An experimental treatise of surgerie in four parts : 1. The first part shewing the dangerous abuses committed among the modern surgeons, 2. Of cures of all sorts of wounds in mans body ..., 3. Of the symptomes of wounds ..., 4. Treating of all kinds of balmes, salves, plaisters, ointments, oyles, bloodstenchers, potions, tents, corrosives, &c. which are used for wounds ... / by that most famous and renowned surgeon, Felix Wurtz, citie surgeon at Basell ... ; exactly perused after the authors own manuscrip, by Rodolph Wurtz, surgeon at Strasburg ; faithfully the second time translated into Neather Dutch, out of the twenty eighth copy printed in the German tongue, and now also Englished and much corrected, by Abraham Lenertzon Fox, surgeon at Zaerdam ; whereunto is added a very necessary and useful piece, by the same author, called the Childrens book, treating of all things which are necessary to be known by all those, to whose trust and overlooking, little children are committed.

CHAP. VIII.

Of the Head-ach after the Cure, and how that is to be helped. How to make the subtile Head ointment, with remarkable examples of Head-wounds cured.

IT happeneth sometimes, after that a Wound hath been fully cured, that the Patient after two, three or more dayes,

or after so many weeks feeleth pains in his head, and the same pains do increase more and more, and many die of it; for all Surgeons do not understand the cause thereof, and how the same were to be helped, of the which I will inform you here.

First, when a Head-wound is healed, and riseth after the healing, and swelleth, and is very painful, then lance the Wound presently, for it signifieth that some splinter would fain be out, and if you do not open it, then the matter would make a mighty great hole, and break out in another place, which would cause many simptoms and troubles, and the blow would come on a fresh; therefore look you give vent to that matter, and when such things are opened, then the plaister will draw out the splinter, together with the matter bloud and water, and if you think it good, you may let him use an expulsive vulnerary potion, then the Wound will be cleansed and cured.

Secondly, look well to these following signes; if the Pa∣tient complaineth of great pains, feels great prickings in the head, and these smarting pains increase more and more, and cannot endure to be toucht in that place where the Wound formerly was, yet no swelling nor rising of the skin ap∣peareth, as you heard formerly, then is it a sign, that with∣in the scull there is a splinter, which hangeth inward, and causeth these prickings; in this case that place must be lan∣ced instantly, and the splinter must be taken out, as hath been said.

Thirdly, In case the Patient complaineth more and more after the Cure, not onely of the place where he was cured, but all his head is panting and broyling, accompanied with extream pains. This is a sign, that congealed bloud is ga∣thered under the scull, and is turned to an Imposthume. And if his eyes be swelled, and some bloud and matter runs out of his nostrils, then is it a more sign of it.

This infirmity may, with Gods help, be cured easily, as hath been said already: Viz. Cut off the hairs in the place where the pains are, lance the skin cross way to the scull, in the breadth of half a Crown, and put back the four pieces, that

the scull be naked, then cut with a Raisor or other Knife a Wound into the scull, open it, that you may look into it, then the matter will start out against ye, and the Pa∣tient will be eased; and if there be any splinter at hand, you may easily see it, and take it out, as you have heard be∣fore. This is the onely way to help such a Patient. Such Wounds now made are soon healed again, onely govern the Patient well, as is fitting, and as I have informed you be∣fore: You must lay nothing to his brains, as I told you a∣fore, for the brains will expel the things of their own ac∣cord, when they have a vent for it, without any further help, and suffer not any strange matter to stay or abide there.

Touching the cutting up of the scull, note, that there is no difficulty in it, and is done easily and quickly. For the scull gapeth and openeth, if there be any splinters or little bones there, therefore with a little help those small bones may be taken out; onely look narrowly to it, whether there be any fracture at hand, for you may easily discern, whe∣ther a splinter within goeth down and inwards, or whether there be any more of congealed bloud there. But if you find after the opening of the skin, neither fracture nor scissure, a hundred to one but there is, and however you are sure, that the scull must be opened, be it either by reason of the congealed bloud, or by reason of an Imposthume; take a well turn'd sharp borer, and bore thorough the scull at the place where the pain is, then the matter will startle out, and when the place is almost thorough bored, then work gently, and look well to it, that you cause no small bones with the boring to fall into the hollow of the head, for if so, then you will find somewhat to do, and not without danger.

