Ars chirurgica a compendium of the theory and practice of chirurgery in seven books ... shewing the names, causes, signs, differences, prognosticks, and various intentions of curing all kinds of chirurgick diseases ... : to which is added Pharmacopoeia chirurgica, or, The medical store, Latin and English ... / by William Salmon ...

CHAP. XXIII. Of an ƲLCER of the EYE.

I. WHAT the Greeks call 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉. and the Latins, Ulcus Oculi, vel Oculorum; we in English call, An Ulcer of the Eye, or Eyes.

II. The Kinds. They are consi∣dered; 1. In respect to the Part. 2. In respect to their Qualities, Natures, or Accidents.

III. In respect to the Part af∣flicted: the Ulcer possesses either the Coats of the Eyes, as the Adnata or Conjunctiva, Cornea, Ʋvea; of which those in the Conjunctiva or Cornea, are chief: or the fleshy Corner next the Nose. Those of the Cornea are either superficial, or deep.

IV. In respect to their Natures: some are mild, and these chiefly possess the Tunicles of the Eye; or malign, and they possess the fleshy part.

V. The malign are also twofold; viz. either not contagious, or contagious: the not contagious are twofold, viz. Ʋlcus depa∣scens, or Ʋlcus cancrosum: the contagious are threefold, viz. Carbunculosum, Venereum, and Morbillosum.

VI. So that out of what has been said, we must treat of Ʋlcers of the Eyes, 1. As they affect the Adnata or Conjunctiva. 2. As they affect the Cornea superfi∣cially. 3. As they affect the Cornea deeply. 4. As they af∣fect the fleshy part with Ʋlcus depascens. 5. As they affect the fleshy part with Ʋlcus Cancro∣sum. 6. As they are contagious in the Small Pox. 7. As they are contagious, in the Venereal Disease. 8. And as they are contagious, from a Pestilential Anthrax, or Carbuncle.

VII. The Causes. The Proca∣ctartick Causes, are from Blows, Contusion, or some external Vio∣lence. The Antecedent Causes are from a Cacochymy of evil Humors, or a Plethory, if such a thing is in Nature. The Pro∣ximate or Conjoined Cause is an Inflammation, or Ophthalmy, or sharp corrosive Humors lodged in the Part.

VIII. The Signs. These Ʋlcers are known by sight; from the Part they affect, and the nature and quality of the Ulcer.

IX. The Prognosticks. They are dangerous, and difficult in the Cure; especially those in the Cornea, and Pupilla, where for the most part, they leave Blind∣ness.

X. If the Cornea is wholly eroded, the Aqueous Humor is let forth; and many times also the Crystalline.

XI. If there is an Inflamma∣tion withal, it is generally very painful; and ought forthwith to be removed, by those things prescribed in an Ophthalmy.

XII. Ʋlcers of the Eyes in Per

sons of a Cacochymick Habit of Body, if they are cured, (which is always with difficulty) yet they generally leave some ble∣mish, or other weakness upon the Part.

XIII. If they happen in Chil∣dren, they are always of difficult cure; because of their froward and untoward, or fearful and uneasy disposition.

XIV. The Indications of Cure are threefold. 1. By Ʋniversals, as by proper Catharticks. 2. By Revulsion and Derivation. 3. By Vulneraries, as Abstersives, In∣carnatives, and Cicatrizers.

XV. An Abstersive Collyrium, from Barbett. ℞ White Amber, red Myrrh, A. ℈ss. Sugarcandy ʒi. Saffron gr. vi. Eyebright-water ℥ijss. white of one Egg, mix them.

XVI. Another. ℞ Red Coral prepared, Frankincense, A. ʒss. crude Antimony, Harts-horn burnt, white Troches of Rhasis, A. ℈i. burnt Lead, gr. xv. Honey of Roses, q.s. make a Liniment.

XVII. An Incarnative. Take Celandine-water ℥iii. Gum-tra∣gacanth ℈i. Aloes, Frankincense, Tutty prepared, A. ℈ss. Glass of Antimony levigated gr. vi. mix them.

