Mellificium chirurgie, or, The marrow of many good authours wherein is briefly handled the art of chyrurgery in its foure parts, with all the severall diseases unto them belonging, their definitions, causes, signes, prognosticks, and cures, both generall and particular : as also an appendix wherein is methodically set down the cure of th[o]se affects usually happening at sea and in campe, with others necessary to be known, and lastly an addition of severall magistrall receipts approved and heretofore kept secret / gathered first for private use and now put forth for publique benefit by James Cooke.

THE ART OF CHIRURGERY .

PART . I.

SECT. I. CHAP. I.

PAssing by the Arguments that discover the excellencie ; we come to its self , being the second part of the curative part of Medicine , ( contained in naturall Philosophy ) which teacheth how divers diseases of the body are to be cured by manuall operation . The parts of which are foure : 1. To unite parts dis-joyned . 2. To separate parts unnaturally joyned . 3. To remove things superfluous . 4. To supply things wanting .

In the first is comprehended , 1. Tumors , the Solution , being gathered by Reason . 2. Ulcers , Wounds , Fractures , and Dislocations , apprehended by Sense .

Of the first , Tumors , consider , 1. The Definition , viz. It is most frequently a disease , sometimes a light affection , for the most part incident to the Organicall parts , increasing their quantity above nature : by reason of superfluous humours sent from other parts .

2. The Causes in generall , are fluxion and congestion . The first , when a humour offending in quantity , or quality , suddenly ceizeth upon a part . The latter , when a humour is collected by little and little .

The speciall Causes are either externall , or internall ; The first is , all outward things , which may cause Solution , whether non-naturalls , or of venemous quality , the internalls are humours or flatuosities , and these are either naturall or unnaturall ; the first is either sincere , as Choler , &c. or mixed , as some of the former , with Blood . 2. Unnaturall , as water . The 3. Generall thing is the differences , which are either simple , or compound . The simple are either hot , as Phlegmon , and Erysipelas , or cold as Oedema , & Schirrhus , and two more , which are Tumor . Aquos . & Flatuos . which are the off-spring of crudity , caused by weaknesse , or defect of naturall heat . 2. Compound , which is begotten of the combination of the former , and according to the predominancy of the humour , ariseth the name , as if blood abound it is called Phlegmone Erysipelatodes , &c.

Now for the generall Indications of curing , they are taken either from the matter or times of every Tumor .

In the first , Motion . consider the Motion , and its Nature : for the former , it s either flowing , or received into the part .

The causes of Fluxion are two , Plethora , Causes . & Cacochymia . The first is twofold , ad vasa , when the veines are onely full , and the body quick , &c. And this is either Pura , when the Humours are in due proportion , or Impura , when there is excesse of any Saving blood . Ad vires , when there is such a fulnesse as causeth sluggishnesse , this requireth bleeding ; as Cacochymia purging .

As for Bleeding , Manner . first , observe the manner , in fulnesse quoad vasa , draw what is convenient at once , but in quoad vires , by repetition .

Secondly , Quantity . the Quantity , in weaknesse , lesse ; in strength , more ; both which is discerned by the Functions : as the weaknesse of the Naturall , by the crudity of Urine , and Excrements of the body . Of the Vitall , by a weak and small pulse ; as also weak and thick breathing . Of the Animall , by defect in moving , and feeling . But be diligent in distinguishing between weaknesse indeed , and oppression , by reason of fulnesse , which makes dull and slow . For , as in the first , great moderation is to be used . So in the latter , wee may more freely evacuate .

Thirdly , The ends . As first Derivation , Ends. which is a drawing of the humour to the parts adjacent of the same side . Secondly , Revulsion , which is a drawing to the parts opposite , and this is used when the matter flows slowly , or to prevent a disease ; not having any place in contagious Tumors .

In translation of humour flowing from any place , it must bee doue either by rectitude of parts , or of vessells , as if one bleed immoderately at the right nostrell apply cups to the region of the liver , &c.

The second cause of Fluxion is Cacochym : which is not so much by reason of the quantity as the quallity offending . Now this latter either moveth from place to place , or else resteth where it first invaded . If it move , it 's best abated by bleeding ; if it rest purge with proper medicaments .

The second Indicat is taken from the contagiousnesse , or not contagiousnes . If not , the fluxion proceeds from three causes :

First , from the strength of the part sending , being burdened ; in this case doe as in the second cause of Fluxion .

2. the Thinnesse of humour , in this , if we cannot use bleeding or purgation ; then must be used revulsion , by Cups without Scarif : Ligatures , Frictions , bathing , Vesicatories , and Fontinels .

Thirdly , the Attraction of the part affected , which is caused either by distemperature or pain , the first must be removed by contraries , onely if with it , ther be joyned patent passages : then apply astringents , as Bac. Mirtil , ros. rub . Cort : granat. Querc . Balaust . Sumach , Sloes decoct in vin , rub . vel aq. & aceto , or new Tanners woose rouling the part hard , or apply this upon leather , ℞ rad. Torment . Bistort . Symphit . ros. rub . gallar . balaust . Malicor . Sang. drac . bol. arm. santil . rub . cerus . anaʒi . cerae alb . ℥ iii. el. Myrtil . ℥ i. M.f. Ceratum .

For paine , it s caused either by solution or venemous quality ; the first , proceeds from hot , and sharpe humours , which are to be encountred , with Anodyns , or Narcoticks . If from the second , biting of venemous beasts , &c.

First Scarifie , then apply cups , foment the part cum Theriae . dissol , in aceto accerrimo , applying stupes wet therein , and above this . ℞ Pic. Naval . ℥ j. Sal. Nitri ℥ s. Sem. Sinap . ℥ ii . Cepar . allii sub prun . cocti ana ℥ iij. assae faetid sagapen anaʒiii . sterc . Columb . ℥ i. ss Aristol . rotund . Dictam alb. ana ℥ i. ol. lilior . alb . ℥ s. f. Emp. Note the cups are to bee applyed with great flame , and your stupes very hot , Pigeons applyed are good , but the Actuall Cautery is best , after which Scarif : to the quicke ; not forgetting strong ligature , three or foure inches above the place bitten , withall administring inward Antidotes for many dayes together , with some convenient decoctions ; the same course take with Tumours arising from contagious humours .

Now for indication from the tymes being foure , beginning , increase , state , and declination .

The first is , when the parts begin to swell , the action being not hindered , for which apply repellers , remember to use slender diet , convenient evacuations of the belly and bleeding . But note , that in six causes repellers are to be omitted , as when the matter is maligne , or criticall , when the body is plethor . or Cacochym . when humours flow to the Emunctories , if the part have little naturall heat , and when the pain is vehement .

The increase is when the part is stretched , and the symptomes are increased , for which are to be used partly repellers , and partly discussers , the matter being partly possessing , and partly flowing . But note , if the matter flow with such force that it threatneth corruption , or be thick and hot , as in a Carbuncle , use scarif : and Leeches . Of discussing Medicaments there are three sorts , which are severally to be applyed according to the constitution of the party .

The state is when it s come to such degrees , as that it can go no further in bignesse , nor in symptomes , and the veynes of the parts adjacent continue in the same fulnesse , here we are to use Anodyns and discussives .

The declination is , when Tumour and symptomes abate , then strong discussives are to be applyed in necessity , using Diachyl . Mag. cum Gum. Mesu . vel ireatum . Now because Tum : end not only by resolut : but by induration , corruption , changing of the place , as also by maturation , we come to the cure of a Tumour come to Suppuration .

CHAP. II. Suppuration .

FIrst considering when this is required ; Suppuration . and that is , first , when the humour is too plentifull , and naturall heat cannot rule it . Secondly , when its crude . And thirdly , when the matter is hard . That which I have found most effectuall is this Cataplasme , ℞ Medul. pan . alb. ℥ vj. rad. Althaeae ℥ ij . pul . sem. lini . faenugr . ana ℥ j. ficuus N. vj. cum decoct . rad. Althaeae f. Catap. ad . in fine Butyr . recent axung . porcin . ana ℥ i s. vitel ovor . N ij . Croci ʒ s. Misce vel ℞ Med. pan . alb. ℥ iiij . Lact. rec . lb j. Malv . viol . ana Mjcum farin . trit . f. Cataplasma ad . ung . popul . ℥ iij. croc . ʒj . Where its most likely to break use pledgets dipt in the yolke of an egge ; when its ready to open which is knowne by the vanishing of the former accidents , and it being pressed fluctuates , and especially when its riveled , then open it by incision , rather then by Caustick , unlesse the Tumor be large , and a flux is expected , or when it s to bee kept long open . After opening by incision , apply upon pledgets astringents for 24. houres , as this if it be necessary . ℞ Oliban ℥ j. aloes ℥ i s. f. pul . Misce cum alb. ovi ad consisten . Mell : & adde : pilos Lepor . concis . If by Caustick apply dialth ; if they faint , use Confect . Alker . cum aq. vel decoct . Cinam : after accidents are allayed to mundifie use this ℞ Succ apij . lb s. Mell. pur . ℥ iiij . farin . hord. . ℥ j. orobi ℥ j s. myrh . ℥ ij . Terebin . ℥ j s. decoq . omnia simul f. ung . to incarne and heale up , look to the curation of ulcers . This in generall , now for particular Tumors : and first for a Phlegmon .

CHAP. III. Phlegmon .

WHich proceeds from blood , if it be proper , it s onely caused of quantity , the differences being either from the matter or parts it possesseth ; those from the matter are either true or spurious , the causes are either primitive , antecedent , or conjunct , which may be also observed in all other Tumours .

Signes .

It beginneth suddenly , Signe . and encreaseth speedily , its hot , the pain pulsive , tension in the part , veynes conspicuous , and the colour a fresh ruddy .

Prognosticks .

If moderate , healthfull . Prognost . If superabound in plenty or malignity , beware of Gangreen , & sphac . If in a young hot body easily cured : if internall upon great joynts , and great vessels , dangerous .

Cure .

Diet very spare and cooling , Cure . alwayes let blood , if the Tumour possesse the upper part , in the arme . If the lower parts in the legges or feet , if it proceed from any accustomed evacuation stopped , then purge with this or the like , ℞ aq. Cichor . endiv. acetosae ana ℥ ij elect . diacath . & de Sebest . ana ℥ s. Syr. Papav . rub . ℥ j. Misce f. pot . Topicall meanes are three , Revulsion , Repelling , and Defensives . The first hath been handled , the defensives must be applyed to the parts most empty of flesh , as this . ℞ Cerae alb . ℥ x ol Mirtil. & Cydon . ana ℥ j pul . Masticʒ iij bol. Arm. Sang. Drae . anaʒ x. M f. Empl.

As for the repellers , they are to bee either cold and moist , or astringent , coole and drying , this course is in principio . For the increase , use repellers and discussers more of the former . In the state use them equally , and if there be pain , some Anodyns , as this excellent one ℞ Mica pan . alb. in aq. Calid . macer lb s pul . ros. rub . & absinth . ana ℥ vj ol Anethi . & Mell. ana ℥ ij . Misce f Cataplasme . If it end in maturation , then follow the method in suppuration .

CHAP. IV. Tumors .

FOr spurious Tumours they are made from a mixture of the three other humours with blood ; therefore if choler abound , coole and moisten in a higher degree then in a phlegm . If phlegme , heat more . If melancholy , warme and moisten .

Now for Tumours that have reference ; as first , Panicula , Panicula . it most commonly possesseth the glandulous parts somewhat flat on the top , whereof there is the representation of a pustle , being hard , hot and greater in paine , then the magnitude requires , having in it more choler then blood ; but contrariwise , Phyma Phyma hath more blood then choler , being a little red and painfull , and much elevated .

As for Furunculus , Furunculus . it s an inflamed pustle , with paine possessing the skin of the soft parts , growing commonly to the bignesse of a doves egge . For the cure of these if necessity requires , first , bleed and purge , then apply either Empl. Corcatum or this Cataplasme ℞ rad. lilior alb. fol. malv. viol ana M j coq. in lact ad mollitiem & f. express . ad farin . Hord. tritic . Sem. lini ana ℥ j vitel . over . N ij ping gal . butyr . rec . ana ℥ j Croc. ℈ ij . f. Cataplasme , after being opened proceed , S. A. as in page 10.

CHAP. V. Erysipelas .

Signe .

A Tumour near red , Signe . like a pale Rose , hotter then Phlegmon , pricking pain , if touched white , caused of Alimentary choler .

Prognostick .

That which is driven to the outward parts easie , Proguost . if in the head ulcerous , a wound , ulcer , fracture , dislocation , sometimes mortall . If suppurate , or happen upon a bare bone , ill .

Cure .

Diet coole , Cure . and moyst , if in any part , and blood predominate , Bleed : if exquisite , forbeare ; if the cause bee externall , and far from noble parts , use coole and moyst Medicaments , if internal : and milde , cool glysters wil serve : if strong , use this ℞ Rhei ʒ j. spic . gr. v. vini alb. parum infund . in decoct . Tamarind . f. expres . ad . El. e succ ros. ʒ iij. Syr. ros. fol. ℥ ij . Mis. f. p. Use sweating , cum aq. pap . err . & lap . Bezoar . And note if it appear in head or face , let blood , use Leeches , and revulsion , if in the legs , vomit .

The locall Medicaments , are to be cold and moyst , not unctious , as aq. p. 2. acet . vini . p. 1. vel Sapon alb . ℥ j. dissol . in aq. Sambuc lb iij. & bulli . Apply it with Linnen cloathes , and as they dry , moysten them , vela q. sper . ranar. cum acet . & Myrrh . or the juyce of horse-dung with Camphire , apply them till heat be abated , and colour recovered , if it turn livid , use Lixivium to foment withall , and apply this , ℞ farin . fab. Hord. & Orob . ana ℥ iiij . Lixiv. debilis lb iiij . coq. ad consist . Empl. ad . Oxym . ℥ iiij . If it be deep , scarifie , if gangren . or Sphac . Vide. Now the bastard , are according to the humour associated ; but of them that break the skin , there are two kindes .

First , Herpes Miliaris , caused of a salt waterish humour , mixed with sharp unnaturall choler . In this pustles break forth , having matter issuing , representing quitour , being of colour red , and pale : which is without danger .

Cure . Cure .

Cum aq. & acet . vel ℞ Lanam Succidam torref . donec . f nig & pul . Misc . cum aq. ros. with which anoynt often , vel cum unguent ros. Mes.

Secondly , Herpes Exedens , vel ignis Sacer , caused of unnaturall choler , thick , sharp , and hot corroding the skin onely , with many small ulcers .

Cure . Cure .

Use decoction of Sarsa , foment it with this , ℞ Knotgrasse , Horstaile , Plantain , water-lilly , and Oken barke , Pomgranate flower and rindes , Mirtle Berries , red Rose leaves boyled in Tanners Woose , after which ℞ cerae fla ℥ ij . resin pin . ℥ i s. Tereb ℥ j ol Mirtinʒ v j. succ . Nicotia ℥ iij. Coq. in cerat . Molle . If they spread and are putrid , ℞ Litharg Cerusae an . ℥ ij . cortic granat , ℥ s. Myrrhʒ j. Thur. ʒ i s. flor. aeris alum usti ana ʒj cum ol Myrti & cerae q.s. f. unguent .

CHAP. VI. Oedema .

A Tumor caused of Flegme . Oedema .

Signe .

It s soft and loose , Signe . if pressed it pits with none or little pain , being white and cold , the Liver chiefly affected , as also the head and stomach .

Prognostick .

If of long continuance , Prognost . or the body be diseased with Phthisis Cacexia or Dropsie , it is dangerous , otherwise not .

Cure . Cure .

Internall , Diet dry , aire hot and dry , bread made with hot seed , drying dyet drinks , Sweating is excellent . If it possesse the hands , worke , if the feet , walke .

There are three sorts of unnatural Flegmes :

First , Soure , which betokens want of natural heat in the Stomacke .

Secondly , Salt Flegme .

Thirdly , Glassie Flegme , which causeth great pain , if contained in any part .

For Purging use Phlegmagog . the Chymicall are , Merc. Vitae . Vitr . Antim . Merc. d. acuated cum Merc. vitae . Galenicall . Have your diaphaenic dia earth . pil Hier. cum agar . acuated cum Elater .

Cure .

Externall ℞ aq. & acet . & add . parum . alum . f. foment , Cure . before which rub the place well . If it be in the belly , and tend to Suppuration , in 60 dayes , then to hasten it , apply Empl. Crocatū Nost. vel diachy cum Gum. After being opened , dresse S.A. if it Suppurate not , discusse it with this , ℞ Sulp. ℥ j. stercor Columb . ʒ x. far. fab. . ℥ i s Lupin . ℥ j. cum decoct . flor. Cham : f. Catap. this is worthy observation , The primary Oedema is caused by congestion , and cometh on by degrees , but that which is Symptomaticall , is procured by fluxtion , and suddenly appeares . A bastard Oedema needs not to bee touched , others that are referred , are in other places handled .

CHAP. VII . Schirrhus .

CAused of Melancholy .

Signe . Signe .

It s a Tumor hard , cold , without pain , and is fixed without veines appearing .

Prognostick . Prognost .

If exquisite , or not , yet if great uncureable , but if sensible , and cause of thick Flegme , it is curable . Difference , it s either Primary , and this either exquisite , or not , when another humor is joyned ; or Symptomaticall , when it proceeds from another Tumor , not artificially handled .

Cure .

Let not blood , Cure . unlesse the veyns be very great , blood black , and strength and age admit : If it proceed from accustomed evacuation stopped , procure them . Let the dyet be moist and thinne , purge with Malanag . as Confect . Hamech , Senna . note , that decoction of Lignum vitae , & Sarsap : is excellent , continually used every morning sweating .

Externall , ℞ bdel . Ammoni gal . ana ℥ j. dissol in Mortar Calid cum ol lilior add . mucilag . sem. lini & faenugr . ana ℥ v j. ficuum torref . ℥ ij . f . catapl . apply it too a day , if it be above a tendon , take heed of acetum the part had need , first to be fomented with a decoction Malu althea Cham. Melilot flor. prim . veris in acet & ad spr . vini . If it be Symptomaticall , use this ℞ , Bees wax , Duckes grease , ana ℥ j. ol. Lilior ℥ ij . Marrow of Oxe bones ʒ ij . Misce , Those that are referred are handled in other places .

CHAP. VIII . Tumor Aquosus .

CAused of Serosity , Tumor Aquosa . too plentifully abounding , otherwises its but a vehicle of the blood , and after cast out per poros cutis , the difference as sudamina epinictum , &c. The causes of the humour sending to externall parts , is the weaknesse of the Attract : quality of the kidneyes , the coldnesse of the liver , or immoderate drinkings .

Sign . Signe .

