If it is cut thro', then the whole Body is deprived of motion and feeling, breathing will be hindred, and by consequence, death will ensue.

XI. The Signs. Celsus, lib. 5. cap. 26. says, That the Spinal Marrow being wounded, a Palsy or Convulsion follows, feeling is lost; and after a while the Sick cannot retain Seed, Urine, or Excrements of the Belly, and sometimes a total suppression of Excrements will ensue.

XII. Fernelius, Patholog. lib. 7. cap. 8. says, If the Spinal Mar∣row is wounded, the inferior parts become paraly••ick, their feeling, motion, and functions are lost; so that Seed, Ʋrine, and other Excrement, do sometimes come away involuntarily.

XIII. If the Nerves of the fifth, sixth, and seventh Vertebrae of the Neck are wounded, Convul∣sions happen to the Arms: if the the Nerves of the Vertebrae of the Loins and Os Sacrum are wounded, the Thighs and Legs become in like manner af∣fected.

XIV. The Prognosticks. Since Galen, de Temperament. lib. 3. cap. 3. says, That the Spinal Marrow is of the same nature with the Brain: and de Facult. lib. 3. that it is near to the Brain: de Ʋsu Partium, lib. 16. cap. 2 that it is derived from the Brain: de Motu Musculor. l. 1. c. 1. that it resembles a compact Brain: and, de Ʋsu Part. lib. 12. cap. 11. & 15. that it seems to be another Brain under the Head and Neck. It follows, That all Wounds thereof, can be no less dangerous than those of the Brain.

XV. The Reasons are manifest: 1. Because it draws its Original from the Brain. 2. By reason of its Consent with the Brain. 3. Because of its Composition, being covered with the Dura and Pia Mater. 4. Because of the Symptoms attending its being wounded; as Convulsions, Palsy, loss of Motion and Feeling. 5. Because of the Nerves springing from it. 6. Be∣cause of its Action and Use, communicating Motion and Feeling to the Parts. 7. Because of its Situation; it lying so deep, that the force of Topi∣cal Applications can scarcely reach it.

XVI. If the Spinal Marrow is not wholly cut asunder, but only wounded, then dreadful Convul∣sions ensue, which for the most part end in Death.

XVII. And the Wounds of the Spinal Marrow are sometimes cured, yet Hippocrates, in Coacis Praenot. accounts them mortal; which I interpret, that they are for the most part mortal. See Fallopius de Capitis Vulneribus, cap. 2.

XVIII. If therefore it is wounded in the upper part, or in the begin∣ning of it, Forestus, Chirurg. Obs. lib. 6. cap. 6. says, that Convul∣sions of the whole Body will follow, and so Death must of necssity ensue.

XIX. But if it is wounded in the lower part, the Wound is not always mortal, unless it is large, or a Puncture, but Convulsions will always ensue.

XX. The Cure. It ought to be attempted, how dangerous so∣ever. Sennertus, lib. 2. part. 2. cap. 22. saith, Cum autem Spina∣lis Medulla quasi Cerebrum oblon∣gatum sit, eadem etiam Medica∣menta ei, quae suprà Lib. 1. Part. 1. Cap. 24. de Vulneribus Cerebri proposuimus, adhibenda. In like manner, we say, that the same Medicaments which we have proposed in the Cure of Wounds of the Brain, in Chap. 28. Sect. 30. ad 47. aforegoing, are to be used here.

XXI. The Indications of Cure are, 1. To ease Pain with Ano∣dyns. 2. To resist the Convul∣sions, with Neuroticks. 3. To induce Digestion, with Digestives void of biting and sharpness.

XXII. ℞ Oil of Hypericon,

yolks of Eggs, A. ℥i. Turpentine ℥ ss. Oil of Mace by expression, Mithridate, A. ʒii. Oil of Aniseeds ʒss. mix them.

XXIII. Or, ℞ Oils of Hype∣ricon, and of Whelps, A ℥ii. Gum Elemi, Oil of Nutmegs by expres∣sion, A. ℥ss. Theriaca Chymica, Chio Turpentine, Balsam of Peru, A.ʒii. Oil of Spike ʒi. mix them.

XXIV. And then anoint the whole Back-bone and Head with this: ℞ Oils of Whelps and of Castor, A. ℥i. Oil of Nutmegs by expression ℥ss. Oil of Rosemary, of Limons, of Sweet-marjoram, and of Savin, A. ʒii. Camphir ʒi. mix them.

CHAP. XXXV. Of the WOƲNDS of the WIND-PIPE and GƲLLET.

I. THEY are called in Greek, 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉. in Latin, Vulnera Asperae Arteriae, vel Fistulae Spiritalis; in English, Wounds of the Wind-pipe. Also, 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉. in Latin, Vulnera Gulae; and in English, Wounds of the Gullet, or Swallow.

II. These Members or Parts are seated either in the forepart of the of the Neck, or in the back∣part of the same: in the fore∣part of the Neck is the 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, Aspera Arteria, or Wind-pipe; in the back∣part is the 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, Oeso∣phagus, Gula, Swallow, or Mouth of the Stomach.

I. Wounds of the Wind-pipe.

III. It has three parts: viz. 1. 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, Larynx, the upper∣most part of it. 2. 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, Bronchus, Caudex, Fistula, the great Pipe it self. 3. 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, Branchiae, the Branches of the Bronchus, which are spread throughout the sub∣stance of the Lungs.

IV. The Signs. If the 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉 or Aspera Arteria is wounded through, then 1. Wind, or the Breath will come out at the Hole. 2. Blood will come out at the Mouth. 3. The Speech will be hurt. 4. Coughing will come upon, and trouble much the Patient.

V. The Prognosticks. Tho' Wounds of the Larynx are not mortal of themselves, yet they may be such by accident: 1. Be∣cause of its necessary and con∣tinual use, it making the Inspi∣ration and Respiration of the Air. 2. Because it it difficult to be cured, for that Medicines cannot ca•…•…ly be applied or kept to the Part. 3. Because of the fearful Symptoms many times accompanying such Wounds.

VI. For, 1. It is near to the Jugular Veins and Soporal Arterie; so that it can hardly be wounded, unless these parts be also hurt. 2. It has several Muscles, and divers Branches of the Recurrent Nerves: so that besides a great flux of Blood, there may be vehement Pain, Inflammation, and Convulsion of the parts, so that Strangling may at last ensue.

VII. VVounds of the Bronchus, or Pipe it self, tho' they are not so dangerous as the former, yet they have some danger also: for being made of a double sub∣stance, as the Annuli, or Rings, which are cartilaginous; and the Medium of the conjunction of these Rings, which is mem∣branous, they seem to be of difficult cure.

VIII. For Hippocrates, Lib. 6. Aph. 19. says, A Bone or a Car∣tilage cut asunder, or a Nerve, it neither grows again, nor is united: viz. we are to understand, that the Medium of Unition is not by a like substance: and this he repeats again, Lib. 7. Aph. 28. to which Galen. Meth. Med. lib. 5. cap. 7. assents.

IX. Vidus Vidius, de Curat. Morb. Membr. lib. 8. cap. 6. says, That Wounds which pass thro' the Windpipe, cause most commonly present death; for that the Blood issues out of the Jugular Veins, falls upon the Lungs, and causes suffication.

X. Forestus, Observ. Chirurg. lib. 6. Obs. 4. says, That large Wounds of the Bronchus, chiefly those which divide the Cartilagi∣nous substance, are seldom cured, because it is dry, hard, and with∣out Blood; and withal the Pa∣tient draws his Breath by the Wound, which hinders conso∣lidation.

XI. The Cure. The Wound is either transverse, or acccording to the length of the Bronchus or Windpipe: if it is transverse, then the Patient must bend his Head downwards; but if ac∣cording to the length, then he must hold his Head upwards, that the lips of the Wound may be brought together.

XII. Which done, it is to be stitcht as firmly as you can possibly do it: some say Needles, as in the stitching of a Hare-lip, are best, because all sorts of Thread will easily rot.

XIII. After the Wound is stitcht up, Agglutinative Medicaments are to be used: you may apply Bal∣sam de Chili, Balsam de Peru, or Arcaeus his Liniment, or some other good Artificial Balsam: and over all you may apply Diachylon simplex, malaxed with Oil of Ben, or of Myrtles, or of Quinces.

XIV. You must beware in dres∣sing, that neither Blood, Sanies, or Pus fall upon the Windpipe, lest it causes Suffocation: but that they be outwardly discharged in a descending Part.

XV. If after dressing, the Patient breathes with difficulty, there is danger of suffocation: because the cavity of the Larynx or Bronchus is filled with Blood, or Pus, or both, or by reason of great Inflammation.

XVI. In this case, the Wound is to be dilated, and a Silver

Pipe, a little bended towards the point, that it may not hurt, and Wings on the outward end, that it may not fall in, is to be kept in, 'till the Patient is able to breathe freely, and then to be taken out.

XVII. And in the time of the Cure, this following Gargarism ought often to be used. Take Barley-water of the second de∣coction lbiii. in which Red-roses, Balaustians, and Sumach, A. ʒii. Raisons stoned, and Figs, Liquo∣rice bruised, A. ℥i. have been well boiled: strain it, and add thereto Tincture of Catechu, Syrup of Myrtles and Mel Rosarum, A.℥ii. and let it be used warm.

II. Wounds of the Oesophagus, or Swallow.

XVIII. The Signs. Fernelius, Pathol. lib. 7. cap. 8. says, If the Wound is deep, Meat and Drink will come out at it, there is diffi∣culty of swallowing; also the Hiccough, Vomiting of Choler, Fainting, weak Pulse, cold Sweats, with Coldness of the Hands and Feet.

XIX. And Celsus, lib. 5. cap. 26. says, There is a Vomiting of Meat and Drink.

XX. The Differences. Either the whole Gullet is cut asunder, or it is only cut in part. If it is cut but in part, then it is either wounded near the Stomach, or far from it. It is also wounded either straight, or obliquely.

XXI. The Prognosticks. These Wounds, if small, straight, and remote from the mouth of the Sto∣mach; are less dangerous, than if large, deep, and near the mouth of the Stomach.

XXII. If they are great, deep, transverse, and near the mouth of the Stomach, they are uncura∣ble, as Guido says, Tract. 3. doct. 1. cap. 1. 1. Because the passing of Meat and Drink, does hinder consolidation. 2. Because an Inflammation may easily be communicated to the mouth of the Stomach, which is very ner∣vous. 3. Because, being wholly cut asunder, the Cure is im∣possible; for that the upper part shrinks upwards, the lower falls downwards.

XXIII. The Cure. The first Intention is, by stitching to bring the lips of the Wounds together; yet leaving an Orifice in the de∣pending part, to be kept open with a Tent, that the Pus may be discharged, and that the Meat might not stick there, lest an Inflammation ensue.

