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. V. Of an ƲLCER with PAIN.

I. WHAT the Greeks call, 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉. and the Latins, Ulcus do∣loribus vel doloris plenum; we in English call, An Ulcer with Pain.

II. Pain is one of the Symptoms which obstructs the Cure of an Ʋlcer, whence various Accidents many times arise, as Fainting, Watching, Fever, and the like: for which reason, it ought im∣mediately to be mitigated, lest it attract, or cause an Afflux of Humors, or enlarge the Ulcer, or cause an Inflammation, or an Erysipelas to arise.

III. The Cause. This Pain for the most part arises from acrid, sharp, and corroding Humors, which gnaw the Ʋlcer, and heat the circumjacent Parts; pro∣ceeding either from a Cacochy∣mie of Humors abounding in the Body; or ill-applied Topicks, as Digestives not used timely enough, or Abstersives too long.

IV. The Signs. The Patient's being ill at ease will shew the Pain, and the Symptoms the Cause; whether from a Cacochymie, and abundance of Humors; or from want of Digestion, or Abs∣tersion, as is usual.

V. The Prognosticks. There will be no difficulty of removing of the Pain, if the Cause thereof is rightly apprehended, and that taken away.

VI. But if it continues any long time, it will be apt to induce a Flux of Humors, Inflamma∣tion, or other worse Symptoms.

VII. The Cure. The Indica∣tions are twofold: 1. To take away the Antecedent Cause. 2. To remove the conjoined.

VIII. The Antecedent Cause has relation to the Habit of the Body, and how that is in fault; and according as there is a Plethora, or Cacochymia, to make Evacua∣tion, either by Purging, Vomi∣ting, or Bleeding; by some, or all of them, as the condition of the Patient does require: and and then to strengthen and for∣tify the Body by cooling Juleps, Opiats, and a good Traumatick Diet, which may prevent the fluxion of Humors.

IX. This done, the proximate or conjoined Cause is next to be consi∣dered; which is to remove the Pain by things proper to the

Ulcer, and which have power to remove the Symptoms; and herein the Conjoined Cause is to be inquired into.

X. If the Ʋlcer is sanious, and the pain proceeds from thence, it wants digestion; and then such things as are digestive, which have a temperate heat in them∣selves, are to be applied.

XI. If the Pain is with Inflam∣mation, Lenients are to be used; as the Mucilages of Linseed, Fe∣nugreek-seed, Fleawort-seed, Quince-seed, Althea, extracted in decoction of Mallows, Oils of sweet Almonds, Camomil, Dill, Violets, Hens-fat, Hogs-lard, Saffron, yolks of Eggs, and Bar∣ley-flower, which may be made into a Cataplasm or Cerat with Wax: or Ʋng. Populeon, (if more cooling is required) Ʋng. Nutritum, Album Caphoratum, Emplast. è Bolo, Ceratum Galeni, may be applied to the parts about the Ulcer.

XII. And to the Ʋlcer it self, these Anodyns; as Saffron, Oil of Roses, yolks of Eggs, Turpentine, and Pine-Rosin; out of which Liniments and Ointments may be made, and applied.

XIII. If the pain arises from hot and acrid Humors fretting the Ʋlcer, it may be drest with Ʋng. Diapompholigos, è Plumbo, Tutiae, simply by themselves, or mixed with Basilicon; with a little red Precipitate, or some of the Princes Pouder; with Compress or Stuphs wrung out of Oxycrate or red Wine, which will allay the heat, and strengthen the Part, to resist the Influx of Humors.

XIV. If the pain is caused by a sordid Matter sticking to the bottom of the Ʋlcer, and hindring Transpiration, you cannot then (says Wiseman) remove the pain without Detersives; of which, red Precipitate, or the Princes Pouder, or Turpethum Minerale, are the best and mildest.

XV. If the pain is extream, you ought to fit the Medicament to the Cause; which being for the most part from hot and sharp Humors, are to be qualified with lenient Cataplasms, or with cooling Medicaments, or with Narcoticks.

XVI. A Cataplasm. ℞ Mal∣lows and Marshmallows, A. M.i. boil to softness, beat them, and pulp them thro' a Hair-sieve; to which add yolks of two Eggs, Saffron ℈i. Barley-flower, Linseed, and Fenugreek, Oils of Camomil and white Lillies, A.℥i. Mucilage of Althea-seed ℥jss. Oil of Roses ℥ii. mix, and make a Cataplasm.

XVII. Or, ℞ Crumbs of white Bread ℥ii. which soften in Milk, yolk of one Egg, Oil of Roses ℥jss. Barley-flower, Linseed, A. ℥i. pou∣der of Camomil-flowers, Oil of Water-Lillies ℥ss. Saffron ℈i. mix, and make a Cataplasm.

XVIII. Or, ℞ Flower of Bar∣ley, and of Millet, A. ℥ijss. Milk ℥viii. boil to the consistency of a Cataplasm; to which add, pulp of Cassia and of Raisons, pulp of Pippins or Pomwaters, Oils of Roses, of Earthworms, of Eggs, and of Dill, A. ℥i. Saffron ʒi. mix, and boil to a consistency.

XIX. If you are forced by the vehemency of the Pain to use Coolers, these things are commen∣ded;

Juices of Mallows, Marsh-Mallows, Horstail, Cucumbers, Lettice, Purslain, Plantan, Water-Lillies, &c. to which Barley-flower may be added, with Saccharum Saturni, whites of Eggs, Ʋnguentum Album, Frog∣spawn-water, &c.

XX. If yet all these things avail nothing, but that the extre∣mity of the pain continues, you must come to the use of Narco∣ticks; the chief of which are these Simples: Hemlock, Hen∣bane, Housleek, Mandrake, Night∣shade, Peru or Thorn Apple, Opium, Poppies: from which you may make distilled Waters, or Juices, or Oils by Infusion; of which, with Henbane and Poppy seed, Extract of Opium, and Barley flower, you may make Cataplasms at pleasure, according as the exigency re∣quires.

XXI. ℞ Juices of Henbane and Nightshade, A. ℥ii. Barley-flower ℥ii. mix, and boil to a consistency; then add Oil of Poppy-seeds, Ung. Populeon, A.℥i. Ex∣tract of Opium ʒii. pouder of Hen∣bane-seed q.s. mix, and make a Cataplasm.

XXII. You may also dress the Ʋlcer with Rose-water, wherein a little Roman Vitriol, or some Roch-Alum has been dissolved; applying over all Diapalma, or Empl. Album; renewing the Dressing Morning and Evening, 'till the Pain is wholly gone.