Sometimes more , or lesse swelled , is soft and loose , if pressed it speedily returnes ; if looked on betwixt you and light it shines , withall it itcheth when it breedeth .

Prognost .

If from imperfection of the liver , Prognost . dangerous , all unlesse smal , are hardly cured .

Cure .

Diet drying and spare , Cure . use watching . Cornar diet excellent , which is of bread and meat , ℥ xij . and of drink , ℥ xiiij . a day , use purging drinkes , wherein is Mecoach : and Zalap : provoke urin and sweat , which is not only good in this , but also in most ulcers , and contagious diseases , this purge is excellent ℞ acinorum ebuli siccatʒ j. Cinam . ʒ s. f. p. & exhib in vino alb. vel pil. Euphor , &c.

Externalls . First , use foment made of lee and hot herbs , after anoint it cum sal nitr . ℥ s. sulph . ʒ iij. pul . bacc . laur . ℥ j. amoniac . ℥ s. ol. rutac. Cerae . ana q. s. f. v. after which , apply this , ℞ sem. sinap . sem. urticae sulphur . Spum Maris aristol . rotund . bdel . ana ℥ j. Amoniac ol antiq. Cerae ana ℥ ij . Misce . If it cannot bee thus cured , then open it and cure it . S. A. Note pil. Alphang . gr. xx . cum elater g iss. to purge is excellent .

CHAP. IX . Tumor Flatulentus .

CAuses Crudity , and weake heat .

Signe . Signe .

Light , very painfull , soft , and pits not .

Prognost .

If it possesse great joynts hardly cured , and those of other parts not easie .

Cure . Cure .

Diet as in the former Tumour , using meats of easie concoction ; after meat , use Marmalets ; before bed-time anoint the stomach , cum ol. Mastic & absinth .

Externals , use foment of Sack , with discussing hearbs , after anoint , Cum ol. aneth . rutac. Cham. lauri & spir. vini , apply Empl : de bac . lauri vel ung . cum merc . triplic . you may anoint with some mercuriall unguent . If the stomach bee flatuous , use vini Canar ℥ iij. cum elect . de bacc . Laur. ʒij . infusing first Cinam . in the wine foure houres before supper , vel ol. faenec . in a cup of Sack .

CHAP. X. Hydrocephalus .

NOw for particular Tumours , and first of Hydrocephalos .

Signe . Signe .

Deformity of the head , the eyes and face , being Tumified without paine , yeelds to impression , and if looked on betwixt the light , it shines .

Prognost . Prognost .

Those within the cranium are incurable , those without may , but very difficultly .

Cure . Cure .

Internall , as in an Aquous Tumor externall : Cum aq. Cal. viv . si ea spongia imbuatur & capit imponatur vel spir. vini & q. part aq. Scab . good rouling is excellent , and doth alone . After use some discussing unguent , as ℞ pul . absiuth . Cham. Melil . ana ℥ j s. butyr . rec . ol. Cham. ana ℥ iiij . cerae . parum f. unguent . If they cannot be discussed , the matter is to bee let out either by incision or Caustic . and with a matter-sucker draw out the serous humour to the rest that is grumous , apply this ℞ ol. Cham. ℥ x. sulp . ℥ j. pul . origan . Mirtil . ros. rub . absinth . Melilo . anaʒ i ss. cerae . q.s. f. unguent , after proceed S. A.

CHAP. XI . Polypus .

IT s a fleshy excrescens in the nose , which by a small root hangs downe there sometimes very low , or else descends to the pallate , it s caused from viscous phlegme mixed with blood , which flowes from the head to the nose , and fixeth it selfe most commonly upon os Ethmoides increasing much at the full , and decreasing about the new of the Moon .

Prognost . Prognost .

If white , soft , and loose , and without paine , easie cured : If reddish , hard . If livid blacke , painfull , hard , stinking , and cancerous , it s not to be touched , unlesse by application of palliating medicines .

Cure . Cure .

In all , whether the cure be reall or palliative , universalls must precede , those which are the two first in the Prognosticks are either cured by extirpation with instrument , which is most frequent in use , or by Medicaments , in both these there must be speciall care had till it be wholly eradicated lest it againe returne . The instrument is Fabritius Ab : Aquapend , which he applauds above any other in doing its worke safely , surely and speedily . I could have wished he had given in the figure . After it s drawne forth , apply medicins to cicatrize it . If you choose to do it by medicines , apply them about the new Moon , or decrease , after it s scarrified , they are ol. vitriol turund . ex . rad. Gentian anointed , cum Mel. ros. & merc . praecip , washed often till it be sweetned , vel ℞ Empl : Mucilagin . ℥ s. pul Sabinaeʒ ij . malaxentur & incorporentur simul ex hae massa fiant Cereboli debitae magnitudinis in nares immittendi . The nose is to be defended , cum ung . refriger Galeni vel Nutrito popul . vel alb. ov . cum ol. rosar . If it be by some portion of melancholy , mixed with the former humours , doe cause a levidity , and incline it to Cancer , use either unguent Ranarum , vel vitel ovorum in Mortario plumbeo ad nigridinem usque agitata & in unguenti formam cum ℈ . Camphorae redacta . To those curable , some apply waters , you may use this ℞ aq. Solani rosar . ana . ℥ j. Plantag. ℥ s. caphur . ʒ s. Ceruss . ℈ j. merc . Subl . g. vj. Mis. f. aq.

CHAP. XII . Parotis .

A Tumour behinde the eares , some are Criticall , and they tend commonly to suppuration , if not , they are evill , and if turn in are deadly . Some are Symptomaticall , and those are most times resolved by applying anguent . dialth , cum ol. Laur.

Cure . Cure .

Use Clysters , if necessary , venae sect . but if it be from Crisis use an actuall cautery , especially if maligne , but if not apply cups ; if it tend to maturation , use either , Empl. Crocat . vel ℞ rad. lil . & Cepar . sub cineribus coct. ana ℥ iij. vitel . ov . N ij . axung . & unguent . Basi . ana ℥ j. far. sm. lin . ℥ i s. f. Cataplasme .

CHAP. XIII . Tumor Tonsillorum .

IT s an acute disease most commonly deadly , alwayes dangerous . In fevors , if black montall , they often indurate , and are incurable .

Cure . Cure .

Venae sect. in the tongue and arme : First , using a Clister , or presently after . Cups cum Scar. inprincipio ℞ aq. plantag . lb i s. flor. ros. rub . M s. beni . Cydon . ʒ j s. semel bul. Col. adde d●annor . ℥ i s. dia●uc . ℥ . Mise . f. Gar. If tend to suppuration ℞ farin . Tritic. in petia . Ligat . ℥ ● . caricar . ℥ iij. rad. alth . ℥ j s. aq. vel lact. . lb ij . Coq. ad Consum . 5. part deinde col . & f. gar . externals either figs or some maturative Cataplasme , after breake them with your finger , or open them with your phlegme , and then use aq. Hordum cum mel . & sac. ros.

CHAP. XIV . Angina .

OF which there are four sorts . First , a great inflamation of the internall muscles of the throat , this is most dangerous .

Secondly , inflammation of the externall muscles , this lesse danger .

Thirdly , inflammation of the internall muscle of the fauces .

Fourthly , when the inflammation appeares externall in the throat .

Signe . Signe .

Difficulty of breathing and swallowing , fever , paine in the throat .

Prognost . Prognost .

If they froth at the mouth or the matter be sent to the lungs , if spirtle continue crude , and be criticall , deadly , if it appeare outwardly , curable .

Cure . Cure .

Diet thin , cool and moist ; if the passage be strait , and they cannot swallow , put downe a Cathetor , and then by a firinge cast in broths , and use nourishing clysters , what hour soever called , let blood plentifully , Zacc : Lusit . let blood a woman with childe in the seventh month seven times one day , before use sharpe Clysters or after : If necessity requireopen the jugular , foure or six houres after bleeding you may purge , or rather give ℥ ij . aq. bened . which hath presently cured . If the party be strong , use cups , vesicatories , as also Scarif : upon the jaws , topicall in principio , ℞ aq. plantag solan . caprifol . ana ℥ iij. succ . granat . ℥ ij . diamor ℥ iij. sal. pru . ʒ j s. f. Gar. whilst this is using , apply outwardly this , ℞ ol. Cha. lilior . Amygd . d. ana ℥ j. axung . gal . butyr . rec . ana ℥ j s. croci . ℈ j. f. Linim . In the increase use this ℞ fol. Hys . op. plantag. ana M j. liquirit . rasae . passul . mund. ana ℥ j. Caricar . N x ij . ros. rub . Hord. integ . ana p j. f. deco . ad lb j. in col . dissol . Mel. ros. syr. viol . ana ℥ ij . f. Ga. externally apply this ℞ Nidum Hyrundi N i fol. malv. viol . ana M j. rad. lilior . alth . ana ℥ s . ficus N x ij . flor. Cham. Melilot ana p. 1. Coq. & contund . deind . add . farin . Hord. Lini faenugr . anaʒ iij. Croc. ℈ i. Butyr . recent . ol. Cham. Amygd . a. q s. f. Cataplasme , this also maturates which falls out the fourth or fifth day , when it s broken or opened .

Cure . Cure .

S. A. If it indurate , mollifie it . The last refuge is the opening the Larinx , and so keep it till danger bee past , and then scarif . the lips , and cure it as hare lip .

CHAP. XV. De Inflam . & relax . uvulae .

WHich is caused by defluxions from the head which are sharpe , and salt , and also causeth ulcers .

Cure . Cure .

If necessary bleed , purge , and use sharpe clysters , cups , &c. if the flux be very great , ℞ fol. & flor. beton . salv . Scabios . ana M s. ros. M● . Summit . rorismar . & flor. Cham. ana p. 1. Coq. in lb iij. aq. ad consum 8. part . colat . add . Mel. rosar . ℥ iij. alium ℥ ij f. garg . apply the hea●bs boyled in red wine with ol. Cham. to the necke , to it apply this ℞ pul . ros. rub . Balaust . cortic . granat. anaʒ s. rad. bistort . Torment . gallar . immatur Ireos anaʒi . alum usti ℈ ij . f. pul . vel . Cortic. granat. cum pip . long . cum alum ust , excellent . If it bee too long and putrifie , cut so much away as is necessary .

First , purging .

Secondly , take heed humours sall not too fast .

Thirdly , not unlesse it bee small about the root .

And lastly , if it be livid take heed : First , binde it , and then cut it . If it bleed much , use either pul . Hild. or your uvula spoon made red hot . If they be unwilling , try this , ℞ Hord. integr . Mj. rad. plantag . ℥ j. fol. Scab . Geran . Scord. ana M s. rosar . & fol. plantag. ana M j. Coq. in lb iiij . aq. ad . Hord. fracturam utum admisce Mel. ros. & Diamora ana ℥ ij . Misce f. Gargar . touch it three or foure times a day , cum ung . Aegyp . Hild. and so continue them till they be well .

CHAP. XVI . Tu : & Infl. aurium .

CAused by a thin cholericke blood descending from the braine and membraines to the veynes of the tympanum .

Signe . Signe .

Pain with continuall beating , which is vehement with heat and rednesse of the eares and temples , sometimes with a feaver delirium , convulsive motions , Syncope , and coldnesse of the extremities .

Prognost . Prognost .

They are dangerous and often cause death .

Cure . Cure .

It as a Phlegmon , if it cannot be resolved , use this , ℞ Cepar . rub . Nj. sub Cineribus assat . butyr . rec . ℥ ij . ol. Cham. rosar . ana ℥ ● . Croc. ℈ j. f. Cataplasma . If paine be great , use anodyns , if that will not prevaile Narcoticks , the water that runnes out of ashen stickes when they are burning , distilled into the eare easeth paine marvelously , vel ℞ ol. vitel . ovor . ʒ ij . Succ. Malv . ℥ s. Myrrhʒ s. Croci ℈ s. opij . g. iij. vel iiij . Misce , and drop into the eares .

CHAP. XVII . Anchylops .

A Tumor in the great corner of the eye ( which if either neglected , or not well cured becomes a fistula ) hard to be cured .

Cure . Cure .

after bleeding and purging in the beginning use repellers both to the forehead and it , as ℞ Cortic . granat. acaciae balaust . gal . Nuc. Cupres . alum roch . bol. Arm. anaʒ j. cer. alb . ℥ iij. tereb . ʒiij . f. Cerat . In the increase discusse as ℞ pulu . testar . Cochlearumʒij . Myrrh . aloes lot . thur . anaʒ s. Sarco col Sang. drac . cerus . anaʒ iij. opopanac . acet . solut. & lap . Haematitis anaʒ i s. Croc. ℈ ij . Cer. & resin . ana ℥ iij. f. Cerat . excellent . If it tend to Suppuration , either apply Emp. diachal . vel Cataplasme , aut Empl. Croc. and after open it and cure it . S. A.

CHAP. XVIII . Ranula sub lingua

Signe . Signe .

A Tumor as it were lax and soft flesh , it takes away liberty of speech caused of crasse or thicke blood , or flegme from the braine .

Prognost . Prognost .

In Infants it may cause suffocation in adults . If feavor and paine be present it is dangerous , or if it be black or livid .

Cure . Cure .

After universalls , endeavour to resolve it thus , ℞ Cortic. gran. Hysop sic . Sales com . anaʒ ij . f. pul . sub lingua detenendus & frequenter iterandus , instead of common salt use sal Amoniac in adulti , if it cannot be resolved , open it either by incision or cautery , holding your thumbe under the chin , thrust out the matter , and wash the mouth often cum vino alb. & mel . ros. vel posca cum parum sal . If it be inveterat , use the cantery and diaphor . decoct . touching the ulcer cum ol. Sulph . twice a day tempered , cum aq. ros . as ol. Sulph . gut . aq. ros. gutta . vj.

CHAP. XIX . Aneurisma .

IT s a Tumor soft , yeelding to the touch , caused by the Anastomosis , springing , breaking , erossion , and wounding of the Artery , though it happens in all parts , yet most frequently in the throat , especially in women after painfull travell . It s sometimes great , otherwise small , if the latter , and pressed , it goes in , and then after returnes out with noyse , the former doth . If pressed , they are pulsive and of the naturall colour of the skin .

Prognost . Prognost .

Those that are small , and in the head , legs , and armes , may bee knit , and are curable : If great , and in the necke , breast , under the armes , and in the groynes , are uncurable .

Cure . Cure .

Let blood in both armes , then apply Empl. Contr. ruptur . vel unguent . bol. or an astringent . Catapl . or a plate of lead , rubbed with mercury , apply them every third day : If they bee small , cut the skin , and binde the Artery , and then cut it , and let the thread fall of it selfe .

CHAP. XX. Paronychia .

IT s a Tumor red and painfull on the fingers , it many times deprives of sleep , and by extream paine , sometimes causes swooning : if the matter be maligne , it corrupts the bone , and is often a presage of the plague .

Cure . Cure .

The best way is to make incision , and let it bleed , after which apply , Theriac . disol . in aq. vitae , to hinder inflamation , use posca to the whole hand and arm : If they will not admit of incision , then in the beginning apply this ℞ far. fab. Hord. ana ℥ j. Caphur . ℈ j. Mucilng . Sem. pfylii q. s. Misce cum aceto super ignem f. Catapl . if it maturate , apply Empt. Croc. after open and cure . S. A.

CHAP. XXI . Tumors in the knees .

WHich are caused either by congestion or fluxion of hum . stroaks , falls , Crisis of feavors , long travell , riding , they are frequent , with great paine .

Prognost .

Such as follow long diseases , are either dangerous , or long in curing .

Cure . Cure .

Use universals according to the quality of the humor , outwardly apply this ℞ far. fabar . Hord. ana ℥ iiij . furfur . bene Contrit . M ij . Sterco . Capr. bene trit . lb s. Flor. Cham. M j. ol. Cham. Aneth . ana ℥ ij . cum Lixin & Sap. f. Empl. the best is to apply a large Causticke under the knee , as I did in one John Moore , &c. Fontanel infra inguen in parte domestica , is excellent .

CHAP. XXII . Tumor Scroti .

IN it is the stones which are subject to Humor and inflamation , occasioned by stroakes , &c. and Humors , long in curing , hard .

Cure . Cure .

Open Saphena , use Clysters as also diureticks . In principio apply ol. rof . acet . & alb. ovi , after ℞ rad. althaeae Sem. Lini . ana ℥ ij . fol. viol . Malv . parietar . plantag. Hyose . ana Mj. Cham. rosar . Melil . ana pj. Coq. in oxym . cum far. fabar . & Hordii ana ℥ s. Mis. f. Cataplasme . If it suppurate , apply this , with which I cured one Mr. Bradley , whose Scrotum was livid , ℞ rad. lilior ℥ ij . Malv . viol . Cicut . ana M j. Mica . pan . q. s. & butyr . rec . f. Cataplasma , when the colour was come , I used Empl. cum Gum. hee was 84. years old , disposed to a Hecticke .

CHAP. XXIII . Perniones .

IN this its excellent to let blood , bathe them with oats , boyled in aq. & acet . first , anointing them with Pomatum . If they breake use Empl. Melilot . or unguent . Basi . diapomph . & alum ust. mixed vel Empl. Saturn . vel aq. Caphur . Nost. excellent , cum aq. Sper. ranar & Myrrh . Thus having done with Tumors , we come to Vlcers .

SECT. II. CHAP. I. Vlcers .

WHich is a solution of unity from an inward cause eroding . The causes are either Antecedent or Conjunct . The first are foure .

First , Cacochymia , when any of the humors savouring blood is peccant in quality .

Secondly , Contagion , this proceeds either from rotten vapours , as Phthysis , or from lying with uncleane or itchy persons , &c.

Thirdly , Distempers of the parts which are caused either by cold or heat .

Fourthly , all venemous stingings and bitings .

The Conjunct cause is when any humour is changed from its naturall temperature , whether by putrefaction , adustion , or commixtion of any thing unnaturall .

The differences of them are , either Simple or Compound : in the first , nothing hinders from consolidation .

The Compound are either the milde or maligne : The milde are either plaine or sinuous : The last either with or without callossity : The maligne are either lesse maligne , as Herpes exced . Phagaedena : Some or very mal : as Cancer . If internall , it s discerned by the matter expelled as in Ulcers of the kidneyes and bladder , there is purulent matter , in the urin , if in the lungs the matter is cast out by cough , &c. As for externalls they are obvious .

Prognost . Prognost .

In a body Cacochimall or dry and moyst , as aged , children , and women , dangerous ; if criticall , Apost. in the backe or gren joynts : most commonly mortall if the place wherein the Ulcer is , be blackish , blew or grey , of round figure , and painfull , hard to cure : If blewish and pale , and party sicke , death . If complicate with a disease hard . If Tumors in Ulcers suddenly vanish , without manifest cause it portends convulsion , if in the hinder parts , but madnesse or plurisie if they were red and in the fore part : If haires about the Ulcer fall , look livid , where the bone is carious . If a flux of blood follow after pulsation ; if an Erysip appear the bone being bare , are ill , such as cast out an oyley and thin matter that frets the skin , are hard : but Ulcers in a body of a good complexion having soft Tumors , the quittor white , smooth & equall , are easie .

