A rational practice of chyrurgery, or, Chyrurgical observations resolved according to the solid fundamentals of true philosophy by John Muys : in five decades.

Author: Muys, John, b. 1654.1686

A RATIONAL PRACTICE OF Chyrurgery: OR, Chyrurgical Observations Resolved according to the Solid FUNDAMENTALS OF TRUE PHILOSOPHY.

By JOHN MƲYS, Doctor of Physick in ARNHEIM.

In Five DECADES.

LICENSED, Novemb. 12, 1685. Rob. Midgley.

LONDON: Printed by F. Collins for Sam. Crouch, at the Flower-de-Luce at the Corner of Popes-head-Alley in Cornhil. 1686.

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The Spirit Divine is an Alkaly Stout

which Conquers the D— the World throughout.

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[...]

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TO THE READER.

Courteous Reader,

THe following Treatise of Chyrurgick Observations coming casually to my hand, and finding it pathetical to what my proper Genius hath of late years led me to, I could not let it pass without an English Dress, that thereby all those that are born with a Genius fit to understand Reason (though not instructed in the Latine Tongue) may have the advantage of perusing the Judgement of another harmoniously concurring with theirs. For it hath not seldom happened that many good Apprehensions of things have been quickned, and Midwifed into the World by such Publications as these of [Page]our Author, which (otherwise) would never have seen the Light; but have died and perished with the Womb in which they were conceived.

That the following Observations are (in my Judgement) likely to prove serviceable to my Native Country, appears plainly by this my Undertaking: For I doubt not, but that (after perusal) they will be found Consonant to the Reason and Experience of every Rational, Unbyassed and Unprejudiced Chyrurgeon; but more especially to such, the Foundation of whose Practice is grounded upon Reason and Experience onely; not upon a Parrotlike, Emperical, and Pore-blind Doctrine.

In Physick and Chyrurgy the Case is the same, as in Divinity. For there are some whose Faith is so streight-laced, that if you ask them the Grounds thereof, their Answer will be; They believe as the Church believes; and so there's an end of the Argument. But [Page]others there are who are not contented with this Implicite Faith, their Religion being grounded on right Reason and Experience. Such is the true Chyrurgeon, that maketh not the least Application to any part or Member of the Body, but can give a Reason Anatomically (or distinctly) why and wherefore, he doth the same: otherwise he deserves not so much as the Name of a Surgeon.

But that this Author was a true Medico-Chyrurgeon, is plainly apparent by his curiously delineated Observations, which (I am sure) are neither obscure nor dark to the Ingenious. For his highly-to-be-commended Doctrine of the power of Alcalies over Acidums, is of so great use and energy, that all Ingenious Practitioners will confess (if they have made any Observations on their own Practice) that there is no Dolour whatsoever, incident to the Body of Man, that hath been by them subdued, but the Remedy thereof hath been of an Alcalic-nature; it being [Page]apparent to all genuine Artists, that Diseases generally take beginning from Darkness, Anger, Terrour, or Madness, from which all Acidums do arise; and that the onely means of pacifying these Furies are Light, Sweet, Soft, Smooth and Friendly Medicaments, the Nature of which is comprised under that general Word Alcali.

All that I know the Artist hath to do, is in the first place to consider and learn what those things are which fall under his Observation, that are more or less of an Alcalizate Nature; and secondly, to understand their Power and Operation on Acidums; that thence he may be ascertained of their true Mixtion and Dose: as in case of the Loadstone, a piece of a Pound weight of which is capable to draw and hold fast a piece of Iron of an Ounce or two, but not of a Pound or two. Even so Errours often happen, not so much in the Medicine it self, as in the mis-application of the same either in Quality or in Dose.

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Thirdly, he should consider the Patient or Accident, or both; for Acidums are of divers natures, and therefore require Alcalies equally differing for their subversion.

In the last place he should likewise consider how to eschew and relinquish all such things as promote Acidity, and excite Anguish, as generally do Catharticks too frequently used, Tents and Dorsils in Wounds, making of large Orifices in Imposthumes, subjecting Wounds and Ulcers to the Air, and all sorts of unctuous Medicines.

More might here be added, but to avoid Prolixity I forbear, least the entrance prove too large for the House, concluding with the Authors Apology for what I have done; onely adding that golden Saying of Van Helmont.

Whatsoever thou wouldest do to the Sick, do first to thy self, and in thy Medicine separate the Pure from the Impure; [Page]by which means thou art made a fit Agent for the Administration of those peculiar Gifts and Endowments of Healing, granted onely to them that are Alchalizated to the Fear of God: Which that we may all be, is the hearty Prayer of thy real Friend,

J.W.

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THE AUTHOR'S PREFACE.

IN the solid Judgment of a generous Mind, all the Goods of Fortune are out-weighed by Truth, which is the true Food of the Soul; which, though most sweet, and an hundred times tasted of, yet never creates any loathing, as Corporeal Foods are wont to do; which the sweeter they are, the sooner (if often eaten) prove displeasant to the Palat.

He that buys Venison of another, and eats the same well and delicately drest, doth (I confess) conceive and find in his mind a certain Pleasure and Delight. But he who exerciseth Hunting himself, follows, pursues, and at length takes an Hart, Boar, Hare, or other Wild Beast, he is not onely [Page]delighted, in eating of the same well dressed; but also (and indeed more especially) is filled with very great pleasure, whilst he follows the flying Beast, and (after various labours and difficulties overcome) takes the same.

Even so the matter is with Truth, which indeed (when tasted) is savoury and grateful to him who receives the same from another; but he who imploys himself in pursuit of Verity, and in his pursuit at length takes the same, must needs be filled with greater pleasure in his pursuing and taking it, than when he feeds upon it.

He who would rightly exercise this hunting of Verity, he ought by serious Meditation, and an attent Obedience to pure Reason, apply to the Chase, and warily follow and take the same by Experience. If any Physical or Medicinal Verities (by me pursued) in all these Five Decades, have fallen into my Nets, I must needs freely acknowledge them to be obtained by the means aforesaid.

In the four first Treatises I chiefly speak of Simple Cases; but in the Fifth Decade I proceed to Histories of Affects more [Page]compounded. For it seemed good to me thus to make progression; as in Arithmetick we begin with the number of Ʋnity, and so are devolved to Numbers very much compounded. After the same manner in the Mathematick Science, we begin with a Point, and then proceed to a Circle, Triangle, and other Figures.

How compounded and perilous those Cases are, which I have treated of in the Fifth Decade, and how badly they are (for the most part) handled by others, I forbear here to mention, entirely leaving the censure of this matter to the well-meaning Reader.

But I already seem to hear some of my intimate friends saying to me; Friend, why do you proceed thus in Writing? Cease, forbear, and bid adieu to your Studies, by which you can scarcely effect any thing, except it be very great molestation to your self, from Physicians, Chyrurgeons, and others.

To these I answer: I have not written to satisfie others; for I judge that to be wholly impossible, seeing the Sacred Volumes which were written by the Instinct [Page]of GOD himself, are traduced by several Impious and wicked men; which way then shall I that am a mere man, and judge nothing that is Humane alien from my self, be able to expose any thing to publick view, which shall please, content, and satisfie all?

From what motive then am I induced thus to write? I answer; I had attained to the Degree of Doctor in Medicine, and was sometimes sent for to Sick Persons; and, notwithstanding this, in the mean while, I was conscious to my self with how great Prejudices and Ignorance in the Medicinal Science my Mind was affected; I was ignorant of many things, and doubted of more. My tender Conscience daily suggested these Words to me: Either wholly reject the Medicinal Practice, or with all thy might drive from thee thy own Ignorance, Either one or the other must be done, if thou intendest to enjoy Tranquility of Mind. What could I do, being constituted in such a Labirynth? I turned over and perused the Books of ancient Physicians, but there found very little that could satisfie my Mind coveting true knowledge. [Page]I familiarly discoursed with the Chyrurgeons of this Age; but from them I reaped little or no benefit; for they either could not or would not instruct me. Therefore, urged by extream necessity, I was compelled my self to dissipate the Clouds of my own Mind, remove the Prejudices, with which I was blinded, and become my own Instructor. And this Instruction of my self is onely by me here proposed in my Writing. This is what according to my Wish I have obtained. No other thing did I promise my self before, nor do I at this time expect any other.

Wherefore let the Malevolent abstain from their Calumnies, with which (without cause) they endeavour to blast my Repute. I hurt no man, I offend no man, I teach my self, I learn of my self, I am Teacher and Learner in the same person, I am Teacher and Learner of my self. If I be a Physician, it is lawful for me to heal my own Diseases; and by consequence also my Ignorance and Prejudices, which are Diseases of the Mind sufficiently perilous, and had already taken so deep root in my Mind, as it would be great imprudence longer to defer the Eradication of them.

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Therefore take in good part these Five Decades of Chyrurgic Observations, which (if GOD permit) shall hereafter be followed with mere.

Well-meaning Reader,

Thine John Muys.

ADVERTISEMENTS.

A Physical Dictionary, in which all the Terms relating either to Anatomy, Chyrurgery, Pharmacy, or Chymistry are very accurately explained. By Stephen Blanchard M.D. and Physick Professer at Middleburg in Zealand. Price 2 s. 6 d.

Youths Introduction to Trade: Shewing them the way of Contracting and Writing Short most. English Words; Of making Receipts, Releases, Bills of Debt, and Bills of Parcels, incident to most Trades; with Forms of Apprentices Letters, in answer to Country-Chapmen on several occasions; with an Appendix of Arithmetical Questions, very useful and necessary, for a Scholars Practice, by which they will be enabled to apply their Writing and Arithmetick to business when they come to serve their Masters, either as Merchants, Shop-keepers, or other inferiour Trades. By John Ayres. Price 1 s. Both Printed for S. Crouch at the Flower-de-Luce in Cornhil.

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The CONTENTS.

DECADE. I.

OF an Ophthalmy induced by a Fungus. 1
Of the use of an Issue, and its way of perating. 6
Of a Gangrene. 12
Of a Sphacelus of the Foot. 16
Of an Erysipelas of the Leg. 21
Of Varicous Ulcers of the Legs. 23
Of a Wound of the Eye. 34
Of a Suppurated Tumor and Rotenness of the Bone. 48
Of a Fracture of the Shin-bone. 61
Of a Dislocation of the Shoulder. 65

DECADE II.

Of the Puncture of a Nerve. 70
Of Dolour of the Head 75
Of the Contracture of a Tendon, after a Fracture of the Shoulder-bone. 80
Of a Vein cut. 83
Of the cracking of a Tendon. 88
Of an Haemorrhagia, from a varicous Ulcer of the Tibia. 90
Of a vast Contusion of the Arm. 92
Of a Ganglion in the Hand. 98
Of a movable round Tumor of the Lower-lip. 100
Of an affect of the Mouth, vulgarly called De Water-Kanker. 103.

DECADE III.

Of a Coadnate Tumor of the Forehead. 108
Of an Ulcer with Rottenness of the Bone. 112
Of a Wound of the Leg inflicted by Gunshot. 118
[Page]Of a very strange Ulcer. 123
Of a vast Tumor of the Neck. 128
Of a wonderful Abscess. 130
Of a small Stone contained in the Urinary Passage. 133
Of an hard Tumor of the Abdomen. 138
Of the Scurvey. 140.

DECADE IV.

Concerning the Indisposition of the Gum 144
Of an Ambustion. 147
Of the Hernia. 151
Of a Suppurated Tumor of the Breast. 157
Of an hard Tumor of the Breast dissolved. 159
Of a very great Tumor of the Abdomen. 161
Of a Bleeding Teat. 161
Of an exceeding great dolour of the Ear. 165
Of the Cubit displaced by Relaxation of the Liments. 168
Of a Gonorrhaea contracted from impure Contact. 171.

Decade V.

Of a Wound of the Head. 175
Of a Wound penetrating the Thorax. 191
Of a penetrating Wound of the Abdomen. 205
Of an Artery of the Arm wounded. 218
Of a Fracture of the Tibia with a Wound. 222
Of a Dislocation of the Talus, or Ankle-bone, with a Wound. 232
Of a Nose hurt by Winters Cold. 237
Of an Atrophia; Imbecillity of Motion, and an Algor of the Arm. 241
Of the Uvula and Tonsils evily disposed. 244
Of an Hair-Lip. 246.

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Iohn Muys His Rational Practice of SURGERY.

OBSERVATION I.

Of an Ophthalmy induced by a Fungus.

IN the year 1680, on the first day of August, a Boy about Twelve years of Age, playing with another, received into his Eyes (through the hollow stalk of a Mully-puff or Fuz-ball, which in the Dutch Idiom is called een boevyst) a Fume or Dust blown by that other Boy, by which in less than Two hours space his Eye-lids were so swetted, that he could not open his Eyes. His Eyes waxed red all over, [Page 2]no otherwise than as if they had been covered with a red Cloth, and so coloured did the interior Superficies of his Eye-lids also appear; which Symptoms were attended with very great dolour. The Patient neglected the use of Remedies for two days, and in the mean while the aforesaid Symptoms increased; and besides these, there was a continual Flux of sharp Tears.

A thing to be admired indeed, and which I cannot call to mind I have any where read of. But which way could that Fume excite such horrid Phoenomena's? Answer, Thus: The Stalk being hollow within, and perforated onely with a very small hole, and also outwardly compressed on every side by the Boys hand, the more volatile and less cohering Particles; were forced from within outward; but seeing all those could not at once pass out together, the one urged the other, and so were driven out far more swiftly: No otherwise than as we see Water forced out of a Syringe, though the Pistil be but gently (or very slowly) thrust forwards: or as we discern by an easie compression of the sides of Bellows, the Air through the Pipe (or Nose) thereof is driven out with very great force.

But some one may perhaps ask me, of what nature those dusty Particles are? [Page 3]To him I answer, They are Accido-corrosive, and sharply cutting. That such Acid-Particles are in this Stalk is sufficiently evident, by the frequent use thereof in stopping Bloud. For when a small part of this Stalk is put into a sanguiferous Vessel wounded, the Bloud is stayed, partly by reason of the stringy Particles folded one within the other, and closing the Orifice of the open Vessel; and partly by reason of the Acid-Particles of that hollow Stalk, which coagulate the Bloud, as Milk is coagulated by an Acididity infused.

Therefore these Acid-Particles, with great force driven through the aforesaid Stalk, deeply penetrated into the Pores of the Eyes, and interior-Superficies of the Eye-lids; and so, with their cutting sides excited the Nervous Fibres (there dispersed) to a motion more vehement; by which Vehemency the Mind first perceived the sense of pain, which was augmented by that Distention, which took beginning thus: The Pores being obstructed by the Particles of that Stalk, the Vapours wanted their natural Exit, and so were collected within the small Pipes of the Membranes in the form of Humour, which in a very short time waxed sowre, by reason of the Acid-particles of the said Stalk, acting as a Ferment, no otherwise than as we see any sowre Ferment [Page 4](taken in a small quantity) to convert a great mass of Dough into its own Nature.

These Acid-Particles (I say) with the acuteness of their sides, forcibly striking upon the Nervous-Fibres, drew to those parts a more copious influx of Animal Spirits than usual; whence arose certain slight Contractions, which notwithstanding proved sufficient in some measure, to impede the Circulation of the Bloud and Humours, circulating through the small Veins of those circulating parts. For they were, in this case, helped by the Vapours within the Veins of those parts converted into Water.

When the Bloud conteined in the Capillary Vessels, and the Humours in the Veins were thus stagnized, they likewise (in the aforesaid manner) waxed sowre and were coagulated, and by that means rendred more unapt for Circulation. Hence it is sufficiently manifest, whence the Redness and Tumour of the Eyes and Eyelids had their Original.

But whence proceeded that continual efflux of sharp Tears? From the aforesaid, the true cause thereof is easily gathered, and it is thus. Certain Acid-Particles, forced from within that hollow Stalk, had entred the Pores of the Glandules and Lachrymal Vessels, and there, by their irritation, [Page 5]exciting certain Convulsions, did continually force out Tears: But whence were they imbibed with a more than usual sharpness? There is no mortal Man, who (by the taste onely) finds not Tears to be Saline; wherefore these, in their passage with the acid Particles there inherent, were invaded with a certain sudden Effervescency.

These things being by me for some small time considered of, I soon ceased to admire that that Fume should be the cause of so great Evils thence ensuing; and also at that time discerned, that the Cure would not be difficult; For I knew that hot Milk coagulated by an Acidity, if digested with, some fit Salt, would again be dissolved in the space of one hour. Like wise I knew Vinegar was easily deprived of its sharpness, by infusing Crabs-Eyes or Lithargyry therein: Also I understood the reason of that Effervency which is excited by commixion of the Saline Oyl of Tartar with the Acid Oyl of Vitriol.

Hence I concluded, that the Bloud coagulated by Acidity, might again be made fluid, and the sowreness temperated by Crabs-Eyes, Lithargyry, and many other Medicines containing much Salt; such are White-Vitriol, Gum Ammoniac, Sagapenum, Galbarum, &c.

Therefore I (being called the third day [Page 6]after the Boy was hurt) instilled hot into his Eyes some Drops of a certain Collyrium, compounded of White-Vitriol, and other things mixt with convenient Waters; and upon the Eye I applied a Plaister of Gum Ammoniac, Galbanum, Sagapenum, Lithargyry, &c. spread upon a Linnen-cloth. This I changed daily twice, and commanded the Boy should be kept in a dark place; by which means, in the space of two Weeks he recovered his pristine Sanity.

OBSERVAT. II.

Of the use of an Issue, and its way of Operating.

A Young Maid Thirteen years of age, had for several years been afflicted with dolour and redness of her Eyes, and tumour of her Eye-lids, which (after sleep) were closed together by a viscous Humour, concreted into a Rosin-like matter. This Ophthalmy, for a long tract of time, was attempted to be cured by two Surgeons, but not overcome.

I being afterwards sent for, judged the cause of the Disease to be the too great Acidity [Page 7]of the Bloud, and a Ferment of the same nature produced from that Bloud, and firmly inherent in the Pores of the Eyes and Eye-lids, there causing the Bloud in the Capillary Vessels, and the Humours in the small Veins, to become too acid, and be coagulated and stagnized: For from these few signs it was not difficult to judge of the aforesaid apparent Symptoms.

Moreover, I firmly perswaded my self that the Maid might soon be cured, provided that Acidity could be temperated and expelled by the Pores of the Eyes and Eyelids, and that acid Bloud purged out of the Body; wherefore I used a Collyrium, consisting of Medicaments containing much Salt, and besides that applied to the Eyes a Plaister made of like things.

But I did little good by this method; for, so soon as any part of that Ferment was rendred temperate and cast out, shortly after a new Ferment, arising from the Bloud, succeeded in place of the former: Seeing this, I for several weeks purg'd the maid twice a week, but in vain: At length I found the Assertion of the famous Silvius, which is written in the first Book of his Praxis, Chap. 2. in the 26 Section, to be most true, viz. That there are scarcely any purging Remedies (at least known to us) which can purge out acid Humours from the Bloud.

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Finding the matter thus, I judged it high time to betake my self to the searching out of better Remedies; and whilst I was occupied in consideration thereof, the following Experiment came seasonably into my mind, and it is this:

When you have a Compound of Water and Oyl mixt, and would separate the one from the other, proceed thus. If you would have the Oyl to pass through a Filter of Paper, the Water remaining in the Filter, you must first anoint the Paper with Oyl; but if you would filter the Water onely, and have the Oyl remain in the Paper, then you must first well moisten the Paper with Water.

But what is the cause of this Phoenomenon? The Pores in Oyl are otherwise figured than in Water; therefore that most subtile matter of the World, which flows through the branched particles of the Oyl, much differs from that which passeth through the moist and smooth particles of the Water. Suppose to your self Water put into Paper first imbibed with Oyl, and you will easily discern that the same must necessarily be debarred entrance, by that most subtile matter, proceeding from the Oyl contained in the Pores of the Paper, and not able to enter through the Pores of the Water (otherwise disposed) as also by the most subtile matter of the Water [Page 9]unable to enter the Pores of the Oyl inherent in the Paper. But if Oyl hasten to pass through Paper, before moistned with Oyl, then the most subtile matter of either of them holds parallel, and what passeth out from one part, enters through another, and on the contrary. So Oyl approacheth to Paper anointed with Oyl, and is filtred through it; and if it happen that any aqueous Particles poured in should in any measure obstruct this Filtration, they must be removed to the sides, and so taken away.

Often pondering this Experiment in my mind, and the reason thereof, I at length cut a small Wound (called a Fontinel or Issue) in the sick Maids Arm, and kept it open by a-Pea put in and dairy renewed; and by this means many Humours freely circulating through the Veins of the Arms, by reason of those passages interrupted by the Wound made, concentred in that Issue, were changed into Pus, and by long staying there waxed acid, and like a sowre Ferment infected the Pores of the Veins nigh to the Issue.

Therefore, whensoever certain bitter, sweet, or other Particles of the Bloud, endeavoured to enter the aforesaid passages, the Pores of which were filled with that acid Ferment, they were repelled by a most subtile Matter, every way unlike themselves, [Page 10]no otherwise than as in the above-recited Experiment, we have even now explained; but when the acid Particles of the Bloud approached, they had access without repulse, and entred the passages nigh the Issue, which were before infected with the acid Ferment; but if Particles of another nature intruded themselves, they were repelled by the same most subtile Matter, which admitted the acid Particles (like it self) to enter those passages imbibed with Acidity; no otherwise than as one Magnet is seen to approach to another, by reason of particular Rays, which proceeding from one Magnet, enter the other without impediment, and so exclude all intermediate Air.

By this means I happily effected that, which I had before in vain attemped by Catharticks. For the Bloud was daily disburthened of a large quantity of Acidity by the Issue; and this Evacuation the better succeeded, because what was in the mean time externally allied, rendred the acid Ferment more temperate, and attracted it through the Pores of the Eyes and Eye-lids, which (being too much enlarged and distorted) were again restored to their natural state by gentle Astringents. This last work I effected with a Cataplasm, prepared onely of Wild-Tansey or Silverweed, boiled unto softness in Water. [Page 11]For this Herb contains in it self much volatile Salt, which first evaporating from the Cataplasm, did temperate the acid Ferment, and attract it through the Pores; but the more gross and astringent Particles which (besides its volatile Salt) this Herb possesseth, came forth last, and being gently Astringent, closed the Pores of the Eyes and Eye-lids as was fit; almost after the same manner as we see Cinnamon and Nutmeg in a Diarrhaea, by their volatile and aromatick Salt, first to temperate and extract from the Pores of the Bowels, the acid and irritating Ferment; and afterward, by their more gross Particles, with gentle force to constringe the (too much dilated) Pores of the Bowels and Vessels.

Thus this young Maid, within one month after her Issue was made, recovered her pristine state of health, and so remains to this day. After this Maids Cure was in this manner compleated, I cured many others according to my wish.

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OBSERVAT. III.

Of a Gangrene.

IN the year 1680, September 7. A Woman Sixty years of age was suddenly afflicted in her Back, Breast, and left Arm, with many Blisters rising, containing a limpid Water, and very painful; yet in the mean while she could eat well, and was not sensible of any internal dolour. Therefore she neglected Remedies for two days, which being elapsed I was called. Then I opened the Blisters, and found the subjacent Skin and Flesh black and gangrenenate.

For that very acid and corrosive Ferment lay hid unmoved, and indeed very deep within the Pores of those parts; and whilst it lay so unmoved it could infer no dolour, because pain is excited by motion of the Fibres of the Nerves more than usual; and the Body being unmoved, another part cannot move.

But when that acid corrosive Ferment was expelled from its own Pores, by the Humours (issuing from the Pores of the [Page 13]Arteries, and circulating through the Veins of the Parts) very great dolour was suddenly excited, and the Humours circulating were speedily coagulated, and by that Ferment changed into a corrosive Acidity.

Now, the more slippery, flexile, and smaller Particles of those coagulated Humours, were (by the Humours following them) driven up to the Superficies of the external Cutis, which (because the Pores were constringed by the cold Air) they could not penetrate, therefore elevated the same on high in form of Blisters; but the more gross, more acid, and more ponderous Particles remained in the bottom, and so corroded the small Fibres of those parts, that the circulating Humours could no more enter into them; and hence the Gangrene of those parts took beginning.

It being now obvious to me, that the aforesaid corrosive Acidity was peccant in this case, I could readily conclude what Remedies were fit to be applyed, viz. Such as I had known to render like Acidities more temperate: And, because I knew that Spirit of Nitre, and the Acidity of Salt, would wax sweet by Spirit of Wine adjoyned, therefore I made a Lavament of Spirit of Wine, to which I added Lethargyry, Crabseyes, Spirit of Scurvy-grass, Chalk, and other things resisting Acidity. I often in a day [Page 14]applied this Lavament with a Linnen-cloth four double; and in the mean time the Patient every two hours took two Spoonfuls of the following Mixture (temperating Acidity) that part of that coming through the Arteries to the parts affected, might contribute help to the Remedies externally applied.

℞. Water of Bawm, ℥iij.
Treacle-water.
Mathiolus his Aqua Vitae, of each ℥i.
Sugar Perlat. ʒiij.
White Coral prepared, ʒj.
Crabs-Eyes prepared, ʒj. ss.
Bezoardic Dinerale, ℈j. ss.
Spir. Harts horn, xx Drops.
Oleaginous Volatile Salt, xxv drops.

Make a Mixture.

Using this Lavament for one day, and finding little benefit by the use thereof, I scarrified the parts affected, and washed them with Unguentum Egyptiacum mixt with Spirit of Wine; I did not at all fear any damage to accrew from the Vinegar which is put into this Unguent, because in the boiling that is all evaporated. Also I anointed the exteriour Circumferences of [Page 15]the affected parts with Oyl of Tyles, called Oyl of Philosophers. Lastly, I applied a Cataplasm of Rue, Wormwood, Dittany of Crete, Root of Galangal, and Calamus Aromaticus, Flower of Lupines, Metheglin, and other things temperating Acidity.

By use of these aforesaid Remedies good Pus began to be generated, which (by its gently cutting Particles) brake in sunder the remaining intermediate Fibres, which as yet had retained the dead and living flesh together, and by this means the parts affected with the Gangrene were separated. Seeing this, I applied Common Turpentine, mixt with Basilicon and the White of an Egg, by which all the viscous Particles were removed, which were otherwise wont to obstruct the Pores of the Arteries, and cavities of the Veins. By this means several Particles came forth from the Arteries, and adhered to the Ulcers, by reason of the similitude of their Superficies; and soon after all the Ulcers were discerned to be filled with flesh: then I applied dry Lint scraped, and in a short time induced an Eschar by that onely. For that imbibed all the Pus which otherwise would have corroded, and wholly closed the Orifices of those tender Vessels.

Thus our Patient was compleatly restored to her pristine sanity, Octob. 21.

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OBSERVAT. IV.

Of a Sphacelus of the Foot.

A Man of Seventy years of age, that had all his life-time devoted himself to Wine and Venery, and by frequent intervals was afflicted with a Spasmus of his right Leg, in the year 1681, February 22, was invaded with a small Fever not vehement. On the 26th day of February his prostrated appetite seemed to return, wherefore on that day he twice eat a great quantity of very sowre Butter-milk, and the same day (about nine at night) he began to complain of a very great pain of his right Foot, and (soon after) of a Stupor and great coldness of the same; and the same Dolour, Stupor, and Algor, in two hours space ascended above the Knee. The 28th of February I was called, and by Scarification found, that the Sphacelus had ascended an hands breadth above the Knee; for so far was present that extream Cold and Rottenness, and in Scarification no sign of Dolour appeared, nor did any Bloud issue out, except a very little very black and [Page 17]coagulated, breaking out in one part or other.

Very attentively considering all these things, I concluded, that the abuse of Wine and Venery, had rendred the Bloud of this Man (its more subtile and more volatile part being absumed) too viscous and acid; and when certain acid and viscous Particles of this Bloud, were by Circulation come to the right Foot, perhaps they there stagnized, and afterward pertinaceously adhered, and by their stay there acquired greater sharpness.

These Particles inferred no Dolour so long as they remained unmoved; but when by intervals they were forced from their residence by the Humours circulating, and by them excited to motion, then they became the cause of the Spasmus of the right Leg, irritating and cutting the small Fibres of those parts, and so gave occasion to a greater afflux of the animal Spirits.

But the continued excess of Wine and Venery had left scarce any thing in the Bloud of this man, except a Caput-mort (as I may call it) that is, nothing besides Bloud very viscous and acid, which could no longer duly exercise its proper effervescency in the Heart, nor circulate through the parts; yet this Bloud, when it had by a small Fever received greater motion, and was rarified more than usual, did sufficiently [Page 16] [...] [Page 17] [...] [Page 18]open the Pores of the Arteries, so that many acid and viscous Particles issued out, and stayed without; and this hapned rather in the right Foot than elsewhere, because there resided the acid and viscous Ferment, which caused the Acidity and Viscosity contained in the Bloud, to draw nigh to it self in such a way as we explained in the Second Observation; and perhaps a great cause was that abundance of acid Butter-milk eaten, because this happened the 27th day of February, rather than at any other time.

Those acid and viscous Particles that passed out from the Pores of the Arteries on the 27th of February, setled in the Veins of the right Foot, and conjoyned themselves with the acid Ferment therein contained, and there (by the acuteness of their sides) impressed on the small Fibres a very vehement motion, and so produced that Dolour; but the small Fibres, being not long able to sustain that violence, were soon after wholly cut in sunder, and by that means the sense of pain, notwithstanding the Scarification then made, was totally annihilated, and the broken Fibres (infolding themselves each within the other) had so obstructed the veiny passages of the right Foot, that the Bloud and Animal Spirits could not enter; this was occasioned by the coagulation of Humours in the Foot, produced by the aforesaid Acidity. [Page 19]Hence I discerned the Original of the Sphacelus of his right Foot: also that it must needs take beginning from Acidity, is confirmed by that black and coagulated Bloud which in scarifying had its Exit: For every man knows, that the Bloud waxeth black and is coagulated by Acidity.

This Sphacelus had by this time transcended the Knee, and soon after (a little above the part affected) the Patient felt an intolerable pain.

I, considering with my self the fore-passed dessolute Life of the Sick-man, his Age, his Leg above the Knee infected with this Sphacelus, and his whole Mass of Bloud grievously tainted; and moreover calling to mind that I never knew any Old men infected with this Disease to escape, did boldly predict the inevitable death of the Patient; yet in the mean while I promised I would mitigate the dolour as much as I could, and (if possible) prevent the further ascent of the evil.

In order hereunto, I commanded the Patient should every two hours take two spoonfuls of a mixture tempering Acidity, consisting of Borrage and Bugloss-water, Treacle-water, Sugar-perlate, Crabs-Eyes, Coral, Mineral Bezcardic, and other things infringing Acidity, and attenuating Viscosity.

[Page 20]

Also I caused a Decoction to be made, consisting of Water, Wine, Roots of Calamus Aromaticus, and Enula Campane, with Rue, Dittany of Crete, Wormwood, Flower of Lupines, &c. which I applied hot with a double Cloath; by which Application some ease of pain was induced: For the Acidity, inducing dolour by its accuteness, was thereby rendred more temperate. Therefore when the Cloath was dry, I again moistned it in the same Liquor; and this reiterated Application I continued for several days.

Now, when the 7th day of March was come, I saw that Down or Mossy Lanugo (which is vulgarly called Mouldiness or Mucor) dispersed through the whole internal part of the Leg, from the Ankle to the Knee; and had I at that time had at hand a good Microscope, I might have there discerned many Plants, with their Stalks, Leaves, and Flowers, in excellent order disposed, springing up from the Leg of the man yet living, no otherwise than as a Fungus (or Mushroom) is wont to arise from the Earth.

The Sick-man in the mean while eat not any thing, and was every day afflicted with a Fever often coming and vanishing. At length on the 14th day of March, at four in the Morning he slept well, his Pulse before death often intermitting, which also [Page 21]may easily be understood to proceed from Acidity.

