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. VII. Of an ƲLCER, SORDID and PƲTRID.

I. WHAT the Greeks call 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, vel 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉. Ulcus cum sorde & putridine, vel, Ulcus sordidus & putridus; we in English call An Ulcer with filth and putri∣faction, or, An Ulcer sordid, or, foul and putrid. But Dioscori∣des, lib. 3. cap. 6. has 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, Ʋlcus putrescens: and Hippocra∣tes, 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, Ʋlcera putrida.

II. The Differences. Ʋlcers sordid and putrid, differ only in degrees. That is sordid, which (proceeding from the afflux of moist Humors) becomes foul, with a thick and snotty Ex∣crement.

III. That is a putrid Ʋlcer, when the said Excrements come forth with a noisom smell, like unto that of a dead Carcas; and withal putrifies and corrupts the Flesh which lies under it, and contaminates the softer parts.

IV. Guido, Tract. 4. Doct. 1. Cap. 3. says, These Ʋlcers differ only in degree, viz. that the one is such in a lesser, the other in a greater degree: for if the Excre∣ments be simply thick and foul, then we call it a Sordid Ʋlcer; but if they likewise receive a putridity and stink, in so much that they putrify and corrupt the Flesh under it and the softer parts, then we call it a Putrid Ʋlcer.

V. The Causes. The proximate Causes of this Ʋlcer are depra∣ved malign Humors, in a Body cacochymick, receiving a putrid∣ness from external heat and moi∣sture: or by reason of the too much, or unreasonable use of moist, unctuous, or greasy Me∣dicaments.

VI. Or from the Ʋse of vehe∣ment and over-strong Abstersives; which resolve the sound Flesh, and stir up a putrifactive heat in the Ulcer; whereby the Hu∣mors become so sharp, that they corrode the parts circumjacent.

VII. The Antecedent Causes are, excrementitious and gross Humors in a cacochymick Body, from ill Diet, bad Air, Slothfulness and want of stirring, &c. also from malign Fevers, which by means of the Expulsive-virtue stirred up, transmit their malignity outwards.

VIII. The Signs. A sordid Ʋl∣cer is known by sight; there appears in them, a great abundance of viscid and clammy Impurities;

the Flesh is soft and flaggy, and the lively colour of the Part is vanished.

IX. If it proceeds from a flu∣xion of Humors, whether from the whole Body, or from any one Part thereof, it will be known by the Signs delivered in the former Chapter.

X. If it proceeds from the weakness and distemperature of of the Part, it may likewise be known by its own signs, and signs of the Distemperature; and there will not then be any appearance of a fresh and lively colour in the Part.

XI. If it comes from Ʋnctuous Medicaments, it then appears white, and the whiteness goes round about the whole Ulcer, like a border.

XII. If it is from strong Abs∣tersives, the Ʋlcer grows hollow, and every day more than other, a small quantity of thin hot Quittor flowing forth.

XXIII. If it is become putrid, it will be known by the grievous stinking smell, and the disco∣loured matter.

XIV. The Prognosticks. If by reason of the great abundance, and the thickness of the Sordes or Impurities, the transpiration is hindred, the Part soon after corrupts; and so of a sordid Ulcer, it afterwards becomes a putrid Ulcer, or depascent, which is an eating Ulcer.

XV. If the putridity is in∣creased, or be not checked in the Ʋlcer, at length a Gangren will succeed, and then a Sphacelation follows.

I. The Cure of a Sordid Ʋlcer.

XVI. In this kind of Ʋlcer, great care is to be taken in the course of Diet; and the Body must be first purged from vitious and corrupt Humors, with Our Family Pills, Pill. Catholicae, Pul. Cornachini, Syrupus Catharticus, Tinctura Purgans, &c. and then a Traumatick Decoction is con∣tinually to be exhibited.

XVII. Outwardly, you must cleanse with Abstersives; as juices of Smallage, and Wormwood, and Centory; and meals of Barley and Orobus, Myrrh, and Honey of Roses, juices of Li∣mons and Citrons, Aqua mulsa, and Salt-water: but more espe∣cially with Wine and S.V. which is of exceeding benefit in cleansing all sordid and pu∣trid Ulcers; and is therefore to be mixed with other Medica∣ments.

