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. XXIX. Of an ƲLCER of the NECK.

I. WHAT the Greeks call 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉. and the Latins, Ulcus Colli, vel Cervicis, vel Juguli; we in Eng∣lish call, An Ulcer of the Neck.

II. The Causes, It may be pro∣duced from some external violence, as a Wound ill managed, or a Con∣tusion: or it may proceed from a Phlegmon, or an Apostem: or it may be caused from Venereal Contagion, or Poison, or stru∣matick Tumors, by degenera∣tion.

III. The Signs. The Ʋlcer it self is manifest at sight; but the Signs of the various Causes, must be learnt from the relation or discourse of the Sick, or some who belongs to them.

IV. The Prognosticks. If re∣cent, and not near any of the prin∣cipal Vessels, or the Spina, it will be the more easily cured.

V. If it is in the Neck behind, and has corrupted the Vertebrae; the Patient is then in a dangerous condition; if it has pierced to the Medulla, Death only can

put a period to the poor Patient's misery.

VI. If the Ʋlcer spreads, and creeps near to the Jugular Veins, or Soporal Arteries, there is great danger: if they once come to be corroded, nothing but a Miracle can preserve Life.

VII. If it is inveterate, and has otherwise eaten deep, or taken possession of the Glandules, (of which that Part is full) tho' it touches none of the great Ves∣sels, or recurrent Nerves, yet it will be of very difficult cure.

VIII. If it becomes fistulous, nothing but a palliative Cure can be expected; and in this last case, keeping the mouth of the Ulcer open, and the Ulcer it self al∣ways clean, it may prove (in Strumous cases) an advantage to the Sick.

IX. If being near the Spina, it should affect some of the conjuga∣tions or pairs of Nerves, proceeding from those Vertebrae; the Parts which are replenished with Branches from those pairs of Nerves, will be apt to suffer an incurable Palsy.

X. The Cure. Let it proceed from what cause soever, it is neces∣sary that Purging precede, or goes hand in hand with the other Ope∣rations of the Cure; that the su∣perabundance of the Morbifick-Matter may, as much as possible, be carried off.

XI. In all the common cases, and where it is primary, vegetable Catharticks may do, or those mixed with dulcified Mercury, or white Precipitate; but if it proceeds from a Strumous or Venereal Cause, (being Symptomatical) it will be necessary to add to them Mercurials; as red Preci∣pitate, the Prince's Pouder, Arcanum Corallinum, Turpethum Minerale, Aurum Vitae, Praecipi∣tatum per se, &c.

XII. This Purging is to be done at first every third or fourth day, for eighteen or twenty days: af∣terwards for a Month or six Weeks, only twice a Week: and after that time, only once a Week, 'till the Ulcer is healed up.

XIII. If it proves inveterate and rebellious, you must in the inter∣vals of Purging give constantly a Diet or Wound Drink, made of Guajacum, Winter's Cinamon, Sarsa, Sassafras, with addition of the principal Wound-Herbs, and and every Night at Bed-time this following Pouder.

XIV. ℞ Turpentine reduced to pouder by boiling, Crabs-eyes levi∣gated, Goats-blood dried; Ana; make all into a fine pouder; of which give ʒss. or ℈ii. going to Bed, in any proper Vehicle. This will cause a great part of the Morbisick Matter to be carried off by Urine.

XV. As to Topicks, if it wants digestion, (as Ʋlcers in this Part very often do) you must then dress it with Medicaments proper there∣to. This following is good. Take Venice or Strasburgh Turpentine, Honey, A.℥i. yolk of 1 Egg, Mastich in pouder ʒii. mix them.

XVI. After you find the Ʋlcer is well digested, (which you may know by the kindness of the Ulcer; not being full of pain, red, fretful, or eating, and the good condition of the Pus) you must then cleanse it with

Abstersives, as Ʋng. Nicotianae, Basilicon; or Basilicon mixed with a little Precipitate: or with this. ℞ Ʋnguent. Nicotianae ℥ii. Basilicon ℥i. Aegyptiacum ʒiii. mix them; and over all apply Empl. Album, or Diachylum cum Gummi, or Emplastr. Mercuriale, according as the Cause may be.

XVII. The Ʋlcer being suffi∣ciently cleansed, you may incar∣nate with Sarcoticks, as the Linimentum Arcaei, or this. Take Linimentum Arcaei ℥iii. Ʋnguent. Nicotianae ℥ii. Basilicon ℥i. mix them. And if the Ulcer is apt to be over-moist, you may add a little Precipitate thereto; which in this case will keep the Ulcer clean, and also help to incarnate.

XVIII. And now being filled up with Flesh, you have nothing more to do, but with some proper styptick Water, or astringent and desicca∣tive Pouders, Ointments, or Em∣plasters; to induce the Cicatrice, and perfect Healing.

XIX. If it is malign, you must often wash it with the Water of the Griffin; and apply such things, as we have directed in cacoethick and malign Ulcers.

XX. If it is from a Strumatick or Venereal Cause, it will scarcely be perfectly cured, but with such a course as may possibly cure those Diseases.

XXI. If it seems to be very habitual, or is become fistulous, you will do well to apply your self to the palliative Cure, (which we have in a former place already delivered:) because Ulcers and Fistula's in this Part cannot be laid open, but with much cau∣tion; lest the recurrent Nerves, or the other great Vessels should be hurt, or suffer in the Ope∣ration.