But his whole Mass of Bloud was infected, therefore here Phlebotomy could in no wise be admitted; for three days before the Sick-man died, his left Foot also (from the great Toe to the Ankle) was infected with a Sphacelus; and both his hands for 24 hours before his death were cold as Ice, though after return of the Fever they again waxed warm.

Now, that to this Evil I applied convenient Remedies, will (I suppose) be very apparent by this, viz. that the Sphacelus, which at first (good advice being neglected) had, in four hours space ascended from the great Toe to above the Knee, after the application of my Remedies, had not ascended in the space of two Weeks above one hands breadth.

OBSERVAT. V.

Of an Erysipelas of the Leg.

A Man Forty years of age was invaded with a Fever, which vanished the 12th hour after the Assault; then the Sick-man began to complain of pain and redness of his right Leg.

[Page 22]

In some solid part of this man lay hid a a certain acid Ferment, which (by some cause or other) was thence expelled and forced into the Mass of Bloud, in which it excited that Inimical Fermentation, which is known by the name of a Fever.

But when that Ferment was circulated with die Bloud, perhaps certain Particles thereof stagnized, and inhered within the Cutis of the right Leg; which Particles in a short time, compelled all the other Particles of that acid Ferment to recede from the Bloud and approach to them, almost after the same manner as one Magnet causeth another to approach to it self.

Those Particles there inherent, and sufficiently corroding the small Fibres, excited dolour in the Leg: But the Redness took beginning from the Bloud stagnized in the Capillary Veins, by reason of the coagulation beginning and proceeding from Acidity; as we perceive a sufficiently intense redness in the Face, when the Neck and Veins there contained are by a Collar (or any other thing) too much constringed.

To this affect we give the name Erysipelas. But how came the Fever so soon to vanish when the Erysipelas appeared? I answer: Because at that time the Sanguinous Mass was freed from that acid Ferment, [Page 23]which then passed into the Leg.

This Disease I entirely cured in two days space, with one onely Lavament (temperating the Acidity) which consisted of Spirit of Wine, Camphire, Lithargyry, Chalk, Salt-prunella, &c. being firmly perswaded, that these Phoenomena's had derived their Original from Acidity.

OBSERVAT. VI.

Of Varicous Ʋlcers of the Leg.

A Virgin aged Forty years, having for a long series of time devoted her self to an ill habit of Diet; and, among other inimical Foods, she too much delighted to eat things viscous, Vinegar, and other sowre things, in the Summer-season also often putting her Feet into cold Water; she had now for Fifteen years been afflicted with a Varix of her left Leg, extending it self from the Sole of the Foot up to the Knee; and also with two Ulcers (nigh the inward Ankle of the same Leg) deep, sordid, and very dolorous, and for the most part filled up to the top with a certain sharp and thin matter, and often having round about them [Page 24]an Erysipelas attending. Many Physicians and Chyrurgeons, for a long time in vain attempted the cure of these Ulcers; yea, also that most famous Practitioner of Feium, Lord of Cranenburg.

From the too great quantity of acid and viscous Meats assumed, the Bloud of this Maid was rendred gross and apt to stagnize; wherefore a certain portion thereof, conveyed to the left Leg, there stayed and resided about the small Valves of some Vein, the Membranes of which, by a great abundance of Bloud (there congested) were so distended, that the Humours passing out from the small Arteries, dispersed among the Membranes of that Vein (for among the Membranes of the Veins, you may by a Microscope discover small Arteries, Veins, and Nerves, and undoubtedly there are also present small Lymphatick Vessels) and wandring through the small Cavities of the same Membranes, could not freely pass, but stagnized there, and thrust themselves between the Interstitiums of the small Fibres, in so great abundance, that they not onely enlarged those Interstitiums, but also denied passage to the Animal Spirits from the small Nerves, gliding into the aforesaid small Cavities, and otherwise in some sort constringing the Vein, and in it producing a certain Peristaltick motion, for promoting the Circulation of the Bloud [Page 25]in the Vein; and so the Bloud in that Vein (in some sort) stagnizing, and above measure distending the Membranes thereof was the cause of the aforesaid Varix.

But why should that Varix rather present it self to sight in the Leg than elsewhere? I answer: Because die Veinybloud must there ascend, by a Perpendicular way, to the Horizon; and besides, this way is in some measure closed up by the Garters we are wont to use to retain and keep up our Stockings; so also the same was here occasioned by this Maids too often putting her Feet into cold Water.

Therefore the Bloud, in greater abundance than was fit, congested in this Vein, distended the less resisting parts of the Membranes of the same more than other more gross parts, and so formed to itself certain Recesses, and especially about the small Valves, in which die Bloud (now of its own nature become much too acid) contracted to it self a greater Acor, because it stay'd too long there without Circulation.

But many of the more acid Particles of this Bloud penetrated the more distended (and consequently more rare) parts of die Varix; that is, through those Recesses, and so the small Fibres being there irritated [Page 26]and afterwards cut in sunder, great dolour was excited, and soon after two very painful Ulcers, which by the breaking of more-small Fibres, were rendred very deep.

Those acid Particles, pertinaciously adhering in the pores of the Lips and bottomes of the Ulcers, they converted the as yet sincere Humours into acid; which being unable to continue their Circulation, were (by the Humours continually following them) forced outwards into the Cavities of the Ulcers, which they usually filled almost up with a sharp acid and thin Humour; yet not so thin, but that (in the mean while) certain more viscous and more stringy Particles were mixt therewith; which, with their strings (entangled each within the other, and sticking in the Superficies of the Ulcers) rendred them very sordid.

Thus far we have explained how certain and acid Particles have passed through the aforesaid Recesses unto the near adjacent Flesh; now 'tis time to observe that many more acid Particles were, from those Recesses, forced into the sanguineous Mass, circulating with which they entred into the Ulcers, rather than into other parts, by reason of the acid Ferment lurking there, after the same manner as we shewed in the Second Observation: Thus was the abundance [Page 27]of acid Humour (filling the Ulcers, and from them proceeding) augmented.

The Erysipelas, which for the most part surrounded the Ulcers, derived its Original also from the Acidity there inherent.

When I had for sometime well weighed all these things in my mind, I at length converted my endeavour to the cure of the Varix, (as the first Original of the Evil) which, if in things profitable it be lawful to use the Terms of Art, may be called the Procatartick or primitive Cause; therefore from the Varix, opened with a Lancet, I drew forth several ounces of stagnized Bloud, acid and black.

Then I proceeded to the sanguineous Mass, infected with the acid Ferment, which may be called the anticedent Cause (according to the subtilty of die Wits of our time, which more regards the Pomp of vain Words, than things themselves) and by a good Diet instituted began to correct that (prohibiting all things viscous and acid) by a Powder temperating Acidity daily taken, consisting of ℈j. of Crabs-eyes, and the same quantity of White Coral.

After this I set about the Ulcers themselves, in the bottoms and Lips whereof lay hid an acid Ferment, which (if it be the pleasure of some) may be called by [Page 28]the Name of a Conjoyned Cause.

The principal thing that remained for me to do, was to temperate and remove that Ferment, and gradually and without sense to depress the Lips of the Ulcers to the bottom; for from this last business I promised to my self a threefold Utility.

First, I knew that the cavities of the Ulcers being thus removed, none of that acid, and at least in some part Viscous, Humour could be there collected, which by reason of its viscous and stringy Particles, had before rendred the Ulcers sordid, and (through its acid and cutting Particles) daily more and more excavated them; there being always in the Cavities of them a great abundance thereof continually congested. But if this Humour have access to the Ulcers, it must be cast out presently after its coming there, to the sides of the Ulcers, their Lips being strongly depressed by some hard and heavy Body superposited.

Secondly, I was certain by this means to restore the Circulation of the Bloud and Humours, in which is sited a great part of the cure of Ulcers: For the Lips of the Ulcers being not prominent (as before) over the Superficies of the bottoms, I could discern it was possible to be effected, that the Humours (circulating through the small passages contained in the Lips of the [Page 29]Ulcers) which before, by reason of those passages obstructed, did flow into the Cavities of the Ulcers, would now find out their own way through other passages in the bottoms of the Ulcers, and so again renew their Circulation, which cannot (as before) be impeded by the ambient Air, because that is sufficiently repelled by the same body which depresseth the Lips of the Ulcers, that being sufficiently thick, solid, and hard, to answer my purpose.

Thirdly, In cure of Ulcers and Wounds, I have often observed, that an Eschar to be generated never took beginning from the Center or any adjacent parts of Ulcers or Wounds; but always begun from the extremity of the ambient Cutis, by reason of the similitude of Superficies which is found between the Cutis and the Eschar. Hence I firmly perswaded my self, that the Ulcers, first freed from their acid Ferments and Filths, and rendred plain in the aforesaid manner, (their pristine Circulation being restored) would in a short time be covered with an Eschar.

Therefore I prepared certain fit Medicaments (temperating Acidity) to resist the peccant Ferment, lying hid in the Ulcers; and that (as the saying is) I might with one Brush whiten too Walls, I formed of them two Cakes, sufficiently hard and thick, and somewhat larger than the Ulcers, so that [Page 30]they would also cover a small part of the Lips, and those I laid upon the Ulcers, and with a sufficiently strict Ligature firmly bound them on, and left them so for 12 hours; which being elapsed, I could soon discern, that the hope I had of them conceived failed me not: For I found the Ulcers wholly plain, freed from all filths, and conspicuous, with a pleasing redness, and little or nothing painful. Whereby, being almost wrapt into admiration, I concluded that the acid Ferment in the Ulcers for the most part was, and the remainder would in a short rime be temperated.

After a few days, Circulation being restored, certain well-known Particles, passing out through the Pores of the ambient Cutis, firmly adhered to the extremity thereof, having a like Superficies with the Cutis it self. Thus we plainly understood the certain Rudiment of that Eschar, which had in the space of five Weeks fully closed either Ulcer; for it every day increased more and more.

Afterward I every year once opened the aforesaid Varix, and drew from it lib. j. of Bloud, by which means those Ulcers never after opened any more.

In the mean while, to the Erysipelas which I had almost forgot, I applied a four-doubled Cloath moistned in a mixture prepared with Water of Elder-Flowers, Spirit of Wine, [Page 31]Camphire, and Saccharum Saturni, for temperating the peccant Acidity, which being effected, all Symptoms of the Erysipelas ceased, together with the burning before induced by the acid Particles, when with the acuteness of their sides they, oftner than usual, invade the small Fibres.

But whence was it that these Ulcers could not be healed in so great a space of time, by so many Physicians and Chyrurgeons, though men well in years? I answer: Those men, by reason of their age, contemning the solid Reasonings of others, would never approve of any thing but their own experience.

Experience without true Reason can profit little: For as among a thousand humane Faces, no one is found exactly in all things like to another; so among so many Diseases there is not one which in all things wholly agrees with another. Moreover it is very credible, that the Bloud and internal Parts of one man do no less differ from the Bloud and internal Parts of another than the External. Whence again ariseth the various Temperament of men, the variety of which requires various Remedies, and (besides Experience) sound Judgement in the Physician; that he may know how to make choice of this or that, and other Remedies instead of either.

Now, plainly to shew the Case as it is, [Page 32]those Physicians and Chirurgeons, directing their Conceptions according to a certain vain and unprofitable Theory and Philosophy, could neither find out the Cause of the Varix nor its Effects, much less the Remedy of the same.

For they deduced almost all Diseases from their Four Humours, viz. Choler, Phlegm, Bloud, and Melancholy; though in the mean time they understood not what any one of them is, or of what Particles it consisted. Hence it came to pass, that it was impossible for them to find out true Remedies. They had much more prudently acted, if they had in a special manner had respect to the various Particles of the Bloud, which differ each from other in Figure, Magnitude, and Motion; as also to the Acidity and Salt (as well as they might have done) whether of these holds dominion in the Bloud: If it were Acidity, then Purgations by the Belly could in no wise be thought convenient.

In like manner, they too much confounded their Conceptions, when they thought those Ulcers were first to be cleansed by certain peculiar Medicaments, then by others incarnated: lastly, that (again) by others the Eschar must necessarily be induced. Now that this too anxious distinction is very unprofitable, will be plainly evident by this, viz. That I, with my one [Page 33]onely Placentula in a short time cured both Ulcers.

Likewise they in the Cure had respect to their own Axiom, which saith, Contraries must be cured by Contraries; and discerning great heat in the Erysipelas surrounding the Ulcers, they endeavoured to expel that by cold things which stopped the Bloud and Humours, and by that means did in no small measure augment the burning hear of the Erysipelas: But these men were abused by their own Axiom; which had they endeavoured to make a right use of, they should first have considered that burning Heat to be onely the Effect, and owned for the Cause certain acid Particles, by reason of Obstruction inherent about the Ulcer, which (with their cutting sides) struck the Nervous Fibres with a more than usual trembling, and then they had more rightly cured Contraries with Contraries, viz. applying such things which they had by experience found fit to resist the corroding Acidity, and remove the Viscosity obstructing.

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OBSERVAT. VII.

Of a Wound of the Eye.

IN the year 1680, on the 21th day of November, I was commanded to be sent for by a young Nobleman leading a Military life, who three days before was wounded with a Leaden-Bullet, in that part of the left Eye which is between the Iris and Pupil; so that the Bullet had penetrated even into the Eye, and soon after the Wound made, no small quantity of aqueous Humour flowed out. I found the Orifice of the Wound closed with a certain fibrous and white Matter. The Iris with the Pupil wounded waxed very livid, and the remaining part of the Eye (thus hurt) was intensly red and swoll'n, attended with burning Heat, and a proflux of sharp Tears. The dolour was continual, except that it was more remiss, when the Patient held his head backward; but as oft as he held his head down the pain augmented. The Sight of the Eye hurt was wholly lost, and the right Eye (though it remained untouched) was red and much pained. A certain [Page 35] Chirurgeon to that matter, closing the Wound, had applied sharp things, and to the remaining part of the Eye cold things: This was done three days before I was called.

It will perhaps seem strange to some, that all the aqueous Humour issued not out by the Wound; but their wonder will soon cease after they have well weighed and considered the following Reasons.

First, Let them consider, that the Bullet (in its inferiour part) was more strongly forced into the Eye than in its superiour part; and so it broke the inferiour part of the Membrane of the Eye, the superiour part of that Membrane remaining entire. By this means part of the Membrane broken turning inward, formed a certain Aperture, through which part of the aqueous Humour issued out, and in its efflux again turned outward the before turning inward Membrane, which then like a Valve, turning from without to within, not from within outward, again closed the Aperture of the Wound, and so impeded the outflowing of the aqueous Humour from die Eye.

Secondly, That fibrous and white shining Matter closing up the Orifice of the Wound, falls under our consideration. But whence had this Matter its Original? Should I now, with the Company of vulgarly-learned [Page 36]men, fly to the accustomed Asylus of Ignorance, I could readily subjoyn a Reply, saying onely, that Nature was so provident in this case, that she in a short time filled up the hole with fit Matter; not onely that all the aqueous Humour might not issue out, but also that the most cold ambient Air might not penetrate to the parts and endamage them. But such an Answer seems to me no less rediculous, than if I should ask; why in boyling hot Broath exposed to the Air a thin Skin is generated on the Superficies? And another should answer; The nature of the Broath is so provident, that it presently forms a Pellicle on the Superficies of the hot Broath, lest the cold Air, having access to the internal Particles, should hurt them; and that the heat in the Broath might be longer preserved, and (the otherwise flying) Vapours retained and constringed within the Broath by the superposited Membrane; whereas he should rather have said, that many of the more thin parts of the Broath, apt for motion, having figures fit for the same, easily evaporated into the Air, and in their flight carried with themselves up to the Superficies of the Broath, certain Particles more gross, stringy, and less fit for motion, which (their motion being terminated by the ambient Air) acquiesced in the Superficies [Page 37]of the Broath; where, with their small Fibres, folded one within another, they concreted into that Cuticle which covered the Broath.

But, returning to our purpose, we shall by a better right answer in this manner: Some Particles passed out from the Pores of the Arteries, and circulating in the small passages of the Membranes of the Eye, were carried to the end of those passages interrupted by the Wound, and so indeed the more thin parts evaporated, but certain more stringy Particles, prolapsed without the said passages, their motion (by the extream coldness of the Air at that season) being taken away, by their stringy Fibres infolded themselves one within the other, and so concreted into a certain fibrous and white Matter; not unlike to that, which is often seen in that Water, into which flows the Bloud from a Vein of the Foot or Hand.

That leaden Bullet could not enter into the Eye, but very much contused it, and broak certain small sanguiferous Vessels, from which the Bloud flowing (by reason of the cold was stagnized) and infected the Iris and Pupil with a livid colour.

This Wound could not be made in the Eye but many small Fibres must needs be broken, and being broke, retire together into Curls, and so obstruct many passages, [Page 38]in which the circulating Humours (accumulated) did press the sanguiferous Vessels nigh, so that the Bloud in the Vessels stagnized, whence the tumour and redness almost all over the Eye had their beginning.

The Bloud stagnizing in the Capillary Vessels, especially that which lay extravasate in a short time assumed Acidity, and then (with its cutting Particles) sooner than usual, and more vehemently shook the small Fibres nigh, whence that burning heat and dolour derived their Original.

Moreover, the acid Particles of the same stagnized and coagulated Bloud, by their irritation excited certain light Concussions in the Glandules of the Eye; whence the Liquors contained in them, viz. Tears, were expelled almost continually, which were more sharp than usual: For they, being saline, in their eflux excited a certain suddain effervescency, with the acid Particles of the Bloud stagnized inherent in the passages.

But the Dolour, of which I spake, did not onely proceed from the acid and cutting Particles, but also from the Leaden-Bullet within the Eye, turned now hither and then thither again; and this was that Dolour which remitted when the Patient held his head backward; because then that [Page 39] Bullet lay unmoved, and rested upon the Bony Orbit of the Eye: But when the Patient inclined his Head to his Breast, then a very acute dolour was perceived, because the Bullet was again moved and pressed the wounded part of the Eye.

A great part of the Pupil was covered with that fibrous and white Matter, so that Globuli Coelestes the Coelestial Globes could not enter through the Pupil to excite the small Fibres of the Optick Nerve (dispersed through the bottom of the Eye) therefore no man hath cause to wonder that the Patient was wholly deprived of the sight of his wounded Eye.

But it may rather be cause of admiration, that the right Eye, which was not hurt by the Bullet, should in the mean while be vexed with redness and dolour; yet I shall endeavour to remove this cause of Wonder.

There is no man but sometimes experimentally finds in himself, that one Eye being moved, he can scarcely retain the other unmoved. The reason of this is, because the Animal Spirits suddenly passing from the Brain, through the Nerves, into the Muscles of one Eye, can scarcely be terminated, but some of them will (at the same moment of time) pass into the Muscles of the other Eye. Whence it is manifest, that when one Eye is pained; [Page 40]that is, when in it is present a more vehement agitation of the small Fibres than usual, then I say, a greater abundance of Animal Spirits (by reason of the Pores in the Brain then more open) must needs flow, not onely into the Eye affected, but also into the found Eye, in which, by this means, are produced certain light Contractions, which in some measure constringe the small Passages and sanguiferous Vessels; and by that means the Circulation of the Bloud and Humours is in some sort obstructed, so that they in a short time wax acid, and by their cutting Particles infer dolour, which is attended with Redness, proceeding from the Bloud stagnized in the Capillary Vessels.

Things standing thus, I predicted to the sick Noble-man, an impossibility of recovering the sight of his wounded Eye, in which he readily acquiesced, saying, He would give me eternal thanks, provided I could preserve the fight of his other Eye. This I suddenly promised him.

Therefore, proceeding to the Cure of this Wound, I judged my principal work was to restore the Cireulation of the Bloud and Humours impeded, and then to repress the external Air, and temperate the Acidity.

In order to this, I first, for temperating the Acidity, instilled hot into both his Eyes [Page 41]some few drops of the following Collyrium twice a day.

rx;. Water of Eye-bright,
Of Celandine, of each ℥ij.
Of Hysop ℥j.
Crabs eyes prepared
Coral prepared, of each ʒj.
Troches alb. Rhasis ℈ij. ss.
Saccarum Saturni ℈j. ss.
Tutia prepared ℈ij.

Make a Collyrium.

Then I applied to the Eyes two small Bags, filled with Faenugreek, Hysop, Lavenderflowers, and other things abounding with volatile Salt; afterward, instead of these, I applied Plaisters containing much Salt; such as is found in Gum Ammoniac, Sagapenum, &c.

And at length I so bound both Eyes, that they remained unmoved, and kept the Patient in an hot and dark place.

But, to take away all occasion of wonder, which some one or other may perhaps conceive, because I had so much trouble to cure the right Eye, which was not wounded, I purpose here to subjoyn Reasons (which I judge) sufficiently valid.

I did not this that I have done so much in [Page 42]respect of the right Eye as of the left. For if the right Eye had remained open, the sick man would often have moved it, and seen with the same.

That external motion of the right Eye scarcely ever happened but the left Eye was also moved; and hence how much the dolour in the wounded Eye would have been exasperated, he can easily conjecture, who hath at any time experienced with how great dolour a wounded Hand or Foot is moved from place to place.

Moreover, if the right Eye had not been closed, without doubt it would with the sight have touched many Objects at one time or other; and that could not have been without the producing of some internal motion de novo (by the Celestial Globes) in the small Fibres of the Optick Nerve; because indeed the least fibre in the opticknerve in the right Eye cannot be moved, but at the same time the small Fiber of the same Order in the Optick Nerve of the left Eye, must necessarily be moved also. This is evidently apparent by the following Figure, which the famous Rohaultius also used in his Physical Treatise, (never to be sufficiently commended) but for an end far other than mine. He shews the way by which two Images (whereof one is described in the right Eye, the other in the left) when they come to the Brain, might [Page 43]give Conception to the Mind of one onely Image.

[optick nerves]

In this Figure each Eye hath delineated onely five small Fibres, that thereby the matter may be more easily conceived. But what is here spoken of five small Fibres, may be understood of many more, viz. that there is no small Fiber of the Optick Nerve of the right Eye can be moved, but [Page 44]the Fiber of the same Order in the left Optick Nerve will presently be moved also. The reason is, because these Fibres joyn together, and are terminated into one point.

Thus, to the right Eye, in a short time, both pristine Sanity and entireness of sight returned; but the left Eye could not be healed before the Month of March in the Year following. About that time all Tumour and Redness passed away, the livid colour being long before discussed. The Bullet stuck fast to one part or other of the Eye, and so remained unmoved, and to the Bloud and Humours their free Circulation was restored. And then the Humours, by the Wound interrupted, circulating through those small passages, continually deposited certain Particles to the sides of the Wound; which Particles, by reason of the similitude of the Superficies, did adhere and were aglutinated, and so formed an Eschar, which covered the Wound, and drove out that fibrous and white Matter. But because it was so thick that it prohibited the Celestial Lights, therefore the fight of that wounded Eye remained lost.

But in the mean while this Eye (as to bulk) scarcely differed from the right Eye, though it had cast out no small part of the aqueous Humour when the Wound was first inflicted, because certain smooth [Page 45]and slippery Particles flowed through the Pores of the Arteries into that Cavity, in which the aqueous Humour is contained, and so supplied the defect of that Humour.

In time of the Cure I always abstained from cold things, because they obstruct the very small passages and Pores of the Eyes: For the same cause I here also reject fat things, being such as, with their small Branches, do so profoundly and pertinaceously infold themselves within the most small Pores of the Eyes, that you cannot (without very great difficulty) expel them again.

But why could not this Wound be sooner healed? I affirm this happened partly through the errour of the Chyrurgeon, and partly of the sick Lord himself.

For he too much indulged both Venery and Wine, whence his Bloud was very much disturbed; and what was so disturbed (in no small quantity) ascended upwards, as by a more strait path, and there struck upon the obstructions of the wounded Eye; which notwithstanding (by reason of their pertinacy) it could not break, and by this means the dolour increased.

Besides, in most deep Snow falling from the exceeding cold Air of that Season, he would sometimes ride, on hunting whole [Page 46]days with his right Eye (against my will) open; and hence the Obstructions were rendred yet more pertinaceous and numerous.

The Chyrurgeon, who for the first three days, applied Medicines to the Wound, erred in this, viz. that to that fibrous matter which impeded die afflux of the aqueous Humour (and therefore should not have been taken away) he applied sharp things, which the Eye it self cannot bear; also to the remaining part of the Eye he applied cold things to stay the afflux of Bloud and Humours, as he himself said. But, are you ignorant (good Sir) that this afflux of Bloud and Humours is to the Eye, and also to other parts, both natural and necessary? and had your Medicaments operated according to your wish, a Gangreen would certainly have immediately followed. You see Bloud and Humours (in greater abundance than is fit) to be present in the Eye; but you reason amiss when you think this to be caused from a greater afflux than usual; whereas it rather proceeds from Obstructions which prohibit the reflux of Bloud through the Veins, and of Humours through the Lymphatick Vessels, whence the Bloud and Humours were, in greater abundance, collected into the Eye, stagnized and waxed acid. Wherefore you should rather have applied things temperating Acidity, which would also [Page 47]have been convenient for taking away the lividness of the Iris and Pupil, produced by the clotted Bloud: For it is certain, that clotted and coagulated Bloud cannot be restored by cold things, but are unavoidably rendred more gross, and the peccant Obstructions (by this means) not removed, but augmented.

But before I put an end to this Observation there remains yet one Phoenomenon to be discoursed of relating to Wounds.

It is undoubtedly true, That the Cause being taken away, the Effect ceaseth. But why then the Sword, Knife, or any other thing wounding, being taken away, is not the dolour in the wound presently removed, but sometimes persists very long? Dolour in the part hurt is not, unless there be a Concussion of the small Fibres, more vehement than usual, which cannot be unless by another body put into motion. Therefore what shall I say of the dolour, which sometimes is portracted whole days, yea, whole weeks after the Wound is inflicted, when the Sword, Knife, or any other thing wounding, hath been long before laid aside? Let me circumspectly consider, whether I can find any thing that can excite the small Fibres of the wounded part to a greater agitation than usual. Behold! I have found it. When certain small Fibres are cut in sunder by a Sword, then suddenly [Page 48]they crisp up on heaps, and obstruct the small passages of the wounded parts, so that the Humours cannot freely circulate, but strike upon those Obstructions; whence is excited dolour, which still increaseth, when those Humours begin to wax acid, and (with their cutting Particles) yet more and more irritate. Besides, many small Fibres, which before were covered with skin, after the Wound inflicted, are exposed to the ambient Air, which affects them with more vehements trembling than is fit, whilst it communicates somewhat to them from its own motion, by which indeed it is continually and powerfully enough agitated.

OBSERVAT. VIII.

Of a Suppurated Tumour; also of Rottenness of a Bone.

A Young Maid ten years of Age, afflicted with a burning Fever, soon after the Fever felt a pain, and (quickly after that) a Tumour in her Shoulder, which was of the same colour with the skin and somewhat hard.

[Page 49]

The Bloud more than usually agitated by the Fever, from the recesses of this or that solid part, washed off many acid and viscous Particles, which circulating with the Bloud, did part of them pass out from the Pores of the Arteries, at that time too much dilated (by reason of the heat of the Fever) into the small passages about the Shoulder, sited far within the Cutis; in which passages they adhered and excited dolour, whilst with their pricking sides they more vehemently than usual made a commotion, and by this means in some measure distorted the bordering passages; whence also the Humours there stagnized, which (though they were before pure) by a small delay there, waxed acid; hence also the Bloud stagnized in many Capillary Vessels, but so deeply sited within the Cutis, that the redness could not be apparent through the skin, and therefore appeared of the same colour with the Cutis.

But whence was that hardness of the Tumour? for it was Liquor that was contained therein; and such liquor, as (being fluid) and gently touched with the hand, offering no resistance, could not be judged either hard or soft.

A great quantity of liquor is contained in an Apple, and may be pressed from it; yet in the mean while it is found to be somewhat hard, because that Liquor is [Page 50]very much divided, and abides separated in severall small passages and Pores of the Apple, distinct each from other. Therefore the hand touching the Apple meets with the first small passage; whence the Particles of Liquor (in that contained) do indeed in some measure recede; but approaching to the subjacent passages they find resistance. Hence the hardness of the Apple is made manifest, and by consequence also the hardness of the Tumor.

Therefore, being perswaded that in this case the viscous Particles obstructing, and the acid, cutting, and irritating, I judged nothing could be more conducent for altering them than things aperient and temperating Acidity. Wherefore to the Tumor I applied Paracelsus his Stiptick Plaister; but (I am willing briefly to note this) the Magnet in it seemed to me superfluous in this case, that being added onely to attract things hurtful to it self. Yet the Magnet cannot draw to it self all bodies without distinction, but another Magnet and Iron onely; and it wholly loseth this attractive power, when reduced to powder (as Rohaultus found by experience) because then the striate Pores are broken. This same Rohaultus reduced a very good Magnet to powder, which he put into Lint, and rubbed the powder well in to joyn with the same, and by Application found the [Page 51]pristine vertues in the Magnet to be totally vanished.

But to return to our purpose, I left the aforesaid Plaister several days upon the Tumor, hoping by this means the Acidity would be temperated, and the viscosity so attenuated, that it might be partly restored to its pristine Circulation, and partly evaporated through the Pores of the Skin; but the evil was too pertinaceous, and frustrated my hope. What was to be done then? The Acidity, with its cutting Particles, had broke the small Fibres, and several concave passages, so that the Liquor in the Tumor contained, flowed all into one place; then the Tumor was no more hard but soft, no otherwise than as the Liquor before expressed out of an hard Apple, and received into some Vessel, exhibits it self soft to the touch. In that I judge the Suppuration made in the Tumor to consist.

Now I seem to hear our vulgarly-learned men exclaiming against me, saying, I proceeded not in cure of this diseased Girl according to Art; that is, according to their false and unprofitable Theory, which commands first of all to apply to Tumors repelling Medicines. But this clamour is easily silenced by onely saying, that the cause of almost all Tumors is Obstruction, which (according to their proper Axiom, viz. [Page 52]that Contraries are cured with Contraries) must be removed by Aperients, but not multiplied by repelling Medicaments (vulgarly so called) viz. by cold and astringent Remedies.

But what if I should beat the Adversaries with their own Weapons, and convince them by two Arguments, that repelling Medicaments (vulgarly so called) in the beginning of almost all Tumors, very rarely, yea never, can be profitably useful. I will at least attempt it.

Their will is, that repelling Remedies be applied in the beginning of Tumors, yet they except two Cases. The first is when the Tumor is made by Congestion. The second, when it is found in an Emunctory.

As to the first, it is known to every man (not plainly blinded with prejudice) that no Tumor is made by a Fluxion, as such, provided it be natural; but every Tumor is made by Congestion; that is, when the flowing of Bloud and Humours is impeded by Obstruction, by reason of which the Bloud and Humours must be somewhere congested and accumulated; hence it most evidently follows, that repelling Medicaments can never be available in Tumors.

As to the other, for brevity sake, let us take one onely Emunctory, by them vulgarly [Page 53]so called. They affirm repelling Medicaments not safe in Tumors of the Groin, because that is the Emunctory of the Liver; that is to say, because by it the impurities of the Liver are expelled; but this in truth is a most false reason: For the Lymphatick Vessels conveigh their contained Liquor upwards from the Groin, so that nothing remains but Nerves and Arteries, through which the Excrements of the Liver are deposited; but though the Nerves eject some Excrements by the Groin, yet it doth not follow that that is the Emunctory of the Liver, but rather of the Brain and Spinal Marrow: For the Nerves, of which there are very few found in the Liver, receive nothing from it; and although by the Arteries (which also receive nothing from the Liver) certain Recrements are driven into the Groin, and by that expelled; the Groin doth not therefore deserve to be called the Emunctory of the Liver, but rather of the whole Mass of Bloud. Therefore if repelling Medicaments be not to be applied to Tumors of the Groin, because that is the Emunctory of the Bloud; then by consequence, it will be unsafe to repel in any other part of the Body; because every where many Particles of the Bloud are eevacuated and exhale through the Pores of the Body.