XXIV. This done, Agglutina∣tives are to be applied, such as we have mentioned at Sect. 13. aforegoing: and a great respect is to be had to the Diet of the Patient, because the swallowing is with difficulty: and there∣fore it ought to be liquid and thin: as strong Broths made of Flesh, Gellies made of Sheeps∣trotters, Calves and Oxes feet, Harts-horn, &c. Cows and Goats Milk sweetned with Saccharum Rosatum, Chicken-broth, and Cordials made with yolks of Eggs, &c.

XXV. But if the Patient can∣not swallow at all, then nourishing Clysters are to be exhibited; (the Excrements being first removed

by Purging Clysters, several times administred, till the Bowels are sufficiently cleansed.)

XXVI. A Purging Clyster. ℞ A Decoction for Clysters, or Mutton-broth ℥ x. brown Sugar ℥ii. Honey of Roses ℥ii. Milk of Scammony ℥ss. mix them.

XXVII. A Nourishing Cly∣ster. ℞ Strong Mutton-broth ℥x. good Brandy ℥ii. white Sugar∣candy in pouder ℥i. mix for a Clyster. Or, ℞ Gelly of Calves∣feet ℥x. yolks of Eggs N^o ii. white Sugarcandy in pouder ℥ i. mix them. Or, ℞ New Cows∣milk ℥ x. (hot enough for a Clyster) yolks of Eggs N^o ii. Gelly of Harts-horn ℥jss. white Sugarcandy ℥i. mix them for a Clyster.

CHAP. XXXVI. Of WOƲNDS of the VESSELS of the NECK.

I. THEY are called in Greek, 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉. and in Latin, Vul∣nera Vasorum Colli; and in English, Wounds of the Vessels of the Neck.

II. These Vessels are of three kinds: viz. 1. Venae Jugulares, the Jugular Veins. 2. 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉. Arteriae Soporariae, the Soporal Arteries. 3. Nervi Recurrrentes, the Recurrent Nerves.

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.

II. Wounds of the Recurrent Nerves.

XXVI. These Wounds are also found in the lateral parts of the Neck: and they are called Re∣current, because they come down from the sixth pair of the Nerves, and return again up towards the Muscles of the La∣rynx: using in the left side the Trunk of the Aorta, and on the right side the Axillar Artery, as Pullies.

XXVII. If one of the Recurrent Nerves is cut asunder, the Voice becomes hoarse; but if both are divided, the power of Speaking is wholly taken away, so that the Patient becomes dumb.

XXVIII. The Cure. If in these Wounds there is any great He∣morrhage, it is first to be stopt; as we have before taught; as also in Chap. 4. aforegoing.

XXIX. This done, the Wound is to be consolidated with this Balsam of Paraeus, in Lib. 10. cap. 29. viz. ℞ Simple Oil of Hypericon ℥iv. fine Gum Elemi ℥iii. Venice Turpentine ℥vi. mix, and melt them together; to which, when they begin to cool, add fine Bole, Sanguis Draconis, A.℥i. Aloes, Myrrh, Mastick, Orrice∣root, all in fine pouder, A.ʒi. Aqua Vitae ℥ii. mix them well.

XXX. Linimeatum Arcaei, or Our Friendly Balsam, are incom∣parably good for this purpose: so also Balsam de Chili, de Peru,

de Tolu, and many other arti∣ficial Balsams.

XXXI. As, ℞ Balsams Capi∣vii, de Chili, and de Peru, A.℥ii. Gum Elemi, Chio Turpentine, A. ℥iii. Bees-wax, Oil of Hypericon, A. ℥iiii. mix, and make a Balsam.

XXXII. These Balsams are to be applied warm, and over the Balsam Diapalma, or Empl. al∣bum malaxed with Oil of Hyperi∣eon, which will also prevent an Inflammation.

CHAP. XXXVII. Of WOƲNDS of the BRAST and HEART.

I. THey are called in Greek 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉. in Latin, Vulnera Thoracis; and in English, Wounds of the Breast. 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉. in La∣tin Vulnera Cordis; and in Eng∣lish, Wounds of the Heart. 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉. in La∣tin, Vulnera Diaphragmatis; in English, Wounds of the Midriff.

II. The Kinds. They do either not penetrate, and then they are to be healed according to the common Method of ordinary Wounds of the fleshy parts; or they do penetrate, and then we must consider the depth, and whether any Wound is inflicted upon any of the parts contained within, or that they are free from any Damage.

III. The VVound is also either in the Mediastinum, in its hollow Cavity in the lower parts of the Brest, or it penetrates into the lower part of the Thorax.

IV. The Signs. You may know whether the VVound penetrates or not by searching with a Probe, or Searching-Candle, which will enter into the Cavity.

V. And when the VVound pene∣trates, if the Patient does but hold his Breath, by shutting his Mouth and Nose, the Breath will come forth with a Noise, so as it will move, or extinguish the Light of a Candle.

VI. And sometimes 'tis known by the large quantity of Blood, dis∣charged by the Mouth, or Wound, or both; and the Patient will have also a great difficulty of brea∣thing.

VII. If the Heart is wounded, much Blood will come forth, the Pulse will be small or fail, the Face will be pale with cold Sweats, and a trembling of all the Members of the Body; the Patient will be troubled with frequent Swoonings; and when the Limbs grow cold, Death is at hand.

VIII. If the Diaphragma or Midriff is wounded, the Patient has a Heaviness on that part, dif∣ficulty of breathing, a sharp pain, a Cough, with a Fever also; and there is a Raving, by reason of

the Branches of the Nerves of the sixth Conjugation of the Brain, which are spread thro' the Body of it; and sometimes the Stomach and Guts will, by the vehemency of breathing, be drawn up into the Capacity of the Thorax, as Paraeus, lib. 10. cap. 30. does seem to affirm.

IX. If any of these Vessels are wounded, there will be a vehement Hemorrhage, difficulty of brea∣thing, and Fever, which will in∣crease; Blood in abundance will be poured forth into the Cavity of the Thorax; there will be vo∣miting of Blood; and the Blood being putrified, the Breath will stink, Appetite will be lost; he will be uneasie in sitting up, and subject to often faintings, from noisom Vapours assaulting the Heart, rising from the putrified Blood.

X. The Prognosticks. Wounds which either pierce not into the Ca∣vity; or if they penetrate, hurt not the Vessels nor Bowels, are not mortal, but may be soon and ea∣sily cured.

XI. If they be in the hinder part of the Thorax, they are dan∣gerous, because of the Nerves and Tendons; and if they penetrate that way, there is another great Danger from the great sanguife∣rous Vessels, which are sooner met withal this way, than when the Wounds are more forward.

XII. But all wounds of the Brest are dangerous, by reason of the continual motion of the Lungs, and of the Blood which falls down on the Diaphragma, and corrupts it.

XIII. Hippocrates, Prorrhet. l. 2. and Celsus, lib. 5. cap. 26. say, That if the great Vessels, whether Veins or Arteries, be wounded, the wound is mortal, by reason of the vast effusion of Blood not easie to be stayed: 1. Because they lie so deep, that no Medicine can be applied to them, nor can they be bound up. 2. Because their Coats are membranous, and so not to be healed by the first In∣tention.

XIV. If an Artery is divided, the wound is yet more dangerous: 1. Because the Blood it contains is more spirituous than that in the Veins. 2. Because their Coats are harder than those of the Veins, and sometimes Cartila∣ginous. 3. Because of an Aneu∣rism, which often remains after the wounded Artery is cured. 4. By reason of the manner and impetuosity of the flowing of the Blood. 5. Because of the Motion of the Arteries in their Systole and Diastole, which makes their Consolidation dif∣ficult.

XV. In wounds of the Heart, either the Pericardium only is wounded, or the Substance of the Heart also. If the Pericardium only is wounded, the Wound of it self is not mortal, because it is but a subservient and ignoble part, having but sew and small Vessels and Nerves; nor does it cleave to the Heart, but is at such a distance, as to give li∣berty to the Pulsation of the Heart, and is fitted to contain a waterish Humour.

XVI. But by accident they may be mortal: 1. If the Wound is great. 2. If all the watery Hu∣mour

flows out; for then an Hectick Fever seizes upon the Patient, because Nature has or∣dained that Humour for cooling and moistning of the Heart.

XVII. If the Substance of the Heart is wounded, the Wound is accounted mortal; as Hippocrates, lib. 5. Aph. 18. Celsus, lib. 5. cap. 26. & Aristotle de Parte A∣nimal. lib. 3. cap. 4. have de∣clared. See also lib. 1. cap. 50. sect. 42, 43, & 44. and lib. 4. cap. 1. sect. 49. of this present Work.

XVIII. And the chief Reasons seem to be: 1. Because it is the very Store house of vital Blood. 2. Because the Hemorrhage is vastly great, and the Blood fal∣ling into the Cavity of the Brest, causes Suffocation. 3. Be∣cause it is the very Elaboratory of the Vital Spirits. 4. Because it is a very hot Bowel, and so subject to Inflammation. 5. Be∣cause it is the Original of Motion or Pulsation. 6. Because it is in continual Motion, which hin∣ders Consolidation; for that Consolidation requires Rest, as Galen. Meth. Med. lib. 5. cap. 8. has observed. 7. Because its Substance is compact, hard and dry, which does not easily ad∣mit of Agglutination.

XIX. Superficiary Wounds of the Heart, do not so soon kill as deep Wounds: but a Wound in the left Ventricle sooner termi∣nates Life, than a Wound in the right.

XX. Wounds of the Diaphrag∣ma or Midriff, but chiefly if they be in the nervous Center, are said to be mortal; as Hippocrates, lib. 6. Aph. 18. and Galen in his Comment. also Celsus, lib. 5. cap. 26. do affirm. 1. Because it is membranous, and in continual motion. 2. Because the Wounds thereof are very painful, by rea∣son of the Branches of Nerves it receives from the lower Ver∣tebrae of the Neck. 3. Because the Pericardium is tied to it.

XXI. And tho', if the fleshy Circumference of it be only wound∣ed, whereby some hopes of recovery are afforded; yet even those Wounds are not without great Danger.

XXII. And the Reasons are: 1. Because some principal parts must suffer also; as, the Brain, from the Nerves which are in∣serted in it; the Heart, by rea∣son of its Proximity and the Ar∣teriae Phrenicae; and the Liver, because of its Contiguity and Venae Phrenicae. 2. Because the whole part is in continual moti∣on. 3. Because breathing is much hindred. 4. Because the Blood flows forth into the Ca∣vity of the Thorax, which may cause Suffocation. 5. Because of the dreadful Symptoms which may ensue; as, difficult brea∣thing, sighing, Cough, Pain of the Back, pulling up of the Heart-strings, Fever, and Ra∣ving, from the Affinity which it has with the Heart and Brain. See Celsus, lib. 5. cap. 26. Fer∣nel. Patholog. lib. 7. cap. 8. and Forrestus Observ. Chirurg. lib. 6. obs. 47.