Generall Cure . Cure .

In it observe first , that all Ulcers require desiccation .

Secondly , that in them there is foure times :

First , Princip: when the quittor is thin and waterish .

Secondly , Aug-tum , when the quittor flowes more sparingly and thicker .

Thirdly , statu , when there appeareth pus . and yet it is thinner .

Fourthly , Declin . when its white equally without smell .

The wayes of curing are two .

First , removing Antecedent causes , as Cacochym . by altering and purging the humors offending , Contagion by Alexiphar . Poyson by Antidotes ; the distemper of the part by contraries .

Second is Artificiall dressing , with which we meet with the conjunct causes applying Medicaments according to the times . In princip. using suppuratives or digestives , the quality of which are to be proportionated to the temperature of the part .

But note , in two cases they are to be omitted . 1. In putrid , 2. In Rheumaticke ulcers about the part apply repellers , which hinder fluxion , those are simple and compound , is dicapal . cum succ . de mire vel Empl. refar . N. For the Ulcer it selfe , use unguent Bassilic . cum parum mercurii pp. lot . in aq. plantag. It s well digested when there is laudable quittor , the colour of the ulcer , be good and soft : Then mundifie ( which is the Auguent ) cum Mel. ℥ iiij . Terbin ℥ ij . Coq. Lento igne ad Consis unguent . deinde rem ab igne & Mes. cum vitel . ovi Nj. If the ulcer be foul , mixe with an ℥ of this mercury pp. & lot . ℥ j. & its excellent . It s sufficiently mundified , when its red , sensible and clean , neither too dry nor moist ; after incarne , cum Bal. Hyper. vel ung . Nic. unguent . Basilic . Major . And lastly , Cicatrise with lead ℥ ij . melt it in a crucible , after take it from the fire , and adde to it mercury viui . ℥ j s. after its cold , powder them , Empl. diap . cum aq. Cal. viu . vel aq. Caph. Nost.

CHAP. II. Cure of a plaine and hollow Vlcer .

THe cure of the former may be omitted because it s included in the latter ; the diet is to be thin , and of good digestion , the body to bee kept open : for the Ulcer it selfe it requires digest mundifie and incarne . All which is affected by this ℞ Cer. & resin . ana ℥ vj. picis Naval . ℥ iiij . Gum. clem . ℥ ij . ol. oliu . ℥ v s. vernic . Clar. ℥ iiij . sevi ovil . ℥ ij . Terbinth . ℥ ijs oliban. Mirrh . purae . ana ℥ j. f. ung . ex La. if it bee sordid use with ℥ j. of this , ℈ ij . of this following ℞ merc . praepar . ʒj . Alum . ustiʒ s. Misce pul . this is also good to abate superfluous flesh .

CHAP. III. Compound Vlcers .

FIrst , of distemper that causeth the composition ; if it bee moist , use dryers , as alum ust . if hot , coole , if cold , heat , and if there be paine , remove it .

CHAP. IV. Sinuous Vlcer .

IT s like a Conyburrow caused by Apost: lying deep a long time , or if long before opened . They are of two sorts , one without , the other with callosity .

The Cure . Cure .

First internall , purge cum pul . Arthr. vomit , use Diaphor . especially drying , and purging drinkes , ℞ Sarsap . ℥ vj. rad. Sarsaf ℥ js. Guaic. ℥ iij. Eupator . Scabios . Tussilag . Saniculae Hyper. ana Mj. rad. Symph . Torment . bistort . ana ℥ s. rad. borrag . buglos . ana ℥ . passul . Mai. enucleatar . ℥ iij. Liquor . ℥ ij . infund . per Noct. in in aq. feruentis lib. xiiij . seq. die coq. Lent . igne cum reliquis ad cons. ss bibat singul. diehus lb iiij . vel lb s. mane tantundem hora. 4. pomeredia . in prand . bib. lb j. ac tantund . in caenam quando sitit . superest lb j. hauriend . take it for 21. dayes .

Externalls , first , by injection , ℞ decoct . Hord. lib. j. Mel. ros . ℥ iij. Sarcocol . ℥ i s. Myr. Thur. ana ℥ ij . rad. Torment . bistort . Symphy . ana ℥ s. balaust . ʒj . bacc . Mirt. ʒ ijs . Sumach . ʒjs . vini odorat . ℥ vj. bul . ad consumt . 3 part ac . col . cui ad spir. vini ℥ j. if you perceive this is not sufficiently mundified , which you may know if matter bee either stinking , reddish , pale , blackish , thin , or waterish , then apply this ℞ vini in quo infus . sunt Marrhub . alb. Centau . minor absinth . flor. hyperic . Card. Bened. lb s. unguent . Aegypt . ʒ ij Mel. ros . ℥ s. if matter flow not much , dresse every three dayes , when the matter is white , and doth not stinke , and the cavity be without paine , and remarkable Tumor , then agglutinate it S. A. in the manner of dressing , observe these three thus :

First , lay upon the whole cavity , Empl ros. vel Emp. Cont. rup .

Secondly , infect the Medicament .

Thirdly , put in a leaden pipe short , shut up the pipe with an Empl. Snipt . and above it a peece of sponge , and upon that a pledget of tow , letting from the lower cavity to the orifice a boulster be applyed , and above all a double linnen cloath , beginning your cowler at the bottome somewhat strait and towards the orifice somewhat slacker .

Secondly , by opening when the matter cannot conveniently be discharged , and that is done two wayes :

First , by Causticke , and that when the cavity is lower , then the orifice , either direct or oblique , but not very deepe , yet though deep , if in the breast , or the cavity be broad , you may either use causticks , or incision of it ; to open either first the lower end , or the whole cavity , the first is best , if the sinus be enorme , or in a great joynt , or there be great vessels , tendons , or nerves in the way , upon which a great flux and lamenesse , the whole cavity with a causticke .

Secondly , incision which is sooner done , with lesse pain , and easier cured , which done , arme , pledgets , and dossets , with this ℞ alocs Hepat . ʒ ij . resin . nigr . succin . ana ʒjs . farinae volatʒij . Calc . non extinct . ʒijs . alb. ovo q.s. f. ung . fill the place well , that the lips may bee kept asunder , and dresse it not till the second day at least .

CHAP. V. Fistula in generall .

IS a sinuous ulcer , narrow and long , with callosity , having the quittor virulent , ugly and stinking , paine small , unlesse in sensible part .

These are the differences with their signes , if plenty of matter , it not passing to a remarkable cavity , there is more then one sinus ; if matter be various , divers parts are affected , if it passe to the fleshly parts , the matter is white , smooth , plentifull , if to a nerve , fatty and oleous ; paine is more , and motion is impared , being proved , is pricking ; if to a vaine and Arteries , and coats not eroded , its redish , if Artery eroded , then the blood comes bright with leaping , if a veyne thick and blacke ; if to the bone , the matter is thinne and yellow ; if the smell be ill , and the bone hard without slipping , the bone foule .

Prognostick .

No , Prognost Fistul . is of easie curation , those that are shallow , and of short time , and in fleshy parts in young and strong bodies , there is hope : If end in veynes , Arter , nerves , Tendon , blade , throat , breast , spina , joynt , have sundry sinuosities , and of long continuance , hardly cured . If in depending parts , and nature , by them dischargeth superfluities , they doe good , therefore heale them not .

Curing generall . Cure .

Secondly , which is either palliative or reall , that palliative which for a time dryes and shuts up the sinuosity by a thin skin , till humidity open it again , and this is to be used when they help nature in discharging superfluities ; this is knowne if before their breaking open there be distemper , and after ease .

First , in this a convenient diet as in Tumor Aquosus .

Secondly , purging either by decoct . or Ale , the latter being fit for those that are aged and have weake stomachs . As thus , ℞ Guaiac . sarsap . ana ℥ iiij . rad. Torment . bistort . Symph . an ʒ●s . Polip . q. ℥ iij. Eupator . Sanicul . Alchimil . ana M j. fol. sen. Hermod . ana ℥ v. rhabarb ℥ j. sem. anis . Coriand . faenic . d. ana ʒ vj. glycyrrh . ℥ ij . f. pul . crass . indendus saccul . qui suspend . in gal . 29. zithi . after foure dayes drinke dos . lb s. in mane after which sleep , about ten a clocke , taking some broth , and as much at foure a clock in the afternoon .

Externall cure , for which inject this ℞ aq. Calc . viv . in qua dissol . Litharg . aur. ℥ iij. per ebul . Syr. ros. vel Myrtin . ℥ j. Misc . vel aq. Plantaq . ℥ iij vitriol . Rom. pul . ʒ j s. diss . dresse it . every other day , if matter flow not too plentifully .

Reall Cure in generall . Cure .

Dyet as before , purge either with the Ale before , or some other proper , in the meane time use this ℞ Cayocost . el. de succ . rosar . ana ʒ iij. syr. ros. cum Agar . ℥ j. aq. Cichor . ℥ iij. Misce : Consolidatives are also to be used , as ℞ sarsap . ℥ iiij . Cuai . ℥ vj. rad. Torment . Osmund . regal . bistort . Symphyt . ana ℥ j. Eupat . virg. Aureae & ( si nil restat praeter consolidationem , & cicatrizationem , sume Hyper. & sigil . Salom. ana Mj. passul . major exacinat . ℥ iij. liqui . ℥ ij . sem. Corand . Faenic . dul . ana ʒ v. infunde infundenda in aq. sont . feru . lb xx . coq. lento igne , additis reliquis ad consum . lb viij . ac coletur decoctum ; if the party be strong , let him drinke three pints a day one ss pint in the morning , another at foure a clocke in the afternoon , and at dinner and supper a quart , if they be weake , adde sugar , and make by evaporation a julep , which administer according to strength , as lb vj. of the decoct . Mel. & Sacc . ana lb j.

In Externall cure , five things are observable .

First , Dilation , which is either by incision if the party bestrong , and it superficiall , being sure no cavities be left for feare of relapse ; or by a sponge prepared with Melilot plaster . Thirdly , by the Fistula Tent.

2. Intention is to remove the callus if it be not confirmed , it wil in probing be painfull and bleed ; now it s removed either by Medicament or actuall Cautery : the first is of three sorts ; the first is to be used to young persons its in a fleshly part , and the callosity is small , as unguent Peti ℥ j. cum Turb . min. ʒ j. The second is more strong , and are for strong bodies , &c. as ung . Apost. & Turb . as before mixed . The last sort are Causticks , the more gentle is Turb . mixed in greater quantity then before . The more harsh , as ℞ Realgar . alb. Auripigm . & Calc . viv . ana part . aequ . this is good in strumas also ; to use these , if incision bee sprinkle the callus with them , if by the spunge mixe your powders with unguent . popul . wherewith anoint your Tents , or apply Troch made of the same medicaments , upon these apply an Anodyne Catap. as ℞ Lac. vaccin . lb j. Mic. pan . alb . ℥ vj. Coq. ad Catap. consist . tum adde unguent . Popul . ℥ ij . cum Hyos . ℥ s. Crociʒ j s. qnod applicetur part . affectae mane & vesperi .

Note that you let your Tent Troch pop out of themselves , if there be many sinuosities make injection ℞ aq. plantag . lb j. in qua dissol . vitriol . vomit . ʒ ung . Aegyp . ℥ s. Syr. ros. sicc . Caryophyl . ana ℥ ijs . Misce vel ℞ vitriol . vomit . Caphu . Calcin . simul bol. ver. ℥ iiij . aloes ℥ s. aq. font . lb vj. coq. ad consum . 3. part , the Articall Cautery is not convenient .

3. Intention is to mundifie as ℞ vini . alb . lb s. ung . Aegyp . ℥ s. spir. viniʒ vj. Misce , inject this warme once a day till it be mundified .

The 4. Int. is to consolidate the part , for which , take this , Take rad. Aristol . rotund . Torment . bistort . cumfrey , Centaurie , golden rode , burnet , plantaine , knot grasse , yarrow , and Solomon seale , put these into a Limbecke , and water to come three inches above the symples , draw out the Spirits , and reserve them , take the decoction to every quart of it , ad Mel. Sac. ana lb s. clarifie it with the white of egges , and then strain it again , boyling it after to a Syr. of which ℞ ℥ j. with the spir. ℥ ij . and make injection , this is excellent .

The fifth Intention is to cicatrise it , which is to be performed when the matter is small , thicke , and the place void of paine and Tumor .

CHAP. VI. Fistula Lachrimalis .

IT s situated in the greater corner of the eye , being pressed , the matter flows the probe will passe to the very end of the sinus .

Prognostick . Prognost .

It s of hard curation in regard of the motion and moisture of the motion and moisture of the place if the bone be foule , and lips livid .

Cure .

Let bleeding and purging bee repeated , Cups vesicatories , and Causticks be applyed , Cure . exhib . the decoct . of Chin. & sarsap . for many dayes at the same time , dry the braine with fumes and powders as in the curation of Catarrh .

Externall .

First , dilate it , Externall then remove the Callus with this , ℞ Turb . M ʒ ij Alum cal . ℥ j. Misce of the powder . ℞ ʒ ij . ung . popul . ℥ j. f. ung . and with it as in your Tents . To mundifie ℞ aq. rutae ℥ ij . Syr. a succ . rut. . ℥ ij . aut Mel. ros. Misce dresse once a day . To incarn ℞ ij . aq. plantag ℥ ij . Syr. Mirtil. aut ros. rub . sicc . ℥ j. Misce . Dresse with this but every other day , unlesse quittor doe flow remarkably . If the bone be foule , either the actuall Cautery must be applyed , or this course to bee followed , first finde out the cavity , with a bended probe both upward and downeward , then draw a line with nicke between the glandule of the eye and the pupilla ; then make incision to the bone , dividing the parts incised with you naile till you can put in a pretty pledget ; after thrust in a Troch made of Turbith . M. vitriol . vomit . & Ter. sigillat . wrought with ung . popul . til it be a stiffe paste , & afterward dried , upon which apply pledgets armed with popul . being kept on , cum diapal . cum succis , malaxed with the oyle of Henbaine , afterward filling the orbit of the eye , with little bolsters moystened in sperm . ranar. cum Camph . & so roul it up , dresse it thus twice a day till the Troch with the callus fall out of themselves , then diligently vlew the bone , & so how much is carious , to which apply if the party be strong , pul . Euphorb . or if weak , pul . Cephalic . the cavity fill up with prepared spunge upon it pledget of popul. &c. after the scale is fallen which is about the twenty day mundifie and cure , S. A.

If the whole substance of the bone be foule , peirce it with a gimlet , that the matter flowing inward , it may be healed up , and this is the last refuge : If you perceive it maligne , or tend to cancrosity which is knowne by the hard and livid brimmes , pain , stinking , and virulent matter , apply this ℞ Calamin . usti & in vini acet . extincti ℈ j. Myrrh . plumbi usti & lot . ana ℈ s. Croci g. v. opij g. ij . aeris usti ℈ iiij . decoc . faenugr . vel axung . lot . in aq. ros. Misceantur exquisite omnia super lapidem pictorum ; this is also excellent for all ulcers of the eyes whether maligne or no.

CHAP. VII . Fistul . Thoracis .

Prognostick .

HArd to cure : Prognost . If it hath corrupted the diaphrag . incureable .

Cure .

First , Cure . convenient diet .

Secondly , pectorall decoct . ( upon the use of which the cure chiefly dependeth ) as that of Arceus , or the experimented ℞ sarsap . ℥ vj. Guaiac . ℥ v. Chin. ℥ iij. rad. enulae ℥ i. Capill . Ven. scabios . fol. Tussil . Vener . scolopend . summit . Hyper. ana Mj. flor. borrag . buglos . viol . betonic . ana p. 1. polypod . ℥ iij. liquer . ℥ j. Passul . majore exacinat ficuum ping . incisa . ana ℥ ij . infundantur ista per noctem in aq. fontan . feruentis lib. xxiiij . deinde lento igne coq. ad consumpt . lib. viij . ac coletur decoctum bibat aeger sing . diebus lib. iiij . i.e. ss. at five a clocke in the morning , foure in the afternoone , at his meales two pints , and the rest between . If the ending of the Fistula be lower then the externall orifice , a lower is to bee made by incision , beginning at the beginning of the next rib , Cure . and not at the lower end of that above the which , the orifice shewes it selfe , for under is a veyne , artery , and nerve couched .

First , divide the skin , then make way through the intercostal muscles , after dry all this with a spunge , and put into the incision a swelling spunge ; if you passe no further then pleura , you need not feare , if you doe , beware of the diaphragma & pericardium . If with it there bee a Marasmus or hecticke ( use coole and moystning diet , and of easie concoction ) and the orifice bee inconvenient , you may pronounce them incurable or very difficult . For a Marasm : it s an immoderate drynesse and consumption of the body by reason of the defect of humidity substantiall , of which there is two degrees :

The first , is in fieri in consuming .

The second , is in facto esse , or consummate .

In the first , the muscles begin to fall , the skinne becommeth flaggy , strength and ability decay , and a manifest defect and impotency in the body in all the faculties . Against this degree , contend with a moyst dyet .

If in the second degree the eyes grow hollow , the colour of the skin fadeth , the forehead dry and stretched , the eye-lids heavy , temples hollow , and one would thinke that the belly wants its contained parts , these are past cure .

Now Maras . is twosold , for one is accompanied with heat , and may be called a dry Marasm . and the other accompanied with cold , and this is twofold ; the one naturall which is decrepit old age ; and the other unnaturall , and is a decay by reason of sicknesse , and doth follow a burning or Hecticke feaver , or else by medicaments used in the curing of them , for the Hecticke doth not onely waste the naturall humidity , but the heat also , thence the heart becomes colder then it ought .

Sign . Signe

In this case the pulse and breathing is small , weake , slow , and cold .

A Hecticke is an unnaturall heat which seising upon the solid part wasteth their moysture . Where note , as in the body there is a threefold moisture , viz. the blood , a dewy substance and glutten . So there is three degrees of Hecticks .