XVII. If the Ʋlcer is made sordid by the use of too strong Detergents, Wiseman commends Ʋng. Basilicon mixed with red Precipitate, also Vng. Diapom∣pholigos, as things proper to dress the Ulcer with: and some cooling Unguent or Cerat, as Refrigerans Galeni, may be ap∣plied over it, with a Compress wrung out of Oxycrate.

XIX. If it is become sordid by the use of Lenients, and is covered thick with the sordes or filth, you need not fear (says Wiseman) to fill the Ulcer with red Preci∣pitate, and apply some mild Abstersive on Pledgets of Lint over it, with a Compress wrung out of Aqua Calcis, or Aqua

Aluminosa, and not to dress it 'till the third day after.

XX. For thereby the pain will lessen, and the Sordes will come away in a Slough; after which, the Ulcer is to be digested, 'till it looks more fleshy and natural, and then you are to incarnate with Medicaments of a milder quality, &c.

XXI. In a common sordid Ulcer: ℞ Ʋng. Basilicon ℥ i. red Precipitate ʒiii. mix them. Or you may dress with Ʋng. Apostolorum, or with Mundifica∣tivum Paracelsi, mixed with Alumen ustum.

XXII. This Liniment is good. ℞ Roots of round Birthwort ℥i. Agrimony, Centory the less, Worm∣wood, A. M. i. boil them in Wine: to the straining add, rind of the Frankincense-tree, Scammony, A. ʒiv. boil in the Wine again, then strain out, and add meal of Oro∣bus ℥ss. pouders of Tobacco and of Myrrh, A. ʒii. S.V. ʒi. Honey of Roses ℥ii. Turpentine q.s. mix, and make a Liniment.

XXIV. Or you may wash the Ulcer with this. Take Barley-water lbi. Honey of Roses, S.V. A. ℥ii. mix them.

XXV. And you may dress it with this. Take Turpentine, Honey of Roses, A. ℥i. flowers of Barley and Orobus ʒii.A. pouders of Myrrh and of Tobacco, A. ʒi. mix them.

II. The Cure of a Putrid Ʋleer.

XXVI. If the Ʋlcer is putrid, you are to wash it with a good Lixivium of Pot-ashes, in which Centory, Southernwood, Worm∣wood, Carduus, &c. have been boiled, or with good Brandy, and Ʋng. Aegyptiacum.

XXVII. Sennertus advises to wash it with Oxycrate, Lye, Brine; upon which are to be imposed Medicaments made of meal of Orobus, and pouder of long or round Birthwort-roots, mixed with a Decoction of Squills, in Wine and Honey.

XXVIII. Or, Take Honey ℥ii. Turpentine ℥i. Scammony in fine pouder ʒvi. Tobacco in pouder ʒiii. mix them.

XXXIX. If the Ʋlcer is hol∣low, you must use some cooling Ointment; as of fine Bole, lest an afflux of Humors should be excited by hot and biting things.

XXX. If the Ʋlcer is corrosive, and undermines the lips, making the Flesh soft, or unfit for healing, you are to deal with it, as we shall shew in Phagedenick Ul∣cers.

XXXI. However, that which is corrupted must be taken quite away, either by Incision, or by Cautery, (whether Actual, or Potential, it matters not much) 'till at length we come to the sound and quick Flesh.

XXXII. If you fear it should degenerate into a Gangren, you must use stronger things; as Balsamum amarum, Oxymel of Squills, Lixivium of Quick-lime, round Birthwort-roots, Scammony, To∣bacco in ponder, Emphorbium, the Ablution of Mercurius dulcis in Lime-water, Flower, or volatil

Sal Armoniack, Butter of Anti∣mony, &c.

XXXIII. But if the Putrefacti∣on shall yet be encreased, and the Ʋlcer tends to a mortification, you must treat it as we have taught, in Our Discourse of Gangrene and Sphacelus.