XXIII. The Cure. If the Wound penetrates without hurt of any internal part, the danger is the less: and these, for the most

part, are left to be cured by Nature, which here (as in some other Cases) does Miracles.

XXIV. The Patient being laid in his Bed, his Feet stretched out at length, and the Orifice of the Wound downwards; the first thing then to be done is, the stopping of the Haemorrhage with some proper Styptick.

XXV. Then the extravasated Blood is to be discharged, which is said (by Physicians) to be done three ways: 1. By the Wound. 2. By the Mouth through Ex∣pectoration. 3. By Urine.

XXVI. 1. By the Wound. Tents and Pledgits are here hazardous, lest they should fall into the Cavity of the Thorax, and so do more mis∣chief; for which Reason a Flam∣mula or Seton-string may be used, which may be anointed with this Liniment.

XXVII. ℞ Oils of Mastick and of Pine-rosin A.℥i. Gum Elemi ℥ii. Manna of Frankincense ℥ss. roots of Tormentil, and of Comfrey in Pou∣der, A. ʒii. Saffron, Earthworms in Pouder, A. ʒi. Sherry Sack ℥i. mix them, and evaporate to the consumption of the Wine.

XXVIII. Or, ℞ Turpentine or Balsam of Peru ℥ss. which mix with the Yolk of one Egg; then add thereto Oil of Hypericon ℥i. and make a Liniment. This Flam∣mula may be continued, if need require, even to the fortieth Day.

XXIX. Or instead of a Flam∣mula, you may use a silver Pipe, with large Ears or Stays on both sides, such as is used in Paracen∣tesis, that a Thred of reasona∣ble Length may be fastned to it, to keep it in its Posture.

XXX. The Wound and the Pipe may be anointed with the former Liniment or Balsam, or with Ar∣caeus his Liniment melted in a Spoon, or with some other ar∣tificial Balsam; and over it Di∣achylon Simplex may be applied.

XXXI. Where note, That if it is in Winter-time, a Chafing-dish with hot Charcoal may be conveni∣ent in time of dressing to hold near the Wound, to preserve the na∣tural Heat, and hinder the In∣tromission of the cold ambient Air.

XXXII. Wiseman puts a Que∣stion, Whether the wound should be kept open, or agglutinated? They (says he) who are for a speedy Agglutination, do urge it, lest the intromitted Air should corrupt the parts with∣in, and the Heat expire. They that are for keeping ir open, do design thereby a readier Dis∣charge of the matter.

XXXIII. In these Wounds of the Brest (says he) I consider the Wound, how it is capable of discharging the extravasated Blood and Matter. If it is inflicted so, as that the Blood and Matter may be thereby discharged, then it is to be kept open, the Wel∣fare of the Patient depending chiefly upon the well-dressing and governing of it: but if it does not lie well for Evacuation of that extravasated Blood, then it may do hurt, and so ought to be healed.

XXXIV. The second way of evacuating the Blood and Matter, is by Expectoration; and then they say, it must first pass (into the Pleura, say some, and so) into the

substance of the Lungs, than into the Aspera Arteria, or Wind-pipe, and from thence it is coughed up, and spit out by the Mouth.

XXXV. And then Galen ad∣vises to further Expectoration by Exhibition of Posca, or Vinegar and Water, warm, because it pow∣erfully dissolves clotted Blood; and if the Sick coughs with Difficul∣ty, Pectorals are to be admini∣stred, as Syrup of Vinegar, of Limons, and of Juice of Citrons, Syrup of Coltsfoot and of Li∣quorice, Decoctum Pectorale, Pe∣ctoral Lohochs, Oxymel, Syrups of Alehoof, of Maidenhair, of Jujubes, &c.

XXXVI. The third way of e∣vacuating the Blood and Matter is by Ʋrine; and then they say, it passes first into the substance of the Pleura, and then into the Azy∣gos, or Vena sine pari, near to the Diaphragma, by the Spine, whence a Branch comes, through which it passes by a streight Course to the Emulgents, and so to the Kidneys and Bladder, as Aqua∣pendens, part. 2. lib. 2. cap. 42. affirms.

XXXVII. But if we acknow∣ledge the Circulation of the Blood, this Passage is not allowable; for it is impossible to come to the emul∣gent Arteries, but by a prior tran∣sition through the Heart.

XXXVIII. However, if the matter of Fact is true, that there is sometimes a discharge of the matter by Ʋrine, then it will be necessary that Diureticks be given, to promote the same; as, Infusi∣sions, Decoctions, Syrups, Es∣sences, &c. of Maidenhair, Be∣tony, Roots of Parsley, of Smal∣lage, of Fennel, of Asparagus, &c. Also Ptisans made with Barley-Cream, Emulsions, Spi∣rit of Sulphur, Liquorice, &c.

XXXIX. But says Wiseman, I never saw any that I could say, that passed their Disease by Ʋrine; nor many of them that had a free passage of their Ʋrine, during the time of their lying under these Wounds.

XL. Nor have I often seen them (says he) who have recovered, to expectorate any such quantity of matter, as might be thought to proceed from the great quantity of Blood extravasated. They cough'd fresh Blood most of them, like to what they discharged from their Wounds, but more florid.

XLI. Arcae••s, lib. 1. cap. 1. administers this Vulnerary Po∣tion. ℞ Juyce of Pomegranates, Waters of Scabious and Bugloss, A. ℥i. Rhubarb in Pouder ʒss. Mad∣der, Mummy, A.℈i. Terra Sigillata, ℈i. mix for a Dose.

XLII. And to cause easie brea∣thing, be gives this pectoral De∣coction: ℞ Hull'd Barley ℥iiii. Bu∣gloss-roots ℥iii. Liquorice bruised ℥ii. Jnjubes, Prunes, A. N^o xx. Raisons stoned ℥i. Rain-water lbxiv. boil to the Consumption of a third part, strain out, and aromatize with Cinnamon ʒiii. dulcifying it with Sugar-candy ℥iiii. Sugar Pe∣nids ℥iii. Syrup of Roses simple, and of the two opening Roots, sine Aceto, A. ℥ii. Dose ℥vi. every fourth hour.

XLIII. Fambesarius advises, to give Morning and Evening a vul∣nerary Potion, made of Leaves and Roots of Comfrey, Bugloss, Plantane, boiled in Water with

some Vinegar, which being strained, is to be sweetned with Sugar of Roses, dissolving also in it some fine Bole.

XLIV. And outwardly Inje∣ctions may be made with Honey of Roses, thus: ℞ Decoct. of Liquorice ℥iiii. Sugar of Roses ℥ii. Honey of Roses ℥i. mix them. But you must be sure, that all the In∣jection comes forth again; for if any of it should stay behind, it would putrefy.

XLV. Lastly, According as the quantity of the Quittor is, less or more, so dress it once or twice a day; and when the Patient breaths freely, has but little Pain, finds no Weight towards the Midriff, and there is but small quantity of Pus flowing out of the Wound, and that good, you may then, with all the speed that may be, induce the Healing.

CHAP. XXXVIII. Of WOƲNDS of the BACK, and SPINAL MARROW.

I. THey are called in Greek 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉. in Latin, Vulnera Dorsi; and in English, Wounds of the Back. Also 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉; in Latin, Vul∣nera Medullae Spinalis; and in English, Wounds of the Spinal Marrow.

II. The Kinds. These Wounds are either in the fleshy parts only, or the Bone is hurt also: Or there is a Wound of the Marrow of the Back-bone.

III. And in this case, the Mar∣row is wounded but in part, or it is wholly cut asunder.

IV. The Signs. If the Mar∣row is only wounded, and not wholly cut asunder, then dreadful Con∣vulsions will of necessity ensue, and so, for the most part, Death.

V. If it is wholly cut asunder, then the whole Body is deprived of moving and feeling; breathing it self will also be hindred, so that of consequence Death must en∣sue.

VI. Celsus, lib. 5. cap. 26. says, That a Convulsion or Palsie follows, feeling is lost, and after a while the Patient cannot retain either Seed, Ʋrine, or Excrements of the Belly; and sometimes a total sup∣pression of the Excremnnts will fol∣low.

VII. And Fernelius, Patholog. lib. 7. cap. 8. says, That the in∣feriour parts become paralytick, and that their feeling, moving, and functions are lost. See cap. 34. Sect. 10, 11, 12, 13, aforegoing.

VIII. The Prognosticks. Al∣most all Wounds of the Spinal Mar∣row

are mortal; if the Patient out-lives them, they generally leave a Paralysis of some one Part or other. See the rest of the Prognosticks, in Chap. 34. Sect. 14. ad 19. of the following Book.

IX. The Cure. If the Wound is made only in the Fleshy or Mus∣culous Parts, then it is to be dressed and cured as those Wounds which happen in the Fleshy Parts.

X. If the Spina Dorsi, or Back-bone is hurt also, then it is to be dressed as a Wound of the Head, wherein there is a Fracture; of which we shall speak at large in Lib. 6. Chap. 12. and 13. of this Work following.

XI. If the Spinal Marrow is hurt only, the Sick may by chance escape: but if it be wholly divi∣ded, the sense and motion of all the parts under or below the Wound, which receive their Nerves from the lower parts of the Spinal Marrow, will be hurt and taken away: for the Influx of the Animal Spirits in∣to those parts will be wholly obstructed.

XII. The Indications of Cure, as also the Topical Medicaments are the same with those in Chap. 34. Sect. 20. ad 24. aforegoing of this Book; and therefore referring you thither, little more need be said con∣cerning the same here.

XIII. However, if the Verte∣brae are in part divided, this following Liniment is com∣mended. ℞ Yolks of Eggs ℥ii. Gum Elemi, Strasburgh-Turpentine, A. ʒvi. Oil of Hypericon ℥jss. Oil of Spike ʒii. Saffron in pouder ʒi. mix them.

XIV. Or, ℞ Balsam de Chili, de Peru, yolks of Eggs, A. ℥i. Oil of Hypericon ℥jss. Mithridate, S.V. A.ʒii. Oil of Petre ʒi. mix them.

XV. And the whole Spina Dorsi may be anointed with this Mix∣ture: ℞ Oils of Limons, La∣vender, Marjoram, Rosemary, Sage, Savin, Sassafras, Amber, A. ʒjss. Oil of Hypericon or of Ben ℥jss. mix, and anoint there∣with.

XVI. And you may Embro∣cate the whole Back with this: ℞ Oils of Hypericon and of Whelps, A. ℥i. Oils of Juniper∣berries and of Lavender, A. ʒvi. mix them.