XVIII. A Cicatrizing Colly∣rium. ℞ Rofe-water ℥iv. Sac∣charum Saturni, Sarcocol, white Troches of Rhasis, burnt Lead, A. ℈ss. mix them, to wash with.

I. Ʋlcers of the Eye, affecting the Conjunctiva.

XIX. The Tunica adnata, or Conjunctiva, is derived from the Pericranium, and is common to the Eyelids: and therefore an Ulcer in that is the most simple, and easy of cure; and proceeds (as has been said) mostly from an Ophthalmia.

XX. An Ophthalmia is said to proceed from two Causes. 1. It may proceed from Inward Causes. 2. From Outward; and then it is either mild, when the Conjunctiva is only inflamed; or vehement, making red, and turning up the Eyelid, wherein the Humor is so sharp, as to cause an erosion, or ulceration.

XXI. First, cleanse with this. ℞ Honey of Roses strained ℥ss. Goats-milk ℥ijss. fine Aloes ℈ss. mix them.

XXII. Or with this. Take Goats-milk ℥iii. yolk of one Egg, Sugarcandy, Honey, A. ʒi. Myrrh, Aloes, A. ℈ss. mix them.

XXIII. Consolidate with this. ℞ Rose-water ℥iii. Gum-traga∣canth ℈i. red Coral prepared, burnt Harts-horn, Sarcocol, Dragons∣blood, burnt Lead, white Starch, A. ℈ss. Crocus Metallorum, Sac∣charum Saturni, A. gr. v. mix, and make a Collyrium.

II. Ʋlcers of the Cornea, superficial.

XXIV. Some Authors make the superficiary Ʋlcer to be fourfold. 1. 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, Caligo, a Misti∣ness and Dimness of the Sight. 2. 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, Nubecula, a little Cloud; which is deeper than the former. 3. 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, Ʋl∣cus ad Iridem, an Ulcer grow∣ing about the Iris, posses∣sing part of the white, and part

of the black of the Eye; by some said to be Albugo, a Pearl in the Eye; which in the Iris appears white, but without it is reddish. 4. 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, Ʋlcus simplex Cculi, a simple Ulcer or Erosion of the Cornea in the Eye, which makes it ragged, and of an ash-colour.

XXV. But of all these, the last, which is a Sore of the Eye caused by Erosion, can only be called an Ʋlcer; the Cure of which only we shall here treat of; for that those things which cure or help the latter, will certainly cure the former.

XXVI. A Collyrium, to wash with. ℞ Juices of Celandine, of Fennel, of Rue, of Southern-wood, white Port-wine, A. ℥iv. Bnlls-gall ℥ii. Aloes, Sarcocol, A. ℥ss. distil in a Glass-body in B.M. in which infuse Crocus Metallo∣rum levigated ℥i.

XXVII. ℞ Juices of Fennel and Rue, A. ℥iv. Honey of Roses strained ℥i. choice Brandy ʒii. mix them.

XXVIII. ℞ Honey of Roses strained ℥i. Rose-water ℥iv. Aloes finely poudered, Tutty prepared, Saccharum Saturni, A. ℈i. mix; with this or the former, let the Ulcer be drest daily twice a day, and it will quickly be well.

III. Ʋlcers deep, or piercing the Cornea.

XXIX. Of the deep Ʋlcers some Authors make four sorts: 1. 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, Fossula; a hollow, narrow Ulcer of the Eye, with∣out filth, like a round Puncture. 2. 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, Ʋlcus cavum; a hollow Ulcer, wider than the former, but not so deep. 3. 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, Inustio; which is yet deeper, made by Burning; being an impure crusty Ulcer, thro' which the Humors sometimes come, when cleansed by Abs∣tersive Medicaments. 4. 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, Pro∣cidentia Ʋveae Tunicae; which is, when the Cornea is corroded quite thro', and falls down.