In the beginning when the two first humidities beginne to faile , the Hecticke is not easily discerned , although the curation is not difficult ; but if the Radicall moisture which keepeth together the Terestriall substance of every part be consumed as it s easily discerned , so hardly cured , as long as the moysture is somewhat plentifull , sufficient to entertaine naturall heat . The body seemeth well coloured , of a comely figure , of a decent quantity ; but if contrary , leave such a one to himself , unlesse hee implore your helpe ; then for the Fistula it selfe , inject of aq. plantag. cum syr. ros. sicc . cover your Tents and pledget with diachylon . sym . for the Maras : appoint broths of mutton , veale , or chicken , wherein damask prunes , rasins stoned , currans washed and bruised , Mallow flowers and roots , Marrygold , cinque foile , cowslip flowers , and coalts foot leaves and flowers , have beene boyled , gellyes are made of young cockrels and veale , with a little mace and nutmeg ; let him have betweene meales almond milke made of the broath of chickens boyled with French barly , use every morning and evening Asse milke , or Goats , or Cowes , milked through the conserve of borrage or buglosse flowers , Calves , and Sheep feet stewed are good with currans ; sometimes let him eat pigs flesh , if hee have minde to fish , grant him Whiting-mops , Smelts , Perches , young Pickerels , Trouts , Sole , Flounder and Plaice , sometimes Eeles , poched egges , cum Butyr . S.S. and aq. ros . are good for breakfast .

If a Hecticke be the cause of a Maras . then you must moysten and coole in the broaths , then boyle borrage , succory roots , sorrell , luiula , primrose , violets , flor. bor . & buglosse , let his sallets be lettice , spinage , and purslaine , boyled in chicken broath , use almond milk every morning , & even , as ℞ amygd . d. ℥ ij . sem. 4. frig. major ana ℥ j. sem. pap . alb . ʒij . cum aq. Hord. s . q.f . Emul . quae dulcor Man . Christ . perlatis , vel adde sac . q. s . Misc . super igne & f. sapeda vel ℞ conser . ros. viol . cichor borrag . buglos . ana ℥ j. spec. diamargar . frig. santil . citrin . ana ℥ s. cum syr. viol . f. Elect. administer no milke , but butter milke soure with sugar , which is excellent , if they complaine of heat and watching , give twice a weeke , Phylon . Persic . cum diacod . Syr. rad. caryoph . capil . ven. in aq. sperm . ranar. vel pap . Use nourishing Glisters often in lesse quantity then others . Externally use bathes & oyntments , as ℞ Gum , trag . Arabic . ana ʒj . infu . in aq. ros. per diem & noctem ad ol. viol . ℥ js. butyr . recent . ℥ j. Camphor . ℥ j Misce in mortar Lac. mulier . is excellent : Anoint the whole body three houres after supper , one cured thus in a moneth ; if thus they recover their strength and a good habit of body , then they may recover , which if they doe , first , remove the Callus , in which let not the Troch reach to the cavity lest it fall upon the diaphrag : and so cause death , after mundifie cum aq: Calc : & mel ros: incarne cum aq: plantag: & Syr : e ros: the pledgets being dipt in the Syr : or Syr : Mirtil : and above apply Empl : Paracelsi . Remember if a flux follow a Maras : then use aq: hord: cum Syr : Cydon else Rice pottage , excellent .

CHAP. VIII . Fistula's of the back , belly and joynts :

FOr the first , if the vertebr : be foule they are incurable , which onely dresse cum aq: plantag: regin. pratens : syr: ros: sicc : & spir: vini being tinctured with aloes , myrrh mastic , & Crocus , you may judge the vertil foule if extraordinary store of stinking sores flow out , the party dayly grow weaker , and more extenuate , notwithstanding all means .

CHAP. IX . Belly .

FOr the second , of the Belly , they are of two sorts :

First , those in the groyne .

Secondly , those in the Ano :

The first falls out most often after venerall bubos or in Plethoricke and Cacochym bodies , yet sometimes they are above the groine : If in these the guts bee eroded , they are incurable , therefore use an inject ex rub : vino in quo par. alum . dissol : cum syr: Mirtin : lot the party observe to eat calves and sheeps feet stewed , sheep and calves heads , Rice boyled in milke , wherein steel hath beene often quenched , every morning and evening take a draught of Aligant warmed with a white toste , keep the orifice open with a spunge untill the gut bee consolidated , then proceed as in Fistula's in generall , if they runne onely superficially , the best cure is by incision .

CHAP. X. In Ano.

FOr that in Ano , it either peirceth into intestinum rectum , or not , if it doe , the excrement and wind will breake forth with the matter , the injection and probe will passe into the gut that you may feele the latter ; it is hard of cure , being the jakes of the body .

Cure , is either by incision , injection or deligation ; the two former have beene sufficiently handled , which are to bee used when it peirceth not intestinum rectum , to consolidate use the Syr. Magistr: & pul . Cephalic . if you cannot conveniently use the first , use the Troch : or the spunge ; for the last deligation , first dilate , then remove the callus , after bind it with sealed thred , or silke twisted , put one end of the thred in the eye of the probe , after thrust it in at the sinuosity into intestin . rectum , where have your finger ready to receive the thred , and draw it out at ano if it be not thicke and long , you may binde it at twice , otherwise you must use sundry , after it s done , cure S.A.

CHAP. XI . Fistul . Juncturarum .

IF they be not with corruption of Cartilages or bones , curable , if accompanied with hard tumors , its incurable .

Cure , First , Cure . dilate cum spunge proper .

Secondly , remove the callus cum pul . Turb . Min. Ter. lem . sigillat . bol● orient . vitriol . vom . an . part . aeq . Misce cum ung . popul . for easing paine , ℞ ol. Lumbric . Cham. Aneth . ana ℥ ij . furfur . flor. Cham. farin . Hord. aesypi and ℥ ijs . vini aligant . ●x . f. Catap. renew it twice a day , after Callus is removed , cure . S.A. If they bee incurable , move the patient to suffer dismembring , before they grow weake , whether foot or arme ; but in aged and crasie persons beware .

CHAP. XII . Maligne Vlcers .

NOw of Maligne Vlcers , which are not easily cured , they have fierce causes , extraordinary symptomes , and yeeld not to ordinary medicaments , these happen when Cachexia hath possessed the ulcerated part , and doe corrupt the aliment sent for nourishment thereof , this is done either by putrefaction , or a venemous quality communicated .

Sign , Signe . Of Maligne Vlcers , great paine , plenty of virulent and stinking matter . The first is , Herpes exedens .

CHAP. XIII . Herpes exedens .

IT s livid and uneaven , the middle heales , and lips remaine sore , they appeare most often in old people in the leg at the beginning of the tayles of the Muscles , being very painfull and rebellious , the lividity is caused by melancholy joyned , when its absent , the part is yellowish .

Prog. Not easily cured , the liver , Gall & porus bilaris , being out of frame , and so they not able to evacuate the humor by the guts and urin , and therefore they passe to the habit of the body by the veynes and arteries . If Atra bilis be added its more hard to cure .

Cure . First , Cure . stay the humor by purging , pul . Nost. sol . or ℞ rhab. ℥ j. fol. sen . ʒiij . zz ʒ s. spic . ℈ s. infundantur ista per hor. 2. in aq. Font. fervent . ℥ vj. deinde . lento igne exhalent . ℥ iij. ac coletur decoctum in quo dissol . Mannae & syr. Cichor . cum rheo ana ℥ j. Misce ut f. potio , if the body bee Plethorae or cacochy . use a purging decoction for sundry dayes , as ℞ rad. Cichor . nalu . borrag . ana ℥ js. polyp . q ℥ ij . flor. borrage . buglos . viol . ana p. 1. fol. sen. & Hermod . ana ℥ ij . sem. anis . & faenic . d. anaʒvj . rhei . ℥ vj. liquir . ℥ js. infundantur infundenda per noctem in aq. Font. fervent . lb viij . sequent . die adjectis reliquis coq. ad medias , ac coletur decoctum quod aromatieztur cinam . ʒvj . sumat . aeger mane lb s. ac tantundem hor. 4. pomeridiana , betwixt ten and eleven a clocke , let them take some broth , caudle , or alebury , exhibit the medicament in Summer cold , and in Winter hot .

Second Intention is to evacuate the humor imparted , this is done by such medicaments as abate spungeous flesh , as the Troch Mus. Andronis , &c. but the best is Turbith M. as ℞ Turb . Mj. ʒij . alum . Calc . ʒj . Mis. these are to be mixed with Paracel . Mundif . to every ℥ of it adding a ʒ of pul . use these till the ulcer be red , leave spreading , and bee very cleane : where note , it mercu . proper lot . in aq. ros. & mis. cum ung . sarcot . doth admirably heale rheumetick ulcers in tender persons .

Third Intention , wherein first fill up the cavity , then cicatrize it , for which use ung . Enul . cum merc . to an ℥ of which , adde flos sulph . ℥ . vel spir. vitriol . as for the rest proceed S.A.

CHAP. XIV . Phagedaena & Nome .

THese may bee joyntly handled because of the liknesse of the symptomes , the first is an ulcer corrhoding skin and flesh , having the brims tumified , but without putrefaction .

The second is a consuming ulcer , without Tumor in the brims , indued not onely with malignity , but putrifaction of the part feeding upon the adjacent sound parts , and that deeply .

Cure . If the party be weak , Cure . use these Pils , ℞ aloes ℥ ij . rhei , agaric . Trochis . anaʒj . Myrrh . ℈ ij . Mast . ℈ j. syr. August . q. s.f . massula ; dos . ℥ j. Pilulce 2 pondoʒ s. a primo somno vel sumat . unam aut paulo ante caenam , alteram paulo antequam ineatur somnus . To the strong , use Pil. Hier. Diacolocynth . vel Aggregat . major . whether they be weake or strong , use decoct . of Sarsap . Guaia & vul . Herbs , sometimes these possesse the privy parts after impure copulation .

For locall applycations . To the first , apply unguent . popul . & album Camphorat . an . part . aeq . Misce : As for noma , it requires stronger medidicaments , this following may serve both , ℞ Calc . viv . vitriol . vomit . Auripigment . ana ℥ ● . Malicor . Balaustior . C. C. usti , gallar . Pumicis calcin . alum . usti , Aristol . rotund . ana ℥ s. Croc. Mart. Plumb . calcinat . alum . usti anaʒvi . cum mel despum . f. Elect. vel primo infund . absinth . Card. b. Centaur . Min. Scord. Chamaedryos malicor . balaust . Galla. rad. Arist. rot. in acet . forti , ℞ Hujus Aceti colati ℥ vij . Aerug. ℥ v. mel . ℥ xiiij . Coq. lento igne ad ung . consistentiam : This is effectuall in venere all ulcers of the throat , privy parts , and all sordid ulcers , these are to bee continued till they spread no more , looke red , and be well mundified , after cure . S.A.

Note that you promise sudden cure ofno ulcer if it hath continued a moneth , and if any uIcer in what part soever be more painfull , then the solution of such an unity requireth , and yeeldeth not to medicaments , suspect there is a latent malignity .

CHAP. XV. Cancer .

IS a Tumor unequally painfull , hard , livid , and hot , having full veynes in the adjacent parts . In the beginning , being hard to discerne , being no bigger then a Pea , proceeding from Bil. Atra , begotten of yellow choler caused from a hot distemper of the liver , weaknesse of the spleen , stopping of the Hemorod or menstr . or from ill dyet , as by hot things ; shewing themselves most commonly at the end of Sumer , and in the harvest quarter .

Prog. None are of easie curation . Prognost . If they possesse any great cavity , as Matrix and Anus , deale not with them by excision , causticke or burning . If they bee great , and the party weak , incurable : If in the outward parts and superficiall , and be not of remarkable bignesse , they may by incision be cured .

Cure . Cure . Dyet cold and moyst , shunne all melancholy meats , as also watching , immoderate grief and labour , as also all other things which thicken the blood , and inflame the humors . Bleed in the full of the moon , for it miraculously stayeth the ebullition of blood , asswageth pain , and hindereth encrease of the Tumor . If it be in the lip , open Cephalic , if in the breast the Basilic of the right arme ; if in the right breast . If in the Matrix or Anus , open ven. Poplit . or Saphaena . Purge ℞ pul . Sanct. ʒ●s . syr. ros. dam. ℥ j. seri . Lact. q.s. f. pot . at the first exhibit them twice a weeke , and afterward a day before , or after every quart , and full of the Moon . The fittest applications outward , are those that repell and digest , as ung . de Ranis viridibus , Catap. made of succ . solani , farin . siligi . & ung . popul . vel coclear . & Hederan vel far. lupi , aq. sper . ranar. & fol. Herb. Ropert . Take a good number of green frogges , whose mouths fill with fresh butter , afterward put them into an earthen pot well glazed , having the bottome full of holes and a cover , place this in the mouth of another set in the earth , lute these well together , and the cover of the upper pot ; then for the space of three houres , let a gentle fire of charcole bee set about the upper pot ; when the pots are cold , take out the frogs of the upper pot , and beat them into fine powder , then mingle the moyster in the lower pot with the powder , and f. unguent . a plate of lead rubbed with merc . viv . excellent .

CHAP. XVI . A Cancer ulcerate .

IT s ugly , having a moyst stinking smel , thicke lips , and turned outwards , greenish and fretting , yeelding a sanies blacke , or of a darke yellow colour , and is exceeding painfull ; in the thighs and legs its called lupus , &c. for inward meanes . ℞ rad. bugloss . & Cichor . ana ℥ j. fol. Agrmon . borag . ceterag . & veronic. ana M s. Coq. cum pul . gallinaceo . in Col. dissol . Cremor . Tarta . ʒj . f. juscul . which take twelve mornings every fortieth day , adde ℥ ij . of this syr. ℞ succ . rec . expres . & per resident . depurator . borag . bugl . fumar . Cichor . lb iij . succ . veronic. & Pomor . redol . ana lib.j. Sen. Mund. ℥ vj. Epithym . ℥ ij . rhei . & Agar . rec . Troch ana ℥ j. zz . & Caryoph . ana ℥ j. infund . & decoq. ut artis est donec colaturae super sint lib. 5. in quibus dissol . sacc . alb. lb 5. f. syr. in last dos . of the broth , adde extract . Helleb . Nig. g. iiij . after the broth , use warme bath for three dayes , apply the leeches , make font . in each thigh Fifteen dayes , after the taking the extr. take the same quantity againe , cum . diaprun . sol . ʒiij . apply outward ung . ranar. virid . If it bee in the Matrix or Ano , use proper injections , as aq. sper . ran. cum pul . ranar. If Cancer in other parts be superficiall , you may eat them out with Arsnicke , Subl . or ol. ejusdem cum ol. rosar . Lepros . come next in order , but because it s seldome presented to be cured , wee passe it by , and come to accidents that hinder cure , and these are either familiar to nature , or estranged from it : of the first of these wee will first speake , and in the first of Superfluous flesh .

CHAP. XVII . Superfluous flesh :

WHich is abated with Turbith . M. ʒij . alum . ustiʒj . Misce ; if it be too hard apply causticke , or cut it off , the last is best .

Corruption of the bones , the causes are either outward , as cold and heat exceeding , or inward , as superfluous humidity , sharpe and maligne matter .

The signes are either sensible when the bone is blacke , feel rugged , if the flesh above be spungeous , or of a livid colour , if Tents reaching to the bones smell , or intellectuall , if quittor flow too plentifully be thin and stinking ; if it admit of skinning , and break forth againe , if it bee long in healing , and rebell against proper medicaments , its soule .

Cure . Cure . First , lay bare the bone , either by incision , causticke , or dilatation .

Secondly , scale the bone , cum pul . euphorb . excellent , if it be deep with some instrument , sometime by actuall cautery when humidity abounds and the bone feeles soft , pul . Cephalic is good , ℞ mum . sarcoc . anaʒ s. euphorb . ʒj.f . pul .

CHAP. XVIII . Of a discoloured .

THe first is of foure sorts , red , yellow , livid or blacke , red proceeds from heat , or by blood offending either in quantity or quality . The first is knowne if the body bee plethoricke . The second , if it be too hot and fervid .

For the first , bleed , scarifie the part , and apply leeches , if it happen through defect of Hemorod or menstr . procure their fluxion : The first by applying the leeches : The second by using Elix . propriat . or pil pestilent Arab. being taken sundry mornings . For the second , open Saphaen . in foot is most apparent , exhib . calyb . medicament : for quality use cold and moyst dyet , apply acet . ros. vel sambuc . & acetum .

Secondly , livid comming by corrupt and blacke blood setled in the part ; for this you are to scarifie , apply leeches , after foment . cum oxymet . dissol . in aq. Card. bened. If it proceed from cold which is perceived by the temper of the part apply this , ℞ a Turnip and a radish root , scrape these two , and adde to them of the powder of mustard-seed , ℥ j. Caryoph . pul . ʒiij . ol. lini & jugland . q.s.f. Catap. which apply warme , this hath cured divers Gangreens .

Thirdly , blacke , which may either proceed from heat or cold , if from heat an inflammation went before . If from cold lividity did proceed , which is a signe of mortification , especially if no heat or feeling doe remaine .

In both these cases the parts are profoundly to bee scarified , using a lixiuum , wherein is decocted absinth . Centaur . Minas , Scordium Card. bened. flor. Cham. aneth . flor. Melilot . after fill the incision of the scarifications , with some of the medicament following using a feather , ℞ oxym . simp . ℥ ij . ung . Aegyp . ʒiij . spir. vini ℥ ij . Misce , after apply this , Catap. ℞ Farin . fab. Hord. & orob . ana ℥ iiij . lixiu . mitioris lb iiij . Coq. ad Catap. tum adde oxymel . s . ℥ ij . ung . Aegypt . ℥ j. mixe al wel , continue the use of these medicaments till the part returne to its right colour .

CHAP. XIX . Varicous Vlcer .

WHich is the tumefication of the veynes , by reason of superfluous grosse blood , it happens oftnest to those that have bad spleens to men rather then women , it s caused by thick and impure aire , immoderate exercise , long standing , thicke wine , and grosse food .

Prognost . Prognost . If they appeare in those that are mad by reason of melancholy , the griefe ceaseth , they mitigate bunchings of the body , those that proceed from the spleen , are not to be cured .

Cure Physicall , Cure . use convenient diet , purge often grosse humors , as ℞ Elect. lenti . ℥ vj. pul . sanct . ʒ. syr. Cichor . cum rheo . ℥ j. M. cum aq. ejusdem q.s. ut f.p. Chirurg. The best is to take up the veyne above and below , and upon it betwixt the deligation , that the blood may be discharged out of it .

CHAP. XX. Vermous and lousie Vlcer .

WHich is knowne by a strange itching and paine in the part and stinke : use decoct . of dry Tobacco , excellent , or ℞ absinth . Centaur . M. Marrub . ana Mj. Coq. in aq. Fontan . in lb. v. cola . dissol . aloes ℥ s. ung . Aegyp . ʒiij . Misce .

CHAP. XXI . Particular Vlcers , first of the head .