[Page 54]

But it is now time we should return to the, purpose from which we have too far digressed.

Because the Tumor was ripe, and the Pus contained therein, so deeply sited, that it could not break through the superposited Skin and Flesh, I therefore made an Apertion in that part of the Tumor, which appeared more soft and more eminent; this peared more soft and more eminent; this being done, not a little Pus issued out. But behold! I then found a black and putrid Subject (rendred such by the Acidity contained in the Tumor) which had cut in sunder the small Fibres of the Periosteum, and after that had corroded the Bone it self, and corrupted its volatile Slat, which is natural to Bones, and is found abounding in them, as is evident by the distillation of the Humane Craneum, from which is forced out much Spirit, and no small quantity of Volatile Salt in a dry form.

But if any man be not as yet fully satisfied with these my Reasonings, let him apply to his Teeth Oyl of Vitriol (which is very acid) and he will by proper experience find them not onely to rot, but also to fall out by piece-meal.

Yea, this was well understood by Fabritius Hildanus, that most famous and highly-experienced Chyrurgic-Physician; therefore he, in rottenness of the Bone, condemned nothing more than acid Oyl of Vitriol, Oyl of [Page 55]Sulphur, Aqua Fortis, &c. and indeed deservedly.

I long since knew, that Ulcers attended with rottenness of die Bone, could not be healed, unless by restoring the Bone first to its pristine condition; therefore I here first took in hand to cure the perished Bone.

I also was not ignorant, that Fat things were very hurtful to the Bones, because they (with their stringy Particles) do easily obstruct the small Pores and passages of them, and indeed pertinaciously enough. For which cause I here shunned all Fat things, worse than I would a Dog or Snake, and upon the putrified Bone I strewed Rowder of Euphorbium, which contains much Volatile Salt, and that indeed very tart. By this means, in a short time all the rottenness was gradually removed from the Ulcer in form of an impalpable Powder.

That the Fatness of Euphorbium is not acid, as some perhaps may conjecture, but saline, is manifest by this, viz. because it so vehemently excites Sternutation, no otherwise than as Spirit of Sal Armoniack, which every man owns to be saline. On the contrary, apply to your Nostrils the acid Spirits of Nitre, Vitriol, Salt, and Sulphur, and you will find them, though most sharp, yet not to excite Sternutation.

Now, that with External Medicaments I [Page 56]might help the Internal, whilst I was using the Euphorbium, I gave to the sick a Decoction made with China, Sarsaparilla, and other things containing much Volatile Salt.

When I saw the rottenness would not give place to these, I applied red-hot Iron which is by some called an Actual Cautery, to distinguish it from that which is called a Potential Cautery, but very improperly; For there is no such thing as a Potential Cautery. Every Cautery; that is, every thing that burns, acts. If that may deservedly be called a Potential Cautery, which though it cannot presently burn, yet in a short time will effect the same; then Ice, by a better right, shall be accounted a Cautery, because that may be reduced into boiling Water; but how improper such a saying is, I leave to the judgement of others.

But burning Iron in rottenness of a Bone, for two causes helps. First, it communicates so much by its own motion to the Acido-corrosive Ferment (inherent in the Bone) that it can evaporate as Spirit of Vitriol is (in distilling) by Fire elevated on high. Secondly, it can temperate that part of the Acido-corrosive Ferment, which is left in the rotten Bone. For Iron egregiously resists Acidity, as is evident in preparation of Vitriol and Mars; in which is excited a sufficiently manifest Fermentation, [Page 57]when the Spirit of Vitriol is infused upon the Filings of Steel; and so in a short space of time the Spirit of Vitriol loseth much of its acor and corrosive force; yea, it waxeth sweet.

The rottenness of the Bone removed, the remaining Ulcer was in a short time filled up with flesh onely by Common Turpentine applied with the White of an Egg; and Skin was induced by dry Lint onely, that continually imbibed the Pus, which (left in the Ulcer) did not a little hinder the generation of the same.

There are many that suppose, that Arteries and Veins partly cut off can never be regenerated, because they are Spermatick parts, (so by them vulgarly called) but they are deceived. Why may not the Bloud, issuing from a small Artery cut off, thrust to the sides certain Particles stringy and less apt for motion (infolding themselves each within the other) there form the rudiment of some Tunick, which may deserve the name of a small Artery? and why may not the same Bloud in its course, impeded by somewhat offending, be reflected, and so the stringy Particles being again cast to the sides, there produce the rudiments of some Vien? no otherwise than as may be seen in an Egg (after Incubation for some days) in which both Arteries and Veins after the same manner proceed [Page 58]from the liquid matter of the same Egg? This case is indeed very easie to be understood.

Yea, a very light contact of that tender flesh, with which the Ulcer is filled, presently causeth Bloud to issue out, which certainly could not be, were not the Arteries and Veins so far prolonged.

But if there be yet found any one that shall be so incredulous as not to belive what I have written, him I refer to the Medico-Physical Collections of the industrious Blankart, wherein he declares, that either himself or some other man, in Ulcers first hollow and afterward filled up with new flesh, hath (by a Microscope) discovered Veins and Arteries; yea, by his Eyes onely, without a Mycroscope, if the part healed was first sucked for a little time.

Thus far proceeding, I have now (as I judge) so clearly explained the Phaenomenons occurrent in this little Maid, that her Case may by all be understood; having acted far otherwise than the anxious Sectators of old Authors were wont to do. For should I ask them, Whence that Tumor of the Shoulder (of which I spake even now) derived its original in the sick Maid? They would presently answer, Nature had discharged her self in that place. But I judge this equally as absurd as if I should ask why Beer newly boiled [Page 59]casts up its Dreg through the Bung of the Cask? and another should answer. The nature of the Beer, in that place, and by that means, frees it self from its burthen; whereas it should rather be said, the Beer forments; that is, there is a certain intestine motion in the small Particles of the Beer, and by them the stringy and other Particles, not sufficiently apt for like motion, are thrust out by the Bung, where they are not compelled to a motion so swift.

Moreover, should I ask them why that Tumor rather exposed it self to sight in the Shoulder than elsewhere? they would readily thus answer: This hapned by reason of the debility of the expulsive Faculty in the Shoulder. An excellent way of reasoning indeed! containing as many Chimaera's as words.

If any one from a large Vessel pour any Liquor, with a small and equally continued Ray, through a small Tunnel into a narrow-mouth'd Bottle, and see the Liquor to pass out with the same celerity as it was poured into the Tunnel, but afterwards observes the liquor in the Tunnel to be more and more accumulated, doth he not egregiously expose himself to the derision of every man; if he produce as a cause of this the debility of the Expulsive Faculty in the Tunnel; whereas the cause is some obstruction (in the inferiour small Pipe of the [Page 60]Tunnel, or in the narrow Neck of the Bottle) induced by some more gross body by chance contained in the Liquor? Whosoever shall diligently weigh all these things in his mind, will find the matter to hold parallel in either case, and discern the reason of either side alleadged to be equallyridiculous.

Before I put an end to this Observation, there remains yet one Problem to be discussed by me, and it is this, viz. Whether an Ulcer or hollow wound may not be filled up with some other Flesh, whether that Flesh be taken from some other part of the same man, or else from another man, or from some Beast? especially seeing we often find that the Spurs which Cocks use in fighting one with the other, cut from their Legs are not onely agglutinated to the head, but also largely increase in a short time; as we daily see the like when Cocks are castrated; yea, almost every man hath (at some time or other) seen how a Branch cut from one Tree, doth grow together and unite with another.

But the reason here is far unlike; for the passages (or Pores) existing in the Spurs of Cocks, and Branches of Trees, are constant, so that the Section of them distorts them not; wherefore the circulation of Liquors through them is easily renewed, although inserted into another [Page 61]part or another Body. In our flesh it is otherwise, the small passages there are very tender, so that by Section or any other force, they are presently distorted, and their sides (by this means) do almost close together, and so at that time the circulation of Humours through the same is wholly impeded.

OBSERVAT. IX.

Of a Fracture of the Shin-bone.

A Man Thirty years of Age leaping out of a Coach, suffered an oblique Fracture almost in the middle of his Shin-Bone, which was attended with inequality of the Leg, grating of the Bone, dolour and imbecility of morion.

For one extremity of the Shin-bone, by reason of the Fracture, tended this way, the other that way, (whence was the inequality of the Leg) and when those two extremities hit upon each other, the grating of the Bone was heard; and when they with their sharpness pressed the Periosteum and adjoyning parts, the first cause of dolour discovered it self; but the second cause, [Page 62]when the extremities of the broken Bone, by their pressure, compelled die Humours in the small passages of the bordering parts, to stagnize, wax acid, and irritate the small Fibres.

But when the Fibrils were thus disturbed by the points of the Bones and acid Humours, the Animal Spirits could not be determinated rather into this than into that Muscle, but without distinction, rushed into all disturbed parts; and if (though but in a small quantity) they approached nigh to certain Muscles, they could not enter and flow in, by reason of the passages of those Muscles obstructed by the stagnizing Humours. And although some Spirits had flowed into the same Muscles, yet all their tendency was was to move one extremity of the cutting broken Bone to this party, the other to another; whence proceeded nothing but Vellication, Pressure, and Renovation of the dolour. Hence the cause of the imbicility of motion is sufficiently manifest.

I, being called presently, set the Broken Bones, and then my principal end was to restore the circulation of the Bloud and Humours; for without doubt the Bloud was here and there stagnized. Therefore, to temperate the peccant Acidity, I washed the affected part with Sprit of Wine, in which a little Gum Ammoniac was dissolved; [Page 63]and for the same end I applied a Plaister composed of Diapalma, Bolus, Spirit of Wine, and Oyl of Camomil: Then for retaining the Bones so lately set, I used Ligatures and other things fit, renewing these by certain intervals; and so the Patient in six weeks time could again walk.

I am not willing in this place to say, that a Fracture made transverse may more easily be retained than an oblique Fracture; nor that it is for the most part accounted a good sign of restriction, if the great Toe of the Foot directly respect the Knee, seeing these things are well known. Nor shall I endeavour to render a reason why the dolour is mitigated after the Bone is let; because it is known that this is effected by removal of the first cause of the Dolour of which I so lately spake. But, before I conclude, I purpose to shew how the Callus is induced which conglutinates the fractured Bones.

When the Circulation of the Bloud and Humours is again restored, as well in the fractured Bone as elsewhere, then certain Particles, issuing from the Pores of the Arteries, pass through the small passages of the Bone; and when they come to the extremity thereof, they can proceed no further by a right Line, because the passages were interrupted by the Fracture; therefore they turn to the sides, where (adhering [Page 64]to die Bone, and each to other) they constitute a Callus, which again conjoyns the Bones.

This Callus in the aged and weak is difficultly generated, by reason of the gross and viscous Bloud, which cannot pass through the streight passages of the Bones. Therefore, in such a case, the more gross Particles of the Bloud must be attenuated by ʒj. of the Stone Osteocolla daily taken. Yea, it will not be injurious, if powder of the same stone be mixed with the Plaister that is externally applied.

But in our Patient the matter was far otherwise: For the Callus extended it self to a very unseemly bulk; wherefore I applied a Plaister of Frogs with Mercury, to the end that this Plaister should so attenuate certain Particles of the Callus, that they might fly away; and also a good Ligature, that it might so compress the Callus, as nonothing new might have access thereunto.

Thus I put an end to this Observation, after I shall have told you, that I commanded the Sick-man's Leg always to lie extended; and took care that the Sole of the Foot might rest upon a small Pillow, in the middle of which was an hole. For otherwise (as experience testifies) a Gangrene might have invaded the bottom of [Page 65]the Foot, because the Vessels and small passages of the parts are vehemently compressed by long lying.

There are some who in a Fracture of the Tibia (as this was) commend viscous things, which I reject as noxious; because in a body without exercise Obstructions do not a little augment, which (on the contrary) should rather be diminished.

OBSERVAT. X.

Of a Dislocation of the Shoulder.

A Man Thirty two years of Age, falling from a Coach, suffered a Dislocation in his left Shoulder, so that the head of the Bone, fallen into the inferiour part, was the cause of a certain eminency there; whilst, on the contrary, in the superiour part, was discerned an unusual Cavity. The Patient complained of very great pain, and could not move his hand by the anteriour part to his Forehead, nor by the posteriour to his Neck.

For the Bone, fallen from its seat, compressed the Periosteum and adjoyning parts, whence arose pain, which was augmented, [Page 66]because in the small passages of the parts, compressed and distorted, the Humours stagnized, waxed acid, and shook the small Fibres.

He could not move his Arm as formerly, because the head of the Bone, thrust from its former Cavity, no longer (as before) enjoyed an hollow and slippery place, requisite for its motion; also hence was the occasion that the Animal Spirits could not enter (through the small passages obstructed by the stagnizing Humours, and compressed by the dislocated Bone) into the Muscles and excite them; hence it happened that no motion could be, because the head of the Bone did more and more compress the parts adjoyning; whence arose a new excitation of dolour, which also induced no small impediment to the due performance of motion.

I, being called to the Sick, reposited the dislocated Bone, and then the motion presently returned; there was indeed some dolour present, because the acid Humours stagnizing did (as yet) in some measure irritate the Fibrils; nevertheless the pain was very much diminished, because the head of the Bone, now contained in its proper Cavity, did no longer press upon the sensible parts.

The Bone being set, I endeavoured (by things temperating Acidity) to dissolve the [Page 67]stagnizing Humours, and restore to them their due Circulation; wherefore I washed the affected part with Spirit of Wine, in which Gum Ammoniac was dissolved; and applied a Plaister, (composed of Spirit of Wine, Bolus, Diapalma, and Oyl of Camomil) and then put Lint wrapt up like a Ball, under the Arm-pit; and by this means the Patient was healed in a short space of time.

Peter Pigraeus a French Author, and Chyrurgeon worthy of praise, commends Astringents to a Bone lately reposited; but (be it spoken with the leave of so famous a man) in this he is egregiously deceived: For Astringents augment Obstructions, which should rather be diminished.

Paulus Berbette wills, that the influx of Humours (in this case) be prohibited, but improperly; because that influx being natural, should not be stopped. That man undoubtedly saw in 2 Dislocations, the near adjoyning parts often elevated into a Tumour. Also he observed by frequent experience, that Frankincense, Mastich, Bolus, and the like, removed this Tumour: But when he judged this Tumour to be produced from an influx more copious than usual; and when, according to this stated opinion, he thought his Medicaments did therefore help, because they prohibited that Influx, then (I say) he erred. For Obstructions [Page 68]were the cause that the Humours were coacervated and elevated into a Tumour, and so waxed acid; and the said Medicaments onely profit, because they remove the Obstructions, and temperate the Acidity.

Having now spoken of the Dislocation of the Shoulder suddenly happening; there is yet another Dislocation slowly invading, and more slowly sanable, viz. when by External force the Ligaments of the Shoulder are contused, so that the small passages are distorted, whence the Humours (circulating through the Ligaments) do there subsist, and in process of time insinuate themselves into the Pores of the Fibrils (of which the Ligaments consists) and extend those Pores, not according to the breadth, but according to the length of the Ligaments. For the Ligaments, when motion is, are often extended in length: even so, the Ligaments, which otherwise were wont to contain the head of the Bone in its Cavity, are now so far prolonged, that the Bone falls out of its proper seat.

This Dislocation is easily restored, but the Bone reposited is very difficultly retained in its place.

External Medicaments, helpful to retain a Bone reduced to its place, are such as consist of much Volatile Salt; because Volatile [Page 69]Salt can attenuate the Particles inherent in the Pores of the Ligaments, and so force them out, and restore the circulation of Humours. But the cure will be rendred more easie, and in less time accomplished; if we contribute help to the external Medicaments, by a Decoction to be inwardly taken, consisting of Lign. Guaiacum, Root of Sarsaparilla, China, and other Medicaments abounding with much Volatile Salt.

The end of the first Decade of Chyrurgick Observations.

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DECADE II.

OBSERVAT. I.

Of the Puncture of a Nerve.

A Young Man aged Twenty years, exercised in Chyrurgery, with the Puncture of a Lancet hurt the middle Finger of his left Hand, about the middle Article; whence arose pain at first not very great, but by the next morning it was vastly augmented; and besides redness invaded the whole Finger, attended with burning heat and swelling, and the Cutis (in places nigh the Wound) was separarated, pallid, and insensible.

After I had accurately considered the Phaenomena's, I concluded the Nerve to be hurt by the Razor, whence at first arose but small pain.

But by reason of the small passages bordering on the wounded Nerve, Humours (interrupted by that small Wound) otherwise freely circulating, were constrained to subsist about the Wound, and there became [Page 71]acid, and so by the Humours following them were driven to the wounded Nerve, where (permixt with the Animal Spirits hastning through the Nerve) they excited a certain effervescency, by reason of the Volatile Salt, contained in those Animal Spirits; and by this means the acid Particles (constituted in motion great enough) with the acuteness of their sides, egregiously vellicated the Fibrils of the wounded Nerve, and so excited that grievous dolour I even now spake of.

The acid Humours thus forced into an effervescency with the Animal Spirits, not onely irritated and disturbed the Fibrils of the wounded Nerve, but also the Fibrils of the adjacent parts (yea of the whole Finger) whence many small passages were so distorted, that the Bloud and Humours setled in them, and (by a short delay there) assumed the nature of Acidity, whence the heat and tumour of the whole Finger, or inflammation of [...] same, were readily induced.

The same acid Particles, exercising their Effervescency, had wholly cut in sunder those Fibrils which knit the Skin, sited round about the Wound, together with the subjected part, and so the Cutis was separated, pallid, and insensible; because those (often-cited) acid and cutting Particles had cut in sunder very many Fibrils constituting [Page 72]the same Cutis; which Fibrils crisping on heaps produced so many and so pertinacious Obstructions, that the circulation of the Bloud, Humours, and Spirits through the Cutis was totally impeded.

Things being thus, I judged the Wound sufficiently dangerous, and therefore the cure thereof to be diligently set, about; having long before seen a French Souldier, whose Nerve about the Cubit of the Arm was but lightly prickt with a Sword; who after a long series of time, and many difficulties overcome, was with very great care and pains at last restored to his pristine state of health: Yea, I also saw an Husbandman, the Nerve of whose Thigh was wounded with a Leaden-bullet shot out of a Gun; this man (a Convulsion being excited) died in a short time after the wound was inflicted.

I had often before mixed Oyl of Turpentine with the acid Oyl of Vitriol, and saw an Effervescenc [...] [...]o arise thence; yea, with my hands I [...]ave felt sufficient heat, produced in the Glass containing those Liquors: Hence I did without difficulty perceive how powerfully Oyl of Turpentine did resist Acidity, and (by consequence) how excellently serviceable it would prove in this our case; wherefore I poured Oyl of Turpentine (before made sufficiently hot) into the Wound, that so the Parades thereof [Page 73]of (put into greater motion) might more easily and more profoundly penetrate, and consequently act more powerfully in temperating the peccant Acidity. Then I applied Paracelsus his Stiptick Plaister, which also temperates Acidity. Afterward on the Finger, and indeed all over the Hand, I laid a doubled Cloath moistned with a Lavament consisting of Spirit of Wine, Water of Elder, Camphire, and Salt-prunella; changing these twice a day, and with an Instrument removing the Cutis, already separated from the subjacent flesh: Thus our Young man was cured in a short time.

In the mean while it is worthy observation, that I saw a necessity of being industriously careful to prevent the access of the ambient Air; because that contains in it self Acidity, which is apparent thus, viz. because it coagulates Milk; yea Bloud it self when extravasate, is in a short time coagulated by the Air; whereas the same is found to persist in its wonted Fluidness for several days, if it remain in the Vessels of any Carkass where it is free from the ambient Air.

By the aforesaid it is sufficiently manifest, why there is much less dolour in a Nerve wholly cut off than in that which is onely prickt, or but lightly wounded: for when a Nerve is totally cut in sunder, one Extreamity is retracted to this part, the other [Page 74]to another, and is absconded by the flesh, so that the acid Humour (inherent in the Wound) and the ambient Air, cannot have access to the Nerve.

The famous Sylvius deduceth extream dolour, and other Phaenomena's occurring in a Wound of the Nerve, from a far other cause than I do. For he thinks some of the Fibrils in the Nerve being cut, the other (as yet intire) suffer so much the more by a continued stretching produced by the Animal Spirits; and that hence ariseth Dolour, Convulsion, and other Evils frequently observed in such cases: But (with the leave of so great a man) this Cause pleaseth me not, seeing from it I cannot conclude that the pallid and insensible Cutis is frequently separated from the adjacent part. This Cause of his is repugnant to Experience, which teacheth that the Puncture of a Nerve is more dangerous than if the Nerve were cut to the midst: For in a Nerve cut to the midst many more Fibrils are cut, than in a Nerve prickt, in which often but a few Fibrils onely are hurt. But it is certain that Sylvius did himself believe his own reason not sufficient, seeing in the same Twenty third Chapter of his Second Book he saith, that Phaenomenons exhibiting themselves in the Puncture of a Nerve, seem to him more like a Dream, than to any observation made by the Senses.

[Page 75]

Therefore, that I may put an end to this Observation, I say, that in the wound of a Nerve Acidity is peccant, and that such Medicaments should be applied as infringe Acidity: For this Cause is commended Oyl of Wax, and Ear-wax; but acid things are not fit here to be used, which was well observed by Felix Plaiterus, who (in his Book of Observations, page 468) saith, Acidity is very inimical to the Nerves.

OBSERVAT. II.

Of Dolour of the Head.

A Man Forty two years of Age was vexed with a most vehement dolour of his Head, and indeed that only about the Temple of one side, where it remained fixed; which Affect if any one will for this cause insignize with the name of a Clavus, let him for me.

I judged the cause of this Dolour to be an Acido-corrosive Humor, there lying hid and stagnizing by reason of Obstruction very pertinaceous.

There was one (studious of Medicine) present, who perswaded himself that the [Page 76]cure of this Affect would be best performed by Sudorificks; which, by reason of the pertinacy of the Obstruction in this Disease, I judged equally as impossible as in the Panaritium, which I never heard to have been healed by Sudorificks, though the same Affect derives its original from an Acido-corrosive Humor: for it is but a very small portion of the Sudorifick that can arrive to the pained part.

Therefore I rather applied to the affected part Powder of Cantharides (with his own Spittle formed into a Vesicatory) about the evening, and left it on all night.

The famous Sylvius to Cantharides addeth Vinegar, thinking there would thence arise a certain Fermentation, and so the Vesicatory operate the better. Yea the most Learned Willis also adjoyns acid things to many forms of Vesicatories; which I my self have often imitated, but as often observed, that after the space of a whole day no Blisters have been raised by the Cantharides, when I mixed them with Vinegar, viz. for this reason, because the Volatile Salt of die Cantharides was enervated by the Vinegar, in which Salt the principal Virtue of them consists.

Coming the next day, I beheld a large Blister raised by the Cantharides, and understood that the sick-man was wholly eased of his pain.

But I could not perswade my self that [Page 77]this dolour was removed by the Blister raised, and by reason of the Water flowing from the same when opened. For the Water that issued out, was neither sharp of taste, nor could be such; because had it been so, it must needs have inferred some dolour on the subjected skin before apertion of the Blister, which notwithstanding it did not, although the Cutis (the Epidermis being by this means removed) be of it self sufficiently sensible, as is apparent, because it is often hurt, and feels pain, by the ambient Air.

What was it then that removed that Dolour? The Volatile Salt of the Cantharides, which (by the Vapours passing out through the skin) stirred up to a sufficiently swift motion, penetrated to the Acidocorrosive humor, and temperated and cut the same, and took away the obstruction.

But whence then did the Blister derive its original? I say, that in the mean time, when the more volatile Particles of the Cantharides had penetrated far enough for correcting the peccant Humor, other more grose and more acid Particles subsisted about the Cutis, in which they brake certain Fibrils, which (crisping up together) did so obstruct the small passages, that the Humors in circulation were partly impeded, and so gathered together in the Superficies of the Cutis, and elevated the [Page 78]Cuticle into the form of a Blister; which might easily happen, because the Fibrils which joyn die Cutis with the Cuticle were now broken in sunder by the aforesaid more gross and more acid Particles of the Cantharides.

But some one may perhaps here say, that that Water should not have been there congregated, but rather have passed out by the Pores of the Cuticle, by which we so often see Sweats to issue out. To him I answer, the most gross Parts of the Cantharides remained and adhered about the Cuticle, and very much constringed the Pores thereof; which should seem strange to no man, who (even but once in his lifetime) hath seen how easily by heat of fire Parchments may be crumpled up, and that the common Fire which so crumples them, doth also sometimes excite small Blisters, wholly like those that are raised by Cantharides; but because the Pores of the Cuticle were so closed, therefore the Vapours (otherwise freely exhaling) were accumulated, and augmented the abundance of Humor contained in the Blister.

If any man, not as yet plainly convinced by our way of reasoning, believes that the long lying on of the Cantharides (by reason of the Blisters raised) helps until his mind be altered by the Authority of some approved Writer, I would have him go [Page 79]to Lazarus Riverius, who (in his Third Century, Observation 4.) declares, that a Vesicatory left on but a quarter of an hour, had in that time wholly removed the dolour of a Bees sting, no Blisters being raised by reason of so short delay.

Francis Redi, in a Treatise of Insects, affirms, that he had seen a white shining Humor (undoubtedly Acido-corrosive) flowing out from the Stings of Scorpions; and it is very probable, that such an humor (in the Punctures of Bees) doth in like manner flow from their Stings, which is the cause of dolour. Hence it is now manifest, that the dolour, of which Riverius speaks, vanished, because the acid Humor which flowed out from the Bees Sting and excited dolour, was temperated by the Volatile Salt of the Cantharides.

But that the Stings of Bees are hollow, no man will wonder, who hath at any time seen the Glass-Pipes made by Art, which are used for examining and beholding the Bloud and other Liquors through a Microscope; seeing they, though small as an Hair, do notwithstanding enjoy a certain Cavity.

[Page 80]

OBSERVAT. III.

Of the Contracture of a Tendon after a Fracture of the Shoulder-Bone.

A Young man, aged Twenty two years, after a Fracture of the Shoulder-bone healed, could not extend his inbowed and rigid Arm.

The more remote cause of this Evil was the Surgeon's negligence, who left the Arm inbowed for five or six Weeks; whereas he should, as often as, and every time he bound up the Fracture, have frequently extended the same, as a thing of special note in Chyrurgick Practice.

But this is not therefore a wonder, seeing we daily see a Bow which hath for some tine remained unbowed, not to be easily bowed again: Yea, who doth not sometimes experience in himself, how difficultly he is able to go and extend his feet, after he hath sate unmoved in a Coach but for one onely day.

But forasmuch as this Comparison doth [Page 81]not as yet sufficiently illustrate the matter, my purpose is somewhat more narrowly to search out the cause of the same.

When the Arm was inbowed about the Cubit, the Tendon of the two-headed Muscle, bowing the Cubit, was contracted (but what is here spoken of the Tendon of the two-headed Muscle, may be understood of other Tendons of Muscles bowing the Cubit) and so the Pores of the Fibrils, of which the Tendon consists, before round, are changed into oval, so that the greater Diameter of the Pores hath respect to the Latitude of the Fibrils.

In the mean while the Humors passed out from the Pores of the Arteries, which (by reason of motion often instituted) freely perfected their circulation, now (by reason of rest) did in some sort subsist in the Tendon. Yea, in a short space of time, certain gross Particles of those Humors, deeply insinuated themselves into those Oval Pores of the Fibrils, and conserved and confirmed them in that oblong Figure; and in process of time those recited Particles so pertinaceously adhered in the above-named Pores, that they could not by any means be expelled thence: Henee the Tendon of the two-headed Muscle was made shorter; no otherwise than as we see new Ropes, or new Cloath, sprinkled with Water to shrink.

[Page 82]

Hence also the said Tendon appeared hard and rigid; whence it is (as I judge) sufficiently manifest why the Arm could not be extended: for the Muscles, extending the Arm, could not perform their wonted action, being before contracted; these could not be contracted, but the Tendon with its two-headed Muscle must needs begin to cease acting. This was impossible, by reason of the Pores of the Fibrils (obstructed by the aforesaid Particles) by which the Tendon was tumified.

The cause of this Phaenomenon, by this means found out, the method of curing was without difficulty understood, viz. that it was behooful to expel the Particles obstructing the Pores; wherefore I used a Fomentation of Wine, in which were boiled Herbs, and other things abounding with much Volatile Salt; and then I applied a Plaister of Frogs with Mercury, and (after I had continued that for several days) I often commanded the Patient to hold some weight in his hand, that so the Particles inherent in the obstructed Pores, and by the aforesaid Medicaments in some measure macerated (in the Dutch Idiom los gewyckt) might by a certain force be ejected. By this means the Patient recovered his pristine Sanity in a short time.

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OBSERVAT. IV.

Of a Vein Cut.

A Man, aged Thirty six years, commanded a Vein to be cut in the Flexure of his Arm; the next day several Ounces of Limpid Humor flowed out from the Orifice of the Vein cut, and that Efflux continued for several days after; but the Arm in the mean while was neither affected with dolour nor with redness. A rare Phaenomenon indeed! which I cannot remember ever to have hapned in all my Practice.

Perhaps some small Lymphatick-Vessel lay above the Vein to be cut, which in cutting the Vein was wounded, and (by certain Particles stagnizing and waxing acid nigh the Orifice of the small wound made) irritated and continually gently convulsed, sent forth this abundance of Lympid Humidity. I temperated the peccant Acidity nigh the Lymphatick-Vessel with Oyl of Turpentine poured in hot; and so compelled the Aperture to close, and the Lympid Humor (in a short time) to subsist, [Page 84]or rather again to circulate by a natural way.

I likewise knew a certain Tyro in Chyrurgy, who in Section of the Median-Vein, wounded a subjected Tendon, whence arose dolour and redness, which being removed, at length was inferred so great a Contracture of the Tendon of the two-headed Muscle, that the Arm having now for a long time been inbowed, could not be extended by the Patient, whose Cure was effected even after the same manner as I shewed in the foregoing Observation.

That is to say, some Humors stagnizing about the wounded Tendon, waxed acid, and (irritating that Tendon) caused the Animal Spirits to flow in greater abundance than usual; by which means the Tendon (with the Muscle annexed) was contracted, and the Arm incurvated, which afterward remained so inbowed, by reason of certain Particles which obstructed the Pores of the Fibrils in the Tendon, after the same manner as I (in the precedent Observation) have largely explained.

But dolour and redness, which often attend the Puncture of a Tendon, acknowledge the same Cause, and require the same Cure that I proposed in the Puncture of a Nerve.

Many Chyrurgeons, when they would evacuate gross Bloud, make a large Orifice [Page 85]of the Vein; and when they purpose to let out Bloud more subtile, a lesser Orifice; but evily. For if the gross Particles of the Bloud (mixt with the more subtile) can accurately enough circulate through the Arteries and Capillary Veins, is it not more clear than the Sun that no Orifice (in the cutting of a Vein) can be made so very small, but that with the more subtile part of the Bloud, that which is more gross may be exp [...]lled by the same. Which the most acute Bayle (perhaps Boyl) did well observe.

The famous Mr. Leeuwenhoeck, by a Microscope, discovered Humane Bloud to consist of small red Globes floating in a Chrystalline Humor; which, when the Bloud (after cutting of a Vein) received in a Porringer, was coagulated, their motion being lost, descended to the bottom, the Chrystalline Humor (through which they were before moved) floating above.

Certainly a strange and pleasant Invention, but of no use in the Medicinal Practice. For they, who (from this ground) endeavour to deduce the Causes and Cures of Fevers, and other Diseases, seem to me to trifle out the time, and lose all their labour; whereas rather, had they respect to Acidity, Salt, Bitterness, Sweetness, and other properties (undoubtedly contained in the Bloud) they would certainly thence [Page 86]reap far greater understanding in cure of the sick.