CHAP. XXXIX. Of WOƲNDS of the LƲNGS.

I. THEY are called in Greek, 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉. in Latin, Vulnera Pul∣monum; in English, Wounds of the Lungs.

II. The Signs. If the Lungs are wounded, the Blood which comes out of the Wound will be yellow and frothy; the Patient will have a Cough, difficulty of

Breathing, and a Pain on the wounded side.

III. The Sick lies more at ease, when lying on the wounded side, but being laid on the contrary side, is then in more pain.

IV. The Prognosticks. If the Wounds of the Lungs are superfi∣ciary and small, tho' part of the substance of the Lungs has been cut off, yet the Patient has some∣times recovered and done well, and lived many Years after it.

V. Forestus, Lib. 5. Obs. 4. says, That if the Lungs are wounded in the fleshy part, where∣in there is a remarkable Branch of the Arteria Venalis, then the Patient must of necessity dye: for that he will be suffocated with Blood; and the Blood will be much, black, and frothy.

VI. Horstius, de Morb. Pect. lib. 3. obs. 11. Arcaeus, lib. 2. cap. 1. Fabr. Hildanus, Cent. 3. Obs. 36. Platerus, Observat. 3. lib. 3. pag. 690. Valeriolus, Observat. Med. lib. 4. Obs. 10. and Glandorpius, Speculo Chir∣urgico, Observ. 24. with several others, have observed, that dangerous Wounds of the Lungs have been cured.

VII. Out of what has been said, it appears, that tho' some dan∣gerous Wounds of the Lungs have been cured; yet if the Wound is deep, and with the substance of the Lungs being wounded, the great Vessels are divided also, such a Wound is always mortal.

VIII. And the Reasons are ma∣nifest: 1. Because no Medi∣cine can be so applied, as to come to the bottom of the Wound. 2. Because the Arte∣ria Venalis, and the Vena Arte∣rialis being wounded, a dread∣ful Hemorrhage will ensue. 3. Because the Lungs being moist, are very subject to in∣flammation and putrefaction. 4. Because the intromission of fresh Air for cooling of the Lungs, and expiration of fuli∣ginous Vapours, are hindred. 5. Because the Lungs are in continual motion, which hin∣ders consolidation. 6. Because the Heart by its proximity, will be affected by consent. 7. Be∣cause the discharging of the Pus or Matter will be difficult, it being done by Expectoration; and also dangerous, for that it is done by Coughing, which irritates the Wound. 8. Because much Blood falling into the capacity of the Thorax, it presses down by its weight the Dia∣phragma, and so causes difficulty of Breathing: and being turned into Pus, it becomes malign, and so induces a Fever, Phrensy, and Convulsions: and if the Sick continues any time, there will be an Empyema, and after that a Phthisis, which generally ends in Death.

IX. Wiseman says, If the Lungs are wounded deep among the great Vessels, tho' they escape the first nine days, yet they commonly termi∣nate in a Phthisis or Fistula.

X. The Cure. The Hemorrhage is first to be stopt with proper Internals: the Inflammation is to be prevented, or repressed; the Blood which is poured forth into the cavity of the Thorax, is to be evacuated,

and then the Wound is to be agglutinated.

XI. Medicamenta adstringentia & emplastica adhibenda, quae & Sanguinem sistunt, & Inflamma∣tionem prohibent, & Vulnus gluti∣nant: Sennertus, Med. Pract. lib. 2. part. 2. cap. 11. Medica∣ments astringent or styptick, and emplastick are to be used; which may not only stop the flux of Blood, but also hinder an Inflammation, and consolidate the Wound.

XII. These Medicaments are either Topicks, quae in cavita∣tem Thoracis indantur, & infun∣dantur; or Internals, quae ore sumuntur, which are given by the Mouth.

XIII. Those Topicks are to be chosen which bite least, and have no malign quality: all such Me∣tallicks and Salines, which are useful in other Wounds, are in Wounds of the Lungs to be avoided.

XIV. But fine Bole, Terra sigillata, Catechu, Frankincense, Mastich, Olibanum, Gum Avabick, Tragacanth, Acacia, Balaustians, Pomgranat-peels, and such-like, are commended.

XV. A Pouder may be made of fine Bole, Frankincense, and Mastich, Ana; which may be blown into the Wound by a Pipe: or Tent, or Alicant may be in∣jected, especially if diluted with a Decoction made with some Astringents; as Bistort-roots, Cinkfoil, Tormentil, Plantan, Red-roses, and Horstail: but that the Pouder may be the better applied, the Patient is to attract up, or breathe forth, as strongly as may be.

XVI. An Injection. ℞ Roots of Avens, Comfrey, Tormentil, A. ℥ss. Red-roses ℥i. Catechu ℥ss. Aloes, Myrrh, A.ʒi. Barley-water q.s. boil, strain, and add to every Pint thereof, Honey of Roses strained ℥ii. Syrup of d••ied Roses, and of Myrtles, A. ℥i.

XVII. If there is no Fever, nor Spitting of Blood, or any Weight on the Midriff, drop into the Wound Balsam de Chili, or de Peru, or Linimentum Arcaei, mixt with Oil of Hypericon, or some such like, over which apply Diapalma, or Empl. Album.

XVIII. If there is much Blood in the cavity, after it is come forth, you may use a Flammula dipt in the white of an Egg, or a Silver Pipe; as we have advised in Chap. 37. Sect. 2••. ad 31. aforegoing; which may be continued 40 days, more or less, as you see need requires.

XIX. When the Wound runs dige•…•…ed Matter, and but little, the Pipe, &c. may be removed: and if you think it convenient, you may inject a Vulnerary Decoction, blood-warm.

XX. During all the time that the VVound runs, (as much as may be) let the Sick be in Bed, with the VVound downwards, for it••s more easy discharge of the Matter: at other times, put in the Pipe, and lay on it a Spunge wrung out of S.V. with keeps the Air out, and extracts the Pus.

XXI. Afterwards you may lay over the Pipe this Empla∣ster: ℞ Pure R••sin ℥vi. Gum Elemi strained ℥iv. Oils of Bays and Turpentine, A. ℥i. dissolve

the Gum and Rosin over a gentle Fire, then mix the Oils. This you may spread upon Leather, and apply; which change once a day in Winter, and twice a a day in Summer.

XXII. And no way inferior is the Balsam of Peru, mixt with Schroder's Balsamum Nervinum, or Our Balsamum Amicum; or some other like proper Ingre∣dient, to give it a somewhat stronger Body.

XXIII. Inwardly Astringent and Traumatick Drinks are to be given, made of the leaves of Strawbery, Speedwel, Scabious, Devilsbit, Ladies-mantle, Golden∣rod, Sanicle, Woundwort, Per∣winkle, Self-heal, Agrimony, Plantan, Red-roses, and other things of like kind. As,

XXIV. Take Strawbery-leaves, Sanicle, Scabious, Lungwort both sorts, A. M. ss. Ladies-mantle, flowers of Scabious, Red-roses, A. P.ii. Jujubes N^o x. Barley-water q.s. boil, strain, and to each Pint add Julep of Roses ℥ii.

XXV. Or, Take Woundwort, Perwinkle, Speedwel, Strawbery-leaves, Lungwort, Ladies-bed∣straw, Coltsfoot, A. M.i. Devils∣bit, Self-heal, Agrimony, Angelica, Scabius, Self-heal, Plantan, A. M.j.ss. roots of Angelica, Bistort, A. ℥ i. cut and bruise all, and infuse in White-wine, Red-wine, Scabious and Angelica Waters, A. lbijss. boil in B.M. six Hours, strain, and dulcify with fine Sugar ℥iv. Dose, ℥iv. or more, Mor∣ning and Evening.

XXVI. If the Wound was made by Gunshot; Take Lung∣wort M.iii. Mugwort, Comfrey, A. M.j. Wine, Water, A. lbjss. boil in a double Vessel, or in B.M. strain, and sweeten with fine Svgar ℥iii.

XXVII. Galen, Meth. Med. lib. 5. cap. 13 & 14, commends Diaspermaton, which was a thing frequent in use with him, in Wounds of the Brest. Some in place of that Electuary, use Diacodion, which Galen, de Comp. Med. lib. 7. says, Does induce Sleep, takes away the sense of Pain, and stop Fluxes of Rheum from the Head, falling upon the Lungs.

CHAP. XL. Of WOƲNDS of the LIVER. and SPLEEN.

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.

I. Wounds of the Liver.

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.

II. Wounds of the Spleen.

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.

CHAP. XLI. Of WOƲNDS of the STOMACH.

I. THEY are called in Greek, 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉. in Latin, Vulnera Stomachi; and in English, Wounds of the Stomach.

II. They are twofold: first, Wounds of the Mouth of the Stomach, or lower part of the Oesophagus: secondly, Wounds of the Ventricle, or bottom of the Stomach.

I. Wounds of the Mouth of the Stomach.

III. 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉. Vulnera Oesophagi, vel Gulae; Wounds of the Gullet or Swallow, have been treated of in some measure already, in Chap. 35. Sect. 18, &c. aforegoing: but to speak truly, we treated of that part of the Gula which was at a farther distance from the Stomach; here we treat of such Wounds of the Gullet as are near the Stomach it self, and are properly Wounds of the very immediate Mouth of the Stomach.

IV. The Stomach has two parts: 1. The Mouth, which is called Oesophagus. 2. The Bot∣tom, or Belly of the Stomach, which is called Ventriculus.

V. The Signs. Celsus, lib. 5. cap. 26. says, That there is a Hiccough, and Vomiting of Choler, Meat and Drink comes presently up again; the Pulse grows feebie, there is Fainting, with cold Sweats, and a Coldness of the Extream Parts.

VI. The Prognosticks. All Wounds of this Part are dan∣gerous: 1. Because they cause difficulty of Breathing. 2 Be∣cause it can scarcely be wounded; but the Trachaea Ar∣teria, Soporal Arteries, Jugular

Veins, and Recurrent Nerves will be wounded.

VII. The more remote from the Mouth of the Stomach, they are less dangerous: but if they are great, transverse, and near to the Stomach, they are mortal: 1. Be∣cause they admit of no conso∣lidation, for that the passage of the Meat and Drink does hinder it. 2. Because Meat and Drink must be discharged by Vomiting; for that it cannot go to the bottom of the Sto∣mach; so that the only neces∣sary Matter for Life being hin∣dred, Death must ensue.