XXX. This last or fourth kind, which properly is also fourfold: 1. Very small, like the head of a Fly or Pismire. 2. Bigger, being faln down more, and is equal in bigness to a small Grape. 3. Larger, hanging or sticking forth like a little Ap∣ple. 4. When it is grown hard, brawny, and flat, almost nail∣like.

XXXI. These Ʋlcers of the Cornea, viz. the three first kinds, are not to be slighted, for that they have deeply seized upon the substance of the Membrane; lest corroding thro' the whole Mem∣brane, the Humor should issue out, and so the Eye sink, causing an incurable Blindness.

XXXII. The fourth kind, where∣in the Cornea is eaten quite thro', having four several species, they are all of them said to be incu∣rable: but the grape-like and apple-like, may (if their roots be small) have their deformities in a great measure abated, by binding them: but this deliga∣tion will no more restore the Sight, already lost, than it can make a new Eye.

XXXIII. The Causes. The Ma∣terial Causes of all these Ʋlcers,

is a Salt and Nitrous Humor, as Aegineta, lib. 3. cap. 22. will have it, which is sharp and cor∣roding; which being in a Ca∣cochymical Habit of Body, ren∣ders them always of difficult cure.

XXXIV. The Cure. This has relation only to the three first kinds, in which Emeticks are to be avoided, and such Catharticks as are apt to work upwards, which are always prejudicial to weak Eyes: you are only to use such as are gentle and lenient, by which you may gradually, or by little and little discharge the Humor offending; that that which is good may succeed in its place.

XXXV. The Body then being gently purged, Nature oftentimes corrects and amends the remaining part of the Juices; by converting that which is benign into Nou∣rishment; and expelling the superfluous, by Stool, Urine, and Sweat.

XXXVI. To these things add, the right Ʋse of the seven Non-naturals: otherwise, tho' you may fail of the Cure, yet it may be very much prolonged.

XXXVII. Renodaeus, Pharm. lib. 5. cap. 11. has this Topick. ℞ Burnt Lead, Antimony, Tutty washed, burnt Brass, Gum Ara∣bick and Tragacanth, A. ℥i. Opium ʒss. make all into a pouder, which with Rose-water form into Troches. Dissolve one of them in Cucumber, Plantane, or Purslane water, and dress the Eye there∣with.

XXXVIII. Heurnius, Meth. ad Praxim, lib. 1. pag. 141. (in the Roterdam Edition in 8^o. Printed 1650.) has this: ℞ Calamina∣ris thrice burnt, and twice quenched in White-wine, ℈ii. burnt Brass ℈iv. burnt Lead washed, Myrrh, A. ℈ss. Saffron gr. v. Opium gr. ii. Decoction of Fenu∣greek ℥i. grind all upon a Porphyry∣stone, and make a Collyrium. Make the Eyes first clean with a Spunge dipt in Decoction of Fenugreek and Linseed; then with a Pencil dress the Eyes, five or six times a day.

XXXIX. The same Heurnius, in the place cited has this also. ℞ The Gall of Partridges, or of a Hare, or of Fishes ʒss. juice of Fennel ʒss. Sugarcandy ʒii. Syrup of Roses q.s. make a Collyrium. The hard whites of Eggs also beaten with a little Vitriol, and and the Liquor dropping there∣from thro' a linnen Cloth, being anointed on the Ulcer, won∣derfully cleanses it: the Body in the mean while is to be kept soluble with Lenitive Clysters.

XL. It has been observed also, that Sows or Wood Lice, being bruised, and infused in Rhenish Wine, N^o. 200. to a quart of Wine; and the Liquor drank every Morning fasting to ℥iii. is excellent to heal Ulcers of all kinds, tho' malign, as Depascent and Cancerous, and to help dimness of Sight, and cure most Diseases of the Eyes.

IV. Of the Depaseent, or Eating Ʋlcer.

XLI. This is a malign Ʋleer, which begins at the corners of the Eyes, and sometimes at the

white of the Eye, seizing many times, even upon the Horney-Tunicle.

XLII. The Prognosticks. In Cacochymick habits it frets and eats very much, and runs on in such sort, that oftentimes it consumes the adjacent parts, as the Muscles and Lids of the Eye.

