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. XXXII. Of an ƲLCER of the BACK.

I. WHAT the Greeks call 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉. and the Latins, Ulcus Dorsi, vel Tergi; we in English call, An Ulcer of the Back.

II. The Causes. It is caused either from sharp Humors flowing down upon the Part; or from an Apostem, which follows some other Disease, by translation of the Matter to that Part; or from Struma, or some Tumor not well cured in a superior Part, or from external Violence.

III. The Signs. It is known by sight; being either a plain Ex∣ulceration, cavous, cavernous, or apostemous.

IV. The Prognostick. That in the upper Parts, is mo•…•… easily cured, than that in the Loins; and that which is recent, than that which is inveterate or old.

V. If it has been of a long standing, and has Coney-borows, as it were, with many turnings and windings, it will be of difficult cure: so also if it proceeded from an Apostem, or Tumor, which had been of a long con∣tinuance in the Part, before it broke forth into an Ulcer; for then it may be feared, that the Musculous and Nervous Parts are corrupted, or the Vertebrae hurt.

VI. If the Patient is extenua∣ted, or there seems to be an Atrophia or Consumption; it is manifest that the principal Parts are weakned, and that the Pa∣tient is in great danger.

VII. If the Vertebrae be cor∣rupted or foul, which you may easily discern by your Finger, or the Probe, the Patient is very desperate, if not incurable; but if the Mar∣row is touched, all hopes of Recovery are past.

VIII. The Cure. The Cure is to be considered according to the Causes and Symptoms present, or which do appear; you must first order a good Diet, and such as may be restorative, because these Patients always seem to be in a wasting condition: among Re∣storatives, volatil-mimal Salts have not the lowest place.

IX. I commend volatil Salt of Beef or Pork, or of Sal Armo∣niack, to be dissolved in Rhenish-Wine, or in a Decoction of Sarza and Burdock-roots: or in a De∣coction of Guajacum very thin rasped ℥ss. to a Gallon of Li∣quor, with addition of Resto∣ratives.

X. If an Atrophia is present, a De∣coction of Sarsa must be used, Choco∣let, or strong Cock-broth, Gelly of Harts-horn, and other Gellies,

with Goats and Cows Milk, all which abound with Volatil A∣nimal Salts.

XI. Let the Patient now and then Purge with gentle Medica∣ments; as with Sena infused in Wine; or the Infusion of the Species Hiera picra in half Wine, half Water: Or this, ℞ Ele∣ctuary Lenitive ℥ss. Elect. of the Juice of Roses ʒii. Syrup of Roses solutive ℥i. Barley-water ℥iii. mix for a Dose.

XII. Then if the bottom of the Sinus is lower than the Orifice, open it below either by Incision or Caustick, as that of Lapis Infer∣nalis, the white Caustick, the Silver Caustick, &c. and make an Orifice thro' the Eschar.

XIII. Then use an abstersive Injection, till you perceive the Ulcer to be clean, as, ℞ White∣wine lbi. Honey of Roses ℥iii. Ʋng. Aegyptiacum ℥ss. mix, and use it warm.

XIV. Or if it be only caveous, apply this mundifying Ointment. ℞ Juice of Smallage, Honey, A. ℥iii. Juices of Endive, Hops, El∣der, Centory, Scordium, A. ℥ii. Turpentine ℥iss. mix, and boil to the thickness of an Ointment.

XV. If any dead Flesh is pre∣sent, it is to be taken away with the Incision-knife, or Scissars, or with some proper Caustick.

XVI. The Ulcer being clean∣sed, you must Incarnate with this, or some such like. Take Rose-water ℥i. Syrup of dried Roses ʒiii. Olibanum, Mastich in pouder, A. ʒi. Trochisci albi Rha∣sis ʒi. mix, and inject warm.

XVII. Or in a caveous Ʋlcer, dressit with Ung. Nicotianae, or with Arcaeus his Liniment; and apply over all, Empl. de Meli∣loto, or Diachylon cum Gummi; after which Cicatrize, as is usual in other Ulcers.