VIII. Wounds of the Oesopha∣gus or Mouth of the Stomach, are more dangerous than those of the Ventricle: 1. Because it is of a nervous and membranous sub∣stance, and so not easily con∣glutinated. 2. Because it has a great consent with the Brain, it receiving Nerves from the sixth Conjugation. 3. Because Meat and Drink cannot easily pass into the Stomach, without which Life cannot be long con∣tinued. 4. Because, as Celsus says, Vomiting of Choler does many times ensue, which irri∣tates and enlarges the Wound. 5. Because the Pain is ex∣ceeding acute. 6. Because To∣picks cannot be conveniently applied, or giving Traumatick Potions; they either come back again by Vomit, or passing town, make no stay at the Wound, or otherwise come out at it. 7. Because Hippocrates, Sect. 5. Aph. 2. says, Convulsions may be induced, which are mor∣tal.

II. Wounds of the Ventricle, or Stomach it self.

IX. 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉. Vulnera Ventriculi; Wounds of the Ventricle, or Stomach it self, have the differences with those of the Oesophagus; being either superficiary and small, or deep, and passing into the cavity of it: and they are either streight, or transverse; made by Incision, or laceration.

X. The Signs. That the Sto∣mach it self is wounded, you may know, 1. By the place of the Wound; as if it is under the Diaphragma, or below the Carti∣lago mucronata. 2. By the sub∣stance coming forth at the Wound; which is either pure Chylus, or Chylus mixed with the Food, unaltered, except by chewing.

XI. There is also, as Senner∣tus, Med. Pract. lib. 3. part. 1. sect. 1. cap. 26. says, A Hiccough, and Vomiting of Choler, also a Vomiting of Meat and Drink; the Appetite is hurt, nor can the Stomach contain, or rightly digest the Food.

XII. The Patient also spits Blood, and a Pain is perceived in the Stomach it self: and if the upper part of it is Wounded, the Sick may be afflicted with inflammation of the Part, a Fever, Delirium, Swooning, and many other ill Symptoms.

XIII. The Prognosticks. If the VVound is small and superfi∣ciary, it is easily cured; but Wounds which penetrate are ac∣counted mortal. Hippocrat. sect. 6.

aph. 18. Celsus, lib. 6. cap. 26. that is, they are very dangerous, and may prove mortal, or are mortal for the most part: so we understand Hippocrates.

XIV. A Wound penetrating the Ventricle, is not so dangerous, as that which penetrates or divides the Oesophagus: 1. Because the Ventricle is more fleshy, and so more apt to consolidation. 2. Because it is not so principal a Part, the Mouth of the Sto∣mach being the seat of the Appetite. 3. Because it is not of so exquisit a sense as the Mouth of the Stomach. 4. Be∣cause Traumaticks or Wound-Drinks, and other Agglutinative-Medicaments, can make a longer stay there.

XV. But Wounds penetrating are very hard to be consolidated: 1. Because it is of a Membranous substance. 2. Because we can∣not long live without the ser∣vice of its Functions. 3. Be∣cause Food, as Meat and Drink, keep open the lips of the Wound. 5. Because it is a sensible part, and so subject to ill Symptoms; as Pain, Afflux of Humors, Inflammation. 5. Be∣cause Topicks cannot be conve∣niently applied, to bring and keep the lips together. 6. Be∣cause Internal Medicaments pass forth again at the Wound.

XVI. Yet VVounds penetrating the Stomach are sometimes cu∣red, of which I am an Eye-witness; besides, we have several Autho∣rities for the same, as Julius Alexandrinus, in cap. lib. 6. The∣rapeut. Meth.Galeni; it a testatur similiter Christoph. à Vega, ad. aph. 18. lib. 6. Hippocrat. and Fallopius, de Capitis Vulneribus, cap. 1. tells us, that he cured a Man and a Woman, who were so wounded in the Stomach, that the Chylus came out thereat.

XVII. The Cure. In the first place we advise, that the Patient may eat and drink very sparingly: for the lips of the Wound will better agglutinate when the Stomach is somewhat empty, because it will be a little wrin∣cled together.

XVIII. If the Body is Caco∣chymick, yet Purges and Vomits are to be forborn; lest vitious Humors should be heaped upon the Part affected, but soluble Clysters may sometimes be given.

XIX. If the Wound penetrates not, the Cure is best to be commit∣ted to Nature: but if it pe∣netrates, Tents are not to be used; but you must apply Ano∣dyns and Digestives, which may be made of Turpentine, first mixt with the white of an Egg, and then with Oil of Hypericon: this eases Pain, produces Pus, and is glutinative: over all apply Empastr. è Bolo, or some such like.

XX. Sennertus commends this: ℞ White-wine ℥ii. Ma∣stich ℥ii. Oil of Fir, or soft Tur∣pentine ℥i. Manna of Frankincense ʒii. pouder of roots of Comfrey and Tormentil, A. ʒi. Earthworms in fine pouder ℈ii. Saffron ℈i. boil to the consumption of the Wine.

XXI. The Stomach outwardly may be embrocated with Oils of Mint, of Myrtles, of Quinces, of

Roses, and of Wormwood: and he may drink juices of Pom∣granates and Quinces; or a Decoction of Tormentil, Cink∣foil, Comfrey, Horstail, Mousear, and Periwinkle, sweetned with Syrup of Quinces.

XXII. And you may often give by the Mouth Syrup of Myrtles' de Rosis, or Syrup of Comfrey, mixt with a quarter-part of Catechu in fine pouder; which last is to be preserred in this case, before all other Medica∣ments whatsoever.

CHAP. XLII. Of WOƲNDS of the BELLY.

I. THEY arre called in Greek, 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉. in Latin, Vulnera Abdominis, Vulnera Ventris & Alvei; in English, Wounds of the Belly.

II. The Differences. These are either superficiary, and so penetrate not, reaching no farther than to the Peritonaeum: or else they penetrate, and then the Perito∣naeum is cut thro'; in which case, if the Wound is large, the Omen∣mentum or Intestines will slip out.

III. These penetrating Wounds also are either simple, wherein none of the Viscera are hurt: or they are accompanied with the hurt of some of the contained Parts; as the Stomach, Inte∣rlines, Reins, Ureters, Womb, &c.

IV. The Wound also is either a Pucture, or a Cut; and if a Cut, it is either streight, ob∣lique or transverse.

V. The Signs. Make trial with a Prob or VVax-candle, and see whether they go directly deep in, then you may conclude that the Wound does penetrate: now in searching, you must see that the Wound is not inflicted ob∣liquely, for then you may thrust in the Probe, &c. a great way between the Muscles, and yet not penetrating the Wound: but you ought also to be sure that the orifice of the Wound is not stopped with any of the adjacent bodies; as the Fat, Membrana carnosa, or the Muscles.

VI. If you make an Injection with warm VVine, if the Wound penetrates, it will be received within the cavity: but if it penetrates not, it will return again.

VII. If the Omentum or Inte∣stines come forth, the penetration is manifest: but if the Wound is small, you much search it with a Probe, or Wax-candle.

VIII. VVhich of the Viscera are wounded, (if any be wounded) you may guess at, by the Place, or external Part hurt,

but more certainly by their pe∣culiar Symptoms.

IX. If any of the Viscera are hurt, there is sometimes inflation of the Belly, Colick, Vomiting, Fainting, Swooning, or Convulsions, or something extraordinary by Ʋrine or Stool, either some, or all of these Symptoms, or some other more vehement, not na∣med, according to the dignity of the Bowel hurt.

X. The Prognosticks. Wounds of the Abdomen not penetrating, are void of danger, except they be very large: for in such Wounds many parts must suffer a solution of Ʋnity; there will be great Pain, with loss and dissipation of Spi∣rits, and many times fainting and swooning Fits, Convulsions, &c.

XI. If the wound is made in the middle part of the Belly, it is more dangerous than that which is made in the sides. 1. Because of the nervous Body which lyes there, it being more tendinous, and so more sensible. 2. It is more painful to be sticht, and so more difficult to cure. 3. Be∣cause the Omentum and Inte∣stines, press most upon that part.

XII. All penetrating Wounds are accounted dangerous. 1. Because they are commonly large, and always deep. 2. Because the am∣bient Air is apt to hurt the Guts. 3. Because the Pus is apt to fall into the capacity of the Abdo∣men.

XIII. If any of the Viscera, or contained parts are wounded, the danger is very great, and for the most part mortal: concerning which, Celsus says, if the Basis of the Brain, or the Stomach, or the Vena Portae, or Vessels in the middle of the Lungs, or the Jeju∣num, or the small Guts, or the Reins or Bladder are wounded, such a Patient cannot escape.

XIV. The Cure. There are four Intentions of Cure in penetra∣ting Wounds. 1. The Reduction of the Viscera, if started out of their places. 2. The stitching up of the Wound. 3. The Ap∣plication of fit Topicks. 3. The Exhibition of Internals, as Trau∣maticks, and such things as may either prevent or suppress ill Symptoms.

XV. 1. Reposition. If the In∣testines or Omentum thrust out, you are speedily to reduce them with your hands, lest the former is af∣fected with an Inflation, or the latter cool and corrupt.

XVI. If the Gout has been so long out, that it is so puft up, that you cannot reduce it, you must foment it with Red Wine, Milk or Wa∣ter, in which some or most of these things have been boiled, viz. Betony, Camomil, Dill, Fen∣nel, Fetherfew, Germander, La∣vender, Melilot, Mint, Nep, O∣riganum, Pennyroyal, Sage, Sou∣thernwood, Tansie, Worm∣wood; Seeds of Anise, Cumin, Caraways, Dill, Fennel, Bayber∣ries, Juniperberries, &c. which will discuss the Inflammation.

XVII. If notwithstanding the Fomentation, you cannot make the Reduction, you must inlarge the Wound by Incision, and then put the Intestine into its place.

XVIII. If the Omentum or Caul is slipt out, and it is fresh and warm, it is to be reduced

with your Fingers: but if by reason of the cold ambient Air, it is much cooled or tainted; which you will know by the un∣natural hardness of it, or by its being black, or of a livid Colour, then you must make a Ligature near to the warm and sound part, and the corrupt part is to be cut away.

XIX. Then the Wound is to be stitcht up, leaving the thread so as to hang out at the Wound, until the corrupt part separates from the whole, and so casts it off; and then the thread is to be drawn whol∣ly out of the Wound. Now it is necessary to use deligation to the Caul, when any part of it is cut off, because otherwise, much blood would fall into the Cavity of the Abdomen; for that the Caul is composed of a Tex∣ture of Veins or Arteries, inter∣laced with Fat.

XX. 2. Stitching up the Wound. This stitch is called, 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, Gastroraphia; and it is to be done in a clear light, where you may have a right view of the Wound; also the Patient must be laid upon the side opposite to the Wound, that the Guts may fall from it, while stitching; and lastly, you must have a Ser∣vant, or Attendant, to hold up the parts which you are to stitch.

XXI. First, You must thrust the Needle thro' the Skin and Mus∣cles, even to the Peritonaeum, not touching the Peritonaeum on that side: Then the Needle is to be thrust from within outwards, thro' the Peritonaeum, and Muscles of the opposite side.