XLIII. It is dangerous, and seldom cured without deformity, and loss of Sight; for which rea∣son the Patient ought to be in∣form'd of the event or danger, before the Cure is undertaken.

XLIV. The Signs. It is known by sight: but it yeelds a stinking slimy Matter, the pain is vehe∣ment, and there is commonly a Symptomatical Fever,

XLV. The Cure. You may dress the Ʋlcer with this. ℞ juices of Henbane, Nightshade, To∣bacco, and Tarrow, A. ℥i. Honey ℥iii. mix them over a gentle heat. Or, ℞ Juice of Mandrakes, of Nightshades, of Plantane and Pur∣slane, A. ℥i. Honey of Roses strain'd ℥iv. mix them over a gentle heat, adding Sacchurum Saturni ℥i.

XLVI. The Ʋlcer being drost with the former things, apply over it, this Cataplasm. ℞ Pulp of boil'd Quinces ℥iv. Barley Flower ℥ii. Unguentum, Rosa∣tum ℥i. Saccharum Saturni, Hen∣bone-seeds in pouder, A. ℥ss. Oil of Poppies, q.s. mix them.

XLVII. If the Ʋlcer proves ve∣ry malign and corroding, it must be corrected, by dropping into it some of this mixture. Take Rosewater, Henbane, Housleek, and Nightshade waters, Oil of Vitriol or Sulphur, A. ʒii. mix them,

XLVIII. And if by the use of it the pain is very great, you may appy this Anodyn Cataplasm to it. ℞ Pulp of Quinces ℥vi. Hen∣bane, Housleek, Mandrake, Night∣shade, A. M. i. juice of Night∣shade lbi. boil till the Quince Flesh is soft: then add, Barley Flower ℥ii. Oil of Poppies ℥i. Saccharum Saturni ℥ss. Opium ℥i. mix, and boil to a Consistency.

V. Of a Cancerous Ʋlcer.

XLIX. This is that which is said to be caused of an Arsenical Salt, wherein, besides the Corro∣sion, there is a Septick, or putre∣factive quality, which alters the form of the Part after a very strange manner.

L. The Signs. It begins in the black of the Eye; and in it the black and white of the Eye are reddish: the pain is almost con∣tinual, and vehement, and a dark-coloured, sharp, corrod∣ing, putrefactive, stinking Hu∣mor flows from it: and it is the more exasperated by the appli∣cation of sharp Medicines to it.

LI. The Prognosticks. Aegi∣nera, Lib. 3. Cap. 22. says, that this is an Incurable Ʋlcer: and indeed nothing but a Palliation can be promised, because it re∣sists the most probable Reme∣dies.

LII. The Cure. Let the Pa∣tients Food be Milk, and Milk∣meats, Curds and Whey, Milk∣pottage, Custards, Panado's, and Milk boild thick with Oatmeal, which sweetens the Juices of the Body, nourishes, and is of good Juice, and easy concocti∣on:

to which add other Food of easy digestion.

LIII. As to Topicks, you may apply this. ℞ Burnt Lead ℥ii. red Lead, Cinnabar levigated, A. ℥i. Mercury coagulated ℥ss. Palm Oil of a Golden colour, q.s. mix, and make an Ointment.

LIV. Or, ℞ Mucilages of Line and Fenugreek seeds, extracted with Poppy-water ℥i. white Troches of Rhasis with Opium ʒi. mix them, which apply warm, renewing it morning and even∣ing.

LV. And over all you may ap∣ply this Cataplasm. ℞ Rotten Apples, or Pulp of baked Apples ℥vi. Cassia newly Extracted, Barley Flower, A. ℥ii. Burnt Lead ℥jss. white of one Egg: juice of Nightshade, q.s. mix them.

VI. Ʋlcers in the Eyes, from the Small-Pox.

LVI. They generally follow an Inflammation of the Eye, or when any of the Small-Pox break out in the Eye, as I have sometimes seen.