Many Authors prescribe the opening of the Cephalic-Vein, rather than of the Median or Basilic; but unadvisedly. For I have often found by experience, that that Vein easily recedes from its proper place, and so when it is cutting shuns the wound intended.

I have often observed in fat Boys a Vein (presently after the usual Ligature) to be sufficiently tumid and manifest; but if not quickly opened hath soon disappeared, viz. when the Bloud pressed downwards the subjected and readily-yielding Fatness, that so (notwithstanding the Ligature) it might again freely pass through the Vein.

After the cutting of a Vein, when the Vein seemed sufficiently closed, I have often beheld the Bloud issuing out thence with great violence; and indeed from no other cause, than that the Chyrurgeons first applied their Ligature and Lint compressing, and afterward inbowed the Arm: For by this means, the Lips of the Orifice, which before (in the extension of the Arm) were conjoyned, again separated each from other when the Arm was inbowed.

Oftentimes a certain Lividness is found left after the cutting of a Vein, the cause of which is too frequently the evil use of [Page 87]Vinegar, in which is imbibed the Lint compressing, which is put upon the Aperture of the Vein; whereas it is indeed sufficiently manifest, that the Bloud is coagulated by Acidity, and acquires a Livid and black colour.

Before I put an end to this Observation, I think fit to add the counsel of Peter Pigraeus, that we may thence (if possible) reap some further benefit.

That very famous and most dexterous Chyrurgeon commands, that after the cutting of a Vein, the Aperture should be anointed with Oyl, if it be intended again to extract Bloud the same day from the same Orifice without a new made Aperture.

But if Oyl can, though for a short time applied, hinder the closure of the Orifice of a Vein cut, how evilly do they act, who use Oyl in the cure of Wounds; and for no other reason, than because they have seen the same thing done by their Masters? As for Example: Oyl of Saint-Johns-Wort: For if Saint-Johns-Wort profits Wounds, by reason of its Volatile Salt temperating Acidity, why do they not rather extract the Tincture of Saint-Johns-Wort by Spirit of Wine? into which it much more easily and more copiously transfers its Volatile Salt, than into Oyl, which hurts Wounds; because that obstructing the Pores and Passages, stops [Page 88]the Circulation of the Bloud and Humors; whereas that Circulation should rather be excited, to which excitation Spirit of Wine is not a little available. For it egregiously temperates Acidity, which usually coagulates the Bloud and Humors in Wounds, and renders them unfit for Circulation. But least I should be found too prolix in this matter, I here put an end to this Observation.

OBSERVAT. V.

Of the Cracking of a Tendon.

A Woman, aged Forty three years, after greater Labour than usual, in her right Hand suffered an impotency to motion, with Tumor and Dolour; and when the Tendon, sited in the Hand, was pressed with the Finger, it gave a sound.

This is an Affect, which often occurs in the Practice of Chyrurgy, though it hath hitherto been treated of by no man, (that I have heard of) therefore I shall call it Crepitus Tendinis, or the Cracking of a Tendon.

By this Woman's unaccustomed Labour, [Page 89]the Fibrils of the Tendon were so distorted, that the Humors (impeded in their Circulation) there subsisted and were coagulated; whence the Impotency of Motion, Tumor, Dolour, and Cracking of the Tendon, were most readily induced.

I feared, that the Humors stagnizing in the Tendon, would be daily more and more coagulated, and thence that Tumor take beginning, which is known to many by the name of a Ganglion.

Yea, I suspected that certain Particles of the subsisting Humors would be received within the Pores of the Fibrils, compounding the Tendon, and obstruct them so, as (in the Third Observation of this Decade) we shewed to be apt to render them too propense to induce both Contracture and rigidness of the Tendon.

Wherefore, judging it high time to set about the Cure, I ordered Spirit of Wine to be enkindled in such wise, that the Vapour arising thence might surround the hand affected; and this being done, commanded a Plaister of Frogs, with Mercury, to be applied. By this means the coagulated Humors were dissolved, the Obstructions removed, and the Patient (in a few days) restored to her pristine state of health.

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OBSERVAT. VI.

Of an Haemorrhagia, from a Varicous Ʋlcer of the Tibia.

IN the right Tibia of a Woman aged Forty years, from an Internal cause, an Ulcer was formed upon a sufficiently large Varix, which yielded to no Remedies. This Evil was also attended with a Tumor, and a large Erysipelas very troublesome, which in like manner could not be removed by any Medicaments.

After a few days the Varix was unexpectedly opened (by the Acido-corrosive Humor there inherent) from which issued out at least lib. ij. of black and (as the standers by affirmed) very stinking Bloud.

I ordered that Placentula (in a form somewhat hard) composed of Medicaments temperating Acidity, which I commended in the Sixth Observation of the First Decade, to be applied by the Chyrurgeon, and so not onely closed up the Varix, but also temperated that Acidity inherent in the Ulcer, which otherwise (by its corrosion) [Page 91]would easily again have opened the Varix, and besides have much impeded the cure of the Ulcer.

It was wonderful to see, that after the Varix (unexpectedly opened) had cast out so great abundance of Bloud, the Erysipelas and other Symptomes soon vanished, and the Ulcer daily shewed it self in a state more and more meliorated; so that within the space of three Weeks (by the onely help of the aforesaid Placentula) it wholly closed.

I now intend not here to treat of the Original and Cure of the Varix, Ulcer, and Erysipelas, having accurately enough discoursed of that in the Sixth Observation of the First Decade; because a dish of Crambe twice cocted was always deadly to me, if to any other man.

But my intention here, is to confirm what I have spoken by Experience, and hath been before by me treated of (in the said Sixth Observation of the First Decade) viz. to shew that undoubtedly the Erysipelas and Ulcer derived their Original from Acidity, and likewise how opportunely I instituted the Section of the Varix in that varicous Ulcer of the Tibia.

But from the Example before-alleadged these Conclusions may easily be drawn: for neither the Erysipelas nor the Ulcer would give place to any Remedies, so long [Page 92]as that Varix was replete with so great abundance of black and (undoubtedly by its long delay) acid Bloud, which no sooner issued out, but the Erysipelas vanished, and the Ulcer closed in a short time after.

OBSERVAT. VII.

Of a vast Contusion of the Arm.

A Matron, aged Fifty six years, after a Fall from on high, complained of an unaptness to motion, and very great dolour of her left Arm, which appeared very much swoln, although of the same colour with the sound skin. I perceived by the Pulse a more than usual swiftness of motion in the Bloud, viz. by reason of the Terrour which the Patient had conceived by the Fall.

After we had very acurately inquired into the cause of the Evil, we could not (through the whole length of the Arm) find either Fracture or Dislocation, but a very great Contusion of the whole Arm; so that much of the Extravasate Bloud, and also of the Humors (adhering in the small [Page 93]passages of the Arm distorted by the Contusion) stagnized, and in a short time waxed acid; whence that Imbecility, Tumor, and Dolour, may rationally be concluded to have derived their Original.

Some, to render the motion of the Bloud more pleasing, do here presently cut a Vein; whereas I, on the contrary omitted the opening of a Vein, & gave to the Patient an Anodine Tincture (prepared of Opium and other things) which much more securely, and with greater Utility diminished the motion of the Bloud.

After some few hours, I exhibited to the Sick a sudorifick Powder, which would also temperate the Acidity of the Extravasate Bloud and stagnizing Humors; this I repeated the two following nights with good success. This Powder consisted of Diaphoretick Antimony, Crabs-eyes prepared, Salt-prunella Antimoniat, and other things; and hereby the dolour was in no small measure remitted, and the Extravasate Bloud was driven out to the Cutis, which then (all over the Arm) from the Shoulder to the Fingers was very livid, yea waxed black.

The Chyrurgeons, that were present with me, did in the beginning of the Cure (without my consent) anoint the whole Arm with Oyl of Roses, which hurts not so much by reason of the Roses, as by reason [Page 94]of the Oyl-Olive. For although this might do some good, yet it could not profit, unless it could have penetrated to that place, where the Extravasate Bloud and stagnizing Humours lay; but so far it could not penetrate, unless in form of Vapour, and the heat of our Bodies is too weak to convert Oyl-Olive into such Vapours; seeing indeed a sufficiently strong Fire made of Wood and Coals, is not of force sufficient to reduce the Particles of Oyl-Olive (put into a Pot) into the form of Vapours.

Therefore the Oyl-Olive was so far from doing good, that (as I judged) it rather did hurt, because by its stringy Particles it augmented the Obstructions, and so caused the Bloud and Humors yet more to stagnize; and besides (by its closing the Pores of the Skin) it hindered the access of other Medicaments to the place affected.

If common Roses be cold as many think, I should reject them in this case; but because from their bitterness and penetrating Odour the contrary may be judged by those who (laying aside their prejudices) will rather follow Verity than Antiquity. Therefore I in this case condemn Oyl of Roses, by reason of the Oyl-Olive, but not by reason of some Particles of the Roses mixt therewith.

The same Chyrurgeons applied to the whole Arm (anointed with Oyl of Roses) [Page 95]that Defensive Plaister, the description of which is found in the Ultrajectine Pharmacopoeia; which indeed I do not here wholly reject, because it containeth many Ingredients temperating Acidity; as Bolus, Terra Sigillata, Lithargyry, and other things; but to what end should here be added Myrtle-Berries, Oyl of Myrtles, and Austere Red-Wine? These indeed bind up the Pores of the Skin, and so wholly impede the penetration of other fit Ingredients to the affected part.

Experience did in a short time confirm the truth of my Assertion, when many Pustles (dispersed through the whole Arm) came in sight.

Wherefore I prescribed the following Lavament, which I substituted instead of the Oyl and Plaister, as being a Medicament that would powerfully resist Acidity, and consequently well dissolve the coagulated Bloud and Humors.

℞. Roots,
- Of the Flower de Luce.
- Of Calamus Aromaticus,
- Of Bryony, of each ℥ ss.
Herbs,
- Rosemary,
- Betony,
- Sage, of each M. ss.
Berries,
- Of Juniper,
- Of Bays, of each ʒiij.

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Boyl these in a close Vessel with French-Wine, and to two pound of the Colature add

Of Gum Ammoniac ʒij.
Of Salt of Tartar ʒj. Make a Lavament.

By this means the Pustles vanished, the Dolour was diminished, the motion of the Arm gradually returned, and the Livid colour was turned yellow.

Then (the Chyrurgeons willing the Medicaments should be changed) instead of the Defensive Plaister, which they again proposed, I prescribed a Fumigation temperating Acidity, which consisted of Bay-Berries, Juniper-Berries, Frankincense, Mastich, Myrrh, and other things. For if these latter could help in the aforesaid Plaister, where they lay bound up by the Suet and Wax, they must needs be much more profitable, when (in the form of Fume) they could fly up and surround the Arm, its superiour part being covered; and so, being forcibly enough agitated, could enter the Pores of the Arm, by that time well opened by the heat.

After this I commanded Spirit of Wine to be burnt, the Vapour of which ascending to the Arm, and entring through the [Page 97]Pores infringed the Acidity, which had in no small measure coagulated the Bloud and Humours; and by that means the Patient was healed, the dolour and yellowness removed, and the motion of the Arm restored.

I most assuredly perswade my self, that the Contusion would not have been so great, if a Fracture of the Bone in the Patients Arm had also been concomitant: For the Bone when broken, recedes and contuseth no more; but when the Bone remains entire, and consequently (by reason of its hardness) makes strenuous resistance, and when there is (on the other part) a solid Body contusing, then the interstanding Flesh is no otherwise pressed on either part, than as if it were put under a Press, and so it is in a strange manner contused.

And this is no more than what our daily practice confirms; in which I have often observed a Contusion, where the Bone hath been broaken, to be much less than where the Bone hath remained unhurt.

In this Cure my fear was, that the Extravasate Bloud should be so much coagulated, that it could not be afterwards dissolved; and so might at length become so very acid and corrosive, as to infect the adjacent parts with a Gangrene. For it was not long before that I was called to a [Page 98]young Man, who had for eight days neglected a Contusion of the Tibia; after that I was called, and (seeing how it was) compelled to open the contused part with a Lancet, I perceived many sufficiently large Clots of Bloud, firmly coagulated, black and putrid, which had (in some sort) infected the Cavity in which they were conteined, with a Gangrene; which notwithstanding I in a short time removed by washing it with Spirit of Wine, and by inspersing the Pouders of Myrrh and Aloes.

OBSERVAT. VIII.

Of a Ganglion in the Hand.

A Youth, aged Sixteen years, complained of a Tumour hard and painful, which (sited in the upper part of his right Hand) in magnitude equallized an Hazel-Nut, and was of the same colour with the Cutis; and there was now near three Months passed since the Patient (by unaccustomed labour) was affected with this Evil.

The Tendon lay in the upper part of [Page 99]the Hand, the small passages of which were (by that unusual labour) so distorted, that the Humors in their circulation meeting with many Obstructions, stagnized in those passages of the Tendon, and then (by the Humors following them) were forced up to that Membrane, which invests the Tendon; where, having formed a Cavity for themselves, they were collected, and the more viscous Particles were (in some sort) concreted, the more thin Particles in the mean while passing out. Hence the Tumor (of which I here treat, and is by many distinguished by the Name of a Ganglion) derived its original.

I, with my Thumb, strongly compressed this Tumor, and saw it, by this means, suddenly to vanish, viz. when the Humors (constituting the Tumour) were again thrust out on every side through those small passages of the Tendon. But because the Obstructions could not be so removed, I feared their return: therefore (for attenuating the Viscous Humors, and removing the remaining Obstructions) I applied a Plaister of Frogs with Mercury, and upon that a sufficiently strait Ligature, which prevented the Viscous Humors, from gathering again (as before) in the aforesaid Cavity.

But when this Tumor had continued for some years, then it could not be removed by pressure of the Thumb; but I was constreined [Page 100]to use a Wooden Ferula, not differing from that which School-masters use in chastizing Boys, (onely that in the midst thereof a certain portion of Lead lay infused) and with one onely stroak of such a Ferula (the Patients Face being turned backwards from his affected hand) I saw the Ganglion wholly to vanish, which had full three years vexed the Patient, whose Cure was then compleated in a short time after, by the aforesaid Plaister, and a strict Ligature.

OBSERVAT. IX.

Of a moveable round Tumour of the Lower-Lip.

A Young man Twenty three years of age, shewed to me a round Tumor in his Lower-Lip, movable and somewhat painful, which (in the mean while) was not a little troublesome by reason of its bulk, that equalized one of those Balls with which Children are wont to play; but its colour differed not from the colour of the Lip.

This Patient, three Months before, had [Page 101]with his Teeth bit his Lower Lip, and from that time he perceived this Tumor. Now there is scarcely any man (skill'd in Chyrurgy) that knows not how many very small Glandules are inserted, not onely in all the other parts of the Mouth, but also in the Lower Lip; one of which was undoubtedly so hurt, that the Humors (passing but from the small Artery, their passage being shut up) setled in the Glandule, and by that means the small Glandule increased to such a large Tumour, as is here (in this Observation) by me described.

Although this Tumour often occurs in the practice of our Art, yet I know no man that hath explained the Cause thereof, and and but One onely that hath by Example described the Cure of the same, viz. Job Van Meeckeren Chyrurgeon of Amsterdam, who (if my memory fail me not) to this Affect gave a name, which (in the Dutch Idiom) is een steen knoop.

But why do you wonder? that so very small a Glandule should be extended to so great a magnitude? Consider, I pray, how much the magnitude of one and the same Womb differs in a Virgin, and in a Woman with Child. Peruse the Disputation, which the most famous John Munnicks (Ultra-jectine Professor) published November 20, in the year 1678. in which he declares, that the Womb of a certain maid [Page 102]was so largely extended that it did contain 112 Pounds of Water.

Why do you yet doubt? I shall here offer yet one Experiment which comes more near to our purpose. I myself, when I was at any time above measure hurt by Cold, have often found the Glandules about the Neck (which in a state of health I cannot find by the touch) to increase to so great a bulk, that they have exceeded the largeness of a Pidgeons-Egg.

But now at last to hasten to the Cure, I say, Medicaments can neither be commodiously applied nor retained in such a place; therefore I took away the whole Tumour (at one time) by Section with a Knife, and healed the remaining Wound with Honey of Roses onely.

[Page 103]

OBSERVAT. X.

Of an Affect of the Month, by us vulgarly called De Water-Kanker.

I Not long since saw a Man-child two years old (who had for three whole Months been afflicted with a Quartane Fever) and between his Upper-lip and Gum I found an Ulcer (which took beginning four days before) sufficiently tending upwards, hollow, hard, painful, blackish and ill-smelling.

The Bloud of this sick Child, by his acid and sowering Meat and Drink, as also by his long continued Quartane, was become much more acid than was fit, and (being such) did not so much settle any where, as between the Upper-Lip and the Gum; because the Bloud and Humors are there easily coagulated by the cold Air, (admitted by Inspiration) also by the Reliques of Meats sticking between the Teeth, and by their delay there contracting sharpness.

[Page 104]

The Bloud and Humors stagnizing did in time become very corrosive, and so not onely much vellicated the Fibrils of the Lip and Gum, but also broak in sunder many of them; and by this means a deep, hard, hollow, and painful Ulcer took beginning.

But that we may the better find out the reason of the soon-after-induced Blackness, I think good first to declare, that I, not long since, did (by the help of my Microscope) look upon a small piece of white Linnen, and all the Fibrils with which the Threads were twisted, appeared transparent as Ice; but every Thred, made of those pellucid Fibrils, were to the sight white; no otherwise than as Water appears pellucid, but the Froath (which consists of many Superficies of the Water, so superposited one above another, that much Air is contained within them) presents it self white to the fight.

But when I had burned this Linnen, not onely all the Threds, but also all the Fibrils of them presented to my sight (strengthened by the Microscope) a black colour, viz. because the Pores in the Linnen were much distorted by the force of Fire, and many Particles flew away from the burning Linnen in the form of Smoak, insomuch that the Solar-Rays (suffocated in those Pores) could not be reflected to my Eye.

[Page 105]

Now what Fire effected in the Linnen, the same did the Acido-corrosive Particles effect in the Ulcer, when they brake in sunder the Fibrils, and otherwise figured and changed the Pores of them; yea, they compelled many Particles to evaporate from the Ulcer in the form of Vapour, as was manifest by the stink.

But that I may remove from many their cause of wonder, that I should write, that Acidity concurs to the inducing of Blackness, I would have them to examine how good Ink may be made with a Decoction of Galls in Vinegar, in which filings of Steel have been first infused: Or (at least) let them cut a Pome-citron with a Knife, and they will soon see the Knife to wax very black.

Now the evil Odour of the Ulcer onely remains to be explained. Wherefore, that the aforesaid Comparison may in this place also be subservient to me, let any man smell to that ungrateful Odour which in burning of Linnen is wont to penetrate his Nostrils. For, what Fire acts in respect of Linnen, the same operates the Acido-corrosive humor in an Ulcer, whilst it corrupts many Particles of the Volatile Salt (which in an healthful state is in great abundance contained in the parts of the Humane Body, and in the parts of the Bodies of other Animals, as Distillation plainly [Page 106]shews) changeth their Figures, and so causeth them, their Bonds with which they were before tied being broken, to fly away; at which time, by the Air, wherewith they mix themselves, forced into the Nostrils, they affect the Fibrils of the Nerves (subservient to Smelling) with too great trembling, and so to the Mind is exhibited a conception of evilly-smelling odour.

The Phaenomenons of this Disease, so often occurring in the Praxis, and by no man (that I know of) as yet sufficiently explained and discoursed of, it will be all one to me, whether (with Hildanus) it be called a Gangreen; with Charles Battus a Cancer; or with Cornelius vander Voorden, an Eating Ulcer; seeing I little regard those mere Disputes about the name, being affected with nothing so much as the matter it self.

This Evil augments very swiftly, and may (in a short time strangle the sick, as I (two Months before) experienced in a Maiden-Child four years old; which was brought to me (the fifth day after the invasion of the Disease) so deformed, as she seemed not to resemble Humane kind. For half her Nose, and a fourth part of her Tongue was already consumed, her left Cheek hard as a stone, perforated with a great hole; by reason of which and other [Page 107]Symptomes, according to my Prognostick, she died within four days.

Therefore these things being by me seriously considered, I prescribed the following Unguent resisting corrosive Acidity.

℞ Of Treacle, ʒij. ss.
Of Ʋnguent. Aegyptiac. ℥j. ss.
Of Gum Lacca,
Spirit of Salt Armoniac, of each ℈ij.

Mix and make an Ʋnguent.

With this, mixt with a little Spirit of Wine, I six times a day washed the affected part, and applied thereto scraped Lint moistned in the same Medicine; by which onely Remedy I have happily cured, not this Child onely, but also many others, in a very short time.

The end of the Second Decade.

[Page 108]

DECADE III.

OBSERVAT. I.

Of a Coadnate Tumour of the Forehead.

A Maiden-Infant, Fourteen days old, was deformed with a very red Tumor, void of pain, which she had contracted whilst in the Womb. For the Mother of this Infant, when with child, was wounded in her Forehead. From that Wound, which inferred great dolour, much Bloud issued out. Wherefore the Mother, willing to be more certain of her own misfortune, hastned to a Looking-glass, and so was not a little terrified.

Now who knows not how strict the union is between the Mother and her Infant in the Womb? This should not be accounted a wonder, seeing the Circulation of the Bloud is common to both.

In the Hospital in Paris, a Fool is reported to have lived till Twenty years of age, the Bones of whose Legs, Arms, and other [Page 109]parts were broken from his Nativity. The reason of this was, because his Mother (when with child of him) had, not without terrour, beheld the Bones of a certain Malefactor publickly broken by the common Hangman.

If a pregnant Mother can impress so great evils upon her tender Young, when she sees another afflicted with great dolour, consider what greater evil may happen when she both sees and feels (in her proper body) a bleeding Wound.

But to write of the way how this happens (that being little conducent to the Practick part) I shall in this place forbear. If any man be more curious in this matter, let him peruse L. de la Forge his Annotations upon Cartesius his Treatise of Man; also that most acute Author of a certain French Treatise (intituled La Recherche de la Verité) who very elegantly there discourseth of this Effect, and how it is produced.

Having beheld and observed this Tumor, I applied to it a Corrosive, composed onely of Calx vive and common Soap mixt together which was extended all over the Tumor, and by that means an Eschar was induced.

Common Soap is made of a strong Lixivium and Fatness so long boiled together, as until the many small strings of the fat Particles are broken in sunder; as is evident [Page 110]by this, viz. because fatness produceth Spots (in Clothes) pertinaciously inherent by reason of those stringy Particles, with which it infolds it self within the Fibrils of the Cloth, and Soap (on the contrary) is easily washed off with Water only.

Calx vive is an Alcalick fixed, and sufficiently acid Salt. Therefore it is mixed with Water, because that (by reason of its effervescency with the Calx) infringeth the powers of the same; not with Fatness, which too much obstructs the Pores of the Skin; but with common Soap (by its own Lixivial Salt) not a little helping the virtues of the Calx.

This Corrosive being applied, the Vapours (in their usual manner) passed out from the small Arteries, through the Pores of the Cutis into the Air, by which they again forced, into the place they left, a subtile matter, which (in its transit) agitated both the saline Particles of the Calx, and the slippery, rigid, and pungent Particles of the Soap, and carried them (with it self) up to the Cutis; and indeed according to the Longitude, not according to the Latitude of the Particles: as an Arrow shot up on high cuts the Air, not transversively, but by its Longitude; because thus it finds less resistance and a more easie way in the Air.

These saline Particles driven up to the Cutis, and by the subtile matter egregiously [Page 111]agitated there, broke the Fibrils of the Cutis in such wise, that the small passages of the same were in so great a measure distorted, that the circulation of the Bloud, Humours and Spirits, was there wholly impeded, & that part died, presenting it self under the form of an Eschar; which being (in a short time) separated, all the Tumor vanished. Seeing this, I applied my Placentula (in a form somewhat hard) of which I have often made mention, which compressed the Flesh (otherwise easily luxuriant) and induced a thin Cicatrice, which was indeed at first somewhat red; but that redness was afterward wholly taken away, when that thin skin had been several times touched gently with Oyl of Tartar per Deliquium.

The Forehead of this Child being (by these means) happily freed from all Deformity, Chyrurgeons should hence be excited to endeavour the removal of many like deformed Blemishes and Tumors in Infants (impressed whilst they were held captive in the Prison of the Womb) which by many have been accounted insanable.

[Page 112]

OBSERVAT. II.

Of an Ʋlcer, with Rottenness of the Jaw-Bone.

A Matron, aged 28 years, was afflicted with a small, deep, and dolorous Ulcer of her Under-Jaw, from which daily issued out a great abundance of Pus, and spungious flesh was always luxuriant in the Ulcer, and the Tooth nigh the Ulcer was excavated with rottenness, and besides, no small hardness presented it self to the touch of the finger.

According to the relation of the Patient, this Ulcer derived its Original from a great and large Tumour of the Lower-Jaw, and also of half the Face, which (suppurated and spontaneously opened) emitted much Pus into the cavity of the Mouth; but this Aperture was in a short time healed by the Spittle contained in the Mouth. This External Tumour was opened by the Chyrurgeons Knife, and that Aperture for several Weeks after yielded to no remedies.

Therefore I, being called, gave accurate heed to all Circumstances, and exactly enough [Page 113]examined them, and so at length (shunning all precipitate rashness in Judging) most assuredly perswaded my self, that the Bone of the lower Jaw was rotten; and that was principally evident to me, by that always luxuriant flesh, and by a greater abundance of Pus than the streightness of the Ulcer could contain, had not the Bone been infected with rottenness.

But whence did that fungous flesh in the Ulcer, luxuriating with the rottenness of the Bone, derive its Original? Satisfactorily to answer this Question, those things are to be called to mind which I mentioned in the Eighth Observation of the First Decade, of which I there at large discoursed, viz. that rottenness of the Bone is induced by an Acido-Corrosive: which also may be made more evident by the following Example.

Cast some Bones to be devoured by a Dog, and it will in a short time be evident by his Excrements, that the compactness of the Bones swallowed is throughly dissolved by the Ferment contained in the Dogs Stomach, the Acidity of which, I judge there is no man will deny.

Therefore the corrosive Acidity corroded and rotted the Bone, and opened the sanguiferous Vessels more than was fit, from which (then extended in length) the out-flowing Humor was formed into spongious Flesh.

[Page 114]

But whence was the so great abundance of Pus in the Ulcer, that attended the rottenness? That Ulcer was deep, so that not onely the Humors proceeding from the Skin and Flesh, but also from the Periosteum and Bone it self, supplied matter for generating that Pus.

This rottenness I did first discern by the Eyes of my Mind, but I desired sensibly also to be assured of that; and because the streightness of the Ulcer would not admit any Probe of Iron, I therefore used an Hogs Bristle, and with that felt the Bone to be naked and rotten.

What was here to be done? the corrosive Acidity was to be temperated, and separation of the rotted Fragments of the Bone to be promoted, and the hardness in the parts adjacent to the Ulcer to be softened.

But first of all I commanded the rotten Tooth to be drawn out, lest it should more infect the Jaw; but the root of the Tooth pulled out appeared uncorrupted.

Then into the Ulcer I put a Tent anointed with the following Unguent.

℞. Turpentine, ℥ij.
Yolk of an Egg.
Aloes, Myrrh, of each ʒj.

Mix these according to Art.

Turpentine resists Acidity, as the Oyl thereof (waxing hot with the acid Oyl of [Page 115]Vitriol) plainly teacheth; so also Myrrh and Aloes (by their Salt, with which they abound) do temperate Acidity.

Also sometimes, for the better opening the Ulcer, I strewed upon the Tent Crocus Metallorum pulverized, which took away the Luxuriant flesh, or I put in a Tent made of Gentian-root; but upon the Tent I usually strewed powder of Euphorbium, that it (by its own abounding Volatile Salt) might temperate the corrosive Acidity, and so not onely prevent the corrupting of the found part of the Bone, but also hasten the separation of the Fragments affected with rottenness.

Upon the Luxuriant flesh, rising up above the Ulcer, I often applied Burnt Allom.

To remove the hardness in the parts nigh the Ulcer, I applied Paracelsus his Stiptick Plaister; which hardness was by this means removed in a short time.

After I had for the space of three months studiously endeavoured the cure of this Ulcer, three white Fragments (one after the other) issued out of the Ulcer, the two first of which were very small, but the third sufficiently great and broad.

At that time, when some of the Fragments began to be separated, the Pus appeared sanguineous, because the sanguiferous Vessels were hurt by those Fragments. But whence the increase of Dolour then [Page 116]derived its Original needs not here be explained.

Here also it may easily be understood, that the moving Fragments gave increase to that abundance of Pus, and caused the Flesh to be more luxuriant.

But how came these Fragments to be disjoyned? To explain this, it is not behooful to call upon Nature for help, which Empedocles hath long since exploded in the following words:

What Mortals now do Nature call,

Just nothing is.

Indeed I cannot but deride those Physicians who have these words always in their mouth, and are accounted as Oracles.

Nature is the Curatress of Diseases, the Physician Nature's Minister, &c.

Whereas they themselves know not, what they would have intended by these words signifying nothing; which notwithstanding they boldly enough utter before their Patients, by whom they are often accounted as Gods, by reason of their much babling.

Therefore let us bid adieu to this Nature, and call it what in very deed it is, and what may clearly and distinctly be understood by every man: that is to say, the Particles circulating through the sound Bone, approached to the rotten and perished Fragments; but could not contine [Page 117]their course through them (because tho small passages were very much distorted) therefore with united force they daily very often struck upon them, and so (as much as they could) tearing the Fibrils, which had as yet connexed the sound Bone with its corrupted parts; and at length the acid Particles of the Pus (with the acuteness of their sides) cut in sunder these interstanding Fibrils, which did the sooner and more easily happen, because the same Fibrils were very much distended; as we see a Thread stretched out to be most easily cut by a Knife, but a Thred hanging loose cannot be so readily divided.

After the last of the Fragments was come out of the Ulcer, the abundance of Pus was soon diminished, and the fungous flesh (removed by burnt Allom) no more increased again; and so the Ulcer was wholly closed in the space of four days, the Cicatrice notwithstanding remaining hollow and hard, which no mortal man can prevent in rottenness of a Bone: because the nourishing Particles which circulate through the small passages the Bone, and so come to that Superficies of the same Bone, from which the rotten Fragment was separated, are much more solid than fleshy Particles; therefore when there (by reason of the similitude of Superficies) they adhere to the extremity of the Bone, very firmly compacted [Page 118]and connexed each with other, and so constitute (as it were) a certain small Callus.

OBSERVAT. III.

Of a Wound of the Leg inflicted by Gun shot.

A Young man, aged Twenty four years, complained of a Wound of his Leg, (inflicted with a Shot) which was round, blackish, and very painful.

The Leaden bullet could not perforate this young Man's Leg, but did egregiously contuse the same, whence arose that Dolour and blackness.

It is not my purpose in this place to describe the means by which Gun-powder is inflamed, and excited to a motion so very vehement and swift, that it can impress on a Leaden-bullet force sufficient to produce such a Wound; seeing Cartesius hath (exactly and elegantly enough) writ of this matter, in his Fourth Part of the Principles of Philosophy.

Therefore after the Patient came to me, I commanded him to set his Body in the [Page 119]same posture he stood in when he was wounded; and then with a leaden Probe, yea also with a Wax-candle (which we in Dutch call een was-lichtien) I sought very industriously for the Bullet, but in vain; because it had descended too deeply, and absconded it self so that I could not draw it out.

If any man be desirous to see instruments fit for extracting Bullets, let him consult Fabritius Hildanus, Scultetus and others.