In this case some will have (though I never had need of) that when the matter at the first opening doth not ap∣pear, then another hole, a fingers bredth from the first, is to be bored, and then to cut both these holes into one, and so to make a Wound into the scull: into that made hole you may see with a lighted candle in a dark place, and under∣stand

the cause; if you find then either congealed bloud or a swelling, then touch it onely a little with an Instrument, as soon as it feeleth vent, it will soon come forth at the Wound. I should like this way well enough, in case any splinter or loose bones be there. But it is your duty to stu∣dy in what manner it may be done most fitly and conveni∣ently, as the condition of the case requireth, and to regulate your self accordingly. For it is impossible to set all down in writing, onely be mindful of the vulnerary potion, as you shall hereafter hear of.

Before the close of this matter, I will tell you how you shall prepare the Head-plaisters, and the thin ointment, so often mentioned hitherto.

Make the Head plaister thus: ℞ Of Wax ℥ 8. of wash∣ed Turpentine ʒ 4. of oyl of Roses ℥ 2. of the juyce of Bettony ℥ 6. put all these into a pan, let it boil, let all the joyce boil away, when the other are melted, then take it off the fire, and put thereto pulverized Colophonium ℥ ss Ma∣stix, Frankincense, Myrrh, of each half a drachm; this must be continually stirred, till it be so cold, that you may touch it with your hands, then work among it Oleum Storacis Ca∣lamitae ʒ ss, make it up into rouls, and keep it clean for use.

This plaister cleanseth Wounds, leaves no unclean thing in them, and is pleasant and proper for the brains, and the whole head. Therefore use it as it ought, it will not deceive you, and doth better than Oyls, Aqua vitae, Waters, Salves, as you heard above.

I will teach you another Head plaister, which is yet bet∣ter.

℞ Wax lb 1, Turpentine ℥ 6. melt these together, be∣ing well heated, pour it into Rose water, let it cool; take it out and melt it again, and look that the Rose water come all away: afterward take of pulverized Sanicle ℥ 1. and stray it into the melted Wax, and then all these following pieces; Frankincense, Mastix, Myrrh, ana ℈ 1. prepared Calmy∣stone ℥ 2. Terra sigillata, or prepared Bole armoniack, ℥ ss all which must be purely beaten and strayed into: take it off

the fire, and stir it continually till it be cold; then take it out of the pan, and work it with Cammomil oyle, make it into roules, and then into cakes, and keep them for use.

Touching the thin Head salve, make it thus:

℞ Hart Suet ℥ ss purely skimm'd Honey ℥ ss Aloes he∣patick purely beaten ʒ 1. melt the Suet, stir the Honey and Aloes among it till it be cold, then you have a pure subtile Salve for the head; at the using of it, spread a little of it on a linnen, and apply it to the Wound; take heed that nothing of it fall on the brain, which can endure no∣thing at all. These are the Receipts I impart unto you.

Let it not be strange unto you, that I set down no more Receipts, which I could easily do. But to what end are pluralities of Receipts good for, but to confound him that is to make use of them, insomuch that he knoweth not which to chuse, or which to trust most unto. A Receipt which is approved is better than a thousand which prove false. He that is well grounded in Surgery will find Receipts enough in his daily practise. For the Art consisteth as well in the knowledge of Simptoms, as in the knowledge of Simples. He that well knoweth these two, will soon compose Re∣ceipts, either to weaken or to strengthen them in their ver∣tue, and all according to the condition of the Wound.

Thus much be said of the Head-wounds. Touching the Cramp and other accidents in Head-wounds, the same shall be shewed unto the Reader in its due place.

Now I will set down some examples of Head-wounds, which, through Gods help, have been strangely cured; as I have copied them out of my Fathers writing, after his death.