WHich are of two sorts , moist and dry : the first are two , Acher & Favus , the former is an ulcerous Tumor of the head in the skinne , red and duglike , having small holes , out of which issueth a thin and ulcerous sanies ; the latter is the like , onely the holes are larger , and the humor in thicknesse like hony . Note they are contagious , and are caused of sharpe and fretting humors , in both there is an itching , and the Favus hath scales , they are of hard curation .

For Cure , use the same diet prescribed in Cancer , if Plethor , and the head bee full of corrupt blood , bleed in both arms , under the tongue , and vena Frontis , yea and the arteries of the temples . Purge first generall , as ℞ Confec . Hamech . ℥ s. pul . sancti ℈ ij . Holand . ℈ j. syr. ros. sol . cum Agar . ℥ j. aq. betonic . ℥ iij. Misce f. Pot. but these are excellent . ℞ Pil. Aure. & aggreg . ana ℈ j. Troch . Alhand . g. vij . spir. vitriol . gut . 5. f. pil. 5 ʒj . administer them once a week till the party bee healed : For particular evacuation , use neezing . Concerning outward meanes , ol. Bombacinum , is excellent , as also water Cresses boyled in axungia , both which is also good for Tinea , a thing like a cap spread with a medicament made , ex pic. liquid . & Terbith . and applyed for a month every day once , or every second or third day , is good ; so generall means have gone before ; if children be presented , let the caps be so put on , that they may not pull the medicaments off . Secondly , if they bee maligne , meddle not with them till they bee elder . ℞ Sulp. ʒij . sinapis ℥ s. staphyd . agriae . rad. bryon . anaʒj . acet . acerrim . ℥ j. Turb . elect . ℥ s. ping . ursin . q.s.f. Lin. Tinea , little differ , onely they are dry and crusty and commonly white ; if this or other be in children Decoct . folior . nuc . Jugland . ung . Enulat . cum merc . duplic . a fontinell . in the hinder part of the head , is excellent .

CHAP. XXII . Vlcer of the eares and eyes .

OF the first of these , the causes , are either outward , as blowes or falls ; or internall , as sharpe humors sent from the braine , it s sometimes with excrescence of flesh .

Cure . First , purge , as ℞ Pil. aggreg . Aur. ana ℈ j. Troch . Alhand . diagrid . ana ℈ s. spir. vit . q.s. & for . pil. . foure dos . two at five in the morning , foure houres after take broth .

Cure externall , Cure . Troch Andronij dissol . in aceto sambuc . vel Croc. Mart. Coq. in vino aceto ad consistent . Lt. vel syr. sanatiu . In winter use Nicot . succ . coq . in ale , this is excellent , if it be foule , and worming , if they afford great store of quittor , dresse them once a day , if not , once in two dayes , if there be excrescence of flesh ; first administer the Pills , and then consume the flesh with the Fistule powder , after inject this , ℞ vini alb . ℥ ij . Aegypʒj . Mel. ros . ℥ s. Misce syr . after dressing on the sound part a good while .

CHAP. XXIII . Of the eyes .

WHich have the same causes as before . In curing use good diet , bleeding , purging , applying of the Seton or Fontin . the ulcers are either milde or maligne , and because opthal . are the forerunners of the ulcers of the conjunctiva of it , we will first treat .

CHAP. XXIV . Opthalmia .

IT s a Tumor with paine , and horrible heat ; of which there is three sorts .

1. Conturbatio , arising from outward causes or inward , and is not much .

2. Is reall , and is alwayes from an inward cause .

3. Is called Chymosis , when the inflammation is so great that it causeth the turning up of the eye-lids , which often falleth out to those that are very plethorick , and have abundance of Pituitous humors . If it bee from the stomach , the desire to vomit , if from the head , there is a paine , if from the vessels without the Cranium they will bee full in the forehead , the Arteries beat , and the eye-lids be heavy ; if within , the party often neezeth , and the nose itcheth , if of blood , the face will be red , the veynes full , if from flatuosities , there will bee singing in the eares , and tensive paine , if from flegme , the eye-lids will in the night time cleave together .

Cure . Cure . Use cold and moyst diet , after a Glyster , let blood plentifully , if it bee grievous : yea sometimes open Jugular ( according to the length ) if it bee necessary , the opening of this is excellent in the megrim , inflammation , of the Pia & d. Mater & Polypus . Purge by repetition ; if the disease be in princip . with pot . as ℞ Tamarind . ℥ s. sen. mund . ℥ iij. sem. anis . ℥ s. fol. end . chichor . fumar . ana Ms. coq. in aq. ad ℥ iiij . in Colat. infunde rhei elect & Myrobal . Citrin . ol Amyg . dul . cenfricatarum ana ℥ j. Santal . Citrin . ℈ s. in express . dissol . Man . & syr. ros. ℥ j. Misce f. Pot. if in the state , use pils , these excellent , ℞ Pil. luc. major ℈ ij . Aur. ℈ j. Troch alth . g iiij . ol. faenic . gut . 6. cum syr. de staech . ad f. pil. 5. if there be suppresse of customary evacuation , procure them , apply Cups vesicator . excellent defensitives to the forehead , Catap. to ease paine , as panis Cocti ℥ j. Mic. pan . alb . ℥ s. ovum N. 1. cum lac. mulieb . in the eye use this Col. ℞ aq. ros. vini alb. ana ℥ ij . sacc . Cand. alb . ʒj . extinc . three times in the liquor , after powder it , and put it in , or ℞ vitriol . vomit . ℥ j. dissol . in aq. ros. vel plantag. ℥ iij. ad ignem deind . Colat. this seton . or Font. are excellent , also vesicat in sinccipite opening of the salvitella is good .

CHAP. XXV . Vlcers of Cornea .

WHich are either superficiary or deep , caused of salt and nitrous humors .

Cure . Seeing all ulcers of the eies denote a body Cacochyme , Cure . it s to bee altered , but per epicrisin shunning all strong Catharticks . For topicalls , you can have no better then what is prescribed pag. 64. l. 10. Those that are maligne may have the same , remembring to keep an exquisite dyet , purge once a week , as ℞ spec. Hier. ℥ s. diagrid . ℥ ij . Troch . alb . ʒv . cum syr. August . f. Mass . dos . ℈ j. in one pill . Alter your bread and beere , with proper seeds and hearbs , and use after meales a digestive powder , keeping the body open with Glisters ; for Cancers they are either to be extirpated , or otherwise , onely receive a palliative cure , with gentle medicaments .

CHAP. XXVI . Ozaena .

IT s a maligne ulcer caused of sharpe humors , eroding the part , being either contagious , or not , the latter is from the Lues ven . both are hard to cure .

Use dyet , and purging , such as may contemperate and take away the sharpenesse of the humor , bleed , use cups cum scar . as also vesicatories and Font. if necessary , purge twice a week with Extr. Rudii , as also Antimon . that purgeth most by stool , which is excellent .

Externall Cure , First , remove the scabs , Cure . moystning them with Amygd . d. ℥ j. sper . Ceti ℥ ij . Misce , then to procure their fall , ℞ elleb . alb. nig . peti , ana ℈ j. roris . salu . ana ℈ ij . Mosc . g. ij . f. pul . subtil . after that is fallen , use aq. Calc . viv . cum merc . d. vel aq. Aluminosa aut vng . Aegypt . dissol . in aq. Hord. vel ℞ aq. plantag . ℥ iiij . merc . sub g. xij . bul. in phiala vitrea . ad consum . ss. vel ℞ ol. ros . ℥ ij . litharg . Aur. C.C. usti & pp. Tutia pp. plumb . usti anaʒij . procium in mortarium plumb . & cum pistil . plumb . agitentur . ad form . Lt. ad parum succ . Geranij . Candles of red wax their smoake taken by a funnell at the nose is excellent ; or the cautery , other ulcers may be cured by ordinary method .

CHAP. XXVII . Vlcers of the mouth .

ANd first of the lips , as also chops for these , use Pomat. or the sweat behinde ones eares , or ℞ Cerae Flau. ℥ ij . ol. ros. mel . & axung . porcin . in aq. ros. lot . anaʒiij . litharg . arg. Myrrh . zz . pul . ana ℥ j. f. Lt. this is good in Fissur in any part of the body , for the ulcers whether they be milde or maligne , ung . rub . Camphor . is excellent , as also in other parts .

CHAP. XXVIII . Of ihe Palat.

FIrst , touch them with this ℞ aq. Card. bened. plantag. & sper . ranar. ana ℥ iij. Mel. rosar ℥ ij . ol. vitriol . ℈ j. after apply this , ℞ syr. ros. rub . sicc . e bacc . Myrti & de succ . granat. ana ℥ j. ol. vitriol . ℈ s. dresse it often . If the os Palati bee bare , mixe with the former sume pul . Cephal . if a small peece fall , its curable , if a great , you must use a silver plate .

CHAP. XXIX . Of the Tongue .

THe mild may be cured with this ℞ Hord. mund . ℥ iij. rad. alth . ℥ ij . liquor . ℥ js. bul. ista in lib. vj. aq. font . ad medias & Colat. cui adde syr. viol . Tussilag . & scab . ana ℥ js. If maligne , use merc . d. spir. sulph . in children , mixe it cum mel . ros . if they be above foure yeare old , a. g. of laud. is excellent .

CHAP. XXX . Of the Almondes .

GArgar . cum decoct . morsus diabo . vel fol. scab . & Agrimon . ana Mj. nuc . cupress . ʒj . rad. ireos flor. & Aristol . rotund ana ℥ s. myrrh . ʒs . ros. rub . p. ij . Coq. in Hydromel ad lib. j. colatura colluatur os frequ . after apply this , ℞ Centau . minor . rad. irid . ster . Can. anaʒj . cum mel . despu . f. Elect. if they be hard they are never cured .

CHAP. XXXI . Of the Throat .

℞ AQ . Plantag . lib. i. ros. rub . flor. Aurant . ana ℥ i. mere . sub . ʒii . digerantur in arena per hor. quadrantem , ac coletur aq. qua in vase vitreo servetur , if by reason of these Ulcers , the party cannot swallow any solid meat ; minister to the patient merc . d. for foure mornings together in new milke , and you shall finde a wonderfull effect .

CHAP. XXXII . Vlcers of the Backe .

THese commonly fall out after sharpe diseases , which continue till the fortieth day , or Chronicall diseases , whose time is uncertaine , being from translation of the matter .

Prognost . Prognost . If the Tumor be long before broke or opened , hard to cure . If the vertebra bee foule , or the body decayed , desperate ; those in the upper parts are more easily cured then those in the loynes .

Cure . Cure . Internall : First , purge ℞ aq. Cichor ℥ iij. syr. ros. cum agar . ℥ i. elect . e succ . rosar . lenit . anaʒiij . Misce f. p. If ready to open , apply lap . infernalis , or any other ; after mundifie , cum vino alb . lb j. Mel. ros . ℥ iij ung . Aegyp . ℥ j. Misce , and in ject to Consol. ℞ aq. plantag . ℥ iiij . syr. My. tin . & e succ . ros. ana ℥ s. Troch . alb. ros. sine opioʒij . Mis. & injic . upon these , use diachy cum gum .

As for ulcers of the joynts , purge often , ℞ Elec. esucc . ros. Caryocost . anaʒiij . syr. ros. sol . cum agar . ℥ j. aq. Cichor . ℥ iiij . apply to the ulcers Desiccat . rub . anoynt the brims with this , ℞ ung . popul . alb. Camphor . ana ℥ j. ol. Gydon . & pap . ana ℥ s. f. Linem . before you apply the medicaments , use a foment of sumach . Cortio . granat. ros. rub . & bac . myrtil . infus . in vini rub . stet . intus . in aq. Tepid .

Of Thighes and Legs .

Use purging , diet drink , vomit , sweat , apply aq. Camphor . vel ung . diapomph . cum alum . Cal. vel aq. Calc . viv . siccat .

Of the Feet .

Apply this Catap. ℞ far. fab. . ℥ ij . pul . rub . ros. balaust . & nuc . Cupres . anaʒij . Croc. ℈ j. Coq. cum aq. plantag. & ros. & aceti par. adde vitel . ovi parumque ol. ros. apply it warme ( using the former medicaments ) it easeth paine , and Tumif . decreaseth proud flesh . So much for Ulcers .

SECT. III. CHAP. I. Wounds .

Defin.

IT s a solution of unity , Defin. caused by an externall instrument , incising in any part of the body . The differences are in the cures . The generall Prognost . are these : As ,

First , some are dangerous , Prognost . which are sometimes cured , but for most part cause death , as superficiall wound in the braine .

Secondly , difficilia , such as may be cured if well dressed , if not , remaine uncured , as some penetrating wounds of the breast .

Thirdly , malefica , such as leave a hurt after they are cured , as the Nerves want motion , &c.

Fourthly , Lethalia , as those that pierce deep into noble parts , or divided great vessels ; Therefore in all

Prognost . Prognost . Observe these foure things .

First , the parts affected .

Secondly , the adjuncts of the wound , as bignesse , situation , &c. symptomes , or complicate , with other diseases .

Thirdly , the habit of the body .

Fourthly , the use of the part .

For the part it selfe consider : First , the dignity . Secondly , the substance . Thirdly the temperature . Fourthly the situation . Fifthly , the quality : These considered Prog. Prognost . may bee made surely . These premised , union is to be performed , which hath two intentions :

First , Agglutination .

Secondly , Concarnation . All fleshy part alwayes and spermaticall parts till the sixth yeare admit of the first , after the second is to be used : the causes of union are two , efficient and instrumentall : the efficient are Nature and Chyrurg : Nature is the chiefe , the Chyrurg : being a minister , and therefore is to accommodate Nature , with both common and proper duties necessary to both intentions . The common to both are first staying blood , and that s done eight wayes :

First , by applying pledget , with alb. ov . & posca .

Secondly , deligation of the vessell .

Thirdly , applying Gallen powder , using it thus , couch the vessell with your finger , then cleanse the blood away with a spunge and red wine , after besprinkle about your finger with powder , apply upon the place pledgets with the same medicament , which keeping close downe , fill the wound with pledgets or dorsells armed , and upon them a double cloath wet in some astringent liquor , rowling it up beginning below the wound , and at the wound run it three or foure times about , dresse it not till the third or fourth day , then all is to bee taken away except the last , and new besprinkle it , and apply new pledgets : Thus after the first you are to dresse it every other day , untill the place be incarned , and no feare of a flux .

Fourthly , by injection .

Fifthly , by causing an escarr , cum umber & Cal. viv . aeq . part . f. L. cum alb. ov : & pil: lepor : this is also excellent in Amputation .

Sixtly , by opening a veyne .

Seventhly , by setting them in cold water .

Eightly , internall potions , as ℞ diascord . ℈ iiij . Phylon . perfic . ʒs . diacod . ℥ i. aq: pap : erratic : vel sper : ranar : ℥ iii : M. f p sumend , frigid : after taking , keep quiet , and addresse himselfe to sleep , it may be given every twelve houres : the two last are excellent in bleeding of the nose .

Second duty is to remove extraneous bodies , in which observe two things ;

First , the kinds of extraneous bodies ; as first they are so by accident , and these are of three sorts : As first , soft , as contused flesh and clotted blood . Secondly , hard , as bones and Cartilages ; or Thirdly , meane , as peeces of membranes , tendons and haire .

Secondly , extraneous of their owne nature , which are either soft , as peeces of garments ; or hard , as steele , weapons , pullets , shivers of wood , gravell , &c. these are to be removed , such as may be by washing , and the rest with forceps : remembring things deep , painfull , or difficult , ( and yet the wound may bee cured ) may remaine , as also if the wound be mortall , or cannot be got out by instruments , then apply the horned popyes , both the pimpernels and henbane , or this ℞ litharg . lb j. ol. lb ij . Colopho . lb s. cerae ℥ iiij . amoniac . ari stol . rotund . ana ℥ ij . galban . rad. gentiance ana ℥ j. Thur. ℥ js. arnog . rad. dictam cret. aloes Hepat . squam . aeris , propol . anaʒvj . f. Emp. s . a. this is excellent , as also against maligne ulcers , dryeth moist bones , being answerable in vertues to Paracels .

The naturall temperature of the part is to be preserved , and being lost restored , both which are to be done :

1. By a due ordering of the six nonnatnrall things .

Secondly , by applying apt medicament . Now the naturall temper is the convenient drynesse of the part for siccum est sano proximum ; therefore the nonnaturall is to be ordered accordingly , as the aire must be warme , dyet coole and slender , till the seventieth day be past , their drinke may bee this , ℞ aq. Font. lb iij. vini alb . lb j. avenae mund . ℥ iiij . Coq. ad consumpt . lb j. Col. adde aq. ros. Coch. iij. sac . opt . ℥ iiij . For evacuations bleed , if the wound be great or inflamed , if stitches be to bee deep , paine much ; if the body be plethor or fevourish , if furious in Summer , or wound bee in great joynts , purge with Cholagog in wound of the joynts , stitches be deep , inflammation , dilatation , incision , rasping of the bones , or an Erysip : Command rest , forbear immoderate sleep , remove all perturbations of the minde , and chiefly avoid Venus . As for the observation of excrements , Ichor is thin , and issueth either from the veynes or wounded part ; if from the first , its waterish , and thin , without noysome smell , having colour according to the humour predominate : if from the wound it hath an unpleasant smell : the second is sordes , this is compact and viscous , and cleaves to the part : Third is pus which is white , smooth , and equall .

The causes of these , are either efficient , which is either naturall or unnaturall heat : The first begets good matter , the latter causeth putrefaction , and an ill smell : or materiall , and these are either contused flesh , which by digestion must be turned into quittor : or a humor which most commonly symbolizeth with the parts complexion , whether it be naturall or accidentall : the first is good , the latter ill ; the last duty is the removing of generall accidents , which accompany all sorts of wound , as paine and fainting : for the first , either anodyns , as ℞ ung . alb. Camphor . ol. lilior . aneth . vel Cham. f. Lt. if this prevaile not , use Narcoticks , as ℞ ung . Pop. & alb. Camph . ana ℥ j. ol. Hyoscyam & mandrag . ana ℥ js. Misce f. Lt. For fainting , use Confect . Aker . in aq. Cinam vel ℞ aq. ros . lb s. galang . g. xv . Cinam . ʒj . Caryoph . ʒv . contund . & Coq. in B M 2. hor. vel ℞ aq. Card. be ℥ iiij . Thiriacal . & Cinam . ana ℥ s. Confect . Alker . ʒij . diamarg. Calid . ʒ ijs . lap . Bezoar . orie ℈ j. syr. acetos . citri ℥ ij . aq. ros. odorif . Coch. 3. Misce ex la. exhib . Cochl . 1.3 . quaque hor. post agitationem .

We come to the last scope of a Chyrurgion , which is to unite , being performed either Aggluti . the first or Concarn . the second intention . Now for the first , three things offer themselves .

First , the brimmes are to bee joyned together .