XXII. About an inch distance from the former stitch, the Needle is to be thrust thro' the Muscles of the same side, leaving the Peri∣tonaeum: Then from within outwards, the Needle is to be thrust thro' the Peritonaeum and the Muscles.

XXIII. And in this manner you are to go on, if more stitches are required, sometimes piercing the Peritonaeum, and sometimes o∣mitting it, till the separated parts are sufficiently united. Some make but one Ligature of three or four stitches, tying the ends of it firmly together, and using as many Ligatures as are sufficient.

XXIV. Or Secondly, You may stitch the Muscles together, and the sides of the Peritonaeum toge∣ther: In this kind of stitch, the Needle is first to be thrust thro' the Skin and the Muscles, to the Peritonaeum; then the opposite side of the Peritonaeum, is to be joined to the side lying under the Muscles already pierced.

XXV. This being done, the op∣posite Muscles are to be pierced; and this course is to be persued, till all the lips of the Wound are compleatly drawn together.

XXVI. Or Thirdly, It may be stitcht, as are other parts of the Body; the Needle is to be thrust thro' the two sides of the Muscles, and the two sides of the Perito∣naeum: And this is to be done so often, till you have taken stitches enough, according to the magnitude of the Wound.

XXVII. But of all these several ways of stitching, the first way is esteemed best: After stitching, you ought to leave an Orifice in

the depending part, to put in a Tent, that the Pus induced by suppuration, may be discharged. And this kind of stitch is used, because the Peritonaeum being a Membrane, will not admit of agglutination without the inter∣course of Flesh.

XXVIII. And if it should be left unagglutinated, a Hernia or incurable Tumor, would be left in the outward parts, the Intestines thrusting themselves out into the Cavities of the Muscles.

XXIX. This kind of stitch ought to be fortified or strengthned by the dry Suture firmly made, because that in a few days, the Thread will cut asunder the Lips which are stitched, and the stitches will become loose, by reason the Guts do continually butt, or cast themselves upon the Abdomen; for which cause, the dry stitch is as necessary, as in the curing of an Hare-Lip.

XXX. 3. The Application of fit Topicks. These ought to be choice Vulnerary Balsams, as de Chili, de Peru, de Tolu, Gileadense, Capivij, all the forts of Turpentines, Gum Elemi, and divers artificial Balsams made of them, as Bal∣samum Gummi Elem. Nostrum, Bal∣samum Vulnerarium Nostrum, Bal∣samum Amicum nost. Linimentum Arcei, Ʋng. Basilicon mixed with Ʋng. Nicotianae.

XXXI. Over which, are to be laid Agglutinative and Sarcotick Cerats or Emplasters, as Emplast. de Minio, è Bolo, Caesaris, Dia∣palma, or Album, newly made, or not too dry, if it is in Sum∣mer time: or Empl. Sticticum Paracelsi, malaxed with oil of Hypericon, if it be too stiff.

XXXII. To these you may add Cerates, as Ceratum Album, Ceratum de Galbano, Ceratum Ni∣grum, and in some cases Ceratum è gummi Elemi.

XXXIII. Aquapendens, in Chi∣rurg. part. 2. lib. 2. cap. 45. ad∣vises to Astringent Pouders. This following is of singular use. ℞ fine Aloes, fine Bole, Catechu, Oli∣banum, Myrtleberries, Sarcocol, Dragons Blood, Comfry Root, A. ℥ss. make each into fine Pouder, and mix them.

XXXIV. 4. The exhibition of Internals. These are either in order to Healing, and such are Trauma∣ticks, or Wound-drinks; of which we shall say nothing here, having said enough in its proper Chapter: Or such other Exhibi∣tions, as may either prevent, or suppress any ill Symptoms; which are chiefly two, viz. ex∣tream Pain, and Pus, or Blood collected into the Cavity of the Abdomen.

XXXV. For the avoiding of Pain, you may give every night at Bed-time, a Dose of Dr. Gardner's Laudanum Tartarisatum, or of our Laudanum Specificum, or Lau∣danum Volatile, or of our Guttae Vitae, in any convenient Vehicle.

XXXVI. These things not only ease the Pain, but also by their sudorifick and rarifying property, dissolve the collected Matter, and cause it in a great measure, to be dissipated and evaporated.

XXXVII. You may also embro∣cate all the parts from the Arm∣holes to the Groin, with this mix∣ture. ℞ Oil of Hypericon, ℥ii. Oil of Whelps, ℥i. Oil of Scorpions,

℥ss. Oil of Spike, Tinctura Opij, A. ℥ij. mix them. By this means the Pain will be eased, and In∣flammation prevented.

XXXVIII. The second ill Sym∣ptom, which is the collection of Pus, or Blood, into the hollowness of the Belly. Give inwardly some of the Medicines at Sect. 36. afore∣going, every-night at Bed-time; and if the Belly is costive, you may instead of them, give our Cathartick Laudanum.

XXXIX. When such Matter is collected, you may know, 1. By the weight which is felt there, the pain and tension of the part. 2. By the fluctuating of the Matter from place to place, when you press upon the belly with your hands.

XL. Now because this Matter cannot be sensibly emptied, by rea∣son Wounds of the Bélly are not to be kept open, lest the Internals be corrupted; you must endeavour to dissipate it by the Medica∣ments afore-named, and other Rarifiers and Sudorisicks; and you may embrocate the belly, and more especially the Groins, with the Oil at Sect. 37. above, or with this mixture.

XLI. ℞ Oils of Hypericon, of Whelps, and of Scorpions, A. ℥iss. Oils of Euphorbium, of Castor, of Amber, and of Juniper-berries, of each ℥ss. mix them. After a∣nointing, apply over the part, Empl. de Minio cum Sapone, or Diachylon cum Gummi; if these things do not, an Apostem may possibly break out in the Groin, which must then be opened, thro' which the Matter may hap∣pily discharge.

XLII. 5. Wounds made by Pun∣cture. If the Wound penetrate∣ing be so small, that neither the Omentum nor Intestin thrust forth, as it often happens, when it is made by a Rapier, &c. you are to consider, whether the Viscera are wounded by the Symptoms which occur; if you find them well, you must heal up the Wound by agglutination.

XLIII. You are not to dress it with Tents, for that may cause dis∣turbance, pain, flux of Humors, and Inflammation; and by expo∣sing it to the external Air, a Co∣lick, or Putridity may ensue.

XLIV. For which Reasons, these Wounds are to be healed with all possible speed that may be, and the Patient is to keep his bed the mean season: for rising in the day time, the weight of the Guts will press upon the wounded Perito∣naeum, and make their way thro' it.

XLV. So that tho' the external wound in the skin, does not give them a passage; yet they will so insi∣nuate, or thrust themselves be∣tween it and the Peritonaeum, as to cause an incurable Hernia, or Rupture.

XLVI. To prevent which, you ought to hasten the Cure, and not only to keep the Sick in bed, but to apply good Astringents, Stypticks, or Agglutinatives, with firm com∣pression upon the Wound, that the parts may be united, while the Hurt is recent.

CHAP. XLIII. Of WOƲNDS of the GƲTS.

I. THey are called in Greek, 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉. in Latin Vul∣nera Intestinorum: and in Eng∣lish, Wounds of the Guts.

II. The differences. Either the great Guts are wounded, or the small: and in both, the Wound is either superficiary, or it passes to the Cavity.

III. If it passes to the Cavity, the Wound is then either straight or Transverse; and then they are either great or small.

IV. The Signs. If the Great Guts are wounded, then Excre∣ments will come out at the Wound.

V. If the small Guts are wound∣ed, the Chylus comes out at the Wound, the Flanks swell and become hard, the Patient has Gripings in the Belly, vomits Choler, is troubled with the Hic∣cough, and is many times affe∣cted with cold Sweats, and cold∣ness of the extream parts.

VI. The Prognosticks. 1. Su∣perficiary Wounds of the Guts are not wholly without danger, because all the external parts of the Ab∣domen are divided.

VII. 2. Great Wounds of the Guts are for the most part mortal, but more especially when they are transverse: 1. Because Topicks cannot be conveniently applyed to them. 2. Because they are of a Membranous substance, which has but little Blood. 3. Because they are very sensible, whereby Pain, Inflammations, Fe∣vers, and other ill Symptoms may ensue. 4. Because the Chylus and Excrements do continually pass by them. 5. Because their Office is absolutely necessary for the preservation of life, the small Guts distributing the Chylus, and the great Guts discharging the Excrements. 6. Because their Lips are kept asunder partly by their motion, and partly by their distension by Chylus, Wind, or Excrements.

VIII. 3. Wounds of the Jeju∣num are very dangerous, for the most part mortal. 1. Because it has more Mesaraical or bloody Veins than other Guts. 2. Be∣cause by its plenty of Blood, it is soon and easily Inflamed. 3. Because it is nearest to the Liver, and so the apter to be Inflamed. 4. Because it is of a more tender or sensible substance than the o∣ther Guts. 5. Because it receives immediately the most acid Cho∣ler from the Gall; the other Guts receiving it but mediate∣ly, its sharpness by being mixt with other Juices, being much abated.

IX. 4. Wounds of the small Guts are more dangerous than those of the great. 1. Because they are most Nervous and Membranous, and so of a more exquisite sense.

2. Because they are nearer to the Stomach. 3. Because they have more Mesaraical or bloody Veins. 4. Because of their more excellent Office of distributing the Chylus.

X. 5. Wounds of the great Guts are now more easy to be agglutina∣ted than the small, and so more ea∣sily admit Cure. 1. Because they are of a more fleshy substance. 2. Because they are not so sen∣sible. 3. Because the Excre∣ments which they contain, are more solid than the Chylus, and so not being so apt to flow to the Wound, keep not the Lips so long asunder.

XI. The Cure. There are four intentions of Cure. 1. To stitch the lips of the wounded Gut toge∣ther with the Glovers stitch; if the Gut is not without the Wound, some Authors advise to draw it out gently, and then to sew it with good thread not waxed, that so swelling, it may not so soon cut the Lips of the Wound asunder.

XII. But this method, Wise∣man in Wounds of the small Guts, likes not: He says, it is a hard task, and when the Gut is found, what (says he) will it signifie, but to increase the Accidents? He advises therefore, to follow the method of the Antients, to em∣brocate all the Region of the Belly with Oil of Mastich and Earthworms, to dress the Wound with Sarcoticks, and to keep it close and warm with Compress and Bandage.

XIII. But if the great Guts are wounded; so as the Excrements discharge that way, then you may 〈◊〉〈◊〉 ••pen the VVound, and stitch the Gut with the Glovers stitch, sprinkling it with some aggluti∣native Pouder, then reducing it back, to stitch up the external Wound of the Abdomen.