I have, saith he, had occasion to dress one by night in all haste, because he did bleed so much, that I was afraid he would die under my hands before I could dress him. For from his scull was cut off a great part, hair, skin, bone and all clean away, and then on the left side by the temple a great piece was cut off, skin, bone and all was gone: this Wound

looked so ghastly, that I was amazed at it, for it did bleed so vehemently, and it was so great, that I could not cover it with my hand. I dressed it in haste thus: I covered the Wound with Mullipuffs, and bound it with broad Swathing-bands, and did no more to it, for I thought no other, but the Patient would die under my hands; I was forced to make all the haste I could, and had no time to cut the hair away about the Wound. The next day taking off the uppermost rouler, there I found the lint mullipuff stick close to the Wound, which I let alone, and poured round about warmed oyl of Roses, with some of that oyl also I annointed the Patient his neck and back bone, and so I dressed him again: At the next dressing I took off no more of that Wool, but that which easily came off, and daily I annointed his back with Cammomil oyl warm'd. I dressed him still in a dark still chamber, where no air should fall on his brain; and I had a care also, that none of my breath came into the Wound, and the things I intended to use to the Wound I had in readiness, that he in the dressing might not be delay∣ed. The Patient was well governed in his diet, and quiet, according to order. The lint together with the bloud came purely off from the Wound; but the brain began to swell, and in the outside the scull opened, where the brain pressed thorough all along, which a knife might have taken off, and it did pant and work, as if it would come forth and change his place, which it did more in the neather Wound, than in the upper, where the brain was not touched. To all which I did nothing, but dressed the Wound with the wound-plai∣ster three doubled, so that no air might come to it. At the tenth day the upper Wound inclined to healing, and the brains began to settle by little and little, and grew so little, that I could have laid a finger betwixt the scull and the brain, thus empty grew the head. And the brain sinking thus, I spied a little thing lying on the brain, which was not quite separated, in the rest it was wholly pure: on the Pia mater there began to grow flesh, which grew bigger and bigger; I wondered, that in few dayes there could grow so much flesh: but where that said impure splinter did lie,

there it stunk extreamly, and would not come to any heal∣ing; at last the said splinter began to stir to and fro in the Wound, with a subtile linnen I took off nimbly as much as would stick to the cloth, the rest which clung not to the cloth I left there, for I still was afraid that he would die un∣der my hands, though the twenty eight day was past already. At last I thrust that little splinter away also, so that I could see what was beneath it. There I found (there were pre∣sent many honourable persons) that the brain was hurt ve∣ry little, of the breadth of half a fingers joynt; in that place there was alwayes a moisture, as often as it was wiped away, presently another came into the place, and the flesh in it round about looked no other than like a raw Wound, in which there lieth a splinter, which hinders the healing of it: it grew thicker and thicker and soft, that I marvelled at it; yet it would never cover that place where the brain was hurt. At last when the flesh encreased, in one night it covered that place wholly, so that I saw no more moistness, onely some matter lay there, And thus the whole head grew up with flesh, and I suffered the flesh above the scull to grow out, and hindered it not, for here his scull could not be metled with∣al. Now suffering this flesh to overgrow, then I straid in that flesh round about burnt Allum, but none into the mid∣dle, for there he could endure none. Afterward the flesh pressed forth at the Wound and scul so fast, that it drove out some little bones that were loose in the Wound, at which I wondered not a little, that so many small bones should come forth out at the Wound, At last he was cured of this dan∣gerous Wound, and the flesh was good and sound, and not soft (as commonly it is:) for the which he owed thanks to God, without whose gracious help such remarkable cures cannot be performed; and not every one riseth sound from his bed of such heavy Wounds.

Hereto serveth this ensuing example also, that every one may see, that nothing ought to be laid upon the Cerebrum, and the pia Mater, because Nature in that particular work∣eth better, than any Surgeon may perform with his Medica∣ments.