What then was here to be done? The Bloud and Humors (by reason of the Contusion) stagnizing and (by reason of the Acidity) coagulated, were to be dissolved by things temperating Acidity; that by such means the Circulation of the Bloud and Humors (in such wise impeded) might be again restored, and by that restoration the Fibrils (inherent and plainly dead in the Wound) be separated from the living Flesh, and the Wound again be filled up and repleat with new Flesh, and cured; which, notwithstanding the Leaden-bullet remaining in the Leg, was effected in a short space of time, by applying this Unguent, and superpositing the following Plaister.

℞ Turpentine, ℥ij. White of Egg, No 1.
Myrrh, Aloes, of each ʒ ss.
Oyl of Wax, Drops 10, Make an Ʋnguent.
[Page 120]℞ Emplas. Diapalma, ℥ij.
Common Chalk, Bolus, of each ℈ss.
Diaphoretick, Antimony, ℈j.
Oyl of Tartar per Deliquium ℈ss.
Of Cammomil, q. s.

Mix according to art and make a Plaister.

But in the mean time we contributed help to the external Remedies, by internal Medicines also given; and often gave to the sick (instead of a Vulnerary Potion) one Scruple of Crabs-Eyes, and as much of White Coral.

The Ancients, about Wounds made by Gun-shot, laboured with great prejudice, thinking them to be venomous; and Johannes de Vigo had imbibed the same opinion: for he therefore touched such Wounds with hot Oyl.

No less false is the Opinion of those men, who believe a Leaden-bullet (shot out of a Gun) doth in perforating the Flesh egregiously burn the same: For a Leaden-bullet shot against a Wall, and presently taken up, will exhibit no sensible heat.

But whence is it, that Lead hath often been known to remain in the Humane Body without any sensible hurt for a long series of years; but Brass, Iron, and many other things, from without forced inwards, not so? Do we not daily see in the Macrocosm how easily Brass is infected with an [Page 121] Aerugo, and Iron with Rust, by the Air, Water, Vinegar, and other things; whereas (on the contrary) Lead is infected with no Rubigo?

Moreover, Tin is likewise said to be infected with no Rustiness; wherefore this also, may perhaps for a very long time lie hid in our Bodies without damage.

Helmont, Kenelm Digby, and others, much glory of the Symphatick cure of Wounds; but they are miserably deceived. Sir Kenelm Digby set a Vessel full of Water in a cold place, and in that Water dissolved common Vitriol, and then (in that Solution) put a Linnen-cloath, that had before received the Bloud issuing from the Wound; and (doing this) thought that many Particles of the Vitriol would by the Air be carried to the Patients Wound; but perhaps these Particles, could they be conveyed so far, would do more hurt than good. This seems to be very probable, because those Effluviums, which the Air can convey from the Vitriol set in a cold place, must needs be very few.

Before I put an end to this Observation there remains one Problem yet to be discussed, viz. whether it be true, as many men at this time do firmly perswade themselves, viz. that there are such men in the world, who (by reason of a Compact made with the Devil) have Bodies impenetrable [Page 122]by any Bullets, Swords, or other things impressing Wounds.

Although I have with great scrutiny examined this matter, yet I could never unto this day find any man, who (by proper experience in his own Body) could ascertain me of the truth of this matter.

But it is sufficiently evident to be repugnant to reason, that the Humane Body (which is so very soft) cannot be wounded by Leaden-bullets, Swords, and other Weapons, agitated with very great force, whenas a Pellet of Wax, shot out of a Gun, can sufficiently penetrate solid and hard Boards.

Whatsoever is so repugnant to Reason, cannot be consentaneous to the Will of God; for, otherwise he must needs will somewhat that is repugnant to his own Nature; seeing [...] The WORD (or Reason) is GOD himself.

Whatsoever GOD wills not, that the Devil cannot effect, therefore I judge this thing to be wholly impossible, and shall never be induced to believe that such men can be any where found.

[Page 123]

OBSERVAT. IV.

Of a very strange Ʋlcer.

OUt of the City Arnhemium, beyond the Rhine, in that place which in Dutch is called de Praest, a Woman of Seventy years of age asked Counsel of my Father (Doctor of Physick and Chyrurgery) whilst he lived, because she was afflicted in that part of the Thigh (which is about six fingers breadth distant from the Groin) with an Ulcer, the Cavity of which exceeded four hands breadths.

From this Ulcer at one time proceeded thirty Eggs full of a limpid Humor; afterward for several days many other came forth; all which numbred together, exceeded one hundred: some of which were equal in magnitude to Hens-Eggs, others as large as Pidgeons-Eggs, and some of them no larger than Sparrows-Eggs; all of them, each apart from the other separated, were enclosed with their proper Membrane, white and as thick as a Playing-card.

These Eggs appeared very like to subventaneous (or windy) Eggs, and lay all [Page 124]together included in a Common, and gross Membrane.

These Eggs being by Intervals thus evacuated from the Ulcers, I used the following (or like) Injection.

℞. Root of round Birthwort, ʒij.
Herb Carduus Benedictus,
Veronica, of each, M j. ss.
Crabs-Eyes, ℥j.
Myrrh, Aloes, of each ʒj. ss.

Boyl these according to Art in French Wine, and use the Colature.

By this means that common and gross Membrane was gradually consumed, and the Patient at length restored to her pristine sanity.

Many that were present thought this Woman to be bewitched, and therefore affirmed the Devil to be the Author of this Disease, evily attributing that honour and power to the Devil, which ought to be ascribed to the Omnipotent GOD onely. For GOD is the primary cause of Motions, that are made in this Corporeal Universe; and according to the rules of these Motions, giving heed onely to the magnitude of Bodies, to the figure and position of them, not onely the Phaenomenons of this Disease, but also many other (far more wonderful than these) may very accurately be explained.

If you be desirous to know how Plants [Page 125]proceed from a Grane (or Seed) it will behove you attently to peruse the Anatomy of Plants (made by Mr. Grews Microscope) published both in English and in French. There in the greater Bean, you may behold the Rudiment both of Root and Plant already formed; there you may perceive, how the Juice (strained through the Membranes of the Bean committed to the earth) is fermented in the Body of the Bean; also how there through a small hole of the Bean admittance is given to the Air, and an exit also permitted to the superfluous Vapours; how the Juice thus fermented is constringed into the Rudiment of a Root, and converts that Rudiment into a true Root; which then receiving nutriment from the Earth, repels the other Juice, coming from the other part, upwards to the Rudiment of the Plant, that so at length it may present it self to the sight as a true Plant.

If you desire to know the causes of the stupendious powers in the Magnet, of the Ignis Fatuus, Rainbow and other things, consult Cartesius, who will clearly explain them to you.

The same Philosopher (in his Treatise of Meteors) will also there teach you, that Souldiers (sometimes seen) fighting in the Air, touching which the ignorant Vulgar tells so many tales, are no other than certain Clouds.

[Page 126]

I know not indeed whence arose this so evily-founded Judgement of the people, by which such cases (as this of ours is) are accounted Inchantments, and Mawworms (so frequently ejected from the Bodies of men by Vomit and Seidg) esteemed meerly natural; whereas the generation of Mawworms is far more wonderful, than that of these Eggs in the Humane Body.

Vigelius, professor of the Mathematicks, is reported to have formed an Horse of Metal, which in one day (for several hours) could by the help of Rotula's, walk like a living Beast.

Rayselius is reported to have fabricated an Engine like a man, in which a certain Liquor, poured into the mouth, was seen to circulate like our Bloud; the more thin part of which Liquor was expelled by the Yard as Urine; but the more gross part as Dregs (or Dung) of the Belly, by the Fundament.

If Man can do such things, what cannot GOD (the supream Architect) effect according to the ordinary rules of Motions?

Therefore how were these Eggs produced in this Woman? I answer. In the Thigh of this Woman, from this or that cause, many Pores of this or that Artery were distorted and enlarged; so that many Humors flowed out, and were collected [Page 127]in one place, in which (when they began to be fermented) the Particles, stringy and less apt for motion, were thrust out to the sides, where they were not compelled to so swift a motion; and there cohering and twisting themselves one within the other, were formed into that sufficiently gross Membrane, which did include all the Eggs afterward generated.

But because the Pores of the above-mentioned Artery were diversly distorted, therefore some of the Particles contained in this gross Membrane did in some measure differ from the other in figure and magnitude; and perhaps the Particles like each other, flowed into almost an hundred divers places; and so every of those Particles (besides the Congesture of their like) still exercising a certain kind of Fermentation, did again thrust out the more stringy Particles to the sides; and so were formed the Membranes, in which were included all the Eggs.

Thus, I suppose, I have produced a sufficiently intelligible cause of this Phaenomenon, which I beheld with my own Eyes.

[Page 128]

OBSERVAT. V.

Of a vast Tumor of the Neck.

A Young Maid, aged Fifteen years, being otherwise very well, had (now for six years) sustained an hard round Tumor in her Neck, (of the same colour with the Skin, and void of pain) equalizing in magnitude a white Loaf that is wont to be sold at the price of half a Sesterce, and miserably defacing the Patients Countenance.

I judged the humidity of this Tumor to be very viscous, and divided almost after the same manner as we see the Juice in a Pome-Citron or Orange, contained in many Cells.

By reason of the viscosity of the Humor, this Tumor could not be discussed, nor (in the common way) brought to suppuration; therefore I applied a Corrosive, and (the Eschar being removed) put in a Tent anointed with the Unguent Basilicon mixt with common Turpentine.

By this means some part of the viscous Pus issued out daily, and so the Bulk of this horrid Tumor began to be diminished; the [Page 129]viscous Humor nearest the hole was first evacuated, and afterward that also which lay far remote from the Ulcer.

But when the small passages round about this hole (made by Art) were obstructed by the viscosity of the Humor, as it often hapned; then, with the Unguent wherewith the Tent was anointed, I mixed some Crocus Metallorum, that so an Eschar might be induced; which being separated, the small passages were again opened; and so this young Maid in the space of three Months was wholly freed from this Tumor, and that great deformity attending it.

I shall not in this place speak of the way or manner of the Corrosives operating, having already discoursed of that, in the First Observation of this Third Decade; nor will I at this time further explain by what means the Eschar is separated; because this may sufficiently be understood by the Second Observation of this Decade, where I teach, how the rotten Fragments of Bones may be separated from the sound part.

Perhaps some one will wonder that I use Medicaments so few and so little compounded; but to what purpose are so many Simples, and so many composed Forms of Remedies, which many Physicians use at this day, for no other cause than to boast of their vain Learning before the Ignorant?

[Page 130]

If Gun-powder, made of Cole-dust, Nitre, and Sulphur onely, produceth such stupendious effects in the Macrocosm, that (omitting all other) it can blow up into the Air vast and heavy Ships, and also (if put under the Earth) cause the same to tremble and cleave in sunder; why may not a few Medicines, seasonable taken, be sufficient to heal very many Diseases in the Microcosm.

I do indeed assent to Bacon Verulam, great Chancellor of England (who is by some called the Day-star of Cartesius) thus speaking: Variety of Medicaments is the daughter of Ignorance.

OBSERVAT. VI.

Of a wonderful Abscess.

A Man Fifty years of age, was vexed with an Abscess arising below his Ear, which was round, painful, waterish, and soft; with this he had been afflicted some days before he came to me.

I, being certainly perswaded, that ripe Pus was contained in this Abscess, made an Aperture with my Lancet; and so presently [Page 131]issued out no small quantity of white shining Pus, but when I would, by pressure with my finger, in some measure further the efflux of the Pus; behold soon after a piece of a Tobacco-pipe (equalizing the length of the Middle-finger) presented it self to sight; which, with an Instrument I drew out of the lately-made Orifice.

The Pus being gradually evacuated, I in a short space of time healed this Affect after the manner of other Abscesses; so that (in this Cure) nothing hapned worthy of observation.

But the piece of Tobacco-pipe unexpectedly issuing out of this Abscess, gave occasion to the By-standers not onely of admiring so rare a Phaenomenon, but also made them presently to fly to the Devil and his Inchantments.

The Ignorant (and therefore superstitious and miserable) vulgar men, presently hasten to the Devil, the accustomed (but impious) Asylus of their ignorance; when any Effect presents it self to them, the like of which they never before saw.

If they see any thing the cause of which they know not, they do not presently ascribe that to the Devil, having often before beheld the same; so the stupendious actions of that Belching out of Fire (which cannot but be known by all the Inhabitants of these Regions) are by them accounted [Page 132]natural, and not taken for delusions of the Devil, viz. because these are such things as they have often seen, though they cannot render a reason of them, being wholly ignorant of the cause.

So, sometime since, there was an Italian (at Lugdunum in Batavia) who after the drinking a great quantity of clear Water, vomited up the same into various Chrystalline Vessels, not limpid as before, but it was (in every of the Vessels) of a diverse colour and taste.

This effect frequently seen, excited the people (ignorant of the cause) to so great admiration, that they uttered not so much as one Whisper about the Devil. But Mr. Overcamp presently found out the cause of this Phaenomenon, as he relates (In primogenito Ingenii sui Partu) viz. that in the Chrystalline Vessels he both saw and smelt divers subtile Oyls, which in one Vessel tinged the Water with one colour, in another with another.

Not without reason did Virgil say (Felix qui potuit Rerum cognoscere Causas;) He was happy that knew the Causes of things: For they being known, we shall not much wonder at Phaenomenons before seen, much less (with the decieved Vulgar) refer them to a certain imaginary power of the Devil; whereas it is well understood, that the Common people seldom have any regard to the causes of things.

[Page 133]

But, omitting these, what was the reason that a piece of a Tobacco-pipe came forth of this Affect whereof we are now writing? When I had well examined the Patient, I by him understood, that (about six Months before) when he walked in the streets taking Tobacco, he fell down, and internally hurt his Jaws with the Pipe, from which hurt abundance of Bloud did often flow out, viz. because a piece of the Pipe broken off, deeply forced into his Jaw, first produced this Haemorrhagia, and afterward the above-recited external Abscess below the Ear, out of which when opened the piece of Pipe was taken.

OBSERVAT. VII.

Of a small Stone contained in the Ʋrinary Passage.

A Little Boy five years old, suddenly complained of a pain of his Yard, and could not make water. I (as I then judged) with an Iron Probe touched a small stone as big as a Pepper-corn (but very rugged) contained in the Urinary passage. How this Stone should infer so vehement [Page 134]dolour, and stop the Urine, I purpose not at this time here to explain.

Fit Instruments, by many Authors commended in this case, were now by me made use of, but in vain: What then was to be done?

I presently gave to the sick Child two spoonfuls of the following Mixture.

℞. Antinephretick Water,
Water of Stone-Parsley,
Of Fennel, of each ℥j.
Fernelius his Syrrup of Althea, ℥ss.
Crabs-eyes, ʒj. Salt Prunella, ʒ ss.
Salt of Bean-stalks, ℈j. Mix these.

Then I commanded the Mother to apply her mouth to her young Son's Yard, and suck (for some time) as much as she could, and by this means the Stone was (in a short time) drawn forward to the extreamity of the Ureter, from whence then it was easily drawn out with the Forceps; and so this little Boy was quickly, safely, and pleasantly freed from this so very painful Affect.

We must speak with the Vulgar, but not judge with them according to the common Proverb. I said, the Mother sucked, though in the mean while I am certainly perswaded, that Sucking effects little, but all Motion is made by Pulsion. It is true the Mother, applying her Mouth to the [Page 135]Yard, and strictly closing it round about with her Lips, caused the Belly to swell by contraction of the Diaphragma; and so the external Air, by its pressure, forced the small Stone to the extremity of the Yard contained in the mouth of the Mother: which did so much the more easily happen, because that little Air (contained in the Mothers mouth) by the heat there existing rarified; and so being more weak than the external Air, forced from the swelling Abdomen, made the less resistance, as rarified Air (contained under a Cuppin-glass made hot) prevents not the subjected Cutis from being lifted up into a Tumor, the pressure of the external Air contributing thereunto. This Propulsion of the Stone was also not a little furthered by the almost continual agitation of the Tongue commodiously applied.

But no man should here wonder, that the pressure of the Air hath so great force; for this effects many other things much more wonderful, and is the cause that two Brass-Hemispheres, from which the Air hath been (in a great measure) removed by a Wind-Instrument, do so very firmly adhere each to other, that the weight of a Thousand pounds would not be sufficient to separate them again; whereas they may very easily be disjoyned, when the Air is again intromitted; as I with my eyes have beheld (at [Page 136] Lugdunum in Batavia) in the Laboratory of Burcher de Volder, a most acute Professor of solid Philosophy in that place. If any man desires to know more of these things, let him consult the Magdeburgic Experiments, adorned with Brass Figures.

OBSERVAT. VIII.

Of a Contusion suddenly healed.

A Man about Thirty years of age, in a Tennis-Court, received a Ball, with great force struck by a Racket, just upon his right Eye, whence exceeding great dolour presently arose.

The Patient remembred, that he had seen others after the same manner hurt, to be presently healed by cold Water onely, applied immediately after the stroak, therefore he presently to the contused part applied his Handkercheif moistned with cold Water, and when that waxed warm, he again dipped it in other fresh cold Water.

The next day after this hurt, his Friends that had heard of his misfortune, came to visit him; but seeing both eyes very sound [Page 137]and well, they were amazed, having before firmly perswaded themselves, that the eye which had received so vehement a stroak, must needs be livid and very painful.

But what may hence be inferred? Can cold Water profit in a Contusion? It seems more likely to do hurt; because it incrassates, coagulates and stagnizeth the extravasate Bloud. Would not Spirit of Wine, and other Medicaments (that increase the motion of the Bloud) be more convenient in this case?

That you may the more clearly conceive the solution of this difficulty, it is behooful to know, that in the parts hurt (by the Ball so forcibly driven) certain very small sanguiferous Vessels were opened, which had they (before the Water was applied) poured out the Bloud into the small passages of the Parts hurt, then the cold Water would have done hurt: but this cold Water was applied before the Bloud issued out, and so not onely (by its coldness) again closed these very small Vessels, but also was the cause that no new Bloud could (for a certain space of time) enter the same Vessels. So we see our Face to be red, for no other reason than because, through the Cutis of the same very many small Vessels full of Bloud lie dispersed; and discern the same to wax pale by the coldness of Water, [Page 138]Air, and other things; because such coldness for a time prohibits the Bloud from entring these very small Vessels of the Face.

So we see the pleasant redness of the Lips in a beautiful Virgin, augmented by the kiss of a young man, to be changed into a pallid colour, by Acidity restraining the Bloud from entring the small Vessels distributed throughout the Superficies of the Lips.

But whosoever he be, that will attempt such a way of Cure as this here mentioned, after the small passages of the parts contused shall be replete with extravasate Bloud, seems to me to be not well in his wits: for I have not seldom known a Gangrene to arise in a part contused, from the unseasonable application of cold and astringent things.

OBSERVAT. IX.

Of an hard Tumor of the Abdomen.

A Girl Five years of Age, accustomed to evil Diet, was for a long time afflicted [Page 139]with a very great Tumor and hardness of her Abdomen, and her face was very pale.

The following Liniment had before been in vain used.

℞. Ʋnguent. Altheae comp.
Oyl of white Lillies, of each ʒss.
Of Tiles ʒj. Mix these.

Which notwithstanding (in a like case) is not a little commended by the famous Sylvius, in the first Book of his Praxis, Chap. 14. under the Title 56.

Well considering the matter, I judged the Bloud of this sick child to be very viscous and acid; and (by reason of this) that many Glandules of the Omentum were obstructed and augmented to a strange bulk. But which way Paleness of the Face is induced by such Bloud, I suppose to be known to every man, therefore needs not be here explained.

Perhaps some one will wonder, and not believe it possible, that the Glandules of the Omentum should increase to so great a Magnitude, as to become the cause of so great and hard a Tumor, as was in the Abdomen of this Child perceptible by the touch; but I would have him peruse Fabritius Hildanus, who (in the 62 Observation of his Third Century) declares, that he opened a Carcass, the Omentum of which, by reason [Page 140]of the tumified Glandules, weighed Fifty six pounds.

Things being thus, I judged nothing would be more profitable than Paracelsus his Stiptick Plaister, which I commanded to be applied to the Abdomen, after it was spread upon a Linnen Cloath, and anointed with Oyl of Nutmegs.

To correct the viscous and acid Bloud, I commanded certain drops of oyly Volatile Salt to be given daily twice a day; and by this means our little Patient in the space of a few Months, was happily restored to her pristine state of health.

OBSERVAT. X.

Of the Scurvey.

A Man, aged Thirty years, every day evily accustoming himself to viscous and sowre Aliments (according to the bad custom of the Gelders) was afflicted with heaviness and dolour of his hands and Feet; his Gums (in a great measure consumed) would bleed with the least touch; his Spittle was in taste salt as Brine.

Having diligently considered these things, [Page 141]I judged the Bloud (too acid and viscous) to be here peccant, which (by reason of Acidity) inferred that dolour of Hands and Feet, and corroded the Gum and its sanguiferous Vessels; and by its too great Viscosity did so obstruct the small passages of the Hands and Feet, that the usually-free transit of the Animal Spirits into the Muscles was somewhat impeded, whence arose the aforesaid Heaviness.

I speak here of the Animal Spirits; for seeing the Liquor that is through the Nerves (for exciting motion) carried into the Muscle, is subtile; I know not why this Nervous Liquor should less deserve to be insignized with the name of Spirit, than that Liquor which (in Chymical Distillation) is extracted from Hartshorn. But omitting vain Disputes about the Name let us set about the Matter it self.

This Disease is very familiar in these Regions, and is generally known by the name of The Scurvey, and is most difficultly cured, if (in process of time) it have taken deep root. Wherefore I presently applied my self to the Cure of this Disease, seriously commanding the Patient for the future to eat no more acid and viscous Aliments and prescribing the following Medicament.

℞. Syrup of Scurvy grass ℥ss.
Of Salt Armoniac distilled with
[Page 142]Salt of Tartar, ℥ij.
Oyl of Tartar per deliquium,
Tincture of May-worms, of each ʒj.

I commanded the Patient to take 16 drops of this Medicine thrice a day in a Decoction of the Tops of Firr; and indeed to the end that the Spirits of Scurveygrass, and Sal-Armoniac, and the Tincture of May-worms, with the aforesaid Decoction, might attenuate the viscous Bloud and infringe the Acidity thereof. I added Oyl of Tartar per deliquium, that by this means the Volatile Salt of the Bloud (subdued and bound by the Acidity) might again recover its pristine liberty, and so render the Bloud more fluid and more agile.

As we see the Volatile Salt of Hartshorn, or any other Volatile Salt, coagulated and conjoyned with an Acid Spirit, with the help of an Alkali-Salt and Common Water, by distillation to be again restored to its pristine liberty, and separated from that Acidity.

As to the Tincture of May-worms, it is to be observed that that ought not to be extracted with the acid Spirit of Salt, (as Artists are wont to do) because by this means the Volatile Salt of the May-worms is infringed and enervated.

By these Remedies our Scorbutick Patient was cured in a short time.

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But before I put an end to this Third Decade a Difficulty (not very small) remains yet to be removed. I here affirm the Cause of this Disease to be Acidity, and in the mean while say the Spittle was imbibed with a Saline taste; how do these agree? Do they not manifestly contradict each other? No. I promise to unfold this Riddle in few words. No small quantity of Volatile Salt contained in the Bloud (with the Acidity) was coagulated; therefore the Spittle (burthened with this Coagulate) exhibited the afore-mentioned Saline taste to the Tongue. So Common Salt, which we daily use with our Meats, ceaseth not to taste Saline, though it hath not a little Acidity permixt with it self, as Spirit of Salt extracted by Chymical Distillation doth plainly teach.

The end of the Third Decade.

[Page 144]

DECADE IV.

OBSERVAT. I.

Concerning the Indisposition of the Gum.

A Matron Forty years of age, very much afflicted with the Scurvey, complained of an excessive pain of her Gum, which was very much corroded, and (at the least touch) immediately poured out Bloud: and besides, her fore-Teeth were loose. Also the Patient (according to the common custom) after Bloud-letting, had been often purged, but in vain.

How the Acidity (in some sort corrosive) should be the cause of this dolour, corrode the Gum, and make the Teeth loose, I forbear in this place to explain; because I judge the case to be sufficiently clear of it self.

This Evil doth sometimes degenerate into that Malady, which we in Dutch call, De Water-kanker; therefore not to be slightly regarded.

My order was, that the sick Woman [Page 145]should (as much as was possible) abstain from acid things, and unto her I gave the Spirit, of which I spake in the last Observation of the foregoing Decade; and did also prescribe the following Medicament to be externally used.

℞ Tincture of Gum Lacca, ℥j.
Spirit of Scurvy-grass, ʒiij.
Oyl of Tartar per Deliquium, drops
xiij. Make a Mixture.

With this Medicament the Gum was four times a day touched, and washed; and so in a few days the diseased Woman was freed from her pain, and the out-flowing of Bloud from the Gum ceased, and the Teeth were no longer loose; but that part of the Gum that was eaten away grew up no more: at which no man should wonder, because it is as impossible for part of the Gum consumed to be regenerated as a Finger once cut off to grow again.

Sometimes a certain Lapideous matter grows upon the Teeth, which by its roughness lacerates the Gum; in which case the precedent Medicament must in no wise be used, unless this Lapideous matter be first removed with some fit Instrument.

If you desire to know the way of preparing Tincture of Gum Lacca, consult Frederick Deckers (that most famous Practitioner) in his Practical Observations about the Method of Healing, page 15.

[Page 146]

Before I finish this Observation, I cannot forbear to tax the frequent errour of those men who use Oyl of Vitriol for whitening black Teeth. For though this immediately takes away the blackness of the Teeth, yet it afterward hurts them; because it corrupts the Volatile Salt, which is naturally found in great abundance in the Teeth. It would be far better for those that delight in white Teeth, always after Meat to wash and cleanse their Mouths with pure Water, and (once in a Week) rub their Teeth with the powder of Porcellane Earth, which is China.

If any man, either cannot or will not give credit to my words, saying; Acidity (as Oyl of Vitriol, and other like things) hurts the Teeth, let him at least give credit to Solomon the wisest of Kings, who speaking by the Spirit of GOD, said; As Vinegar to the Teeth, and as Smoak to the Eyes, so is the Sluggard to them that send him.

Now if Vinegar (according to the testimony of Solomon) be so inimical to the Teeth, what damage will not Oyl of Vitriol infer, which is much more sharp, and far more corrosive?

[Page 147]

OBSERVAT. II.

Of an Ambustion.

A Man Thirty years of age, setting fire to Gun-powder, burnt his whole Face and both his Hands, whence presently arose redness and exceeding great pain; to asswage which the Patient applied Ink, which was (as it hapned) ready at hand.

Had you seen the Patient in this state, you would have affirmed you saw the Devil, unless you could (with the Aethiopians) perswade your self the Devil is white, which Opinion Sir Thomas Brown (in his Pseudoxia Epidemica) seems to favour, contrary to the Testimony of the holy Scripture, which saith (in the Revelation of St. John, Chap. 19. vers. 20.) The dwelling of Satan is a lake of Fire burning with Brimstone. But the Smoak of Brimstone burnt (as our above-recited Author philosophizeth) is known by frequent experience to whiten Wollen Garments, as Stockings and other things; and hence he concludes, that whatsoever is found in Hell, must needs be white. These things onely cursorily mentioned, let [Page 148]us omit them and come to the matter it self.

I being called to the Patient, applied to the parts hurt Onions bruised, with common Honey. Which Remedy is very profitable to burnt parts, if presently applied, whilst the Skin is yet entire: for that being hurt, vehement dolour will undoubtedly follow the use of this Medicament; which shews, that then it is in no wise convenient.

The next day many Blisters, all over his Face and both his Hands, presented themselves to sight, which (the third day after the accident) being opened, poured out no small quantity of Limpid Water.

Then I prescribed the following Cerot.

℞ Ceruss, Pulp of the Root of the greater Comphry, of each, lib. j.
Lithargyry,
Lapis Calaminaris,
Oyl-Olive, Wax, of each ℥vj.

Make a Cerot.

In the preparation of which it is to be noted, that to the Oyl and Wax first melted together, the Pouders (beaten very fine and sifted) must be added, and when these are almost cold, the aforesaid Pulp must be mixed, which Pulp is thus extracted: The Roots are first made clean, and then cut into thin round slices, which afterwards boyled in common Water till they [Page 149]are soft, are then squeezed through a fine Linnen-Cloath.

With three Ounces of this Cerot I mixed as much of Unguentum Aureum, the description of which is found in the Amsterdam or Augustine Pharmacopoea; and this Medicament spread upon fine and soft Linnen Clothes I applied to the parts hurt; and by this means our Patient was perfectly healed in a short time.

Whence the redness and dolour proceeded you may easily understand, if you do but consider, that the Gun-powder fired, and so posited in a most swift and very vehement motion, had hurt and broke many Fibrils of the Cutis. For hence the dolour manifesting it self in that Ambustion, may easily be judged of: the continuation of which Dolour proceeded from the Obstruction of many small passages (by reason of the broken Fibrils) in which the Humors stagnized, and distended the adjacent parts, and then also waxed acid, and by this means tore and cut in sunder the aforesoid Fibrils. The Blisters were raised by the Humors stagnizing and coacervated about the Cutis which (being constringed by the flame) they could not penetrate.

I applied Onions with Honey, that (with their abounding Volatile Salt) they might open the constringed and stopt Pores of the Cuticle, temperate the acid Humors, and [Page 150]restore to them their usual Circulation.

The third day I opened the Blisters; for had I sooner opened them, the subjacent Cutis would have suffered and been too much pained, not onely by the ambient Air, but also by the Medicaments; but usually on the third day is formed a Rudiment of a new Cuticle.

Then I applied the above-prescribed Cerot with Unguentum Aureum, for temperating the peccant Acidity.

Where the parts were only slightly burnt; that is, where the Fibrils or the Cutis were onely much agitated by force of the Fire, but none (or few of them) broken in sunder; and where the Cuticle was onely lightly shrunk, there Oyl of Tartar per Deliquium would have sufficed, viz. if the affeted part had been lightly touched therewith; because so the Pores of the Cuticle and small passages of the Cutis would have been opened, and the Acor of the stagnizing Humors temperated; as I (not long since) did experience in my self, when I burnt my Foot with boiling hot Coffee, which Burning was not without Dolour and Redness.

[Page 151]

OBSERVAT. III.

Of the Hernia.

A Man Seventy years of age, was vexed with a very great and painful Tumor in his Scrotum, which Tumor was of the same colour with the sound Skin. He felt great dolour in his Abdomen, and vomited up whatsoever he assumed. Having been in this state for 24 hours he implored my help.

Then did the sick Man, by me examined, relate, that he had for a long series of years been afflicted with an Hernia, which (the Bowel being fallen into the Scrotum) did often in a strange manner afflict him; but so soon as the Bowel was again thrust into its place he felt no discommodity thereby: but the Bowel had never before so long as now remained out of the Abdomen, and notwithstanding all endeavours of the Patient, he could not put it up again.

To his Friends I declared his Disease to be full of danger, because the Bowel had so long remained out of the Abdomen. So a man 40 years of age, travelling on foot [Page 152]from Ultrajectum to Arenacum, was afflicted with an Hernia infesting his Scrotum, and yet (after this) he walked on his Feet for full Four hours (with this Hernia he had also been formerly afflicted, but that was onely in his Groin) whence the Tumor very much increased, and was very hard and painful; the Patient in the mean while vomited continually, and was constrained to lodge for one whole cold night in Straw at a Rufticks house; the next day he was carried in a Coach (continually vomiting) to Arenacum.

To the Sick man was given a Mixture discussing Flatulencies, but that was soon rejected by Vomiting; also three Clysters were injected, but to no purpose. The Patient was laid in a good posture, moist and dry Fomentations were applied to the affected part; but these proving ineffectual, the Patients Pulse gradually diminishing, he died the fourth day after this last invasion of his Distemper.

His Carkass being opened, the great Gut Ileon was found to be infected with a Gangrene the length of a Span, and sited in the Scrotum, with flatulent and hard Excrements. Besides, a great part of the Omentum was contained in the Scrotum, wrapped up like a Ball, with the sanguiferous Vessels very much distended.