XIV. 2. The Reduction of the Gut. If it has been some time from the making of the Wound, it must be first fomented with red or astringent Wine, pretty warm, and if a little Catechu has been dissolved in it, it will be so much the better. Then an Agglutinative is to be applyed to the Wound. ℞ Mastich, Oli∣banum, Sarcocol, A. ʒij. Comfry root in pouder, Myrrh, Borax, A. ʒj. mix, and make a pouder; which sprinkle upon the VVound.

XV. 3. To stitch together the external parts of the Belly. This is to be done as we have taught in the former Chapter; and it is better to stitch them, than to leave them open. 1. Because no more Topicks can be applyed to the Guts. 2 Because Air will get in, and cause Pain and Griping. 3. Because the natu∣ral Heat being kept in, the Wound of the Gut will be the sooner consolidated.

XVI. 3. Inward Vulneraries are to be administred; as Wound Drinks, Gelly Broths, which are agglutinating, &c. VViseman ad∣vises to a Vulnerary Decoction made of Plantane, Horse-tail, Burnet, Mousear, Comfry roots, Red Roses, &c.

XVII. His Food ought to be of moist••ing Meats; and emollient Clysters made of Chicken or Veal, or Sheepshead or Sheepsfeet Broth, with Yolks of Eggs, Honey or Su∣gar of Roses; are to be exhibited.

CHAP. XLIV. Of ƲLCERS of the REINS.

I. THey are called in Greek, 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉. in Latin, Vulnera Renum: and in English, Wounds of the Reins.

II. The Kinds. Wounds of the Reins may be either superficiary, or deep; and the Carunculae Papil∣lares may be only wounded, or it may reach to the Pelvis: and this last may be either without any hurt to the Vein and Artery Emulgent, or they may be wounded also.

III. The Signs. Celsus, lib. 5. cap. 26. says, There will be great pain in the part affected, reaching to the Groin and Testicles, and that clots of Blood will come with the Ʋrine, if the Reins are wounded to the Pelvis. Fernelius, Patholog. lib. 7. cap. 8.

IV. Sennertus, Med. Pract. lib. 3. part. 7. sect. 1. cap. 10. says, These Wounds may be known by the place where the Wound is inflicted; There is (says he) either a sup∣pression of Ʋrine, or it is made with difficulty, and it is blood, or bloody: there is a pain felt upon the Region of the Reigns, which reaches down to the Groin; and if the wound is large or great, a watry Blood comes forth from the Wound.

V. If much Blood and Ʋrine do not come forth, the Wound is only superficiary, or the fleshy substance only is hurt: But if much Blood and Water together come from the Wound, the Wound pene∣trates to the Cavity of the Reins.

VI. The Prognosticks. Wounds of the Reins, says Sennertus, are very dangerous, and often mortal: and in the first case, they are difficult of Cure, and it is not performed but in a long time: but they are said to be less dan∣gerous than Wounds of the Bladder.

VII. If the Kidneys are wound∣ed thro' the back, it is for the most part deadly; for the Wound must pierce the Muscle Psooa, so that the Nerves there arising from the Medulla Spinalis, can scarcely be free from hurt.

VIII. If the VVound is made in the side, piercing only to the Ca∣runculae Papillares; it is possible to be cured, but with much difficul∣ty, because the Muscles of the Abdomen and Peritonaeum must be both wounded.

IX. If the VVound pierces to the Pelvis, it is for the most part mortal, 1. Because the carrying off the Serum from the Arteries, is absolutely necessary, otherwise agglutination would be hindred, and a Dropsy induced. 2. Be∣cause its substance scarcely ad∣mits of consolidation, partly from the solidity of its sub∣stance; and partly, because it has within its self the Carunculae Papillares, and the Pelvis, which are said to be Spermatick parts.

X. If the Vein, and Artery E∣mulgent

are wounded, Death may be presaged to ensue, by reason of the dreadful Haemorrhage, which will infallibly be caused thereby.

XI. The Cure. If the VVound is not deep (universals being pre∣mised) the more strong agglutina∣tives are to be used: and says Sennertus, distilled Oils proper for these Wounds, are to be dropt into them, and then some glutinative Emplaster is to be applied over all.

XII. If the VVound penetrates to the Cavity, a decoction of Comfrey roots, Knotgrass and Liquorice made in rough Red-Wine is to be injected; or a Cataplasm to be applyed made of Dates, White-bread, Acacia, and Hypocistis, boiled in Red-wine.

XIII. And afterwards, when the Haemorrhage is stopt, aggluti∣natives are to be injected, and then a glutinative Emplast. to be apply∣ed over all: but Sennertus com∣mends as the chief of all, the Ʋnguentum Sanctum of Joh. An∣dreas à Cruce, so called (says he) from its Effects, which you may find described in his Chirurg. lib. 4. tract. 2. Indicatione 13. and is as follows.

XIV. ℞ New Pine Rosin, clear and well-scented, ℥xij. pure Gum Elemi, ℥ix. the best Turpentine, choice Oil of Bays, A. ℥ij. first melt the Rosin and Gum over a gentle fire, then a••d the Oil of Bays and Turpentine, which boil a very little, and so compleat the Balsam.

XV. You may exhibit also for the first days, Trochisci de Alka∣kengi cum Opio, if the pain is great, otherwise sine Opio, or de Carabe, which may be given in new Milk, or decoction of Com∣fry-roots, sweetned with Sac∣charum Rosatum.

XVI. And because the Passages of the Bladder are many times ob∣structed with clotted Blood, the Share and Groin may be anointed with Oil of Scorpions, or Oil of bitter Almonds, or a Cataplasm may be applyed, made of Saxi∣frage and Pellitory of the Wall.

XVII. Let his Food be of good Nourishment: an Emulsion of the four greater cold Seeds may be ex∣hibited, a little thickned with white Starch: Ptisan also, and Broths made with White-bread, also rear Eggs, Rice Milk, and Water gruel; Juice of Quin∣ces may be mixed with his Drink, which yet ought to be as little as may be, lest a Flux of Humors falls upon the Reins.

XVIII. VVhey of Goats and Cows Milk is good, and Barley-water, in which Liquorice bruised, Jujubes, Sebestens, and the four greater cold Seeds have been boil∣ed: He ought to be quiet, and rest as much as may be; and if costiveness attend, an emollient Clyster made of the Broth of a Sheeps-head, and sweetned with Hony of Roses, is to be exhibited.

CHAP. XLV. Of WOƲNDS of the BLADDER.

I. THey are called in Greek, 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉. in Latin, Vulnera Vesicae: and in English, Wounds of the Bladder.

II. The Kinds. These wounds may be either in the Neck of the Bladder, where is the Sphincter Muscle, which is fleshy: or in the Body of the Bladder it self, and then the Wound is made either in the sides about the Groins, where its Ligaments are, or in the other Membranous parts.

III. The Signs. If the Bladder is wounded, it is known, says Sen∣nertus, Med. Pract. lib. 3. part. 8. Sect. 1. cap. 5. by the place where the Wound is inflicted, and a Pain about the share: and the Urine will be either suppres∣sed, or it will come forthe with a mixture of Blood.

IV. Also (says he) Ʋrine will come forth from the wound it self; and the Stomach is drawn into consent, where there is great Sickness, whence comes Vomi∣ting of Choler, or the Hiccough.

V. Celsus, lib. 5. cap. 26. and Fernelius Patholog. lib. 7. cap. 8. shews us, that the 'Ʋrine comes in small quantity, and bloody; and if the Body of the Bladder is wounded, the Urine then falling into the Cavity of the Abdomen, the Pain will be communicated to the Groins and Testicles in Men, and an Ascites will be in∣duced.

VI. The Prognosticks. Wounds of the Neck of the Bladder, which is the more fleshy part, are not mor∣tal, which is manifest in those who are cut of the Stone.

VII. Wounds in the lateral parts about the Groin, are curable also; if the Patient is young, and of a good constitution, or habit of Body.

VIII. Hippocrates, Sect. 6. Aph. 18. Wounds in other parts of the Bladder which are Membranous, are uncurable; and Galen in his Comment upon the same place, renders a reason for it, because (says he) the Bladder is Nervous, thin, and has but little Blood in it.

IX. And yet Skenkins in his Observations, gives us an Example of one who was wounded in the bot∣tom of his Bladder, who was cu∣red: but Spigelius and Aquapen∣dens will have it, that the bot∣tom of the Bladder is not whol∣ly nervous, but that the exteri∣or Membrane is more fleshy, and therefore is to be accounted as a Muscle of the Bladder of a more constringed substance.

X. Yet says (Sennertus) such wounds of the Bladder are seldom perfectly healed; for tho' the Sick does not die thereof, yet for the most part, it grows Callous, whereby a Fistula is induced, thro' which the Urine issues forth.

XI. The Reasons why wounds

made in the Body of the Bladder are so difficult to be healed, are, 1. Because it is a Membranous Part. 2. Because it contains the Urine, whose acrimony and and humidity hinders Consoli∣dation. 3. Because its Wounds are very painful, whence a Flux of Humors and Inflammation, are easily induced. 4. Because dreadful Symptoms common∣ly follow these Wounds; as Fainting, Watching, Delirium, Hiccough, Nauseousness, and Vomiting, and Convulsions. 5. Because they are apt to gangrene, whence Death infal∣libly follows.

XII. The Cure. The Cure ought to be performed by Maturation or Digestion, lest they degenerate into a Fistula; and therefore Gluti∣natives are to be imposed. And about the place you may anoint with Oils of Roses, white Lillies, and Mastich.

XIII. And Injections may be made into the Wound, of a Decoction of Comfrey-roots, Myrtle-leaves, Red-roses, and Catechu in Red-wine, to which Honey of Roses may be added, the Sick drinking but little the while.

XIV. These Pills given Mor∣ning and Evening, are good. Take ashes of Man's Bones, Tro∣ches of Alkakengi, A. ʒiii. Cate∣chu, Mummy, A. ʒii. fine Bole, Chalk, A. ʒi. Venice-Turpentine a little boiled, q.s. make a mass for Pills. Dose, à ℈i. ad ʒss.

XV. Wound-drinks may also be given, made of VVine, and proper Astringents and Agglutinatives: but they ought not to be given in too great a quantity.

XVI. Topicks anodyn, aggluti∣native and digestive are to be applied; as Natural and Artifi∣cial Balsams made of a due consistence, with pouder of Catechu or Comfrey-roots: also Turpentine mixt with the yolk of an Egg, and some Oil of Eggs, or of Hypericon, or of Earthworms.

CHAP. XLVI. Of WOƲNDS of the WOMB.

I. THEY are called in Greek, 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉. in Latin, Vulnera Matricis, vel Uteri; and in English, Wounds of the Womb.

