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 ...

VI. The Differences. Nome is an eating or devouring putrid∣ness, yet an Ʋlcer which creeps but slowly; and differs from Pha∣gedaena, because it eats with great putrefaction, moving for∣wards from the diseased and unsound parts, to those which are whole and sound; adding to them malign matter, from the unsound: so that its nature arises not from the substance of the thing declared, but from the matter accessary, which is to feed; as Galen, Meth. Med. lib. 5. cap. 4. does demonstrate.

VII. It is distinguished also from Phagedaena; for that as Phage∣daena is always with a Tumor, and the corrosion is only from a a malign quality, and acrimony of Humors; whereby it eats thro' the

parts and flesh lying underneath, and that are about it: so Nome is always without a tumor, and the corrosion which eats deeply and profoundly, (tho' slowly) is from a certain putrified Hu∣mor, &c.

VIII. It differs also from Her∣pes exedens; for as that is only a corrosion in the Skin, without putrifaction; so this is a cor∣rosion in and thro' the Skin, but deeply into the substance of the Flesh also, with putrifaction.

IX. The Causes. The Causes of all these proceed from vitious and malign Humors abounding in the Body, exalted to such a de∣gree of acrimony as may cause putrefaction; partly from sim∣ple Choler or salt Phlegm mixed with Atra Bilis, and so dispersed thro' the whole habit of the Body.

X. Chymists will have them to proceed from an Arsenical Sulphur, separated from the Natural Bal∣sam, or Juices replenishing the Body, and sent or directed to the Part affected. And indeed, an Arsenical quality best represents the nature of these kinds of Ul∣cers: for truly like Arsenick, the Humors here protruded, are of a putrifactive quality.

XI. The Signs. These Ʋlcers are known by sight; partly from their kinds and differences, and partly from the situation, or place which they affect, being accompanied with putrifaction and eating.

XII. Nome eats deepest into the Flesh; the other are more superficial, and are sometimes Ulcers upon a Sarcoma, or ex∣crescence of superfluous Flesh, which sometimes eat more, some∣times less.

XIII. The Prognosticks. These, like all other eating Ʋlcers, are very hard to be cured: and if they happen in a Body Cacochymi∣cal, they are seldom healed, but last for the most part during the Patient's whole life.

XIV. If they be with an afflux of Humors, or near any principal Vein, Artery, Nerve, or Tendon, they are not only so much the more difficult to cure, but also so much the more dangerous.

XV. If they happen to such as are in Consumptions, or are He∣ctick, or Asthmatical, they are of evil consequence, and for the most part kill the Patient; by draining away the remaining part of the Radical Moisture which ought to support Nature.

XVI. The Cure. All these re∣ceive much one and the same Me∣thod of Cure; and the same Medicines which are generally good for one, good for the other also.

XVII. The gentler means, and such as we have prescribed in the former Chapter, are first to be at∣tempted, because sometimes they may prevail: but if those things do no good, as it oftentimes falls out, we must be constrained to come to the use of stronger Remedies.

XVIII. This Pouder is com∣mended in a Nome. ℞ White Vitriol ℥jss. Crocus Martis ℥vj. Galls ℥ix. make all into a fine pouder, which mix with some convenient Ointment, as Ʋng-Nicotianae.

XIX. Or this. ℞ Ʋnslakt

Lime, Orpiment; white Vitriol, A. ℥i. Catechu, Galls, Pomgra∣nate-peels, round Birthwort roots, Tobacco, Alum burnt, Saccharum Saturni, A. ℥ ss. burnt Brass, Crocus Martis, Lead calcin'd, A. ʒvi. make all into a fine pouder, and mix it with clarified Honey q.s. and make a Liniment.

XX. Or, ℞ An Infusion (of Balaustians, Birthwort-roots, Car∣dus Ben. Centory the less, Cate∣chu, Galls, Germander, Pomgra∣nate-peels, Scordium, Southern∣wood, Wormwood) in Vinegar ℥viii. purified Verdigrise ℥iv. Honey ℥xiv. mix, and boil to a consistency.

XXI. Wiseman says, you must use Detersives made of Ʋnguen. Aeg••ptiacum, red Precipitate, Troch. Andronis, Musae; also Causticks, and sometimes the Actual Cautery.

XXII. To these Applications, Objections (says he) have been made: but if drying Medica∣ments without erosion will do no good, you must then come to stronger: and where the putrefaction is great, you will find it necessary to use the strongest kinds, as the Actual Cautery, it not being only of use to remove the corrosive Flesh, but to check the mali∣gnity, and strengthen the weak∣ned part.

XXIII. But where the Patient will not admit of that, you must use Causticks, the parts about being in the mean season defended with Refrigerants: after sepa∣ration of the Eschar, and cor∣rupt Flesh, the Ulcer is to be healed up with Sarcoticks and Epuloticks, as is usual.