In the mean while I admonished the [Page 153]Friends of my Patient not too much to despond, and to that end related to them the Eighth Observation communicated to Riverius, by Mr. Ozia Aimar a most famous Chyrurgeon of Gratianopolis, in which after many Remedies for nine days used in vain, the Bowel (for as many days) remaining in the Scrotum, was happily reposited by Incision made, as far as to the production of the Peritoneum, which stranguled the Bowel. The method by which this Operation was instituted, you will find in the above-cited Observation.

But whence is it that in an Hernia the Bowel slips down into the Scrotum and other Parts? This is occasioned by relaxation of the Peritoneum, which proceeds from Obstruction of the many small passages of the same, and because in them the Humors stagnize and are coacervated, and in process of time insinuate themselves between the Fibrils of the Peritoneum, and so relax the same.

Now why did not the Bowel, fallen into the Scrotum of our Patient, with as much ease return into the Abdomen as it came out, seeing the way is the same? This principally hapned because the Bowel had remained so long out of the Abdomen in the Scrotum, where was less heat: For the Pores of the Bowel, by that means somewhat constringed, prevented the free egress of [Page 154]the Vapours (partly also condensed by the Bowels long lying in the Scrotum) wherefore they were coacervated in the Bowel, and distended it with Flatuses as they are commonly called.

Therefore it is hence sufficiently manifest, that the principal Cure of this Evil consisted in opening the Pores of the Bowel (fallen out of the Belly) and rendring the Vapours (in some measure condensed) again fit for greater motion and agitation, that so they might circulate (as formerly) round their proper Centers.

I effected this with Thread newly twisted (and not purged by boiling) which I first boiled in sweet Milk, and then applied it hot to the affected part; by which means, after it had been applied one quarter of an hour, the Bowel (with gentle force of the Hand) returned into the Abdomen of the Patient, laid in a fit posture.

The Sick man, thus (as it were) snatched out of the Jaws of Death, with the Fisher learned to be wiser, and afterwards always wore an Iron Truss (all over covered with Cotten) for retaining the Bowel in its place: For, to attempt to heal men perfectly that are so far in years, and afflicted with this Evil, is to labour in vain. What Fabritius Hildanus relates (in his Book of Observations) very rarely happens, viz. That a man Sixty years of age, had for [Page 155]Twenty years been afflicted with a great Hernia, which could not be healed by any Physician or Chyrurgeon, and that the same old man afterward was intirely restored to his pristine health, without Medicaments, after he, afflicted with some perillous Disease, had lain upon his Back 14 days; therefore the same Author affirms Rest and lying on the Back to be the best Remedy against the Hernia.

But we see the Hernia's of young Children very often cured (and indeed especially about the Eighth year of their Age) with a good Truss made of Linnen, and Sylvius his Carminative Plaister spread upon Leather (the Discription of which is found in the first Book of his Praxis, Chap. 14. under the Title 58.) in which notwithstanding there is one Errour which I hope no man will follow, worthy to be noted, viz. that Gum Galbanum and other things are dissolved in Vinegar, which not a little infringeth the Volatile Salt of them.

The Oath of Physicians in the Ultrajectine Academy commands, that things heard or seen in a Cure should not be mentioned but involved in silence. And this Oath (I judge) should be strictly observed in the Hernia's of Young men; because this Evil attending them is wont to be more offensive to Maidens than is fit; which (before I finish this Observation) I purpose to declare by an Example.

[Page 156]

A new-married Virgin, when she and her Bridegroom were the first time in Bed together, boldly handled those parts of her Husband which Adam (as the Scripture witnesseth) presently after his Fall, covered with Fig-leaves; and so by the Truss he wore, perceived he was afflicted with an Hernia; whence she, driven almost to madness, passionately uttered these words: You may be ashamed so impiously to deceive your Lover; O miserable wretch that I am, what Counsel shall I take? I am certainly undone. Can such a distempered Body satisfie a Maid in the flower of her Age, having not as yet accomplished her eighteenth year? No, I am totally lost, and had rather die than live longer with you. The Husband in the mean while seriously pondering the matter, at length with kind and good words returned her this Answer: My Love, my Sweet-heart, be of good cheer, and drive from thee this vain and superfluous care; for I promise you by the effect to prove my self a Man sufficient, so that you shall never afterward have cause any more to complain of this matter. Nine Months were scarcely elapsed, before Experience confirmed the Husbands words, by Twins which his Wife was delivered of; who never after durst so much as whisper any thing of her Husbands imaginary impotency.

[Page 157]

OBSERVAT. IV.

Of a Suppurated Tumour of the Breast.

A Woman giving Suck, had for several days laboured with an hard, red, and painful Tumor, sited in the superior part of her Breast.

Paracelsus his Stiptick Plaister being applied, the Tumor was quickly suppurated, and spontaneously opened, and much laudable Pus did for some time issue out thence; in the mean while to the Aperture I applied Arctaeus his Balsam, of which this is the Description.

℞. Sheeps-Grease,
Gum Elemi,
Venice Turpentine, of each ℥ij.
Oyl of St. Johns-wort, ℥j. ss.
Wax, ʒij. Red Sanders, ʒj.

Mix and liquifie all, strain the Mixture, and make a Balsam. I did also apply Paracelsus his Stiptick Plaister, and upon that laid a small Bag made hot, which was first filled with Rye-flower, for softening the remaining [Page 158]hardness; and so this Tumor was healed in the space of a few days.

I shall not at this time explain how the Imposthume was produced, Pus generated, the Ulcer cleansed, and many other things of which I treated above; but onely signifie that I here (contrary to the vulgar custom) used no Tents, and for good reason, viz. because they, in many cases like this of ours, do commonly infer more detriment than ease or benefit; for they are wont by their pungent property to hurt the Bottom of the Ulcer, and render the Lips of the same callous; and in the mean while can do no good, because the Pus is very often found happily enough to issue out without their help.

Not onely in this Imposthume; but also in many others, I have observed, in the first days after the apertion of the Tumor, a white shining Pus to flow out; but afterwards a certain pellucid, yellowish, oyly and somewhat viscous Juice, at the sight of which (being taught by frequent experience) I have been accustomed to judge the Evil would in a short time be healed; and that they do egregiously err (whosoever they be) that seeing this above-described Juice, would keep open Imposthumes by thrusting in Tents.

Now that you may more easily give credit to what is here mentioned, I shall endeavour [Page 159]by solid Reason to confirm this Experience. The issuing out of a white shining Pus, for several days, from an open Imposthume, is caused by an acid Ferment (with which the Interiour Superficies of the Imposthume is imbibed) mixed with the nutritive Juice, by reason of the interrupted passages, falling into the Cavity of the Tumor: but when this acid Ferment is removed, then the nutritive Humor presents it self sincere to the sight, viz. pellucid, yellowish, oyly, and somewhat viscous.

That this oyly Liquor, at first pellucid, acquires a white colour (by its admixion with Acidity) will undoubtedly seem strange to no man that hath even but once in his life seen how soon Oyl-Olive, after it hath been mixed with Vinegar, presents it self white to the sight.

OBSERVAT. V.

Of an hard Tumour of the Breast dissolved.

A Matron giving suck one very cold Night, exposing her left Breast (as she lay in Bed) to the then freezing Air, [Page 160]the next day complained of a great Tumor (of the same Breast) hard and very painful, which continually increased: Some days were elapsed before my Advice was asked.

This Tumor was twice a day anointed with unsalted Butter mixt with common Chalk, and over all was applied hot a small Bag filled with Rye-flover; and in the mean while for several days the Patient suckled her Infant. By the help of these few, and not much compounded Medicaments, this Tumor was happily removed.

By reason of Cold admitted, the Milk stagnized in certain Glandules, was coacervated and waxed acid; whence, as may be easily judged, that hardness and dolour derived their Original.

Chalk mixed with unsalted Butter, temperated the Acor of the stagnizing Milk, and so dissolved whatsoever was coagulated in the Glandules, the small Bag filled with Rye-flower, applied hot to the part, in the mean while contributing help.

How far Chalk is available for correcting acid Humors, you may easily discern, when you mix the same in a Glass with Vinegar, because immediately after the commixion of both, you shall see and hear an egregious and very manifest (although as to our touch cold) Effervescency, and afterwards you will find the sharpness of the Vinegar not a little diminished.

[Page 161]

OBSERVAT. VI.

Of very great Torment of the Abdomen.

A Maid, aged Forty years, had now for six Weeks passed, complained of a most vehement dolour, yet not far extended, but exercising its Tyranny in a very small part of the Belly, and day and night most cruelly tormenting the Patient, who had used very many Remedies, both Internal and External: She was purged, and had a Vein opened, but in vain; so that (after the use of these) she almost despared of recovering her pristine Sanity; in the mean while the External Cutis in the pained part, could not be distinguished from the sound parts of her Belly.

I, being called, with my Knife cut a small Wound, which is vulgarly called an Issue, and kept that open by a Pea put in and daily renewed.

The next day after the cutting that Issue, the Patient had ease of her pain, which from day to day did more and more lessen, so that it was wholly removed quickly after.

[Page 162]

One Month after the Issue made I permitted it again to close up, and so this sick Maid was in a short space of time freed from this exceeding Torment and remained well.

Some Acido-corrosive Particles in the affected part, were perhaps separated from the other Particles of the sanguiferous Mass, with which so long as they lay involved they could not exercise their sharpness.

So Nitre put upon the Tongue infers little or no trouble; whereas the Spirit of Nitre doth not a little corrode the Tongue, because it is now at liberty, and separated from the other Particles of the Nitre with which it was before mixed.

After the same manner Vitriolate Tartar bites the Tongue little; whereas Spirit of Vitriol by distillation thence again separated, recovers its pristine corrosive force which it had before.

These Acido-corrosive Particles, freed from their Cells, in which they before lay included, and collected in a very small part of the Abdomen, did with their sharpness in a wonderful manner continually agitate the Fibrils, and so inferred that almost intolerable torment, which must necessarily cease when these corrosive Particles were driven out with the Pus through the Issue.

[Page 163]

OBSERVAT. VII.

Of a Bleeding Teat.

AN honest man's Wife giving suck, whilst she was cleansing her Infant from his Excrements, was not a little offended with their blackness, the Infant in the mean while was somewhat ill.

I being consulted about this case, first asked of the Infants Mother, whether she felt any pain in her Nipple? She answered she did. I therefore bid her in my presence somewhat to compress her Nipple; and then I saw Bloud issuing out thence, (because one or other of the small Vessels was hurt) which assumed by the Infant, and carried through the Belly, waxed black, by reason of the acid Ferment in the Infants Stomach mixed therewith.

The Mother, by my order, sprinkled Gum Arabic (cut into thin slices, dried and pulverized) upon her finger, first moistned with her proper Spittle, and with that Finger touched her Nipple; by this means she was the next day wholly freed from this Evil, and remained well.

[Page 164]

The most famous Sylvius, in the third Book of his Medicinal Praxis (Chap. 10. under the Title 28, and following) instanceth this Bloud, sometimes issuing from the Nipples of Women giving suck, as an uncontroulable Argument, to demonstrate, that Milk is not generated of the Chyle, but of the Bloud; yet in this he is deceived, because that Bloud issueth out from the sanguiferous Vessels hurt, or otherwise opened by the Child's sucking.

Chaps are often seen in the Nipples of Suckling Women, which affect them with very great torment, and are difficultly healed, because they can have little or no rest, by reason of the Infants continual sucking. But I have frequently healed these Chaps in a short time, by every day often gently touching the Nipples with a Feather moistened with Oyl of Myrrh; the description of which may be seen in the Amsterdam Pharmacopoea.

Prudent Old Women are wont to advise Young Men affecting Matrimony, first with their hands gently to touch the Breasts of the Maids they love, that so they may be assured that they either have or have not Nipples. But though Virgins may often seem to be without Nipples, yet Experience teacheth, that the Nipples before hid (when they become Mothers) may easily by the help of a fit Instrument be [Page 165]drawn forth, and commodiously enough perform their office; therefore there is no need of Nurses, to which many Mothers are much averse, because they firmly perswade themselves, that the Infants by the Milk they assume must needs imbibe the evil and bad qualities of their Nurses. In this case I can determine nothing certain [...]; yet this I know, viz. that Infants daily nourished with Cows-milk do not thence acquire to themselves bruitish and Cow-like manners.

OBSERVAT. VIII.

Of an exceeding great Dolour of the Ear.

A Virgin aged Twenty four years had now for 15 Weeks very much complained of an almost intolerable pain of her Ear, which sometimes would, whole nights, hinder her sleep; the Ear in the mean while daily poured out abundance of well digested Pus, many Medicaments being adhibited in vain.

I being called, gave heed to all (and indeed the least) Circumstances as circumspectly as I could, and at length with my [Page 166]Fingers felt a certain Undulation of Pus, deeply sited behind the affected Ear. This Abscess was not observed by others, though it was the cause of the whole Evil.

Well weighing and considering the matter, I soon understood, that this Abscess behind the Ear would never spontaneously, viz. without external Artifice, be opened; not onely by reason of its depth, but also because the Pus there contained had already sought an Exit for it self by the Ear, although that passage was full of crooked turnings, and not sufficient. Wherefore I quickly applied a sufficiently sharp Corrosive, by which the Eschar being separated, an abundance of well-digested Pus issued out by the hole made by Art; and after that time the dolour of the Ear and the out-flowing of Pus from the Cavity of the same wholly ceased. The hole made by the Corrosive (all the Pus being by it evacuated) in the space of two Weeks wholly closed up, and the Sick Maid was perfectly restored to her pristine state of health.

I judged this Aperture behind the Ear was to be made without delay, lest otherwise the Pus should have touched the subjected Bone, and in time have infected the same with rottenness, although good Pus, abiding for some time upon a Bone doth not always necessarily infect the same with rottenness, as I shall easily demonstrate by the following Example.

[Page 167]

A Man about the Thirty sixth year of his age, travelling in very stormy Weather in the Winter-time, soon after felt a great pain in his right Ear, out of which every day after some Pus issued out, and then followed no small abatement of that dolour. Afterward the Pus flowing out no more, the Sick man again complained of very great torture, which (in the night often producing a Dilirium) had continued now for several Months, and yielded to no external or internal Remedies.

Being called, I found a Tumor behind the Ear extended far and wide, in which (I firmly perswaded my self) Pus was contained, although (by reason of the deepness of the place in which the Pus lay hid) no Undulation could be perceived by the touch; therefore I applied a Corrosive, by which a very gross Eschar being separated, an incredible quantity of Pus issued out. This Pus lay upon the Petrose Bone, which was wholly bare, as I could easily observe by my Probe: Yet in the mean while, without any separation of Fragments of the Bone, the Patient (in the space of six Weeks) was perfectly healed, and remained well afterward; no other Medicaments being used, than a fit Injection, a good Digestive, and at length (the Bone being again covered) my Tincture of Antimony, which I daily find wonderfully profitable in many cases externally used.

[Page 168]

The Drum of the Ear being eroded by an Ulcer, the Hearing is recorded to have remained, by Vopiscus Fortunatus Plempius, in his Fundamentals of Medicine, page 148.

Moreover I remember I have at Rotterdam (with Jacob Lodensteyn, chief Chyrurgeon of the Navy, a most dexterous man) seen all the small Bones, pertinent to Hearing, which after an Ulcer, came out of the Ear of a certain Boy; but that Boy never heard of the same Ear afterwards.

I knew a Chirurgeon, who to remove the pain of the Teeth, was wont with a red-hot-Iron to burn the Ear; but this seems to be a ridiculous and vain operation.

OBSERVAT. IX.

Of the Cubit displaced by reason of Relaxation of the Ligaments.

A Youth about 15 years of age, one evening putting off his Clothes, suddenly and unexpectedly felt Immobility of his arm, with a certain sound arising therefrom, because the Cubit was dislocated, which was easily again reposited; but very often afterwards, upon the least motion it would [Page 169]slip out of its place. This Evil had continued for full three years, notwithstanding all the deceits of Aposems, made of Guaiacum, Sarsaparilla, China, and other things which the Patient (animated by the hopes of health) had during this time greedily swallowed; in the mean while Plaisters, Liniments, and other External Remedies, were not omitted: but the Youths Arm became much more slender than was fit.

The Patient at length committed himself to a certain Chirurgeon to be cured, who certainly promised him the restoration of his Arm, which he set about after the following manner.

To the Arm ill-affected, he (every week often) applied certain Cupping-glasses, but without Scarification; and then the same days after Cupping, under the Arm (the upper part of which was covered) he burned Spirit of Wine impregnated with the Volatile Salt of many Herbs, the Vapour of which surrounded the whole Arm. These were the principal things, which (in the space of half a year) restored to our Young man his pristine state of health; so that the Patient at this time, without fear of a relapse, pleaseth himself with the Art of Fencing, and other like Exercise.

The Ligaments connexing the Gubit with the Shoulder, were relaxed; how that hapned you may see, in the last Observation of the First Decade.

[Page 170]

Besides, there were many Obstructions in the Nerves, Arteries, and small passages of the Muscles, whence proceeded the Atrophia and extenuation of the Arm.

The Cupping-glasses, often applied with Flame, removed the Obstructions of the Ligaments, Muscles, and other parts; by their heat opening the Pores and small passages, and giving more free passage to the Circulation of the Bloud and Humors through the Arm: For the pressure of the Air under Cupping-glasses is much less and weaker than elsewhere; as you may more clearly understand by the 7th Observation of the Third Decade.

The Vapours of the Spirit of Wine kindled into a Flame, did (without any impediment) enter into the Pores and small passages, sufficiently opened by the Cuppingglasses, and there atenuated and dissolved the viscous and coagulated Humors.

And so those Particles (that had insinuated themselves between the Fibrils of the Ligaments, and by that means relaxed them) being removed, the Ligaments acquired their pristine state which they before enjoyed, whilst the Arm remained unhurt, and by that means they again retained the Cubit conjoyned with the Shoulder, as was fit.

The remaining Obstructions being also removed, the Atrophia of the Arm did likewise begin to vanish.

[Page 171]

OBSERVAT. X.

Of a Gonorrhaea contracted from impure Contact.

A Young man aged Twenty four years, a great admirer of Beauties, and a true Son of Venus, after Coition with an impure Harlot, suffered an almost continual Issue of white and viscous matter from his Yard; which was not onely without pleasure, but also attended with a cutting dolour, which was likewise felt when the Patient voided his Urine.

An Acido-corrosive Ferment lying hid in the Genital-parts of this Whore, being more than usually agitated in Coition, passed through the Yard of this Young man, into the Pores of the Prostates and seminal Vessels (by Coition more than usually opened) and so by its sharpness infected both the Seed and nutritious Humors, and excited small Ulcers in those parts: Hence arose that Vellication and almost continual contraction of the Prostates and small Seminal Vessels in the aforesaid manner, with dolour frequently pouring out the Seed and nutritious Humors corrupted.

[Page 172]

This Evil is generally called a Gonorrhaea, and is sufficiently perillous, because it often degenerated into the Venereal Lues if the Cure of the same be deferred: For then the Acido-corrosive Ferment is forcibly removed and mixed with the Sanguineous Mass.

Therefore without delay I set about the Cure, and (for temperating and evacuating the corrosive Acidity, as well as for sanation of the small Ulcers) I prescribed the following Pills.

℞. Extractum Catholicum, granes 24.
Mercurius Dulcis, granes 6.
Salt-prunella Antimoniate, gr. 5.

Make Pills, N^o vii. These Pills the Patient took early in a Morning, and for five days following (every day once) he took this Bolus.

℞. Venice Turpentine, ʒiij.
Rubarb, ʒj. Mix these S. A.

He again afterward used the above-prescribed Purgation and Bolus as before; and by this means recovered this pristine state of health.

Turpentine is, by some, so long boiled, as until Pills may thereof be made, but this is an evil practice; for the boyling forceth the Spirituous Oyl into the Air, whereas in that Oyl the principal vertues of the Turpentine is known to consist.

I do again condemn Acid things in this [Page 173]Affect; but perhaps my Opinion will seem strange to some, viz. that Acidity should be so noxious and inimical to Sanity in a living Animal, whereas Vinegar preserves the flesh of a Beast killed, for a long space of time without corrupting; but, to remove this Scruple, I Answer: The matter is far otherwise in a living Animal than it is in the same when dead.

In a living Animal, for conservation of Life and Health, the free Circulation of Bloud and Humors (through the Vessels and passages sufficiently opened) is absolutely necessary; yet this Circulation is not a little impeded by Vinegar and other acid things coagulating the Bloud and Humors. But in a dead Animal, to preserve the Flesh thereof, the aforesaid Circulation is not requisite; but there is onely need to take care that the very small Particles of the Flesh killed be not too much agitated, fermented, and forced from their station by the ambient Air: to effect this, Vinegar is very fit by reason of its gross and heave Particles.

That the flesh of a Beast killed will remain uncorrupted, if the motion of the very small Particles (otherwise like to be) be by this or that cause stopped, is very manifest by this, viz. that Flesh killed in Winter is kept sound for many days; whereas the Flesh of a Beast (of the same [Page 174]kind) killed in the heat of Summer, is most speedily corrupted by the Air, at that time constituted in very swift motion.

That Vinegar consists of gross and heavy Particles, is manifest by Distillation, which teacheth, that Spirit of Wine is sooner elevated into the alembeck than Water, and Water also sooner than Vinegar.

Moreover it may be said, that the Volatile Salt of Flesh killed is coagulated with Vinegar, and so is kept unmoved, and impeded from being fermented with the Air, losing its Figure, and flying away; as we see the Volatile Salt of Hartshorn, or any other Volatile Salt, coagulated with an acid Spirit, not to fly away, as it is otherwise wont to do.

The end of the Fourth Decade.

[Page 175]

DECADE V.

OBSERVAT. I.

Of a Wound of the Head.

A Youth aged Sixteen years, fallen from an Horse to the ground, received a sufficiently large Wound in the forepart of his Head; which was indeed so great, that the Bone presented it self bare to the sight; in the mean while the Patient did often vomit and was very ill. Two hours, after this mishap, were scarcely elapsed, before I was called to this Youth, in whose Head I could perceive neither Fissure, nor Fracture, nor imbowing of the Cranium; and at that time the Vomiting ceased, and the sick Youth was pretty sedate, and complained not much of pain or of any other discommodity.

It would in this place be superfluous to explain whence this Vomiting proceeded; the matter being (as I judge) sufficiently clear of it self.

The Hair being shaved off, I filled the [Page 176]Wound with dry Lint; and indeed did this for two reasons: First, that the Flux of Bloud might by this means be stopped. And Secondly, that the Lips of the Wound might be in some measure separated each from other, to the end that the Cranium might (the next day) be the better discovered.

Then I superposited a Plaister made of the following Mass.

℞. Emplast. Diapalma, ℥ij.
Bolus, and common Chalk, of each ʒij.
Diaphoretic Antimony, ℥j.
Oyl of Bays, ʒij. Of Tartar, p. d. ʒss.

Mix and make a Plaister.

The next day nothing of evil appeared in the Cranium discovered, and the Patient was scarcely vexed with an evil Symptome; whence I conceived hope, that the Interior part of the Cranium had also received no hurt, and that the Brain likewise lay unprejudiced within both its Infoldings.

Therefore, the Bone being first covered with dry scraped Lint, I applied to the Lips of the Wound this following Medicament.

℞. Common Turpentine,
Honey of Roses, of each ℥ss.
Myrrh, Aloes, of each ʒss.

Mix these, make an Unguent.

[Page 177]

By this means the Patient was in a short time restored to his pristine state of health.

The Plaister was applied for temperating the Acidity, and that it might speedily dissolve whatsoever was coagulated by the Contusion: The Unguent was also added for restoring the Circulation of the Bloud and Humors, somewhat impeded by reason of the small passages (in the Wound) interrupted and distorted.

The bared Cranium was covered with dry scraped Lint, partly that the Pus (issuing from the Lips of the Wound) might infer no damage to the Bone, and partly that the ambient Air might (by this means) be kept from the Cranium, to which, by reason of its Acidity (with which it abounds) it is very inimical, as the daily coagulation of Bloud let out from a Vein cut (caused by the external Air) doth plainly teach.

But that kind of Lint which is in Dutch called Catoen, is not convenient in Wounds, because it is often wont, by its acute Angles (with which it abounds, as by the help of a Microscope may easily be seen) to excite Inflammation.

All fat things I here studiously avoided, because they, with their stringy Particles, too pertinaciously obstruct the very small passages of the Cranium, and so cause the Humors to stagnize and wax acid, corrupt [Page 178]the Volatile Salt of the Cranium, and induce rottenness; and then the Cure must needs be not a little procrastinated, by reason of the perished part of the Bone, which must first be separated.

Scultetus, in his Chyrurgick Armoury, anoints the part adjoyning to a Wound with astringent Oyls (for some time) to prevent Inflammation (as he judgeth) but improperly: For in an Inflammation the Circulation of the Bloud should not be stopped, but promoted; because the Bloud and Humors, by reason of their coagulation, in an Inflammation stagnize more than is fit; therefore it would in this case be an Argument of much greater prudence, to dissolve the coagulated Humors by Plaisters temperating Acidity.

The cutting of a Vein, which many egregiously extol in Wounds of the Head, I wholly omit, because I see not any Utility thence to arise.

To distinguish Medicaments, into Mundificatives and Narcoticks, and to take sometimes These, and afterwards Those into use, is a matter of no Utility; for our Unguent onely is sufficient, and performs whatsoever is necessary; whilst it temperates Acidity, and restores the Circulation of the Humors. But in the mean while it is to be observed, that when the Wound was almost filled up with flesh, omitting the aforesaid [Page 179]Unguent, we at length applied dry scraped Lint; for otherwise the Flesh would have been too luxuriant and risen higher than was fit.

The Ancients in Wounds of the Head used a Swathe which is called Cancer, the delineation of which may be seen in Scultetus; but in these our days a common Napkin fitly applied is generally used.

Vomiting, in a Wound of the Head, for the most part portends much evil; but that it is not always an infallible sign of a Fracture of the Cranium of a Fissure, or any other very great discommodity, is clearly evident by our proposed case.

Full of peril is a Wound of the Head, which beguiles us most when it seems most pleasing. Therefore no Wound of the Head (though very small) should be lightly esteemed, or negligently handled; but here we should rather suspect all things, because where Chyrurgeons are most secure, there commonly lies a Snake in the Grass.

Having for some time pondered these things in my mind, I judge it worth while before I put an end to this Observation, to enlarge my Discourse more than I am wont to do, that if (in this case) I cannot satisfie others, I may at least give satisfaction to my self, for whose Instruction I write these.

It is out of all doubt, that a very small [Page 180]Wound of the Head, long after it hath been inflicted, may infer Death; yet this hinders not, but that it may sometimes happen, that a Patient having a Wound of his Head (accounted almost by all men most dangerous and mortal) may recover, contrary to the expectation of Physicians and Chyrurgeons. So, I remember, some years since, to my Fathers care was committed a certain wounded man, who had with a Spade received so horrid a Wound in the forepart of his Head, that (by the stroke inflicted) not onely a very great part of the Cranium, but also no small portion of the Brain it self was shattered, and notwithstanding this, the same man is at this time (at Arenacum) living and well, yet his Hemiplegia still remains.

By this History I shall (perhaps) prove the opinion of the most famous Willis to be false, who endeavours to perswade his Reader, that the seat of the Memory is found to be in the Cortex of the Brain; for if this were true, then our above-recited Patient must needs have had his Memory much impaired, whereas it is at this time no less vigorous than it was before the Wound received.

But what do I speak of those who have recovered of an horrid Wound of the Head? Is it not much more wonderful, that to some persons very great benefit redounds [Page 181]from a Wound of the Head so very perilous, that it is by most men accounted mortal? especially seeing there want not Examples testifying the same? So you may read (in Schenkius) how a certain man, receiving a dangerous Wound in his Head, was freed from an inveterate and very pertinacious Epilepsie. Also if it be not too much trouble to you, I would have you peruse the most famous Hildanus (in his Second Century, Observation VIII.) who exposeth to sight a case sufficiently rare; where he saith, A certain man received a Fracture of the Cranium, upon the conjunction of the Sagital, with the Coronal Suture; and the same man afterward (the Ulcer notwithstanding remaining) was by this means freed from a great and troublesome Cephalalgy, with which he had been for a long time before) very much molested.

Such Histories as we have now related, very rarely happen, therefore in a Wound of the Head (whatsoever it be) it is best to be always too careful, rather than at any time too secure.

But a Wound of the Head, where the Patient is infected with the Veneral Lues, is much more difficultly healed; as also if the same part hath been often wounded before. For usually in the Lues an Acido-corrosive Humor is peccant, which contributes [Page 182]no small Impediment to the cure of Wounds. But when it happens that the same part hath been often wounded, it is well known, that not a few of the small passages there remain distorted in a wonderful manner; so that the Bloud and Humors are thereby not a little impeded in their Circular Motion, by the benefit of which (notwithstanding) almost the whole cure of Wounds is effected.

That the Circulation of the Bloud and Humors is impeded in a part once or oftner wounded, though the Wound be long before healed, is manifest by this, viz. that the parts formerly wounded are frequently sensible of the approach of Cold or Storms more than usual.

Moreover, a Wound of the Head is more or less dangerous according to this or that part of the Head on which it is inflicted: So a Wound of the hinder-part of the Head is judged less perilous, because the Bone of that part (by reason of its grossness and solidity) seldom suffers a Fracture or Fissure, although it receive a stroke very vehement; and when it doth happen to be broken or crack, then the Filth notwithstanding (in this Fracture or Fissure collected) doth not so easily distil down upon the subjected hard Meninges.

But a Wound inflicted on that small Bone of the Brain, with which maturity of [Page 183]Age afterward fills up the open place in Infants, is accounted, and undoubtedly is, very perilous, because that Bone is tender and nigh the Suturos.

So a wound of the Temples is very formidable for many Causes; and indeed first, because the Temporal Muscle is covered with the Pericranium.

Secondly, because there lies an Artery (sufficiently great) which being wounded induceth a very dangerous Hoemorrhagia, which must needs be very difficultly stopped; because while we speak or eat the Temporal Muscles are moved, and so the flux of Bloud (before cohibited) is often wont to return and be renewed.

Thirdly, because the Nerve (in the Temporal Muscle) hurt is wont to excite a Spasmus, and indeed such as in Dutch is called de klem, and hinders the Patients eating. So when a Muscle of the Temples is very much hurt, its opposite Muscle is contracted, and that Affect excited, which is called Torture (or Wryness) of the Mouth.

Fourthly, because Artificial Section (sometimes necessary in Wounds of the Head) cannot be safely made in a Temporal Muscle.

Fifthly, because the cure of Wounds requires rest of the wounded part, which notwithstanding is often disturbed in a [Page 184]Wound of a Temporal Muscle, viz. as oft as we eat or speak.

A Fissure in Sutures is also worse than elsewhere, and most difficultly found. So Hippocrates (Epid. 5.) freely. confesseth himself to have been deceived, and indeed to the ruine of the wounded man.

A Wound inflicted on the Eye-brow, so as the Cavity be opened, which is found in the Bone of the Forehead, emits wind, because that Cavity of the Bone is previous into the Noethrils; that Wound can scarcely (by any means) be consolidated, according to the testimony of Celsus and others that have seen such cases.

Chyrurgeons, when they doubt of a Fracture or Fissure of the Cranium, give to the wounded man a Nut to crack with his Teeth; or they make a Thred (one end of which the Patient holds in his mouth) observing whether he can bear that trembling motion without trouble.

When the Cranium is bared, we generally with a Probe search whether there be a Fissure or no. But that this Examen may be rightly instituted, 'tis behooful before all things exactly to know the accustomed site of Sutures; least a Fissure be taken for the Suture, or the Suture it self for a Fissure. Also, that this Errour may be wholly shunned, it is expedient for the Artist always to bear in mind, that the Sagittal [Page 185] Suture doth sometimes (contrary to the usual custom) slip down as far as the Nose, and so deforms the Forehead; yea, also that it sometimes extends it self to the hinder-part of the Head and divides that. Here likewise the Observation of a certain Anatomist is worthy of remarque, who affirmeth he saw that little Bone of the Bregma, with which (in riper age) the place lying open in young Children, is filled up to be circumscribed with a small Suture.

