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. XXVI. Of an ƲLCER of the EAR.

I. WHAT the Greeks call 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉. and the Latins, Ulcus Auris; we in English call An Ulcer of the Ear.

II. The Causes. It is caused either by external Force or Vio∣lence; as of a Fall, Blow, Stab, &c. which may hurt and contuse the Part; and from whence Pus, or other sharp Excrements may be bred, which may erode the cavities of the Ear.

III. Or from an antecedent Cause; as sharp Humors, sent from the Brain to the cavity of the Ear, causing Apostems, Ulcers, &c.

IV. The Signs. It is known by Blood and Matter flowing out, and may be discerned also by pain, noise, and trouble in the Ear; and some∣times if Worms are there, there is felt an intollerable itching, not easy to be abated.

V. The Kinds. These Ʋlcers are either without an Excrescence of Flesh, or they are with an Excrescence.

VI. The Prognosticks. If the Matter is white, and without any ill scent, and the Ear itches much, it is without danger; yet it be∣speaks Worms, as aforesaid.

VII. If the Matter comes out of the Ear, and Pulsation is felt with great Pain; you may judge that a Phlegmon, Abscess, or In∣flammation is present.

VIII. If the cure of these Ʋlcers is long deferred, there is much danger of Deafness to ensue.

IX. If a great quantity of Pus comes forth of the Ear, you may safely judge, that it proceeds from a fluxion of Humors from the Brain.

X. The Cure. The Antecedent Cause is first to be removed by proper Purging; for which we commend the Arcanum Jovis, Pulvis Antimonii, Pulvis Cathar∣ticus, and Pulvis Cornachini: and in some Constitutions, the Electuarium Catharticum, which makes a good Revulsion.

XI. As to the Conjoined Cause, if any thing is gotten into Ear, it is to be taken out: and if Hu∣mors abound in the Part, a deri∣vation is to be made, by appli∣cation of Vesicatories, the Seton: or, making an Issue.

XII. The next thing to be done,

is to cleanse the Part with Abs∣tersives: as, ℞ Hydromel lbi. Honey of Roses strained ℥iv. mix; and inject with a Syringe very warm, then dry it with the Probe armed with Lint.

XIII. But the Medicaments which are put into the Ear, ought to be neither too hot, nor too cold; for that Part can ill endure any excess, in any of these two qua∣lities.

XIV. Put no fat or greasy Medicines into the Ear; for as it is composed of Spermatick∣parts, (as Physicians speak) so they will be apt to induce a sordid Ulcer.

XV. Nor let any sharp Medica∣ment be put into the Ear, before the Body is well purged; lest a Fever be procured, and a flux of Humors be moved to the Part.

XVI. Let all the Medicaments which are put into the Ear, be of a thin and liquid substance; that they may sink down the deeper.

XVII. And after dressing, let the Patient lye upon the whole Ear, the disaffected Ear being uppermost, and stopt with some fine Cotton, or Lint, for a pretty while.

XVIII. Trochisci Andronis dis∣solved in Elder-Vinegar, are commended for cleansing; so also Crocus Martis boiled in strong Wine-Vinegar, 'till the Tincture is extracted.

XIX. The Ulcer being cleansed, you must consolidate and heal with this. ℞ Scurvi∣grass M. i. round Birthwort roots ℥i. Canary-Wine lbss. boil, strain, and add thereto Spirit of Wine ℥ii. inject it warm into the Ear.

XX. Or you may inject into it a Sanative Synup, made of the Vulnerary Herbs; as of Agrimo∣ny, Angelica, Avens, Bawm, Comfrey, Horstail, Knotgrass, Ladies-mantle, Mint, Plantane, Scordium, Sanicle, Solomons-seal, Self-heal, Winter-green, Yarrow, &c. which is not only good in Ulcers of the Ears, but in all other cavernous or hollow Ulcers.

XXI. And to these Vulneraries, some few Astringents may be ad∣ded; as Bistort, Balaustians, Catechu, Myrtle-berries, Pom∣granate-peels, Oak bark and buds, Red-roses, Sumach, &c.

XXII. If the Ʋlcer is foul, or has Worms in it, a Decoction of dry Tobacco in Ale or Wine, will be found an incomparable thing: after injecting, you may dress it with this Liniment. Take Ung. Diapompholigos ℥i. distilled Balsani of Myrrh ʒiii. Honey of Roses ʒii. mix, and apply it with Lint.

XXIII. If these Ʋlcers yield much pus, or filth, they must be drest once every day: but if they yield but little matter, it will be enough to dress them once in two days.

XXIV. If the Ulcer is ma∣lign or inveterate, you must cleanse with this. Take Rhenish-Wine lbi. Honey of Roses strained ℥iii. Vinegar ℥i. Verdigrise ʒi. burnt Alum ʒss. boil, strain, and inject warm to cleanse: then afterwards heal the Ulcer, as directed at Sect. 9, 10, 11 above.

XXV. But withal, it will be necessary to divert or derive the Humor, by Errhines applied to the

Nostrils, and Masticatorics to the Mouth; and the Patient must use a Diet drink made of Gua∣jacum and Sarfa, &c.

XXVI. If an excrescence of superfluous Flesh does grow in the Ear, (which is many times does, so as to fill up all the cavities of the Ear, and cause Deafness) you must first purge the Patient very well, as before directed.

XXVII. Then consume the spongy Flesh or Excrescence, by injecting the Composition at Sect. 14. above, and strewing upon it this fol∣lowing Pouder. Take Vitriol cal∣cin'd, Alum burnt, A. ʒi. Auri∣pigment, Verdigrise, A. ʒss. mix them. Or, Take Alum burnt, Vi∣triol calcin'd, A. ʒss. red Precipi∣tate, Turbith-mineral not washe, A. ℈ii. fine Bole, Aloes, A.ʒi. mix them.

XXVIII. And upon every dressing, wash out the Pouders with this Injection. Take White-Wine ℥iii. Honey of Roses strained ℥ss. Ung. Aegyptiacum ʒi. mix them: after injection, strew in some of the former Pouders again, and continue this course 'till the whole Excrescence is wasted.

XXIX. Which done, heal and cicatrize with the Vulnerary-Syrup, or some such-like thing, dissolved in Plantane or Rose Water.