II. The Womb is an Organical Part, placed in the Abdomen of a Woman, between the Bladder and the Intestinum rectum, which is behind it: it is divided into three parts, viz. the Bottom, the Neck, and the Sheath: it has two broad Ligaments, and two round: it is also of a nervous and fibrous substance, and is of different thicknesses, according to the difference of Age, and Time of going with

Child. At the bottom within, there is a cavity whence the Courses flow, and wherein Generation and Conception are also made.

III. If it is made by the Caesarian Birth, it is manifest; but if it is otherwise wounded by chance, it is evident from the site, or place wounded, and a pain which is felt in the Womb.

IV. There also distils forth from Neck, or inner Mouth of the Womb, a kind of Blood and Sanies: and if the Wound is in the neck of the Womb, the pain is sometimes greater, than if it were in the bottom of the Womb.

V. The Prognosticks. Wounds of the VVomb are not impossible to be cured; as the Caesarian-Birth does demonstrate.

VI. Yet notwithstanding they are not void of danger, but are of very dissicult cure; as the many great Symptoms to which they are subject, do shew.

VII. For which, these Reasons are rendred: 1. Because it is membranous, and if the Woman is great with Child, thin of substance. 2. Because it has a great consent with the princi∣pal Parts of the Body. 3. Be∣cause it is as it were the Sink of the Body, to receive its impu∣rities; for which cause, these Wounds many times become cancerous. 4. Because it has an exquisit sense of feeling; whence Pain, and Inflammation may ensue. 5. Because it is a place perpetually moist.

VIII. Wounds in the neck of the VVomb, are more difficult to be cured than those in the bottom of it; because it is more mem∣branous, and perpetually be∣dewed with humidities.

IX. The Cure. It is cured as wounds of the Bladder and other parts are cured: and by reason of its very great moisture, it requires greater Consolidants: the Pain also, if it is great, is to be mitigated.

X. Those Medicaments are most commodious to be applied to it, which are put up the Privity as a Pessary, or injected by a Womb-Syringe.

XI. Pessaries are made of Wax and Lint, or some proper Em∣plaster, which may be anointed with some Vulnerary Ointment, such as these following.

XII. Take Wax, Turpentine, Oil of Hypericon, yellow Palm-oil, A. ℥i. Oil of Roses, Honey, A. ℥ii. Beef Marrow or Suet ℥iv. mix, and make an Ointment. Or: Take Wax, yellow Palm-oil, A. ℥i. Oil of Ben, Beef-suet A. ʒvi. Bears-oil ℥ss. Oil of Roses q.s. mix them.

XIII. Or: Take Frankincense, Balsam Capivii, Galbanum, Gum Elemi strained, Olibanum, A. ℥i. Balsam de Chili, de Peru, A. ℥ss. mix them. Or: Take Turpen∣tine, Balsam of Peru, A.℥i. VVax, Oil of Ben, A. ℥ss. Pompholix, Tutty, Ceruss, A. ʒvj. the three last being levigated, mix with the other things melted, and make an Ointment.

XIV. Injections, or Ʋterine-Clysters, are made of a De∣coction of roots of round Birth∣wort, Cyperus, Catechu, &c. in Chalybeat-water, or rough

Red-wine; adding also Agri∣mony, Angelica, Sanicle, Self∣heal, Mugwort, Plantan, Speed∣wel, Red-roses, and other Vul∣raries, and sweetning it with Honey of Roses, &c.

CHAP. XLVII. Of WOƲNDS of the YARD.

I. THEY are called in Greek, 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉. in Latin, Vul∣nera Penis; and in English, Wounds of the Yard.

II. The Prognosticks. They are known by sight; and are not often without danger, more especially if they be accompanied with Hemorrhage, great Pain, Inflam∣mation, and other vehement and dangerous Symptoms.

III. When the Wound is very great, and vehement Symptoms follow upon it, it is many times mortal; yet we have known the Yard wholly cut in some, who have after done very well: but if a Gangren happens after the Wound, it generally kills the Patient.

IV. The Cure. The Cure of this here is as in other Wounds, chiefly in Parts that are Membra∣nous: for which purpose, a Pouder may be prepared, and compounded of Litharge, Ce∣ruse washed, Tutia prepared, Sarcocolla, and Tragacanth.

V. The Wound is first to be washed with warm Wine, dried, and then the Pouder is to be sprin∣kled thereon: or it may be laid on, being mixed with Oil of Roses.

VI. This Ointment following is very good for this purpose: ℞ Ceruse washt ʒiii. Litharge, Sarcocol, A. ʒii. Tutty, Myrrh, Tragacanth, A. ʒi. Salt extra∣cted out of the Caput mort. of Vitriol, ʒss. Oil of Hypericon, q.s. mix, and make an Ointment.

VII. If there is an Inflamma∣tion withal, it is to be taken away as other Inflammations.

VIII. If an External Ʋlcer happens, the Cure must be perfor∣med both by internal and external means; lest it should contract a malignity, and degenerate into Sphacelus.

IX. You may Anoint with this Ointment: ℞ Litharge, burnt Lead, A. ʒiv. Scammony, Quick-silver, A. ʒiii. Aloes, Tu∣tia prepared, flowers of Sulphur, A. ʒii. Lapis Haematitis, Crocus Martis aperiens, A. ʒi. Oil of Hypericon, or of Roses, ℥ss. Wax q.s. mix, and make an Ointment.

X. If the Ulcer yields not to this, by reason of its foul∣ness: ℞ Whitewine ℥iv. Rose, and Plantan Waters, A.℥ii.S.V ℥i. fine Verdigrise ʒss. boil a little, and wash therewith.

XI. If the Ʋlcer is yet stub∣born, you must strew thereon Scammony in fine pouder; and

if you please, you may add thereto a little red Precipitate ground soft; or they may be mixt with Basilicon, and so used.

XII. If it becomes a Sphacelus, it admits of no Cure, but Cutting-off; lest it should creep in∣wardly, and so kill the Patient.

CHAP. XLVIII. Of WOƲNDS of FINGERS and TOES.

I. THOSE of the Hands are called in Greek, 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉. in Latin, Vulnera Digitorum Manuum; in English, Wounds of the Fingers.

II. Those of the Feet are called in Greek, 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉; in Latin, Vulnera Digitorum Pedis; and in English, Wounds of the Toes.

III. The Kinds. They are either great, or small: and in both, the Musculous Parts are only wounded; or with them, the Nerves and Tendons, or both.

IV. And the Nerves and Ten∣dons are either contused, or lace∣rated, or prickt only, or cut according to their length, or transverse.

V. The Prognosticks. If re∣cent, they are not of difficult cure: if the Tendons are cut asunder, the motion and use of the Part is lost: if the Nerves are cut asunder, a num∣ness or Paralysis of the ex∣tream Parts is induced.

VI. By ill handling, these Parts are easily to be affected with a Sphacelus: which you may well know, by no Matter ap∣pearing in due time; by the lips of the Wound being dry, or yielding but little and thin moisture; the pulsation, red∣ness, and inflammation or heat, which is greater than in the fleshy parts; by the decay, or extinction of the native heat; and by the lips being turned in, and becoming livid, and at length black.

VII. If they degenerate into Ʋlcers, they are apt to be foul, and easily foul the Bones, become malign, and so hazard the loss of a Joint or Joints, and by ill management, the loss some∣times of the whole Hand or Foot.

VIII. The Cure. They are cured as other simple Wounds; but if the Tendons be hurt, care is to be taken, lest a Palsy follows.

IX. You must not put in the Probe too deep, nor too often; and you must be very careful that the Bandage be not too hard, lest (by reason they are Extream-parts) you extinguish the Native-heat: and when it is bound up, whether it is Hand or Foot, it is to be placed as much as much as may be up∣right, or parallel to the Hori∣zon, not in a depending posture.

X. If the Musculous Parts only are wounded, you must apply Astringents, Stypticks, or Gluti∣natives; which peform the Cure in two days time at farthest, seldom more.

XI. If the Nerves or Tendons be wounded, you may dress the Wound with Balsam de Chili or Peru; or with some proper Arti∣ficial Balsam, equal to them in virtue; which many times do the Cure at once dressing, at least they prevent any future Symptoms, or ensuing danger.

XII. Or you may dress the Wound with this Balsam: ℞ Oils of Hypericon, of Turpentine, A. ℥i. Balsam Capivii, Cypress-Tupentine, Gum Elemi, Balsam of Peru, A. ℥jss. Oil of Petre, and of Juniper-berries, A.℥ss. Camphir ʒii. mix, and make a Balsam: it commonly cures at once or twice dressing.

XIII. If it is a Puncture of the Nerve or Tendon, dress the Wound with this Mixture: ℞ Balsam de Chili, or de Peru ʒi. Oil of Turpentine, or of Spike, Oil of Limons, A.℥ss. mix them.

XIV. If the Tendon is lacera∣ted or broken, so as that it hangs out, it can never be united again: and therefore, so much of it as hangs forth is immediately to be cut off; for otherwise it will prevent the Healing; and then the Cure is to be formed accor∣ding to the former Directions.

XV. If the Wound grows foul, and it seems to degenerate into an Ʋlcer, you must then cleanse it with pouder of Scammony, which is one of the best, easiest, and safest Medicines you can apply in this case: for it operates effectualy, and yet without any pain, and cleanses even the Bone it self.

XVI. Afterwards you may heal up the Ulcer with this Ointment. ℞ Basilicon ℥ii. Scam∣mony in fine pouder ʒiii. Tobacco in pouder ʒjss. Camphir ʒss. it powerfully cleanses, incarnates, yet prevents proud flesh, and cicatrizes or heals.

XVII. If after the Healing, a numness or Palsy remains upon the Extream-part, it is very doubt∣ful whether it will be recovered to its pristin state, or not: but in this case you may morning, noon and night, or oftner if you so please, anoint the Part with the following Mixture, rubbing it well in.

XVIII. Take Oils of Amber, of Aniseed, of Lavender, of Li∣mons, of Turpentine, and of Petre, A. ℥ss. Oils of Rosemary, and of Spike, A. ʒii. Oil of Cam∣phir ʒi. Camphir in pouder ʒss. mix them; and anoint therewith.

XIX. And after the An∣ointing you may apply this Balsam: Take Balsams of Chili, Peru, and Tolu, A. ℥ss. VVax, Turpentine, Oil of Amber, A. ʒii. spread it upon Lint, and apply it, binding it gently up.

XX. If a Gangren is coming on, you must then apply those things which in the Chapter of Gangren we have prescribed, either us to prevent, or cure the same: but if a Sphacelus is already induced, you have then no other Remedy but Extirpa∣tion, or Cutting-off.

Explicit Liber Quartus.