In the Writings of Parey, Fallopius, and others, we may read of wounded men, in who (being dead and opened) the external Table of the Cranium, which received the Wound, was discerned to be intirely whole, the Internal (in the mean while) not onely cleft, but also exhibiting certain Fragments, which (by their punction) molested the Meninges. How could this happen? I answer: The vehement stroke had very much agitated the Subtile matter nearest, and so this Subtile Matter most swiftly moved (without delay) freely passed through the first Table of the Cranium, inferring no damage; but when it came to the second Table of the Cranium, much more solid than the first (as Anatomists testifie) it there met with Pores so very small and crooked, that it could not pass unless by a new way, which it in a moments time violently prepared for it self; and so [Page 186](many Pores being broken through) egregiously cleft the Internal Table of the Cranium: As Lightning is reported to have melted a Sword leaving the Scabbard unhurt; so Aqua Fortis dissolves Silver, not hurting Wax.

Many declare that it sometimes happens, that the right-side of the forepart of the head being struck, the left-side is crackt, the right-side remaining whole; and such a Case is usually called a Contrafissure, though this word Contrafissure is often extended to other cases also.

I willingly confess I never saw such a Contrafissure; but Celsus affirms such a case hath happened, Aegineta denies it, therefore I suspend my judgment about this matter.

It so happens sometimes, that the Marrow which is found between both Tables of the Cranium, is (by a forcible stroke) crushed and squeezed out which the Bloud (also by the same force) extravasate: and so this Marrow with the Bloud conceives an Acido-corrosive Acor, by which it induceth rottenness on the Internal Table of the Cranium; and so (sometimes) the acrid and aqueous Humor, proceeding from the perished Bone, infects the Meninges and Brain it self, and infers sudden and unexpected Death, some Weeks, yea some Months after the hurt received; the Cranium in the [Page 187]mean while on the out-side appearing whole, not shewing either Fracture or Fissuren Such Examples are here and there described by Author that have written of Chirurgy.

The Cranium, with the Dura-mater, being hurt, sometimes (in the space of 24 hours) ariseth a Fungus, in magnitude almost as large as an Hens-Egg, which the most famous Malpighius judgeth to derive its Original from those Glandules hurt, of which the Cortex of the Cerebrum is compounded, and which (according to his Opinion) end in the Roots of the Nerves, into which they transmit their nervous Juice received from and purified by the Arteries.

It is by almost all Authors seriously advised, that no Wounds of the Head be sewed up, and indeed very well.

When Wounds of the Head were bound up, Vesalius always used a Wax-candle lighted (not a Suet-candle, because fatness hurts the Bones) to the end it might in some measure temperate the cold of the ambient Air; but at this time some Chyrurgeons use a certain Brass Vessel filled with live Coals, which Vessel is in Dutch called een bedpan.

The middle space, that is between both Tables of the Cranium, is found to be much thinner in Children, than in Men full grown; which is (as I judge) very fit to [Page 188]be well observed by Chyrurgeons when they either use a Trepan or Lancets; for otherwise it may happen that they may perswade themselves they are not yet come to the middle space, when in the mean time they hurt the Meninges it self.

Some, before they use the Trepan, chuse to make a cross-like Incision of the Flesh; others a Triangular; but my Father always esteemed the Circular Incision best, and so he separated and took away all that portion of flesh from the Cranium.

In Operating some dip their Trepan in Oyl for temperating the heat, (as they say) but evily, because Oyl, as we have often said, is inimical to the Bones; wherefore common Water may in this case better serve.

The Ancients opinionated, that the Marrow and Brain in Animals increased in the first Quarters of the Moon; therefore at the Full Moon they forbid the use of a Trepan. But at this time Experience hath taught, that the Brain in the Cranium, and the Marrow in the Bones of Animals, do no more abound in the Increase of the Moon than at any other time; thus this Opinion, superstructed on so sandy a Foundation, falls to ruine.

The Ancients would not permit the Trepan to be put in Sutures; but we have Chirurgeons at this time who do this without fear.

[Page 189]

It sometimes happens, that the Duramater very firmly adheres to the Cranium; yet this is but seldom, and is beside the usual custom.

To the Meninges lying bare, Scultetus applies Oyl of Roses, Celsus Vinegar; both err, the one more, the other less. What can Oyl effect, unless it be the obstruction of the Pores and Passages of that membrane, and so impede the Circulation of the Bloud and Humors? But Vinegar will coagulate the Bloud and Humors, circulating through the Meninges, and so not a little hinder the circular motion of them.

What shall then be here applied? Honey or Syrup of Roses; but best is the Syrup, (being less sharp) which may be put in hot with a round Lint, having a Thred tyed thereunto.

The Trepan being used▪ it sometimes happens, that no Evil is found upon the Meninx, but the Pus lies hid under the same: When this is seen, the Meninx must be cut, that passage may be made for the Pus to flow out. Here is no cause of fear, that the Pia-mater will be hurt, because the interjacent Pus prevents that. I remember that this Apertion of the Meninx was happily instituted at Arenacum.

A Patient wounded in the Head, should rather assume Meats liquid than solid. For otherwise the motion of chewing may [Page 190]somewhat molest the wounded part; and indeed more especially if the Wound be inflicted in the Temples.

If Sneezing sieze any one wounded in the Head, it will undoubtedly too much shake his Brain and hurt the Wound. Therefore it would be prudence so soon as Sternutation is perceived to approach to prevent the same; which may easily be effected, if at that time we often rub the greater Angle of either Eye with our Fingers.

In a Wound of the Head, Anger and Venery must (above all things) be shunned, because they very much disturb the Brain, and so infer no small damage to the miserable Patients; as frequent Experience daily proves.

Thus I shall now at length put an end to this Observation, after I have said, that here I have offered none but thing rare and worthy of note. For all other things pertinent to Wounds of the Head, are largely enough treated of by Parey, Hildanus, Scultetus, and other writers of Chirurgy, which to repeat here (I judge) would be wholly needless.

[Page 191]

OBSERVAT. II.

Of a Wound penetrating the Thorax.

A Young man Thirty years of age, received a Wound between the sixth and seventh Rib (if you reekon from the inferiour) with a Sword, which penetrated into the Cavity of the Breast, as was experienced by a Probe gently thrust in; as also by the Air, impetuously enough issuing out from the Wound. The Patient in the mean while eat well and complained little.

Because this Wound was not sufficiently opened to give Exit to the Pus, we put in a Tent (made of Spunge) with a Thred tyed to it, and by this means the Wound was the next day very well opened. Therefore we then applied a Tent made of a scraped Lint, and anointed with a good Digestive, with a Plaister temperating Acidity, and a good Ligature.

In the mean while the Patient drank twice a day three Ounces of the following Apozem.

[Page 192]

℞ Of the Herbs Colts-foot, Maiden-Hair, Scabious, of each Mij.
Leaves of the Fir-tree, Mj.
Raisins stoned, ℥iij.
Fennel-seed, ℥ss.
Barley, Mij.

Boyl all in equal parts of Common Water and French Wine, and use the Colature; which also, when necessity requires, may be injected by a Syringe into the Cavity of the Breast, being (at that time) mixed with an Ounce or two of Honey of Roses.

The Wound, thus handled for several days, emitted a little Pus, and the Patient was otherwise very well; therefore we daily formed the Tents shorter, and so the Patient was (in six Weeks time) wholly recovered of this Wound.

The Probe, with which the deepness of the Wound was searched, was not Iron; because this Metal (by reason of its rigidness) doth not sufficiently give way to the Muscles, which are wont sometimes to enter and fill up the place of the Wound, when the Patient changeth the posture of his Body; but a Wax-candle (in Dutch called een wassichie) was used, which in this case, by reason of its flexibility, would better serve. But before we set about this work, we commanded the Patient to stand [Page 193]with his Body in the same posture in which he stood when wounded.

The Air brake forth impetuously enough from this Wound, and sometimes so forcibly as it would blow out a Candle held near. But whence did this happen? I Answer, When the Thorax is streightned in Expiration by the Muscles of the Abdomen, as also by its proper Muscles, the Air (commixt with not a few Vapours) is compressed, and compelled to seek for it self an Exit; and so, by reason of the streightness of the place, it is with great force driven out from the Wound, no otherwise than as we see Air with great impetuousness to issue out of the Nose of Bellows, when the sides of the Bellows are only gently compressed. For so a great part of the motion; which before did diversly agitate the several Particles of the Air, is now imployed to move the Air to one part only.

But why was the Tent tied with a Thred? I answer; That it might not be forced into the Cavity of the Breast. For that such a thing hath sometimes hapned, very many Histories testifie; yea, we have read, that Tents have not only been forced into the Cavity of the Thorax, but also that the same afterward hath been by the Mouth of the Patient expelled with coughing.

Therefore, whence is it that the Tent [Page 194]sometimes penetrates into the Cavity of the Breast? Shall we with the Ancients answer, that is done by Suction or indrawing of the Thorax? No: For we can clearly and evidently enough demonstrate that every motion conspicuous in this Corporeal Universe is made by Pulsion.

It would be no less absurd and disconsant to Reason, if I, with many others, should in this place have recourse to the Asylus of a Vacuum which is not, as is clearer than the Sun at Noon, to all those that are not wholly blinded with their own Prejudices; and is distinctly enough explained by the famous Cartesius, in his Second Part of the Principles of Philosophy.

But that we may call this what it is, and what may most easily be understood, we reply in this manner: When the time of Inspiration is present, the Thorax is rendred more capacious, because the Diaphragma is contracted downward. Now because the Diaphragma is thus contracted, the Belly egregiously swells, and so forcibly enough drives out the Air, which (there being no where any Vacuum) at the same moment of time must needs enter the Thorax enlarged as aforesaid; and so the Air enters partly through the Cleft of the Larynx, partly also through the Orifice of the Wound, (as being a passage more commodious, [Page 195]more short, and more free) and when the Air so rusheth inward through the open wound of the Thorax, in its passing through it forceth the Tent in with it self, it be not tyed with a Thred strong enough.

Some Authors, when they suspect that some part of the Bloud or Pus doth lye upon the Diaphragma, they endeavour to heal up penetrating wounds of the Breast, without the help of any Tents, and commend the same to others; but in the first days they cannot be sufficiently assured of this matter: therefore they seem to act more prudently, who (with me) for some days use Tents, and in the mean while as much as they can keep the ambient Air from the Wound. But in the interim we must be very careful in due time to abstain from Tents: For if their use be protracted longer than is fit, an uncurable Fistula may happen, continuing to the last moment of life; because the continual agitation of the Breast in Respiration (which is no small hindrance to the Consolidation of Wounds) is not a little conducent to the production of such an Evil.

Penetrating wounds of the Thorax are very dangerous, and compel many to bid adieu to the Society of the Living, and in others excite a Ptisick worse than death it self. But in the mean while, I remember [Page 196]I have read of one, who was happily freed from an Asthma (with which he was long before cruelly afflicted) by a wound penetrating into the Cavity of the Thorax. Yea, I at this time know an honest Citizen of Arnhemium, to whom a penetrating wound of the Breast proved very salutery. For he for a long time before had been afflicted with an Empyema, and daily expected death: but when by another (I know not from what cause provoked) he was wounded with a Sword, so as the Wound penetrated into the Cavity of the Breast; and by this means, the Pus flowing freely out through the Orifice of the Wound, he was in a short time after freed from his Empyema, my Father (while he lived) being his Physician.

When, in a very small Wound of the Breast, Chyrurgeons doubt whether the Wound hath penetrated into the Cavity of the Thorax or not, they are wont to hold near to the Wound either burning Tow, or the flame of a lighted Candle, and thence they judge of the penetration of the wound; if there be a Trembling motion in the flame of the Tow or Candle, excited by the Air proceeding from the Breast, then the Wound is deep, otherwise not.

When it happens that any part (contained in the Cavity of the Breast) is also hurt, then the Wound must be kept open [Page 197]the longer, and into it twice a day some Injection be emitted hot, without the addition of Carduus Benedictus, Aloes, Wormwood, and other bitter things, as some are wont to add. For the bitter Particles carried upwards with the Air, through the Branches of the Pipe of the Lungs hurt, affect the Tongue with bitter and troublesome taste, as frequent Experience witnesseth.

If any great sanguiferous Vessel (sited in the Cavity of the Thorax) be wounded, then much Bloud is wont to be collected together above the Diaphragma, and (by this means) to excite heaviness about the Diaphragma, Fevers, Watchings, bloudy Excretion, prostrated Appetite, and difficult Respiration.

This Bloud must be several times every day evacuated through the Orifice of the Wound; yea the Pus also, which some days after the Wound received usually follows.

If the Bloud that flows out from a sign the Lungs are wounded; and such a Wound often infers on the sick a Tabes, but more often death. This will not seem strange to any man, who (with Malpighius and other curious searchers of the Humane Body) will not disdain somewhat more piercingly (than the Ancients have done) [Page 198]to inspect the substance of the Lungs. So doing, he will discern the Lungs to be no other than a certain conjested heap of membranous small Bladders, clothed with a wonderful Net (composed of the minute very small Branches of the small Veins and Arteries) into which small Bladders passage is given to the Air through the rough Artery.

Hence therefore it is sufficiently manifest, that a Wound of the Lungs cannot be so very small, but that some small sanguiferous Vessels of these small Bladders must also be hurt; whence the Cure is rendred yet more difficult (which was before of it self difficult enough) because these small Bladders are membranous, and posited in continual motion, into which every hour new Air is introduced. For membranous parts are more slowly healed than the fleshy; and no man can doubt, that rest of the part hurt hastens the consolidation of a Wound, if he hath (but once in his life) observed how easily wounds of the Tibia are healed, the sick keeping himself in a Lying-posture; and on the contrary, how difficulty the same wounds are consolidated when the Patient daily walks about the Streets. And lastly, who knows not that the ambient Air ought diligently to be kept from Wounds?

Therefore wounds of the Lungs (as we [Page 199]said) are by Experience found to be almost all mortal. Yet in the mean while we read, that a Patient may supervive the taking away a piece of his Lungs by a Wound.

Assoon as men are born and respire the Lungs are filled with Air; but it is not so in the Young whilst in the Womb. To this Physicians give heed, when they are compelled by the Magistrate to give their Opinion whether an Infant died in the Womb, or lost its Life out of the Womb. For then they take the Lungs out of the Breast of the Carkass and put them into water; if they swim above the water, they conclude the Infant died out of the Womb; but the contrary when they sink and are submerged.

A Wound in the fleshy part of the Diaphragma, brings the sick into no small peril, yet that is sometimes healed. But when a membranous part of the Diaphragma is wounded, the Patient (a Fever and Delirium arising) expires not long after. Nor indeed is this to be wondred at, seeing (by reason of the continual and very sensible motion of the Diaphragma) the small passages about the Wound are very much distorted; whence the Humors there stagnizing wax acid and produce Inflammation. And when these acid Humors are (from the Inflamed part) absorbed into [Page 200]the sanguineous mass, a Fever is induced, which a Delirium follows. So I remember a Carter of Arnhemium, who was wounded with a Knife in the membranous part of the Diaphragma. Presently after the wound inflicted he came to our house on foot; but soon after became so very weak, that he was carried home by two men, where (siezed with a Fever and Delirium) he died three days after.

But wonderful is that which I not long since read, viz. that in one man the Stomach, in another the Gut Colon (by a wound of the Diaphragma) ascended from the Abdomen into the Thorax, and that both Patients lived for some small time after.

A wound of the Pericardium is judged mortal; and where the substance of the Heart is also wounded, the Patient (for the most part) suddenly dies. Yet I am able truly to witness, that a Jew of Arnhemium, wounded in the very substance of his Heart, did notwithstanding (every day twice) for six days together (before he died) come to our house on foot to have his Wound dressed.

Galen in one place relates (as an Eyewitness) that the Pericardium being corrupted, the Heart lay sufficiently bared in the Breast of a certain sick Man, who notwithstanding recovered. But men at this day are found to be so very incredulous, that [Page 201]with them such Histories find, or seem to deserve, little credit.

Whilst I make mention of the Heart, two Prejudices seem to me fit to be removed. The first is, that with which the generality of the Common sort are frequently affected; that is, they pertinaciously believe, that the Heart hath its seat in the Left-side of the Breast, whereas it is placed in the midst of the Breast. But occasion of this Errour was first given to the people from this, viz. because there is a more vehement Pulse felt in the Left-side of the Thorax than in the Right. But this happens because the great Artery hath its situation in the Left-side.

The other prejudice, which I was willing to reprehend, is this, viz. that some of the Ancients did perswade themselves that the Heart was afflicted with no Diseases; the falsity of which Opinion is notwithstanding daily proved by Experience. So in the French Ephimerides we read, that (in the right Ventricle of a Dogs-Heart) thirty and one living Worms were found, being of the length of one Finger, and as thick as a common small Needle. Moreover the Heart is sometimes affected with a certain Disease, called the Polypus of the Heart; touching which, peruse Malpighius in his Anatomick Treatise of the Structure of the Bowels.

[Page 202]

In penetrating wounds of the Bowels, some Chyrurgeons instead of Tents use small Cannels of Silver, Lead, or of Linnen well waxed; but because Silver is often infected by the Pus, and Lead too soon covers the Lips of the wound with a Cicatrice, here in this place the Cannais made of Linnen well waxed ought to be preferred before the other.

Acid things are inimical to all Wounds, but especially to wounds penetrating the Thorax: For besides their coagulating the Bloud and Humors, and rendring them unapt for Circulation, they do also hurt in this case, viz. because with their Acid-Particles cutting on either side, they are wont to excite a cough.

But although I reject acid things, I do not therefore here commend sweet Syrups, seeing they profit the Lungs little, but (in the mean white) hurt the Stomach and other parts; as many others with my self do daily find by Experience. It is better from Colts-foot, Maiden-hair, and other fit Herbs, to extract their Tincture with boyling hot Water in such a small Vessel as the now commonly known Drink is wont to be prepared of the Herb Tee.

If a Patient be afflicted with a penetrating wound of the Thorax, and the Bloud, latent in the Cavity of the Breast, issue not out by the wound, let him hold one Graine [Page 203]of Musk under his Tongue, and the Bloud will presently flow out, as Sennertus saith; but of the success I very much doubt.

Sometimes the place of the Breast wounded is higher than that the Bloud or Pus, congested upon the Diaphragma, can flow out; then is the Bloud or Pus not seldom seen to be expelled by the Mouth with coughing; yea, not a few Authors testifie, that at such a time the Pus is sometimes driven into the Bladder, and expelled with the Urine; which Pus (they think) may by two ways be brought to the Bladder: First, if through the small Veins or Lymphatick Vessels, it be forced into the sanguineous Mass, and with the same carried to the Reins; and at length (when it shall there be transcolated) descends by the Ureters into the Bladder, and so is expelled with the Urine. But the other way seems to be far more difficult: For they judge that the Pus can, in the form of Dew, transpire through the Pores of the Diaphragma (from within looking outward) and so passing through the whole Abdomen, at length enter the Cavity of the Bladder through the Pores of the same (from without looking inward.) That such Pores, from without looking inward, may be found, is evident by the following Experiment: In an hot Room invert a Bladder, and fill it with hot Water, and then you [Page 204]will see the Water transpire like Dew.

When it happens that the Pus (copiously contained upon the Diaphragma) cannot be expelled by the wounds being too highly sited, nor by the Mouth with coughing, nor be evacuated by the Bladder with the Urine, then is commended a Paracenthesis; that is, an Artificial Incision in a lower place of the Thorax. This Incision is usually made between the fifth and sixth Rib (if you number from the Inferiour) not in the midst of the Breast, but in the Side; and this rather in the Anterior than in the Posterior part thereof; and rather about the Superiour than the Inferiour part of the Rib; and indeed with a Knife, having (for a good part of it) a Cloath wrapped round about, just at that moment of time in which the Patient breaths.

But in this Age wherein we now live, and in these Regions, this operation is very rarely exercised.

The Paracenthesis being made, the Pus must not be let out all together and at once, but at several times. This all Chyrurgeons concede to, but few of them know why they do so. Some say the Spirits would be dissipated if the Pus should be let all out at one time; others feign, that provident Nature is then sensible of that Vacuum, therefore presently sends much, yea too much Bloud and Humors into that [Page 205]place. But both these Reasons are so very frivolous, that they deserve no refutation. Therefore I shall briefly declare what I judge to be the reason of this: It is certain that into that place, from which the hot Pus hath receded, the cold Air hath immediate access; which doth not only molest the Fibrils (before somewhat injured by the Pus) but also produceth many Obstructions in the small passages; so that in them the Humors stagnize, are coacervated, wax acid, and by that means an Inflammation is excited, much after the same manner as when we have been exposed to the cold Air, and presently after are well warmed, we are not seldom afflicted with Catarrhs (as they are vulgarly called) and when we are above measure hot, and at that time drink cold Beer, we are sometimes punished with a Pleurisie.

OBSERVAT. III.

Of a penetrating Wound of the Abdomen.

A Young man, aged Twenty years, was wounded by an Adversary of his, so [Page 206]that the Sword passed through the anterior part of the Abdomen and pierced through his Back.

The Patient soon after he was wounded took his Bed, and the first days did somewhat complain of this or that Discommodity; but afterwards from day to day he waxed better and better; and both his Wounds (in three weeks space) were perfectly consolidated with the use of Tents put in, which were first anointed with a good Digestive, and a fit Plaister superposited.

It was not necessary in this case to search into the profoundity of the Wound, it being sufficiently manifest, that this Wound had penetrated into the Cavity of the Abdomen, because the Swords point had passed through the Belly and came forth at the Back.

Otherwise the profundity of a Wound is wont to be searched out by an Iron or Leaden Probe; but better is a Wax-candle (which is in Dutch called een Waslichie) because it can much more commodiously be bowed, and accommodated to all occurrent Meanders. Here in the mean while it is to be studiously observed, that sometimes the Probe enters very deep, passing through the Interstitiums of the Muscles, and the Wound (notwithstanding) penetrates not so far as into the Cavity of the Belly. [Page 207]And on the contrary the Wound sometimes penetrates into the Cavity of the Abdomen, though the Probe (when thrust in) presently finds resistance, viz. because the parts in the Body hurt were otherwise figured when the sick was wounded, than afterward when the state of the Wound was searched into.

A Wound of the Abdomen, though it penetrate not into the Cavity of the Belly, yet is difficultly healed, by reason of the motion of Respiration: For Wounds to be consolidated require Rest.

But if a Wound of the Abdomen, not penetrating, be in the White-Line (so called) then it is much more difficultly healed, and very painful.

In the Second Observation of this Decade, I willed the enlargement of very small wounds of the Breast; but this Operation deserves not place in wounds of the Abdomen: For in such it is to be feared that the Omentum of Bowel, through too large an hole of the Belly, should slip out of the Cavity of the Abdomen.

Some dream, that the Resurrection of the Dead shall take beginning from the small Bone contained in the 18th Vertebra; but they dream indeed without any similitude of Truth. Truly I know not what answer men of such an Opinion would give me, if I should ask them, whether that man [Page 208]should not rise in whom that small Bone had (while he lived) been broken to pieces by a Wound.

The Testicles hang without the Cavity of the Abdomen, and therefore may be easily wounded; yet their being wounded hazards not the life of the Patient. For we by experience find, that a man can supervive the cutting out of both his Testicles. I my self familiarly knew a man (studious of Medicine) who had both his Stones by reason of a carnous Hernia happily cut off.

What then are the Testicles? They are no other than a certain Congesture of very many most small Threds or Vessels confecting the Seed; which Threds, if separated each from other without breaking, would (in a man) easily exceed the length of twenty Ells. For the Testicle of a Dormouse is extended to fifteen Ells.

Many Chyrurgeons, to Wounds do first of all apply repelling things, that is things cold and astringent; but in wounds of the Groin omit them. If you ask their reason, they will answer you, Because the Emunctory of the Liver is in the Groin. This Answer is both frivolous and rediculous, and we have already (in the Eighth Observation of the First Decade) exploded and and sufficiently refuted the same.

What then is the reason that Chyrurgeons [Page 209]do any where else but in the Groins use cold and astringent things? Attend a little and I will tell you. Cold and astringent things hurt almost every where, but more in the Groins than elsewhere; which Experience (the Mistress of Fools) hath taught them. The fact they know and confess, but are wholly ignorant of the cause of such an Effect. Therefore they seign to themselves such a Chymaera; whereas (in the mean while) the true cause is, that certain Glandules have their seat in the Groins, which Glandules are no other than a Congesture of very small Vessels much inflexied, in the Meanders of which the Humors more easily subsist than elsewhere, if Chyrurgeons (by cold and astringent things unseasonably applied) retard their Circulation.

All penetrating Wounds of the Abdomen are dangerous, but far more perilous when they are large; because the Omentum (or Bowel) at that time easily slips out; and if it be not, presently after its Egress, forced into its proper place, it dies and changeth its colour by reason of the ambient Air. But whence is it that the Omentum for some time remaining out of the Belly so suddenly dies? The Omentum consists of very many small Bags, into which the Grease is conveyed through several fatty Vessels, as the most accurate Anatomists of this Age [Page 210]plainly witness. Hence it is now easily manifest how readily the Grease (in its small Bags) and the Matter (contained in the very small fatty Vessels) may be coagulated by the cold Air.

Now when the Omentum, issuing out of the Cavity of the Abdomen, by reason of some delay, is in the aforesaid manner corrupted; then must a Thred be tyed between the sound and the corrupted part, and least the sound part also be infected what is corrupted must be cut off; and if the Wound be found too large, that must be sewed up: but the aforesaid Thread hanging out of the Abdomen must be a left so, until it falls off of it self in process of time. Thus I knew one, part of whose Omentum (by its too long stay out of the Abdomen) was corrupted, recovered happily of his Wound, who was after the same manner handled by my Father.

In a large wound of the Abdomen, the Bowel sometimes issues, which must be presently thrust in; for otherwise it is so distended with Flatus's, as it cannot be thrust into its pristine place. But whence is it that the Bowel is so distended with Flatus's, remaining out of the Belly for some short time? I answer; A certain Fermentation is excited, not onely in the Chyle, Pancreatick Juice, and Choler; but also in the Feces left of the Chyle, and in the [Page 211]Ferment adhering to the sides of the Bowels. Hence arise many Vapours (not to mention those Vapours which from the Pores of the small Arteries, continually enter into the Cavity of the Bowels) which must needs be accumulated in the Cavity of that Bowel, and distend it; if in the Bowel abiding out of the Abdomen the Pores (from within looking outwards) be closed up by the ambient Air.

Now what remains to be done, when the Bowel out of the Abdomen is seen distended with Flatus's? The closed Pores are to be opened, and greater agitation contributed to the Vapours contained within; which may well be effected, if a Thred newly twisted, but not purged by boyling, having been first boyled in sweet Milk, be applied hot.

Then the Bowel, the Flatus's being absumed, must be reposited, and (if need be) the Wound, in some part sewed up.

If the Bowels be also wounded, the life of the Patient is in very great danger; and indeed the more, if the Wound be inflicted in a thin Bowel, but not so if in a more gross Bowel; because in this the Wound, after it is sewed up, is more easily conglutinated; the Bowel being such as consists of a greater number of small passages, through which the nourishing Humors are conveighed. So the gross Bowels [Page 212]generally contain onely Feces, but Bowels more slender the Chyle.

Whilst I here treat of the Bowels, a certain Dispute, which hath been for a long time contraverted among Physicians, comes into my mind, viz. whether nourishing Clysters injected do obtain the wished Effect; or whether (as some say) they be wholly unprofitable for Nutrition; because, according to their opinion, they come not so far as to the sanguineous Mass? But they err who embrace the last opinion, if credit may be given to credible men, who (taught by Experience) witness, that the same quantity of Spirit of Wine, if injected into the Fundament by a Clyster, will sooner inebriate than if taken in by the Mouth.

The Liver consists of certain glandulous Kernels, into which the small sanguiferous Vessels conveying their own Humor, are terminated, and of the Branches of the Bilary-Pores, which receive the Choler separated in those glandulous Kernels.

Moreover great sanguiferous Vessels are seen in the Liver, whence it is easily understood how dangerous are those Wounds that are inflicted on the Liver. For if the great Vessels be opened, an Haemorrhagia yielding to no Remedies follows. And though those great Vessels be not hurt, yet a wound of the Liver (though but small) [Page 213]doth in the mean while disturb the separation of Choler, which notwithstanding we know to be exceeding necessary in the Oeconomy of an Animal.

But notwithstanding these, Paulus Aegineta speaks of a man that recovered of a Wound that had taken away a piece of his Liver.

It is wonderful indeed, that one man should supervive the loss of a piece of his Liver, and another die by the too-great increase of his Liver. So some years ago, to my Fathers care was committed a Sick-man, afflicted with a vastly tumified Belly, continuing so unto Death. His Carkass being opened, clearly presented the cause of this Evil to the sight, for his Liver was incredibly augmented. I remember the same hapned in an Hen, which never laid Egg, the Liver of which weighed an entire pound.

The Spleen is a congesture of small Membranes, formed into small Cells and Concamerations, in which Cells innumerable oval and white Glandules (into which the Arteries, Veins, and Nerves are opened) do in a wonderful manner adhere.

Here it is to be understood (as an industrious Anatomist of this Age judgeth) that the Humor is carried, through the Arteries, into the Glandules of the Spleen, and by the Glandules (being there separated and [Page 214]somewhat acid) into the above-named small Cells; and from those Cells, imbibed with an acid Ferment, into the Splenetic-Branch, and so to the Liver; where, in the Bloud, it in some sort precipitates the Choler, to the end that may so much the more easily be separated in the glandulous Kernels of the Liver.

Hence it is now manifest, what great misery a Wound of the Spleen infers on the sick.

The Reins consists of Glandules, into which the small Arteries, Veins, and Branches of the Ureters, are terminated. Through the small Arteries the Humour is deferred into the Glandules of the Reins, in which the Urine is separated, and taken from the Branches of the Ureters is forced into the Bladder.

That the matter is thus, you will more easily believe, when you shall know the following Experiment, which a certain Professor communicated to me, and is this: If you, by a Syringe, inject warm Milk into an emulgent Artery, the more gross part will return by the emulgent Vein, and the wheyish Portion be sequestred in the Reins, and thence conveyed into the Ureter.

Hence it is apparent how perilous Wounds of the Reins are, and how difficultly they can be consolidated; also [Page 215]hence, whence proceeds Bloud excreted with the Urine, when the Reins are wounded, is easily understood.

Whilst I am speaking of the Reins, I call to mind a certain Question often bandied about among Physicians, viz. which way the Drink, a little after it is assumed, cast out by the Urinary passage, can come so soon into the Bladder? or whether it first comes to the sanguineous Mass, or not touching the Bloud, presently and immediately hastens to the Reins or Bladder?

The latter seems more probable, and is confirmed by the following Experiment: If a Vein be cut in any one a little after he hath eaten Garlick or Asparagus, neither the Bloud extracted, nor the whey-like Humour floating above it, shall have either the odour or taste of the Garlick or Asparagus eaten, when (in the mean while) the Urine shall manifestly exhibit the odour of Garlick or of Asparagus.

Now, whether this Urine pass out through the Pores (of the Stomach and Bowels) from within looking outward, and through the Pores of the Bladder (from without looking inward) under the form of Vapours, having surrounded the Cavity of the Belly, and so at length is conveyed to the Bladder, or rather hath its tendency thither by a peculiar passage, I shall not at this time dispute, though the latter Opinion [Page 216]seems to me most probable.