Secondly , so to be kept .

Thirdly , Agglutinall medicaments must be applyed .

In the first , let them be done by degrees .

Secondly , equally .

Thirdly , if stiffe , foment with oyle and water .

As for the second to keep them joyned , is first by dry stitching , viz. when peeces of cloath are applyed , cum farin . volat . ℥ j. Myrrh . mastic . Sang. drac . pul . ros. rub . gum . Tragac. f. pul . tenuis . cui adde alb. ovi Nj. aq. ros . q. s . ad consistent . mel . The cloath must be strong indented , and be applyed foure houres before they be stitched , this may be used in women , eminent persons , and to strengthen the other .

The next is stitching with needles , of which there are two kindes , as either the brimmes are kept together with the thred , or else the needle is also left in : of the first of these , there is 3. sorts :

First , is the glovers stitch , which is used in the wounds of the bellies and great branches of aorta & vena Cava .

Secondly , when stitches are taken distant one from another .

The third is when the great muscles of the belly and Peritonaeum are wounded .

The second is when the needles are left in , which is used in the cure of the hair-lip and in Trach , Arteria . Now the use of stitches is either to procure quicke agglut . or to retaine the parts , though distant asunder , and this may be used in wounds after the second intention .

Thirdly , to stay bleeding ; and not in stitching wounds ; stitches are to be an inch asunder in long wound beginning at the ends , in short in the middle , the last way is rouling . The medicaments to be applyed are Lt. Arcei bal. Nigr. Artif . as ℞ ol. olivar . Antiq . lb iij. ol. Terbint . Clar. lb ij . olib . pul . lb j. rad. valerian Card. b. fl. Hyper. ana lb j. frumenti Tritic. parum . contus . ℥ j. Myrrh . ℥ j. Herbar . infus . per 24. hor. in vino alb. tunc exprime & impone herb . in ol. 3 vel 4 horas tunc exprime ; ejice : deinde ℞ ol. & infund . gum . agitando continue donec incorporentur deinde adde vinum & misce & decoq. donec vinum evaporet ; this is excellent also to heale by Concarnation which is by the second intention , and this is to bee followed when substance is lost , the bone is to scale , a great flux is feared , when wound is in the arme-pits , or great joynts , and cachochyme bodies , or troubled with contagious or obstructive diseases : if superfluous flesh arise abate it . There happens upon wounds ,

CHAP. II. A Convulsion .

WHich is a contraction together of the muscles , or parts appointed for voluntary motion towards their beginning ; of which there is two sorts .

First , naturall when one of two muscles appointed for motion is contracted , the other being transversly wounded , as in the temporall muscle .

Secondly , unnaturall , and this is twofold .

First , motus convulsivus , caused of a thin and halituous matter moving too and fro , not long continuing .

Secondly , convulsio vera , is caused either of plentifull grosse matter , or by consent from a noysome vapor : of this there is foure kindes ▪ 1. Emprosthotonos , i.e. when the necke and the rest of the body is drawne forward . 2. Opisthotonos , i. e. when the whole body is drawne backward . 3. Tetanos , i.e. when both back and fore parts are easily contracted . 4. Spasmus Cynicus , i.e. when the mouth is pull'd awry . The causes are three .

1. Fulnesse , discerned by the thicknesse and fleshinesse of the body , if the vessels appeare full , the pulse bee strong , the party looke ruddy , the wound bleed little , and the urin laudable and plentifull .

Cure . Cure . First , bleed , use a slender dyet , purge , beginning first with glysters , as ℞ diacath ℥ j. Confect . Hamech . ℥ s. spec. Hier. pier . ʒij . ol. lil . alb. & Cham. ana ℥ j. decoct . commu . pr. clyst . ℥ x. Misce f. Glyst . for to purge nothing so excellent as Hiera . ℞ Caryocost . Elec. e suc. ros. ana ʒiij . syr. ros. sol . cum Agar . ℥ j. aq. lilior . Conval . flor. Tiliae vel ceras . nigror . ℥ iij. Misce f. potio , give this powder for a week , often sweating , ℞ rad. vincitox . sarsap . succisae , Caryophy . ana ℥ ij . bac . lauriʒj . pul . rorism . salviae Thym. ana ʒs . spec. pleres archontic . diamosc . Amar. dianth . ana ℈ j. f. pul . dosisʒj . in mane in aq. salviae roris . &c. as for externalls , use Pareus unguent , ℞ Salviae Chamapit . Majora . rorism . Menth. ruta lavenda ana Mj. flor. Cham. Melil . Aneth . Hyter . ana p. ij bac . lauri juniperi , ana ℥ ij . rad. Pyrethr . ʒij . mastic . assae odorat . ana ℥ j. Teribinth . venet . lb j. ol. lumbr. Aneth . Catulor . ana ℥ vj. ol. Terebinth . ℥ iij. axung . Human. ℥ ij . Croc. ʒ. vini alb. odorif . lib. js. cer. q. s. Contund . contund . pul . pulver . postea Coq. cum ol. & axung . praedict. & f. Lr. adde aq. vil . ℥ iij. anoint the spina bathes is excellent , especially sulphur , as also foment , and the parts lapped up with the skins of foxes , cats , conies , or haire dressed , your foment and baths must be made of hot hearbs , the first with sacke and mustard ; the second with water and milke ; a third part of oyle , being added , optimum etiam est fovere occiput & cervicem aq. vit. Calente .

If from emptinesse ( which is rare ) the signes are contrary to the former , in this use onely emolient glysters , baths , and anoint as in Feb. Hect. If by consent it happens , three wayes :

1. From a maligne vapour , as in poysoned wound ; in this dilate the wound , then apply cups to it , in it put Mithrad . dissol . in spir. vini vel aq. Ther. parum mercurii proper .

2. From pain , then use as Chap. 32. Sect. 3. If by cold ; first keep the party in a warme room , apply this , ℞ pinguid . Canin . ursi & equin . ana ℥ ij . ol. rapor . Cham. & rutae ana ℥ s. f. Lt. in this case its excellent . Foment the part with decoct of Turnep . Note those that have a Tetanos , either die in four dayes , else escape . A Convulsion , after a wound is commonly deadly : if after raving or immoderate bleeding , ill . If in the face use gargar . errhin . sternut . Cups , if a fevor followes its incurable ; if it proceed from choler to open the right salvatell , is excellent : if from wind , the decoct . of Ebony forty dayes : if from fulnesse , pil. faetidae Hier.

CHAP. III. Palsey .

WHich is opposite to the former , is when the parts are so loosened and weakned that they are not fit for voluntary motion ; the causes of which though many ( viz. cold aire , immoderate Venus , narcotick medicaments , drunkennesse , especially by wine , yet more frequently from flegme , the nerve being made thicker and narrower , and so unapt to receive the Animall spirits . The narrownesse being caused either from obstruction by a thicke tough humor , or by compression , with a humor , or tumor contusion , a sudden luxation , a strait ligature , or leaning upon a part cold , or by solution of unity , and that is , when either divided by a wound , or sharpe humor .

Signes . Signes . It s a privation of motion , sometimes of feeling , which is either universall or particular . If it possesse one side of the face and body , then that side of the braine and spina , is the cause ; if one side of the face , then that side of the braine ; if the head be sound , and either side affected , it comes from the spin . medul . of the same side ; if the arms , the 5 , 6 , & 7 , Vertebra of the neck is affected ; if the legs , it s in the vertebra of the loynes , & or sacrum : if any particular part be paralytick , then the causes is in the sprig of some nerve inserted in that part .

Prognost . Prognost . If from a nerve transversly cut in sunder , incurable ; if strong and proceeding from an inward cause , in old persons in winter time , following an appoplexy , wherein both motion and feeling is lost after strong and sudden luxation of the vertebra , if the part bee extenuated and colour changed , its hard to cure , a trembling after a palsey , the part hot , and fever follow , its good , as also if the belly flux ; but if the parties eie be weak on the side affected , its incurable .

Cure . Cure . Diet , dry and warme , instead of ordinary drinke , use the decoct of Guaic. or in the beere hang a bag of hearbs which strengthen the nerves , forbeare wine ; use clysters , if Plethor . ven. sect . on the sound parts by degrees , but sparingly , after which , presently use frictions on the sound part , and lightly upon the part affected . Use purging , as in cold affects of the head , every fourth or fifth day ; if the disease be contumacious , use these Pills once a week , ℞ Mass . pil. faetidar . major . & Coch. Min. anaʒs . Troch . alhand. g. iiij . but because the humor need pp. therefore betwixt every dos . of pills , for three or foure dayes before take three or foure ounces of this following , every morning two houres before meat ; ℞ Mel. ros. Col. ℥ v. aq. salviae , melissoph . primul . ver. vel rori●mar . ana ℥ v. the dayes which are free take some Cephalik elect . as ℞ Castorʒs . Conser . fior . Beton . ℥ j. misce .

Externall . Use frictions , apply cups to the heads of the muscles of the affected part , let it be narrow and stay but a while , touch the stupid part with quicke nettles , foment with nervall hearbs , after anoint with unguent , Par. vel ℞ succ . fcil. ℥ iiij . succ . Cucumeris silvestris , suc. rutae ana ℥ j. euphorb . Castor . sag openei amontac . bdel . in aceto dissolutorum ana ʒj . Myrrh . thuris , pyrethri , nitri , ana ʒj . ol. sambuc . ol. Terebinth . ol. euphorb . ana ℥ s. pulveres subtil . pulu . & cum cer . f. unguent . after keepe it warme , Bal. nat . or Artif . is excellent , as also baths of sulph . made of 6 lb. of sulph . and 100 lb. of water ; the former unguent is excellent in all cold affects of the nerves .

CHAP. IV. Wounds by poysoned weapons .

Signes . Signes .

THey cause unaccustomed and intolerable pain , strange Tumors appeare , the part is of a livid blacke or spotted colour , though not contused , in time the part putrifieth , and sendeth forth a stinking sanious quittor .

Prog. Prognost . None can be secure , if the signes abate by methodicall meanes there is hope .

Cure . Cure . If the poyson have not passed the part wounded , and the person be not eminent , tender , or fearfull , apply the actuall Cautery , after which , use deepe scarif . which must reach to the sound part , cause the fall of the escar . If the poyson hath passed deep into the body , use not the actuall Cautery . If the party bee tender and fearfull , use Cups , after scarif . to the part , use Basil . commis . cum merc . pp. vel Turbith . M. lot . cum Theriac . vel elec . de ovo , to the place adjoyned oxycroceum , this doe , unlesse the wounded part be so hot that it threatens a gangreen , for then you are to goe about to meet with the symptomes , leaving the griefe for a while . In these wounds till three dayes be expired , refraine from bleeding , purging , vomiting and clysters ; the party must sleep sparingly , and use a moderate dyet , every morning , administer ʒj . of some alexiterium in aq. Card. ben. adde aq. Theriac .

CHAP. V. Morsus Canis rabidi .

Signes . Signes .

IN the quittor of the wound moisten a peece of bread , and cast it to a dog , and he will not touch or smell to it , but flye from it , when the matter hath assayed the noble parts hee is filent , angry without a cause , feeleth gnawing of the stomach , hee complaines of bad weather , when its faire , he is lumpish , and desires candle light by day .

Prognost . Prognost . If it have not offended veyne , nerve , or Artery , and is not deep , there is great hope . If the party feare water , there is little or none .

Cure . Cure . If it be great , first scarifie the part , then apply cups with great flame , and extract as much blood as is sufficient , then wash it with this , ℞ aceti accerrimi lb s. sal . Marin . subtil . pul . ℥ ij . Theriac . ℥ j. Misce ; afterward apply the Cautery deep , which is the most present and approved helpe , after fill it with gossypium , dipped in spir. vini in aq. dissol . Ther. and upon that this plaister ; ℞ Caepar sub prunis aliquot coct. pul . sem. sinapis sal . marin . ferm. acris ana ℥ j. fol. rutae scord . ana Ms. Theriac . ℥ s. & cum Mel. q. s . in form . unguent . diligenter incorporat . the next day scarif . the escar . and cut it off , and dresse it as before , cum Ther. & spir. vini put a pease in it to keep it open for forty dayes , and apply upon the rest this following , ℞ spir. vini ℥ ij . succ . rut. . ℥ j. extrac . scord . Theriac . ana ℥ ij . C. C. usti . pp. ℥ j. bezoar . ℈ j. Misce , or apply a Catap. ex allio , sale , & Tereb . before the forty dayes bee expired , though not in the beginning , you may purge sundry times , they are to be strong as merc . vitae &c. To strengthen the principall parts , the liver of a mad dog boyled , is present remedy , vel ℞ fol. rutae , verben . salviae , plantag. polypod absinth . Artemis . melissophyl . beronic . hyperic . Centaur . minor . ana aeq . part f. pul . dos . ana ℈ j. ad ℥ ij . exter . pul . ʒ s. cum hydromel . is excellent , vel ℞ pul . ciner . cancro . fluviat . ℥ x. rad. genti . ℥ v. olib . ℥ j. f. pul . tenuis , you may give it in aq. horrag . in mane pro 12 diebus , Theriac . Androm . is excellent , dos . ʒs . for forty dayes , as for the biting of an adder or toad , they may be effected with the same .

CHAP. VI. De Sclopetorum vulneribus .

THe wounds are either maligne , or not , if not , it need no other signe then the patients owne describing or others . If maligne , then an ugly colour will appeare , as if it tended to mortification , horrible pain , and pricking , great inflammation , heavinesse of the whole body , a sharpe feaver , fainting , raving , and especially if no evident cause can be given for these accidents . If the bullet be poysoned being cut , it will be of a violet colour .

Prognost . Prognost . If it be onely in a fleshy part , the constitution good , the aire favourable , easily cured . If in the spermaticall parts , violently torne , if the body cacochyme , the aire hot and moist , and the wind south , if there be signes of poyson , feare of a gangreen , hard to be cured , and come slower to suppuration then other wounds .

The symptomes of ordinary wounds are contusion , pain , inflammation , convulsion , heat , palsey , sometimes a gangreen , and mortification , which may be prognosticated . If it be long before it come to suppuration , the colour of the part inclining to yellow and livid , the paine and pulsation ceasing , and the part stupid .

Cure . Cure . First , remove extraneous bodies .

Secondly , draw out the bullet if it be easie to bee done , if wee feare a Tumor which may corrupt the part , or if the weapon be poysoned , before you doe it observe the forme of the body to be drawne out how deep it is in the part , with the symptomes , if paine be great , extract it presently , if great flux be feared , doe it . In extraction , observe , if the weapon be poysoned or cankered , do it presently : but if there be horrible paine , a convulsion , a feaver or a syncope : if the weapon be round ; if the orifice bee narrow by inflammation or Tumor , if you have not a convenient instrument , deferre it . Now for the way by which they are to be drawne ; it must be thrust out ,

First , if it be almost through , if the figure of the instrument will not admit the drawing , the same way as barbed arrowes : if there be a feare of cutting great vessels . The instruments are blunt hookes to lift up a vessell when the weapon is to be taken out , a paire of hollow forceps , goose bills , ravens bills , incising forceps ; note this , that the patient bee set in the same posture in which he was when he was hurt , and search the weapon out with your finger .

Secondly , use suppuratives , such as in contusions , as ol. Catul. or other digestives , only forbearing , in case putrifaction be feared , and when it s in a nervous part , to hinder putrifaction , use unguent Aegyp . cum spir. vini , with tents .

Thirdly , prosecute the cure as in other wounds , with convenient medicaments , ol. Catulor . ℞ ol. lilior . alb . lb iiij . in quo Coq. Catul. N ij . nuper nat. ad ossa , postea ad . lumbricor . terr. in vino lotar. lb j. Coq. simul & colentur sine forti expressione colat . ad . Terebin . venet ℥ iij. spir. vini ℥ ● . Misce , some ℞ but lib. j. ol. & vi . ℥ . of Terb . & spir. vini ℥ ij . vel ℞ Cerae novae ℥ ●●s . gum . Elem. pinguis . clar . ana ℥ j. Colophon . ℥ s. ol. Amygd d. rosar . de vitellis ovor . an● ℥ . dissolu . lent igne & percolentur Colat. admisce Croc. subtiliss . pul . ℥ j. & f. digest . hujus unguent . ℞ ℥ j. cui admisce vitel . ovor . Nj. ol. ros . q. s. ut formam liquidam acquirat . digestiv . in omnibus vulneribus tum contusis tum instrumentis scindentibus factis , especially in wounds by shot .

In the dressing of these wounds observe these cautions : If the south wind blow , and you feare putrefaction , use aq. vitae & vitriol . calcinat .

Secondly , use escaroticall medicaments .

Thirdly , Tents at first are to be made longer and greater that the wound may be dilated .

Fourthly , if the contusion bee great , and possesse much of the adjacent parts they are to be scarified to discharge the parts of congealed blood , which is apt to putrifie .

Fifthly , if there bee any burning , use such medicaments as are fitting .

Sixthly , cooling and astringent medicaments after the first dressing , but those that are Anodyne , Emollient and suppurative , as ℞ Micae panis Tritic. ℥ iiij . lact. recent . lib. j. flor. Cham. Melilo . ana p. j. farin . Hord. & fabar . ana ℥ j. Coq. omnia ad catap . tum ad . vitel . ovor . Nij . ol. viol . & ros. ana ℥ js.

Seventhly , its sufficient to dresse the wounds in twenty four houres once , unlesse much quittor flow , the party be feavourish , and feel great paine , then dresse it every twelve houres after digestion , which will be about the fift or sixt dayes , use mundificat . as Paracel . vel ex opio , after in carne s . a. If soft spermaticke parts bee wounded and torne , use this , ℞ Tereb . venet . ol. Tereb . & hyperic . an● ℥ ij . Turbith . flauʒs . tutiae , Euphorb . calc . viv . ana ℥ j. Misce . If the hard spermat . parts , as bones , and cartilag . then ℞ praedict. compos . Tereb . ol. Hyper. & Tereb . ℥ . pul . Cephal . ℥ j s. apply it warme , this will suppurate and scale the bones .

If it be poysoned .

Then scarifie the brimmes deeply , apply ventosies , and exhibit Mithrid . & Theriac . in aq. Card. b. fragar . vel . Ceras . nig . dressing the wound with this , ℞ decoct . lupinor . ac lentium ana lb js. aceti lib. j sal. commun . alum . ana ℥ j. virid . aeris ℥ s. Mel lib. s. Coq. omnia ad Mel. consistentiam ad . Theriac . ℥ s. either apply this upon tents , or by way of injection , use it till fearfull symptomes cease , neither bleeding nor purging , till the force of the poyson be abated ; but in ordinary wounds you are to bleed , if the party be plethorick , and purge if cacochimick .

CHAP. VII . Wounds of the Head .