LVII. They are known by either Tumor, or Crust, or erosion with matter issuing out, and much pain.

LVIII. Let the Eyes be fomen∣ted with warm Breast-Milk, or with warm juice of Fennel, or with a Mucilage made of Quince, Fleawort, Fenugreek, or Lin∣seed, with juice of Fennel.

LIX. After which, anoint them with this gentle Abstersive. ℞ Honey of Roses strained, juice of Smallage, A. ℥i. Breast Milk ℥ss. Saffron in pouder ℈ss. mix them, and anoint therewith: this Medicament alone will be enough to heal them.

VII. Ʋlcers in the Eye, from the French-Pox.

LX. When these Ʋlcers proceed from the French-pox, you will find the Cure of them very difficult, unless the Cure of the Disease causing them be attempted at the same time.

LXI. However outwardly you may apply this. ℞ Honey of Roses strain'd ℥i. of our Hercules, Cin∣nabar levigated, A. ʒii. Aloes ʒss. mix them.

LXII. Renodaeus in Pharm. Lib. 5. Cap. 11. has this. ℞ white Wine lbi. Plantane and Rose wa∣ter, A. ℥iii. Auripigment ʒii. Verdigrise ʒi. Aloes, Myrrh, A. ℈i. make the dry ingredients into fine pouders, and mix them with the Wines and Waters.

LXIII. This is yet a more ex∣cellent thing. ℞ White-wine lbi. Honey of Roses strain'd, Bul∣locks, Gall, A. ℥iss. Nightshade, Plantane and Rose waters, A. ℥i. juice of Centory the less, of Smallage, of Scordium and of To∣bacco, A. ℥ss. Cinnabar leviga∣ted Vitrum Antimonij, Aloes, Myrrh, A. ʒii. mix. digest two days, then use them.

VIII. Ʋlcers caused from a Pesti∣lential Carbuncle.

LXIV. If it is caused from any Pestilential Ʋenom, there arises first a small Tumor in the Eye, which is hot, hard, painful and con∣tagious;

arising from a thick, black, burnt and venomous Hu∣mor.

LXV. The heat causes the Burning and fermentation of the Humor; and it is contagious by reason of its Poyson and Malignity, which it emits constantly in fumes or vapors: and when it comes to yield matter it stinks, by rea∣son of its putrefaction.

LXVI. It is accompanied with great thirst, heat, especially inter∣nal, watching, and raving: and the Urine is sometimes very red, thick, and troubled.

LXVII. The Cure. These Symptoms appearing, you are first to give inwardly Antidotes, and Alexipharmicks: the vulgar Phy∣sicians give Venice Treacle, Mi∣thridate, and Elect. de Ovo: but we commend our Theriaca Chymica, above all other things in the World.

LXVIII. For it overturnes the Venom, destroys the Poyson, abates upon the spot all the vebement Symptoms, and secures the Life of the Patient.

LXiX. If you perceive a small Pustule on the top of it, open it with a Lancet or Incision Knife, and nbate the vehement heat with Aqua Spermatis Ranarum, or Aqua Solani mix'd with a little S.V. in which Camphir is dissol∣ved; or you may do it with Pop∣py water in which Saccharum Sa∣turni is dissolved, adding a little Camphir in pouder, laying a Cloth moistned in the same over it to the Eye.

LXX. And above it apply this Cataplasm. ℞ Goats or, Cows Milk, or rather juice of Nightshade lbss. Barley Flower, q.s. mix them.

LXXI. When the Crust is fal∣len, Mundifie with this. Take Honey of Roses, juice of Fennel, Ana, mix them: then incarnate by adding thereto Colophony in pouder, a third part.

LXXII. Lastly, cicatrize the Ulcer with this. ℞ white Port Wine lbi. Aloes, Tutia prepared, Ceruse, A. ℥ss. Honey, Sugar Candy, A. ℥iss. Alum, Sacchar∣um Saturni, A. ʒi. mix: digest in a gentle sand-heat, for 48 hours; then keep it upon the Faeces for use.