Wounds inflicted in the bottom of the Bladder are very full of danger; but those that wound the fleshy neck of the Bladder, are oftentimes consolidated, by reason of the abundance of sanguiferous Vessels, and multitude of small passages conveying the nutritious Humors. This is what we daily experience, after the exection of Stones, viz. that though those wounds be healed, yet sometimes the Urine flows from the sick involuntarily by the Yard; the reason of this is, because in Section and Extraction of Stones, not a few Fibres of the Spincter Muscle of the Bladder are cut in sunder and broken.

But if in the Cavity of the Belly, some of the small Lymphatick Vessels be wounded, may not an Ascites be by this means produced? What shall I say? such a case seems not to be impossible, though I cannot remember that I have in my practice seen any such thing, or elsewhere read of it.

Dolour of the Testicles in perilous wounds of the Abdomen, is a sign of approching death, as the most experienced Parey testifies.

I have here hitherto spoken of wounds of the Abdomen inflicted from without, there is yet a Wound (remaining to be spoken of) which is inflicted from within, viz. [Page 217]as when in an Ascites the Navel bursteth, partly from the great distention of Water, and partly from the acuteness of the cutting Particles floating upon that Water. So I remember an Hydropick Maiden-Child, aged five years, which (her Navel being after the aforesaid manner burst) dyed in a few days after.

In such a disruption of the Navel, diligent heed is to be taken, that the Water flow not out too fast; therefore here must be prescribed an Apozem, prepared of Guaiacum, Sarsaparilla, and other things.

Some affirm, that if the Moon shine upon a wound (whatsoever it be) that wound cannot be healed without difficulty; but whether this be true or no, I know not. It is certain, that the cold Air hurts wounds; but whether that be more injurious when the Moon shines than at any other time, is indeed what I have not as yet experienced.

Mr. Blankard, in his Medico-Physical Collections, saith, that Spirit of Wine mixt with Spirit of Sal-Armoniac, doth very much profit in Wounds; and so saying doth not a little confirm my Opinion, whereby I judge Acidity hurtful in every wound, and that our principal care ought to be employed in correcting that.

[Page 218]

OBSERVAT. IV.

Of an Artery of the Arm wounded.

A Souldier Forty years of age, was wounded with the point of a Sword, in his Arm below the Cubit; from which wound the Bloud issued with great force, and indeed with intermediate stops, as if forced out of a Syringe by intervals.

That Artery was wounded which is touched when we feel the Pulse of the sick.

We have known Bleeding at the Nose to kill some; and have read, that the hasty flowing out of Bloud, after Extraction of a Tooth, hath killed others. If the opening of such very small Arteries can infer Death, into how great danger of life shall the Aperture of so great an Artery, precipite the miserably-wounded party?

Therefore, because so great danger is sited in delay, I judged the Cure was to be presently set about, and accordingly (so soon as I came) I applied two Lints pleated together cross-wise a little above the [Page 219]wound, over them putting a sufficiently strict Ligature.

Then, to the wound, with Lint I applied the following Medicament mixt with the White of an Egg.

℞, Root of Tormentil, ℥ij.
Acorn Cups, Galls, of each ʒj. ss.
Mastich, ℥ ss.
Bole armenac, Terra sigil, of each ℈14.

Mix and make a Powder.

In the mean while the Patient often took two Spoonfuls of the following Mixture.

℞. Water of Plantane, ℥ij.
Of Roses, ℥j.
Sugar perlate, ʒiij.
Sanguis, or Sanguinis Draconis, ʒss.
Terra Sigillata, ℈ij.
Salt prunell. Gr. 25.
Laudanum Opiat. Gr. 3.

Make a Mixture.

The Bloud thus stopping we did not unbind the Wound before the third day; and then, from the Wound issued out a little Pus, but no Bloud. Thus was this wound (so very full of danger) with the help of a good Digestive, very well consolidated, after the manner of other wounds, in two Months space.

This Wound was very dangerous, but [Page 220]would have been much more perilous, if it had been inflicted above the Cubit; because there is found one onely great Artery, which (below the Cubit) is divided into two sufficiently large Branches; so that one of them being closed by Art, the Bloud may freely pass through the other.

It sometimes happens, that the Bloud from an Artery wounded below the Cubit, running out with great force, cannot be stopped in the above-prescribed manner; therefore at such a time certain Iron-Instruments must be used, which I have always by me, though I cannot in words well give a plain Description of them. I remember two that were by this means cured by my Father.

So also, I have by me an Iron-Instrument; by the help of which my Patron (Consul and Ordinary Physician of Stenovicum) as he told me, had happily stopped the Bloud flowing out from the Artery Carotides, in the Neck of a Fox wounded.

Therefore, forasmuch as wounds of the Arteries are so very dangerous (as we see) I thought good in this place to subjoyn a double caution. The first is, that we do not, after the manner of the Ancients, in dolour of the Head and other affects, attempt to use Arteriotomy about the Temples, Forehead, or elsewhere. For greater [Page 221]benefit from the opening of an Artery, than from the simple cutting of a Vein, is not to be expected. Secondly, Least judging an Aneurisma to be a vulgar Abscess, we unawares cut the dilated Artery. For by this means I have certainly known some to have augmented the number of the Dead.

Moreover Ligatures must not be tyed too close; for by this means I remember a mortal Sphacelus hath unexpectedly been introduced.

But if the Patient from the wound of an Artery, lose so much Bloud, as he suffers great Swoonings, and Death seems to stand at the door, what is then to be done? Cannot the Transfusion of Bloud (so much praised) in this case profit, especially seeing it is declared by credible men, that a Dog, from whom in one day so much Bloud was taken, that he could scarcely move, by Calves-Bloud received the next day, in a moment of time shewed recovery of strength, and incredible vigour? I answer, I cannot remember this Operation to have been at any time instituted by our Country-men; therefore warily suspended my, judgement about this matter.

[Page 222]

OBSERVAT. V.

Of a Fracture of the Tibia with a Wound.

A Virgin Twenty years of age, by the sudden and unexpected discharge of a Gun (I know not by what misfortune happening) charged with Small-shot, received a wound on the inside of her Leg a little below the Knee. Which wound presented it self (in length and breadth) very large; yea so large, that it exceeded an hands breadth. There was also present a very great Contrition and Commination of the Bone of the Tibia broken into very small pieces, which extended it self the whole length of the Wound, and thickness of the Bone of the Tibia. Whence the sick Maid was afflicted with most cruel dolour, which caused her to pass many Nights without sleep; or if she at any time slept for a very little while, she would suddenly awake, not without very great terrour, attended with a Convulsion (as it were) of her wounded Leg; by which means the broken Bones were often distorted.

[Page 223]

The broken Bones were reposited without great Extension, and the Fragments which were wholly separated loose and at liberty, were presently taken out without much trouble; the remaining Fragments, yet somewhat adhering, were left, till (in process of time) they should be separated.

Then was applied a digestive prepared of Turpentine, the Yolk of an Egg, Powder of the Roots of Flower de Luce, and Birthwort, with Myrrh and other things, together with a Plaister and Lavament temperating Acidity. After these was used a common Ligature, and at length the affected Leg, included in a case of Wood, was aptly placed in the Bed; over which hung a Rope, by which the Patient might raise her body when necessity was; and at her Feet was erected a Semi-circle of Wood, lest the weight of the Bed-clothes should create any trouble to the wounded Leg.

The cutting of a Vein, which very many are wont to commend in such a case, was wholly omitted; because no benefit can thence arise; nor were Purgers here (according to the vulgar method) revoked into use, because in this Evil nothing is more desirable than Rest, and nothing more pernitions than Motion. Therefore whensoever the Patient was necessitated to discharge her Belly, a four-doubled [Page 224]Cloath was laid under her to receive the Excrements.

In the mean while the Patient eat Foods easie of digestion, drank new Beer, and the first Evenings after she was wounded, assumed a certain gentle Anodine, for mitigating the dolour and removing that terror of which I spake.

The Bones were reposited as often as they were found distorted by that Nocturnal terror.

The Wound by reason of great abundance of Pus, was dressed twice a day; and so in process of time very many Fragments were separated. And then we could daily see the Generation and Accretion of a Callus, arising not from the Marrow, but from the very small Pores (or passages) of the Bone, through which are conveyed the nourishing Humors, coming from the small Arteries.

This Wound, so very perilous, was closed up in a Months space, and the Patient could again as well stand and walk as she had done before this wound was inflicted.

I remember another Woman, afflicted with the same Evil, to have been cured by my Father. But these two Examples should not render any Artist so secure, as slightly to regard a Fracture with a Wound: For I have known that to have caused death in many. So, when in the Hospital as Rotterdam, [Page 225]I was present with others, daily for almost whole days, dressing very many wounded Men, which came from the Siege of the City of Graaf, I remember all they that laboured with a Fracture and Wound of the Tibia died; and among others, one was afflicted with a Fracture and wound of the Tibia, in whose wound I beheld (not without Admiration) very many broad, thick, and white shining Worms. But whence had these Worms their Original? I answer, From Eggs fallen from the Air into the wound, out of which the Worms were excluded, when a certain Fermentation was excited in the stagnizing Humors. So not a few Eggs fall from the Air into Milk, of which Cheese is afterward made. As long as that Cheese is new, these Eggs are not excluded; but when the Cheese putrifies; that is, when (in process of time) a certain Fermentation is produced in the Cheese, then do the Worms crawl out of the Eggs.

So in a very great contrition of a Bone, the Fracture with the wound attending, I remember to have been cured no otherwise than by cutting off the Leg a little below the Knee.

In a Fracture of the Tibia with a wound, some are wont to use the Ligature of eighteen Heads, which is in Dutch called een boexwiise Ligatuur; but we have happily [Page 226]used the common, which we changed twice a day by reason of the great quantity of out flowing Pus.

I knew a Chyrurgeon, who instead of the wooden Case of which I spake, used a certain Iron-Instrument, into which the Leg affected was put, and so kept extended and unmovable but I cannot here in words give a description of that Instrument.

In a simple Fracture of the Tibia, Ferula's made of Pastboard are generally applied; but in our Patient these were wholly omitted, because in a wound so vast they seemed not convenient.

With our Digestive, which was put upon the Wound, by reason of the bared Bone no Fatness was admixed. For that Fatness hurts the Bones, Experience doth abundantly testifie; the reason of which we have before given.

Parey in the Chyrurgick Practice was very deserving, and had much Experience; yet in a Fracture with a Wound, he improperly commends Astringents, which, why, and how much they hurt, we have often shewed. I suppose no man will take it in evil part that I should dare to reprehend so great a Man; seeing the more famous any man is, the more dangerous are his Errours; because very many, moved by the onely Authority of so great a Man, with a certain blind force follow him, treading a [Page 227]Path that hath been trod, but not that which should be trod.

It is to be observed, that a Callus is most difficultly produced in Fractures of women with Child, or giving Suck; because the matter fit is withdrawn by the young in the Womb, or by the Infant sucking. So Fabritius Hildanus relates (in the 87th Observation of his Fifth Century) that for this cause, in a Fracture of the Tibia with a wound, the Bones were yet loose the 23d week after the hurt received.

In a Fracture, as well Simple as Compound, when a Callus hath again conjoyned the broken Bone, the Patients are commonly sensible of some trouble in motion; which happens because the newly-generated Callus occupies the place of some Muscles moving this or that part.

Before I put an end to this Observation, two very intricate Problems seem very fit to be here unfolded by me. The one is, why Bones in clear Frosty-weather are more easily and sooner broken than at any other time? The other, whence proceeds the Terrour that generally invades the Sick (afflicted with a Simple or Compounded Fracture) presently after a short sleep.

To the First, Some perhaps will answer, the slipperiness of the Ice is the cause that men often fall to the Earth, and so the [Page 228]Bones may happen to be easily broken. But this doth not untye the Knot; this removes not the Difficulty: For not onely Bones, but also Iron, Wood, and other hard Bodies, are more easily broken in the Winter-season than at any other time. Whence then doth this happen? Attend a while and I will tell you. The more pertinaciously and firmly the parts of hard Bodies are conjoyned each with other, the more difficultly they are broken. This is certain: But what is that which effects coherency in the parts of hard Bodies? Not Rest, as some think, because that is not any thing positive in the Body, but onely a privation of motion. Therefore Rest proproduceth not this Effect; but the Air compressing the parts of hard Bodies, conjoyns and causeth them to cohere, as is evident by the Experiment cited in the Seventh Observation of the Third Decade. The Air whilst Summer's Heat is most vehement, presseth more than in Mid-winter; partly because at that time it is more forcibly agitated by the heat of the Sun; partly because then it is more heavy, by reason it is mixt with very many gross Vapours, forced upwards by the Solar heat. Hence it is now manifest, why Bones, and other hard Bodies, are more easily broken in Winter than in Summer. Hence also it may readily be understood, why Wood is [Page 229]much sooner consumed by burning in the extream cold Winter-season, than whilst we enjoy the pleasant Summer. The Winter-Air, by its more weak pressure, cannot very pertinaciously conjoyn the Particles of the Wood; whence these Particles are easily separated from the Wood, when they suffer violence by certain terrestrial Particles; floating upon the onely most subtile matter of the World, therefore most swiftly agitated. Hence it is, that the Winter-Air, as being less pressing and containing fewer Vapours, permits the Flame freely to enlarge it self.

We now come to the other Problem, by which it is asked. Whence ariseth Terrour, invading the sick, suffering a Fracture of the Bone (in sleep and not while waking) and often again distorting the broken Bones?

Parey, a man endowed with great Experience in the Chyrurgic Art, who himself once suffered a Fracture of the Tibia and Fibula with a Wound, and in his own Body plainly enough experienced this Terrour, as he saith; a reason of which he endeavours to render (in the 26th Chapter of his Book of Fractures) but he there miserably philosophizeth, producing nothing but Impertinencies and Chimoera's.

Therefore, let us see whether we can [Page 230]give a more probable Reason that may come nearer to the truth: We will at least attempt it. When the Sick are not sleeping, they see, they hear, they eat, they drink, and stir their Arms, and (by this means) consume much of the Nervous Juice; so that that cannot flow in so great abundance into the parts irritated, &c. but when the Sick indulge their Members with sleep, the matter is far otherwise. The Ears at that time hear not, the Eyes are closed, the Nosethrils perform not their wonted Office, the Tongue is silent, and the Arms rest. Therefore, when (at such a time) the Humors stagnizing and waxing acid about the Fracture, with their distention molest the Fibrils, and by their cutting property irritate them; then, I say, the Nervous Juice (which, in the time of the Patients waking, is not imployed) in great abundance falls down upon the irritated Muscles, which (by this means swollen) vehemently move the Leg, and miserably distort the Extremities of the broken Bone, one to this part, the other to another; whence ariseth pain cruel enough, by which the Patient after a short sleep is awakened with terrour.

But that you may more readily give credit to the reason of this Phoenomenon, I judge it fit to advise you to attend to these few Words following.

[Page 231]

When you are awake, and not sleepy, and when your Semenary Vessels contain much fruitful Seed, imagine to your self (as strongly as you can) some beautiful Maid, yet (as I judge) you shall not by this means eject your Seed, unless you use some other excitation: But if whilst in a sound and pleasant sleep, a very beautiful young Woman be (by imagination) presented to your Phantasie, and if (in the mean while) your Semenary Vessels be sufficiently distended with the Seed, the Seed not seldom (by such means) flows out with very great pleasure, viz. because the Seminary Vessels are very much contracted by the Nervous Juice, which in great abundance (whilst you sleep) is carried from the Brain into the Seminary Vessels distended and very much irritated by the Seed; because it is not now imployed about other works to be done whilst waking.

So I knew two Epileptick Persons, who never had Fit whilst awake, but always when they soundly slept: which doth not a little confirm my Opinion.

[Page 232]

OBSERVAT. VI.

Of Dislocation of the Talus, or Ankle-bone, with a Wound.

A Man aged Forty years, fell from on high to the Ground, and suffered a Dislocation (in the interior Ankle-bone of his Left-leg) conjoyned with a vast Wound, out of which the Bone was prominent the breadth of three fingers, and the dolour was almost intolerable.

This case is very perilous: For, not without great danger of life, a Gangrene sometimes invades the great Toe, infected by the Dislocation and Wound concomitant, as I remember not long since to have happened. But such horrid Symptomes are not to be feared, if in the great Article of the Talus a Dislocation also be with a very large Wound.

This Affect is not onely perilous, but also rare; so that Parey, Pigreus, Aquapendens, Barbette, and other scarcely so much as mention the same in their Books, although Scultetus (in his Chyrurgic Armory) speaks of it: but whether credit is to be given [Page 233]to his Words, or his Counsel followed, we shall see, after we have pondered the following Words written by himself.

If an Article be luxuriant, so as it is either uncovered, or be a little thrust out through the Skin; the Affect is mortal, of greater danger if restored, than if not restored. For if it be not restored, an Inflammation, Convulsion, or sometimes Death follows. Secondly, Foulness of that Member will be present. And Thirdly, an uncurable Ulcer, which if it happen to be covered with a Cicatrice, that (by reason of softness) is easily broken. If it be restored, it infers very great danger of a Convulsion, Gangrene, and Death. But some fear dangers of this kind onely in the great Articles, viz. in the Wrist, Shoulder, Talus and Thigh, which (by reason of the strength of the Tendons, and magnitude of the Ligaments and Vessels) prohibit Restitution. Then he adds: If a Convulsion follows, the Joynt must be presently again Dislocated.

My purpose is no otherwise to answer these words of Scultetus, than by an exact and faithful Declaration of the Medicines we applied to this our Patient; seeing thereby it will be sufficiently manifest, how well or how ill the above-named Author hath written.

[Page 234]

First, We washed the Bone of the Tibia (forced out of its seat) with Spirit of Wine warm, for removing the coagulated Bloud and Filths adhering; then sufficient Extension being made, we set the dislocated Bone in its place, applying to the Wound a good Digestive, with a fit Plaister superposited; not omitting a Lavament temperating Acidity, and a Common Ligature. The Leg thus bound up, was laid upon a soft Cushion, and so the Patient was carried to his Bed, over which hung a Rope, by the help of which he could raise his Body, as I said in the precendent Operation; and at the Feet of this Sick-man we set up a Board, that the Clothes (with their Weight) might infer no detriment to the wounded Leg.

The Leg affected, by reason of the abundance of Pus (flowing out of the Wound) was dressed twice a day. But in the mean while most vehement dolour exercised its Tyranny on our sick Patient; who was both feverish, and had a Delirium, passing whole night (almost) without sleep; or if he was between whiles, somewhat refreshed with sleep, a little after that was excited the aforesaid Terrour (of which we spake in the precedent Observation) whence the Talus was often of some measure distorted again.

To remove the Dolour, Fever, Watchings [Page 235]and Delirium, the Patient at time assumed some of the following Mixture.

℞. Water of Betony, ℥iv.
Of Bawm, ℥j.
Syrup of Card. Bened. ʒiij.
Antimony Diaphoretic, ʒj.
Salt prunella antimoniate, ʒss.
White Corals, Crabs-Eyes, of each ℈j.
Laudanum Opiat. Gr. 4.

Make a Mixture.

But the Talus, as often as it was found distorted after sleep, was reposited.

By this means, the space of three Weeks being scarcely elapsed, the Fever and Delirium ceased; then also, but more slowly, the aforesaid Terrour vanished, and at length the Dolour and Watchings likewise.

But here I call to mind one thing, which I had almost forgot, viz. that two Abscesses arose in the affected Leg, one nigh the Wound, the other in the External part of the Leg; but both these Abscesses after Apertion were healed.

In process of time very many Fragments were separated from the Bone of the Tibia, which we then gently and easily took out of the Wound; and upon the fungous flesh, which was seen in the Wound, we strewed (almost every day once) the Powder of [Page 239]Burnt Allum; and so at length a Cicatrice came in sight, which from day to day increased more and more; so that (about the sixth Month) the whole Wound was almost covered. Wherefore the Patient began to walk with Crutches; but by this motion the Wound was again inlarged, so that it closed not in every part, which should seem strange to no man. For I at this day know two, who after Dislocation of the Talus with a Wound, had an Ulcer several years.

But what if (after setting the Dislocated Talus) the Patient had been afflicted with a Convulsion, must we needs have followed the counsel of Scultetus, and again have dislocated the Article so lately set in its place? I think not, seeing I see no cause that should incite us to such an Action.

In this place I render not a Reason of many Phaenomenons, and indeed considerately, least I should set before the Readers a Dish of Crambe twice cookt. For I think I have here omitted no reason of any Phaenomenon, which may not be found in one or other of the foregoing Observations.

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OBSERVAT. VII.

Of a Nose hurt by Winters-Cold.

A Young Maiden, Sixteen years of age, in Mid-Winter, in extream cold Weather, complained of a Tumor, Redness and Dolour in the Tip of her Nose; and she had been often before afflicted with this Evil in the Winter-Seasons.

The coldness of the Air, both within and without affecting the Nose, the Bloud (in its very small Vessels) and the Humors (in their small passages) were in some measure stagnized; and in process of time contracted a certain Acor, whence the Tumor, Redness and Dolour, were easily excited.

But whence was it that this Evil had now several times returned in the Winter? This Return proceeded from no other cause, than because the small Vessels and Passages were, the first time, so distorted, by the Bloud and Humors stagnizing and waxing acid, that afterwards they could never so well return to their pristine state, [Page 238]but they would (in Winter-time) much impede the Circulation of the Bloud and Humors.

This Affect (in Dutch called de Roud) is without danger, as to life; yet in the mean while it is not a little displeasant to young Maids, accounting their own Form (whatsoever it is) as their chiefest good, and therefore are often willing rather to lose their Life than their Beauty.

This Evil I wholly removed (in a few days) with a Linnen-Cloath onely, anointed with Sperma Ceti.

I shall not now dispute what that is which is known by the Name of Sperma Ceti; whether it be the Seed of that great Fish, or a certain Substance which is found (in the form of thick Oyl) in certain small Cells in the Head of the Whale (about the largeness of Goose-Eggs;) or lastly, whether it be a certain artificial Composition of the Brain of some Fish dried, made up with a Lixivium of Lime. In this place I say, I will not dispute of this matter; it sufficeth me, that much Oyly Volatile Salt is contained in the aforesaid Medicament, which corrects the Acidity in the bloud and stagnizing Humors.

This Evil is wont to invade not only the Tip of the Nose, but also the Fingers, Toes, and Soles of the Feet. To attempt to render a Reason of this would be superfluous, [Page 239]seeing it is manifest, that the cold Air doth more affect the Extreamities of the Body, than other parts; and small Vessels are sooner obstructed, than others more capacious.

To prevent this Evil Cupping-glasses (with Scarification) are wont to be applied, but improperly; because the Obstructions are not by this means removed, but multiplied; and the distorted Vessels are not reverted to their pristine state, but more distorted. Much better would be the Vapour ascending from Spirit of Wine set on fire; or a Fermentation made of Wine and Herbs abounding with Volatile Salt.

To prevent this Evil, when it is wont to infest the Tip of the Nose, some apply Leeches, but evily; for I have known this Affect to be by them not a little exasperated; the reason of which Exasperation I should here add, were it not sufficiently manifest by the foregoing Paragraph.

This Affect is wont leisurely to increase, but sometimes it meets with another Evil, suddenly proceeding from intense Cold; and is called a Gangrene of Cold, which (beginning) is wont to be cured by Immersion into cold Water. But is this a rational way of Cure? Yes, and consentaneous both to Reason and Experience. Cast a frozen Apple into cold Water, and you [Page 240]shall see that (in a short space of time) to be thawed within, all the Ice adhering to the external Skin of the Apple, without loss of its pristine taste, or former consistency; but set the same frozen Apple near a Fire, and it will presently wither and lose the sweetness of its taste.

Very many Particles, contained in the Pores and small Passages of the congealed Apple, which before were fluid, have now (by reason of the Frost) put on the form of Ice; that is, many Particles, which before, by the subtile matter sufficiently strong, were in their motions (each from other diverse) continually agitated, do now rest each with other, because they are surrounded with a subtile matter, which is too weak to conserve them in their usual motion. When such a congealed Apple is cast into cold Water, the more strong part of the subtile matter, from the Water, flies into the Apple, and so thaws the same. But the more weak part of the subtile matter rusheth out of the Apple into the Water, most nearly touching the External Rind (or Skin) which is therefore covered over with Ice.

But when such a frozen Apple is set to the Fire, the most subtile matter of the World, very strong, and attended with many gross particles of the burning Wood or Turf, endeavours (with great violence) [Page 241]to enter the Pores of the congealed Apple, but cannot, because the Pores are very much constringed with Cold; therefore it breaks them by force, and so the consistency and good taste of the Apple is changed and wholly spoiled.

Hence it is now sufficiently manifest, that this Cure of a Gangrene from Cold is rational; though in the mean while it may perhaps seem fit to some to vary one Circumstance, and that is as here following expressed. A congealed or frozen Apple is cast into cold Water, and indeed well; because the Liquor in a well-constituted Apple is found cold as to the touch; but our Bloud and Humors well constituted, are not cold to the touch, but warm; therefore a Member lightly affected with a Gangrene from cold, should rather be put into luke-warm-Water (by the Dutch called bloet-laeuw) than into cold.

OBSERVAT. VIII.

Of an Atrophia, Imbecillity of Motion, and an Algor of the Arm.

A Young man 24 years of age (as to all other things very well) had now [Page 242]for six Months laboured with an Atrophia of his Left-arm, from the Shoulder to the Cubit, and he could not lift up or otherwise move his Arm, but continually complained of an Algor (or extream coldness) thereof. Some Chyrurgeons had long attempted to cure this Affect., according to their vulgar method; and applied their Plaisters, Unguents; Linements, and other such Medicaments, but in vain.

The very viscous Humor in the Arm of this Sick man, had produced not a few very pertinaceous Obstructions, whence the Astrophia of the Arm, its Impotency to motion, and Algor of the same readily took beginning.

But this gross Humor lay so very deep, that it could indeed be in no wise dissolved by Unguents or other such-like Remedies.

Had the cure of this Evil been longer procrastinated, there would have been great cause of fear, that the Ligaments, connecting the Shoulder-bone with the Scapula, would in a short space of time have been so much extended in length, that thence would have followed such a Dislocation of the Shoulder (most difficult to heal) as we described in the Last Observation of the First Decade.

Therefore without any delay I set about the Work, and ordered seven or eight Cupping-glasses [Page 243]with Flame (but without any Scarification) to be applied twice or thrice every Week, and left on till the Skin waxed red; at which time the affected part was washed (before a Fire) with the following Liquor first made hot; and every other day when the Cupping-glasses were not applied the same was also twice used.

℞. Root of Sarsaparilla, ℥j.
Bark of Lign. Guaicum, ℥ss.
Herb Rosemary
Sage, of each M.j. ss.
Flowers of Lavender, M. ss.
Bay-berries, ℥j.
Salt of Tartar, ʒ j. ss.
Of Armoniac, ℈ij.

Boyl these in a double Vessel, with two pounds and an half of Spirit of Wine; and strain the Liquor from the Simples.

We also took care sometimes to burn Common Spirit of Wine, so that the Vapour thereof ascending might surround the affected part (covered above) and by this means the Algor vanished in 14 days, and the Patient (in six Months time) could as well move and use his Left-arm, as his Right, and in the mean while the affected Arm became daily more and more fleshy.

Which way the Cupping-glasses and aforesaid Medicaments effected the cure of this our Patient, I here pass over in silence, and [Page 244]that indeed considerately; because the same is sufficiently manifest in the Ninth Observation of the Fourth Decade.

OBSERVAT. IX.

Of the Ʋvula and Tonsils evily disposed.

A Young man, aged 30 years, walking in a very cold season, was afflicted with dolour, redness, and tumor of the Tonsils and Uvula; whence he perceived difficulty in Swallowing, though he was (in the mean while) almost continually forced to swallow.

The Bloud in its small Vessels, and the Humors in the minute passages of the Tonsils and Uvula, stagnized (by reason of the cold Air admitted by Inspiration) were coacervated and waxed acid; whence arose the aforesaid tumor, dolour, redness, and difficulty of swallowing.

But whence did that so great Impulse to swallowing derive its Original? I answer. The Membrane, subject to the Uvula, hath Nerves, which touched by the relaxed and incumbent Uvula, are the cause that the [Page 245]Nervous Juice is (in greater abundance) carried into the Muscles adapted for swallowing.

Being called to the sick, I prescribed the following Gargarism.

℞. Spirit of Wine, ℥iij.
Water of Elder-flowers, ℥ij.
Spirit of Sal. Armoniac, drops 20.

Mix these according to Art.

By this means our Patient was cured in a very short time.

The prescribed Gargarism proved very profitable, because it temperated the Acidity, dissolved the coagulated Humors, and removed the Obstructions.

I have in my self often restored the Uvula relaxed, by reason of viscous and coagulated Humors there stagnizing, when I gently touched the same with the tip of my Finger moistned onely with Spirit of Sal Armoniac: the reason of which Cure being more clear than the Sun at Noon, I shall not here add.

I remember most desperate Quinseys to have been often cured with a Decoction made with a fit Liquor, and Herbs containing much Volatile Salt; when the Vapour of the same, (boiling hot) the upper-part of the Head being well covered, ascended into the Cavity of the Mouth, and outwardly surrounded the whole Face and Neck.

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In a Quinsey very desparate, what shall we judge of Laryngotomy? Antonius de Heyde saith, the same may be exercised without peril, and that he himself happily instituted it in a Dog, which (without any troublesome Symptomes) was in a few days restored to his pristine sanity. And besides this, Mr. Blankard (in his Medico-physical Collections) relates, that Mr. Smalsius (a famous Chyrurgeon at Lugdunum) did, in a Patient, exercise this Laryngotomy with good success.

OBSERVAT. X.

Of an Hair Lip.

A Female-Infant 14 days old, had from her Nativity laboured with an Hair-Lip (that is, with an open cleft of the Upper-Lip) miserably disfiguring the Face of the Child, otherwise comely enough.

My Father being called, freed the Lip from the adjacent parts, that the Extreamities might the better and more easily approach each to other. Then he sufficiently excoriated both the Extreamities of the Cloven-Lip, united them, and kept them united with three silver Needles, about which Threds were wreathed, to keep them steady [Page 247]in their places. In the mean while the ends of the Needles were cut off with a fit Instrument, lest they should be infixed in the Bed-clothes, or other things, and so (taring in sunder both Flesh and Skin) fall or be forced out; as I remember to have happened more than once.

On the eighth day the Needles were drawn out, and both Extremities of the Hair-Lip grew together and were united; the Bloud and Humors performing their Circular Motion from one Extremity to the other. But the Holes made by the Needles did as yet pour forth a little Pus; undoubtedly for no other reason, than because the Needles had remained too long infixed in the Lips. Wherefore my Father, when he afterward cured the like Affect in others, sooner took out the Needles; and because Silver Needles are no less liable to rust, than those made of Steel, I therefore instead of Silver Needles used Steel Needles, because they more easily perforate the Skin and Flesh.

The most famous Sylvius would have an Hair-Lip cured without Needles, by the help of Plaisters only; and I remember that a certain Chyrurgeon cured some young Patients by these means.

This Operation is usually exercised in Infants 14 days old: for if they be younger, they have flesh so very soft, that it will (by [Page 248]the least irritation) be torn in sunder by the Needles inherent; and in more maturity of age the Extreamities of the Hair-Lip will not so easily conglutinate.

But whence is it that Infants are sometimes born deformed with an Hair-Lip? Some ascribe this wonderful Effect to the Imagination of the Mother; but others again stifly deny this to be able to effect any thing.

In an Hens-Egg, before Incubation, some affirm that the Chick may (by a Microscope) be seen compleatly formed: After the same manner in an Humane Egg (of which they say we are generated) the little Body of the Infant compleatly formed is contained; whether the same be intire, or affected with an Hair-Lip. But the matter is not thus sufficiently elucidated, there must some reason be added, why in one humane Egg, rather than in an other; is generated a small Body affected with an Hair-Lip. Yet throughly to search out these things, is little or nothing conducent to the practice of Chyrurgy; therefore here we forbear to speak further thereabout.

FINIS.

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