NOw for wounds in particular , and first of the Head , wherein something generall is to be set downe ; as first the aversion of humors , which either have or are likely to procure sympt , this is done three wayes ,

First , by bleeding , either universall or particular ; the first is performed by opening a veyne ( if sufficient quantity did not flow from the wound , when inflicted if the wound be great , and the party strong : if great inflammation have invaded the part , or a feaver seised upon the party . For the quantity , it s either to bee done all at once or at divers times ; for the first way stop the veyne when the pulse apeareth smaller and slower , the forehead sweat , the face grows pale , when a paine on the heart grows on , with yawning , and desire to vomit , or to goe to stoole : If at sundry times you draw blood , you must doe it till all symptomes as feaver and inflammation cease , the veynes to be opened are the Basil . or Median , on the same side , if blood much abound ; if not , the Cephal . will serve , or veines neare the wounded part , as in the forehead , temples , and tongue .

Now for particular detraction of blood is from the part affected by scarifying . To the lips of the wound , apply cups or leeches . If they will not admit of bleeding , use strong frictions of the whole body .

Second thing is to purge with catharticks , clysters , or suppositories : the first of these are to be exhibited when the party is lumpish , and hath the head ache , when a tumor or inflammation appeares , when the body is Cacochym : so there be strength , the matter prepared , and the body open and passable , these are to bee administred in the begining lest strength decrease , feaver increase , and so hinder the ascent of humor to the head . The medicaments to be used , are such as purge choler , yet gently , and the dos . not great , as lenit . vel diapru . in decoct . of myrabal . vel ℞ syr. ros . ℥ ij . aq. plantag . ℥ iij. let the aire bee temperate and thicke , wine is not to be permitted to the fourteenth day , the first seven dayes let him shunne meat , and onely live on panadoes , and after meat , use conser . ros. antiq . let sleep be taken onely in the night , unlesse there bee inflammation of the braine and menynges : if watching trouble , anoint the temples with unguent . popul . inwardly use something that may cause sleep , as lauda vel diacod . the roome is to bee kept darke ; shun venery , and keep the body soluble .

Prognost . Prognost . In persons otherwise diseased , and children , hard to be cured . If a Tumor vanish suddenly ; a feaver happen the eleventh or fourteenth day , its dangerous . If the lips grow livid , reason faile , tongue looke blacke and dry , its deadly ; those in the temples and sutures , are dangerous ; but if the feaver come on the seventh day , and the lips tumifie a little , it is easie .

For paine and inflammation , ℞ farin . Hord. ℥ iiii . poscae ℥ vj. coq. ad Catap. ad . ol. ros. ℥ ij . This asswageth paine , cooles , repells , and dryes , vel B● Micae . pan . alb. ℥ iiij . lac. rec . ℥ vj. f . Catap. adde unguent . popul . ℥ ij . croc . ℈ ij . This is excellent in hot and dry complexions ; after applycation of the medicaments put on a cap to cover the whole head basted with fine tow , not quilted , nor too heavy , then roule with a rouler three inches broad , and a fathome and a half long .

CHAP. VIII . Of the Head .

NOw for particular wounds of the head , and first ,

A Contusion without Effusion of blood in parts above the Cranium .

In it there is a Tumor without a wound , and often blacknes and blewnes ; in this case shave the hair , then apply this medicament , ℞ alb. ovi Nj. ol. Myrtin . & pul . ejusdem ana ℥ j. Misce . This is to be used till the part come to its owne temperature , or conformity , dressing the part twice a day : If after the paine is gone , and the flux of humor ceased ; a tumor remaine , use this , ℞ Empl. de mucilag . ℥ ij . oxycroc . & Emp. Melilot . ana ℥ j. ol. Cham & Aneth , ana ℥ ij . f. ex his Ceratum s . a . If by this it vanish not but paine and fluxion of the humor betwixt Cranium , and skin continue , then make incision , and after , if the skull bee sound , use this , ℞ syr. eros . rub . sic . & absinth . ana ℥ j. Terbinth . ℥ s. irid . aloes Myrrh . mastic . & far. hord. anaʒs . Misce s . a . If the Cranium be foule , then smooth it with a raspitory , and apply this excellent powder , ℞ rad. irid . Gentian . Aristol . rotund . dictam fat . bor . ana ℥ s. aloes Hepat . sang . drac . Myrrh . mastic . sarcocol . ana ʒij . f. pul . and after the scale is fallen , cure S.A.

If by great contusion a gangreen shall ensue , as may bee knowne , when the part growes hard , livid , and blacke , then scarifie , apply cups , and use proper medicaments ; as for wounds of the same parts , whether they bare the Cranium or not , a generall method will serve .

CHAP. IX . Wounds in the Temporall Muscles .

CAll for some speciall consideration , in respect of fearfull symptomes that follow , they are inflicted three wayes , a puncture , transverse , and length wayes ; the two first , if deep , are dangerous , being accompanied with vomiting , convulsion , and deep slumbering , and is hard to cure , being in continuall motion . If a puncture , be not too hasty to dilate , but the hair being taken away , dresse it , cum ol. hyper . & lumbric . & Empl. Paracel . or the last alone .

If transverse , then stitch it , using Lt. Arcei . and above it Emp. Apodoldech . vel Paracel . If according to length ; first , stay the blood , then stitch it : note that its better to cure wounds of the head by agglutin . then Concarnation .

CHAP. X. If the scull be foule or hurt .

WHich falls out three wayes :

First , by the aire , it having laine bare two houres , which you may perceive , if rasped it bleed not , then use that instrument till it bleed , and performe the cure by agglutination . Cure .

Secondly , if the first table bee divided from the second , and cleave to the cutis musculosa , then take it away , and cure either by Agglut . or Concarn . which is most convenient .

Thirdly , when a portion of the whole cranium is divided , so that dura mater is seen , this is to be reduced and there kept by bringing the lips of the wound together , with so many deepe and strong stitches as shall suffice , the wound having beene clensed with either vino vel spir. ejusdem .

CHAP. XI . Wounds of the head with contusion .

OF which there are two sorts ; either ordinary or extraordinary : for the ordinary , which is without maligne symptomes , dresse thus .

First , wash them , cum spir. vini , in which infuse Myrrh . If it bee great , stitch it with needles , otherwaies the dry stitch will serve , dresse cum Bals . Arceivel lucatella , and if it be deepe , keepe a tent in the depending part , untill it yeeld laudable quittor , and then take it out , above apply Empl. Basilic . viz. ℞ Empl. Betonic . ℥ iiij . gum . elim . in ol. ros. dissol ℥ ● . pul . rub . ros. myrtillor . ana ℥ ij Cal. Aromat . Angelic . Caryoph . ana ℥ j. Cer. q. s.f . Emplast . If extraordinary , i.e. with a feaver , inflammation of the whole head , neck and shoulders , as also the breast , the brims bee swelled , and of livid colour , casting out sharpe , virulent and stinking sanies , the party feeling great and pricking paine ; then

First , draw out the malignity by deep scarifications , after apply either leeches or cups , washing the wound with this , ℞ Theriac . Androm . ʒij . Mithrid . ʒ● . aq. Card. bened . ℥ ij . aq. vitae ℥ . Misce , let it be fomented hot , in all your Medicaments , mixe some Theriac . vel Mithri . till symptomes cease , after dresse with ordinary medicines .

Secondly , strengthen the principall parts ; as ℞ Theriac . Lond. Mithrid . ana ℈ j. Confect . de Hyacinth . ℈ js contra yervaeʒs . syr. Caryoph . buglos . anaʒvj . aq. liviul . & pap . err . ana ℥ js. Misce , f. pot . To the heart apply this , ℞ aq. Buglos . meliss . rosar . Cinam . ana ℥ js. acet . ros . ʒvj . Croc. ℈ j. spec. diamarg. frig. & laetificant Galleni ana ℈ ij . Misce f. Epithema . apply it warme with double clothes .

Having handled wounds of cutis musculosa and some Fractures , we come to other Fractures in the Scull .

CHAP. XII . Fractures in the Scul .

IN which observe some common things to all or most Fractures .

Secondly , things speciall .

For the first observe the signes and presages in Fractures .

For signes , they are taken either from sense or reason .

For sense , if the Fracture bee not obvious , it s found out either by the finger , or by a probe , to both which it will feele rugged , but take heed you take not the Suturs for Fractures .

For rationall signes they are taken from divers things , as if the person was strong that did it , the instrument great or sharpe , falls from on high , it s probable there is a Fracture . If the head was bare , the blow hard , the scull thin and tender : If singing of the eares fall after the blow , swooning , slumbering , dazling of the eyes , bleed at nose , eares , eyes , and mouth , vomiting , are signes of Fractures ; those that follow these are , First , a constant paine of the part wounded , so that the patient offereth often to touch it . Secondly , vomiting of choler . Thirdly , convulsion . Fourthly , a palsey of one of the armes and legs . Fifthly , raveing . Sixtly , faultering in the speech . Seventhly , deafnesse . Eightly , imparing of the memory . Ninthly , dulnesse of the understanding . Tenthly , weake judgement , haire stand up , cut in the wound .

Presages . Presages .

A feaver before the thirteenth day in winter , and seventh in summer , is ill ; the wound livid , little quantity of matter , the skin dry and hard ; tongue black , avoiding unawares excrements , the sicke raveing , the tongue pusled , convulsion on the opposite part , and Apoplexy , is deadly , but if dura mater bee its right colour , the flesh be red , the sicke moving well his necke and jaws , are good signes ; give no absolute judgement till the hundred dayes be past ; if at the beginning of the cure the scul bee blackish , and the body cacochymicall , death ensueth ; Fractures in the Sutures or Temples are dangerous .

CHAP. XIII . Fracture without wound in Children .

IF without feareful symptomes dresse them thus : First , shave the head , and then apply this , ℞ ol. rosar . alb. ovi , parumque aceti , it s to bee done with a foure double cloath , cold in summer , and warme in winter , for twenty foure houres after till the eleventh day , use this Cataplasme warme , ℞ ros. rub . bac . Myrti ana ℥ ij farin . Hord. & fabar . ana ℥ j. absinth . & betonic . ana ℥ s. sem. Cumin . ʒij . pulveris . coq. omnia in vini rub . ℥ xij . ad Catap. adde ol. ros. ac Cham. ana ℥ j. Mel. ℥ ij . apply it morning and evening . I have used Emp. Paracelsi & apodoldech . from the eleventh to the twentieth , apply Emp. diapal . slotani malaxed , cum ol. lilior . after which , to the end of the cure , apply Paracels . relented in ol. Cham.

With a Wound .

And no fearfull sympt . take none of the Cranium away , but dresse it with Lt. Arcei . vel Bal. Lucatel . with a feather , but if a fevor , convulsion , vomiting , or palsey appeare , open and dresse it , S. A.

CHAP. XIV . Fractures in persons of ripe age .

IN which the incision is to bee made thus , T. or ✚ after take up all to cranium with a chizell or fingers , begining at the points of the incision ; take heed your Section bee not in the Suturs or temporall muscles , or Transverse a little above the eye-lid , keep all open with dorsels and pledgets , armed with Astrictives , and so rest for twenty four hours , if no remarkable effusion of blood be feared ; the Cranium is to be opened the fourth day , unles ill symptomes hinder , then the seventh and ninth day ; some thinke the fourteenth day ; but let it be done as speedily as may be ; the instruments to be used are ,

First , the Raspatories , which are to bee used in Fissures and sedes , when the print of the weapon is narrow .

Second is the Trepan , which apply not upon Suturs , nor places a little above the eye-brows , lower part of the scull , nor sinciput , nor in children under seven yeares . In the use of which ,

First , observe to take out the pin when you are come to the second Table .

Secondly , moysten it with oyle , and the print with cold water , remove the blood to see if it be cut equall , and when it begins to shake , lift it up with a levatory , after which , take away the roughnesse with a scalper .

Thirdly , Terrebra or Gimlet , it serves for the raising of a depressed part ; first , making a hole in the Cranium with the pin of the Trepan , afterwards scruing it in .

Fourthly , Head-saw , may either be used to give vent in Fract . or to take of some ragged piece of the Cranium .

After the application of the Trepan , apply a piece of Taffity or Sattin , white or crimson , moystened in Mel. rosar . & spir. vini , till the seventh day , nay to end of the cure . I have used the same medicine fitly applied with good successe , being carefull to foment the part with stuphs , well wrung out of Sacke as hot as may be indured , applying upon the part being fitly dressed , Emplast . Paracel . betonic . aut Bassilic . and one of your stuphs upon that , and after rowl up the head . Observe that in Fractures of the temples apply the Trepan above the temporal muscle , using a deterging injection , and a spunge compressed , which will sucke up the matter , after dressing embrocate the parts adjacent with ol. rosar . chiefly in the necke where the jugular veynes are ; for it asswageth paine , and contemperates the heat of the blood . If there happen a flux of blood upon application of the Trepan or other occasions , apply Gallen powder , which I found effectuall when all other meanes failed , upon Mr. Timothy Venner wounded at Rownton Heath neare Chester in the head .

CHAP. XV. The Simple .

NOw because Fract . are either Simple or Compound , we begin with the Simple .

The Simple are three :

First fissura , which is either conspicuous , or not , the conspicuous are either to the second table , or through both which must be dilated as far as it goeth , leaving a passage in the depending part for the matter and blood ; that which is not conspicuous , if you cannot finde it by looking through a multiplying glasse , or the patients holding his breath , apply to the part suspitious , inke made thin with vinegar , and if it leave any print after its made cleane the next day with a wet spunge ; then follow it so far as it goes with the raspatory , which being downe , dresse as after trepaning .

The second is a sedes , or seat , if it passe through both tables , no splint hurt the meanynges , and may bee made to discharge the matter its sufficient : dressing it as before , but if the dura mater be offended , or the passage made , be too narrow , it must be dilated by the raspatory .

The third contusion which happens most frequently to children sometimes with , sometimes without a wound ; the latter of which , with a sedes , I cured in one John Roberts of five yeares old at Warwick Castle , onely by the application of Empl. Apodold . though he was troubled with vomiting & other bad symptomes .

CHAP. XVI . Compound Fractures

COmpound Fractures , are also of three sorts :

First , a depression , and in this the shivers are either quite separated , or cleave to the rest , or both the last ; of which I saw and cured a remarkable one , with sad symptomes in the forehead of a Drummer of Captaine Walfords , of Colonell Bossiviles Regiment , it was long in curing and hard to cicatrise the loose shivers , I removed and raised the rest , with the levatory , but in case it cannot be raised by it , you are to use the Trepan as neare the Fracture as you can . The

Second is a vaulting , when the Scull is pulled upwards leaving a cavity beneath . If it passe no further , then the second table , smooth the scull , and heale the wound , S. A. If it passe through the second table , you must open the scull in the depending part with the Trepan , then cure it , ex . L.A.

The third is Excision , i.e. when the part of the scull wounded , is altogether separate from the whole , the ordering of which is set down p. 121 , 122 , and 123. as for complicated Fractures , which is when divers are joyned together , follow the cure as hath been prescribed .

In the Sutures there happens a depression , which must be cured as before .

Secondly , a separation , if it be large and ligaments torne though not seen , there is danger of death .

Thirdly , a Collision is a contusion of the brims of the sutures in the cases of fearfull accidents , as a feaver , vomiting , and a convulsion follow , then you are to apply the Trepan on both or one side , as often as you dresse the wounded person cause him to bend downe his head , and stop mouth and nose , labouring to breath strongly , that so the sanies may be expelled .

CHAP. XVII . Fractures either without a wound ; or in the contrary part to the wound .

THe latter of these are either neare the part wounded , or opposite to it .

The Signes of the first are these ; Signes .

First , the side of the wound next the Fracture , will not ciccatrise when the other doth . Secondly , from that will an Ichorous and thin matter flow . Thirdly , more matter then the wound can seem to afford . Fourthly , the flesh near to the parts spungeous . Fifthly , the part will be feverish . Sixtly , with your probe you may finde the cut separated from the Scull .

7. Some tumor will appeare in the part above the Fracture .

For the second a Contrafissura , its twofold ; either in the opposite part , or when the second table is Fractured , and the first remaines whole , these are hard to finde , but it may be perceived by these signes .

First , if there bee vomiting choler and feaver , with other that belong to Fractures , the party will put his hand oft to it ; if a Tumor appear , you may bee assured the Fracture is under , if no Tumor appeare in the opposite part then shave it , and apply this , ℞ Picis Navalis & Cerae●ana ℥ iij. Terebinth . ℥ j. mastic . irid . pul . anaʒij . f. Empl. S.A. draw it upon leather , and let it lye twenty foure houres ; if after you have taken it away , the Cutis muscul . appear in any place more moist , soft , and sweld , then the rest , its probable there is the Fracture . As for this , and the other , the scull must bee opened with the Trepan , and cured , ex . L. A. If such patients dye , Chyrurgions are not to be blamed .

Now for curing Fractures without wound , when you have perceived there is one by signes formerly laid downe , and no extraordinary symptomes appeare :

First , shave the haire , then apply this , ℞ F●arin . Hord. aceti , & aq. & f. Catap. in ; winter make it with wine , adding pul . ros. Mastic . bacc . Myrt . & al. rosar . to purge choler , ℞ Caryocost : elect . e succ . rosar . anaʒij . syr. de cicho . cum rhubarb . ℥ j. aq. end . ℥ ij . f.p .

Thirdly , let blood as often as need requires .

Fourthly , drop ol. Amygd . dul . into the ears and nose , the fourth day use gangarismes made of Cephalicke herbes , and aq. Hord. mel . ros. & oxym . simp. the seventh day , apply Emp. Palmar . Slotani cum ol. Rosar . if yet fearfull symptomes appeare after the seventh day , open the scull and cure it , S. A.

CHAP. XVIII . Wounds of menynges and braine .

ANd first of dura mater , in which there is alway a vehement paine with the wound , if withall drowsinesse and sleepinesse seise upon the patient , death follows : for cure , if flux of blood , apply Gallen powder , after asswage paine , cum ol. ros . warme applyed , which continue till quittor bee procured , after use equall parts of Mel. rosar . & ol. rosati till digestion , after Incarne , cum syr. & suc. ros. vel syr. Sanatiu .

The 3. thing is inflammation , then its red with a Tumor , sometimes so big that it fills the hole in the Cranium , yea above often .

Cure . First , open a veyne , use slender diet , Cure . foment it with a decoct of Althaea sem. lini . faenugr . Groundsell fol. violar . After apply ol. Ros. Myrtin . vel Cydon . if the Tumor increase open the passage in the scull wider .

The fourth is a Tumor , if quittor bee contained therein , which is discerned by extraordinary white spots , then warily open it , that you touch not the braine , then apply Mel. ros. & syr. e sicc . ros.