In the Jurisdiction of Bern it happened, that one received a Wound in the head, where the scull to the eye seemed not hurt, because his Surgeon dawbed it up in haste: But ten dayes after the Patient began to complain, every day more and more, till at last he could have no rest: it was time then to send for a Surgeon; among the rest I was called; after consultation had over the condition of the Patient, I open∣ed his scul, at the opening of it there ran out much bloud and matter; three dayes after within the scull there was a splinter about the breadth of a finger, where I had much ado before I could take it out, without further enlarging of the Wound; at last being taken out, the Patient presently was at ease, and inclined to healing, and was fully recovered from this accident.

I must quote one more: In the younger dayes of my travelling for to get experience, at Nurnberg I met with an acquaintance, being a Student, this Schollar was wounded on his head by a Cuttler with an old blade, and was dressed by the City Barber-Surgeon, who had good experience, and the Wound seeming little to the eye was soon cured, and both parties thought all had been well. Now hear what happened: ten dayes after the Patient sickneth upon a sud∣dain, grew very weak in the head, feeling extream pains in that place where the Wound was, and before he could be helped he died. After his death his head was opened, to know the cause of his sudden death, it was found justly, as you have heard in the former example.

These examples I thought to quote, and no more; for if these are not understood, surely others will not be neither, though I should quote hundreds, and if these be understood, then in such like causes Surgeons have sufficient advertise∣ment, whereby they may regulate themselves.

The Reader may take notice by these, that in Head-wounds I use no Balsams, no Salves, no Oyles, no Head-powder, nor any such like thing, name it what you will: And stick onely to the Head-plaister, but so, that it may be laid over the Wound, after the manner of an Opodeldoch, there li∣eth the Whole Art and advantage; and if you use it in this

manner, you effect more therewith, than with all other Salves, Oyles, Balsams, Pouders, that may be found in all Europe. For if you apply these Plaisters rightly, according unto Art, then the Patient will be well, not onely in his head, but also in his whole body; it draweth all heat out of the Wound, and bringeth broken bones and matters better out of the Wound, than any tongs can pull it out; it covereth the Wound in such a manner, that no air can get in upon the brain, nor can any vapour get out, which fitteth and be∣cometh Head-wounds exceedingly. Therefore if you fol∣low this order, you will perform more than all those, which dance after the old pipe and fiddle, as it is apparent among the Italians, French, Spanish, and others: What a miserable thing is it amongst them, if they have in hand but a small Wound in the head? How many die in that way, by reason of their old abuses? I confess, the hot Climate in those parts may occasion somewhat. They write such great Vo∣lumes, of this and that, and so confidently, that even to this day they know not what to do, and yet they perswade them∣selves, that others must beleive and learn of them. I have been present more than once, that Patients were possest with heat, feavers, dryness, yea, the great heat took away quite their senses; and there were used all kind of Medi∣cines, Glisters, Purges, Potions, Coolers, but all would not help. But after I had applied my Plaister in the said man∣ner, they mended, and without the use of any other Medi∣cine, all pain, anger and heat was gone: from thence I could well observe, that their dangerous binding and dressing was the onely cause of all these mischiefs: and I may con∣fidently say, that I have found the safest and fittest manner, and the best, to dress Head-wounds. In new Wounds much groaping and seeking is nought: I do not speak this by hear∣say, but knowingly and experimentally. For if you touch too hard new flesh, which is but newly grown, it bleedeth presently, and separateth again: therefore have a care when you intend to cover a bone in the head, for if you do but touch hard the borders and outsides of such Wounds, they turn blew and go asunder, and will not so easily close again

or unite. Therefore you must take heed, to commit any fault that way, for after it hath been touched, it never closeth so easily again.

Thus I will close the relation of these perillous Head-wounds, hoping you will behave your self well, both in slight and dangerous Head-wounds; and therefore I will write no more of the slight Head-wounds: Much more could be said, how the causes of such mischiefs ought to be judged; but these are the chiefest things, which may lead you to the knowledge of the rest.

Notes

• Head-ach after the cure of a Head-wound.
• When a Wound doth swell after heal∣ing.
• Note the cutting up of the scull.
• Another way to open the scull.
• To make Head-plai∣sters.
• Another Head-plai∣ster.
• Head-oint∣ment or salve.
• Many Re∣ceipts cause errors.
• An exam∣ple of a splinter.
• Another example.