The fifth is Discoloration . If blacknesse be from the violence of the concusion , it lasts but foure dayes ; in this case use ol. rosar . Mel. ros. vel ol. ovor . cum aq. vitae & pul . Cephalic .

If congealed blood hath occasioned it , use this , ℞ aq. vitae ℥ ijs . pul . gran. Tinctor . ʒij . Croci ●j . Mel. ros . ℥ ijs . sarcocol . ʒiij . lent . Coq . use it till blacknesse be gone .

If from improper medicaments , cure it as contusion : If from Putrefaction , which is discerned by the strong sent of the sanies , use this , ℞ aq. vit . ℥ js. syr. absinth . & mel . rosar . anaʒij . ung . Aegyptiaciʒjs . Sarcocol . Myrrh . aloes anaʒj . vini alb. potent . ℥ js. bullia . omnia leniter , Colent . ac serventur ad usum vel ℞ aq. plantag . ℥ j. ung . Aegyp . ℥ js. merc . praep . ℈ j. Misce , after stirring it apply it warme : If this will not doe , but Tumor increase , the eyes grow fiery , and moving , he tosse and rave , its deadly .

CHAP. XIX . Wounds of the Pia mater and braine .

THese of necessity must suffer together , being so adhering each to other ; and though they be accounted deadly , the experience prove they are of curation . The signe besides such forementioned in Fractures , are foming at the mouth , darknesse of sight , losse of reason , deafnesse , and palsey , &c.

Concerning the cure Authors require at first dressing for seven dayes to use ol. ros. cum ol. Terebinth . mel . ros. & ol. rosar . ana ℥ j. aq. vit . ℥ ij . but two eminent ones was only cured with mel . rosar . & spir. vini : one I saw at Worcester after the battell of Poicke , the other I cured at Warwick , of which Mr. William Thorpe , my Mr. had a fight for the rest of the medicaments , with which they were dressed , was Emp. Paracel . and stuffe wrung out of Sacke with fitting rouling .

CHAP. XX. Concussion .

NOw the accidents of the braine are divers ; the first is Concussion .

It s , if vehement , often deadly , alwayes dangerous , deadly , as I observed in one Mr. Symons , the Gentleman of the Ordinance in Warwicke Castle , who going forth to kill a Rabit , and having done it , was assaulted by the Keeper and his man , the one of which with a blow strucke him downe without any remarkable wound or fracture at all , and notwithstanding all methodicall meanes used , he dyed . For the cure , it s to be dressed , as in Fractures without wounds , bleeding not to bee neglected , clysters to be used , and purges fitting exhibited , anoint the whole head , cum ol. rosar . and apply either Vigoes Corot . or Empl. basilicon .

CHAP. XXI . Fungus .

IT s a Tumor sometimes hard without blood and small sense , otherwhiles soft of exquisite sense , and an ill smell , beneath narrow , and above broad , and sometimes increaseth to the bignesse of a hens egge .

Cure . First , Cure . use glysters ( Hildanus used a bag of Cephalicke herbes with water and red wine decocted ) and after apply this powder , ℞ rad. Caryoph . Angel Cal. Aromat . anaʒs . rad. Aristol . rotund . Iridis Guaiac . anaʒij . salu . rorismar . major . anaʒj . f. ex omnibus pul . or this , ℞ Sabini . ʒij . ocrae . ʒj.f . pul . or Turb . flau . If it grow to the bignesse of an egge , binde it with silke at the root , and when it s fallen away , strow the former powders .

For a Tumor proceeding from flatuosity , use the method in Fungus , and apply Emp. Basilic . upon it .

CHAP. XXII . Wounds of the eye lids .

FIrst , stitch them ( especially if they be made transverse ) after either use this , ℞ bol. Arm. Ter. sig . anaʒij . sang . dracon . sarcocol . anaʒj . & f. pul . strow it upon the wound , or use Bals . Artificial . or Lt. Arcei Empl. Palmar . if there bee lesse of substance , be not too hasty to cicatrise , if the eye lid will not come downe , then you are to divide the cicatrise like a halfe moon and cure it up againe . Remember defensitives are to bee used about the eye , lest blindnesse follow , as also convenient ligatures .

As for those in the eye , Mr. Woodalls course is excellent , i.e. apply Hyperic . upon the eye lid , and Emp. Paracels . laying upon the neighbouring part frog water , with cheese curds and rose-water , let both the eyes be rouled up : Here generall evacuation is not to be neglected , as purging and bleeding , as also cups and glysters .

CHAP. XXIII . Wound of the lips .

IF they peirce not through , cure them as ordinary wounds if they doe , cure them as a haire lip ; First , peircing the brimmes of the wound with a needle , having on both sides a thin small piece of lead , after tw●● the silke about the end of the needle , then snip off the ends ; this is to bee done in the midst of the wound , and at either end use an ordinary stitch , to these may be added the dry stitch , especially to children , to the wound apply Bals . Artific .

CHAP. XXIV . Wounds of the Ears .

THese are either wholly cut off , or else in part divided ; if cut off , apply pul . Cephalic . & ung . de minio cum Empl. Paracel . and let the hair cover the deformity , if onely divided and small , use dry stitch , if great , use the needle taking onely hold of the skin on each side the eare , keep a tent in it .

CHAP. XXV . Wounds of the Nose .

IF onely in the soft part , dry stitch will serve , to which apply unguent alb. Camph . If the hard part , it s either above in the bone , and then there is a Fracture , or below in the Cartilage ; if a Fracture , put into the nose fit pieces of wood lapped in linnen , and then reduce the bone , after put in small pipes a little sharp above , and flat below , yet not too high , let these be fastened by strings to the cap on each side . For the wound bring it together , either by dry stitch or needle , and apply bol. Mastic . sang . drac . alum . usti & alb. ovi , using fitting ligatures .

CHAP. XXVI . Of the Tongue .

STitch them deep and sure , cutting the thred close to the knot , using this , ℞ fol. & flor. liquestri , plantag. rosar . rub . ana Mj. cortie . granator . balaust . ana ℥ s. Coq. in lb ij . aq. Chalybia . ad Consumpt . 3. part . in Colatur . dissol . Acatiae . ʒij . syr. e suc. ros. ℥ ij . Misce f. Gargar . with which often wash the mouth , feeding on liquid things , as broths , almond milke , gellies holding often in the mouth , Syr. e sic . rosis . Cydonior . de Ribes , corser . Cerasor . & coagul . Cydoniorum .

CHAP. XXVII . Of the Throat .

ANd first of the vessels which are the jugular veynes , the soporall Arteries , and recurrent nerves . These wounded deeply , the party can hardly escape by reason of a great Hemorage , which is to be stayed with pul . restrictiv . Hildan . vel ℞ Thur. ʒij . aloes , sang . drac . telar . Aranear . quae in mollis planae sunt farin . volatilis hypocistid . mastic . sarcocol . Terra umbra , pul . volatis fung . anaʒj . f. ex omnibus pul . subtilis . If this will not doe , ℞ praedict. pul . ʒij . sublim . & Auripig . anaʒs . f. pul . Misce cum alb. ovi & pilis leporinis . If you feare an Aneurisma ( after flesh is come , which must be procured speedily ( if restrictives will not doe , nor actuall cauteries , then assay to binde the vessels ) which is knowne by pulsation , apply this , ℞ fol. solani , Hyoscyam . mandrag . contus . ana Mj. farin . Hord. & pul . malicor . ana q. s . & f. Catap. sine ulla coctione . Let diet be thin , glutinous and cooling , use drinkes in which steele is quenched , with healing syrrups . If there want sleep , use this , ℞ Diascord . ʒj . Phylon . Persic . ℈ j. diacod . ʒvj . aq. papau . Crr. ℥ iij. exbib . hor. somni , use to the wound Linim . Arcei , Bals . Artif . or this of Pareus ; ℞ ol. Hyper. s . ℥ iiij . gum . elem . ℥ iij Tereb . venet . lb s. liquefiant ista simul ac colent . cum frigere incipiunt add . bol. Arm. sang . drac . ana ℥ j. irid . floren . Aloes Myrrh . Mastic . anaʒj . aq. vitae ℥ ij . Misce . s . a. apply it warme , and above it diapal . malaxed in ol. ros . to hinder inflammation .

CHAP. XXVIII . Of Trachea Arteria .

ORder these as in wounds of the lips , using Bals . artificial , using this gargarisme , ℞ Hord. mu. Coch. iij. flor. ros. rub . p. 1. Sumach . flor. granat . anaʒij . passul . major . exac . jujub. ana ℥ s. glycyrrhiz . ℥ j. bul. ista simul in lb iij. aq. Fontan . ad consump . ss. ac Col. cui admisee mel . ros. & syr. myrtini ana ℥ ij . use it warme ; it moistneth the mouth , easeth paine , agglutinates the parts and causeth the party to breath easie .

CHAP. XXIX . Of the Oesophagus .

THe signes are difficulty of breathing , and swallowing , Hicket , vomiting of choler , meat and drinke , and if deep , the meat comes out . If it bee wholly divided , the cure is impossible , if neare the mouth of the stomach , great and transverse , it s so also . If otherwise , first , stitch it , leaving an orifice in the depending part , and cure it , as in Trach. Art . using after ordinary glyst . without oyle and sugar , nutritive ones , and a speciall dyet .

CHAP. XXX . De Spinali Medul .

THe signes , palsey , convulsion , feeling lost , not being able to retaine seed , urin or excrements , sometimes a totall suppression of them .

Prog. Prog. No lesse dangerous then the brain , if in the beginning , or wholly divided , death ensueth .

Cure . Cure . If the wound peirce not to the Medul. it s only in the muscles , and so dresse it as wound in fleshy parts , or in the bones also , and then dresse as in the head . If in part divided , then first poure in this , ℞ ol. Hyper. & de vitel . ovor . ana ℥ j. Tereb . ℥ s. Croci ℈ j. Misce .

Secondly , anoint the whole backe bone with this , ℞ ol. vulpin . Hirund . & lumb. ana ℥ j. Mastic . & de castor . ana ℥ s. Misce .

Thirdly , Embrocate the whole head with this , ℞ ol. Cham. ℥ j. lumbric . ʒs . Misce . They are to be applyed warme .

CHAP. XXXI . De Thorace .

THese either penetrate or not , if they doe , they have these signes , the mouth and nose , being stopped , breath will breake through with a noise , so that it will move the light of a candle . If penetrating , they offend other parts , we may know by those proper signes as if the

Heart .

Much blood gusheth out , an universall trembling , the pulse small and weake , cold , sweat often swooning , and when the limbs grow cold , death is near .

Of the Lungs .

The blood is yellowish and frothy , cough insueth , difficulty of breathing , paine in the wounded side , yet lying upon it , is at more ease , hard to cure .

Of the Midrife .

Having in the part raveing , breathing difficult , cough , sharpe pain , a feaver , sometimes by vehemency of breathing , the guts and stomach is drawne into the cavity of the breast through the wound . It s deadly .

Of the Vessels .

If the blood bee powred into the cavity of the breast , breath difficult , feaver increasing , vomiting blood , afterward the breath will stinke , appetite lost , desire to sit up , fainting , it causeth death .

Thus you have the Signes and Progn . Cure . now we come to the Cure .

Of penetrating wound in the breast .

First , the patient is to be laid in naked bed with the wound downward that by couching and holding his breath , the matter may be discharged till things be ready , if he finde no weight upon the diaphragma , nor feaver or spitting blood , use no tents but drop in Lt. Arcei , or Artificial Balsome , and upon it Diapal . but if there be much blood in the cavity , after the blood is got out , use a flammula dipped in the white of an egge , the greater part of it hanging forth of the wound , this may continue for forty dayes , if former symptomes still remain , instead of the flam . you may use a silver pipe , which , when the wound runnes , matter good and little , is to be taken forth ; for injection , if you have a mind to use any ( for I have cured dangerous penetrating wounds without ) receive this , ℞ Ptisa . ℥ iiij . sac . rub . ℥ ij Mel. ros . ℥ j. Misce . This being cast in , let him betake him to his former posture that it may all come forth ; upon your pipe apply a spunge wrung forth of aq. vitae , it doth keep out the aire , and extract the quittor instead of the spunge , this Empl. is excellent , ℞ Resin . pini rec . clar . & odorat . lb j. ol. laur . & Terbinth . ana ℥ ij . gum . Elemni ℥ iiij . M. & f. Emp. s . a . Let it bee spread upon leather , a hole cut and applyed ; with this and the Arti. Balsome , may wounds penetrated be cured , for it draws out the matter wonderfully . If need be , let blood on the arme of the contrary part , and if strength permit reiterate it upon the same side afterward , taking this , ℞ rheiʒs . rub . tinctor . Mumiae ana ℈ j. Terr . sigil . ℈ s. aq. scabios . buglos . suc. granator . ana ℥ j. M. after to procure easie breathing , and ease paine , use this , ℞ Hord. ℥ iiij . passular . major . exacinat . ℥ iij. rad. bugl . Miij . liquor . Contus . ℥ ij . jujub. N. 20. Pruna . 15. rad. petrosel . contus . Mj. f. decoct . in aq. pluvial . lb xiiij . ad consumpt . 3 part . aromatic . decoct . Cinam . ʒiij . ac col . in Colatur . dissol . penid. ℥ iij. syr. ros . s . & de duabus rad. sine aceto ℥ ij . sac . cand. . ℥ iiij . quarta quaque hor. capiat aeger . hujus decoct . ℥ vj. this doth nourish , therefore he is not to take any other food for three dayes , unlesse a Ptisan , having the omission of the foure cold seeds , wherein the roots of fenell and parsley have been boyled , if matter offer it selfe to be purged by expectoration , use vinegar and warme water to helpe it . If the patient cough , use this ℞ sac. cand. & penidiat . ana ℥ j. pul . elect . diatragac . frigid . ʒij . syr. violac . & jujub. ana q. s . f. lohocb . quo utatur frequenter cum baculo liquirit . sensim lambendo ; if spittle decrease syr. Tussilag . liquirit . & oxym . simp. the matter being come to suppuration , use this , ℞ Eupator . scabios . Caryoph . saniculae Alchym . Tussilag . ana Mj. rad. Consolid . major . & borrag . ana ℥ j. Coq. in aq . lb x. ad Consump . ss. postea ad . sac . & Mel. ana ℥ iiij . & alb. ovo . N. ij . to clarifie it , and then straine it taking at five a clocke in the morning lb s. and sleep , take the same quantity in the afternoon at foure a clocke , if the body be much macerated , then let them suck womens milk and inject the same , saith Dr. Dachamen a French Physitian , which certainly helps .

CHAP. XXXII . Wound in the belly penetrating , and yet not hurting contained parts .

Signes . IF the probe goe deepe straightwayes , if inject. signe . made returne not , if the caule and the intestines start out , it penetrates . All wounds penetrating are dangerous , and many deadly .

Cure . If the injestines start out , Cure . reduce them , unlesse by continuance out , the cold aire hath filled them with flatuofities , then foment them with a discussive decoction , or else pricke them with a needle , if after you cannot reduce them , in large the wound , if the caule come forth , and by the aire be cooled , so that its hard , blacke and livid , then binde it neare the sound and warme parts , cutting off the corrupt , and letting the thred hang forth till the rest fall off ; if it be not altered , but warme , put it in , and then stitch the wound ; first , thrusting the needle through the skin & muscles to peritonaeum not touching it on that side , then from within outward , on the other side thrust through , also tye that within the distance of an inch , stitch it againe contrary to the other , after stitching leave an orifice to put in a tent , you may strengthen this stitch with a dry one ; to the wound apply Artificiall Balsome ; upon it in Summer , Empl. diapal . In Winter Parac . Embrocat . the pained part with this , ℞ ol. rosar . Myrtin . ana ℥ s. lilior . lumbric . ana ℥ j. Cham. aneth . anaʒvj . ung . dialth . popul . anaʒiij . Misce . If matter fall into the belly ; as by heavinesse , paine and tension will appear , then Embr●cate the groyn , cum ol. rutae . Cham. aneth . &c. after apply Emp. cum gum . malaxed cum ol. scorp .

CHAP. XXXIII . De Ventriculo .

SIgnes as in wound in the gullet , if great , and in the bottome of the stomach , deadly , as also if in the mouth of the stomach .

Cure . Cure . You must not suffer your tent to enter in to the stomach , onely keep the parts lying above open , yet your tent bee armed with a digestive of ol. Hyper. Tereb . & vitel . ov . or ℞ ol. olivar . rec . ℥ iij. Tereb . ℥ ●s . sum . valerian . Hyperic . Card. bened. ana p. 15. Thur is . ℥ j. Myrrh . aloes opt . anaʒiij . Cocci infect . ℈ iij. Resin . pin. rec . ʒij . vini maluat . ℥ iiij . Misce , stent . in digest . per hor. 4. Leniter . ebul . donec consum . vinum colent . & expri . Embrocate the stomach , ol. Menth. Myrtil . Cydon . absinth . & ol. ros. inwardly exhibit this , ℞ Herb. betonic . sanicul . Matris silu . pyrol . ana Mj. torment . Ms. coq. in s . q. aq. ad . ℥ iij. adsyr . Hyssop . ℥ j. drink sparingly , use nutritive glyster , and good broths , wherein are decocted vulnerary hearbs .

CHAP. XXXIV . De Intestinorum vul .

Signes . Signe . IF the small guts , the chilus comes forth , the flankes swell , and become hard , vomit , hickot , gripings in the belly , they are more dangerous then the great ones , which being wounded , the excrements come forth , yet these also if great and transverse are dangerous , and for most part deadly .

Cure . Cure . Stitch them with the glovers stitch , with good flax thred unwaxed , after its fomented with red wine , apply this , ℞ Mastic . sarcocol anaʒj . borrac . Myrrh . anaʒs . f. pul . after which , reduce them , which done , stitch the outward parts , for there can be no more applycations to them , being they shift ; use moistening meats and glysters Emollient made of the decoction of sheeps head and feet ; and administer vulnary potions .

CHAP. XXXV . De Hepatis vul .

Signe . Signe . A Great flux of blood in the right side , the sides all draw towards the spina , the party delighteth to lye upon his belly , often casting out blood both by stoole and urin , pricking paine up to the necke , and downe to the bladder , the face wan .

Great wounds are deadly , the lesser may be cured ; which to effect astringent Troch ; are to bee used in aq. plantag. vel decoct . ros. rub . add . syr. e sicc . rosis & Myrtin .

CHAP. XXXVI . De Lienibus .

Signes . Signes . BLacke blood issueth out of the left side , the side it selfe and the stomach becomming hard , great thirst ensueth , and the paine reacheth to the necke . If deepe , deadly ; if small , curable , which may bee cured as wounds in the liver , it happens that in both , great store of blood falls downe into the belly ; but it s either discussed with naturall heat , or else causeth a Tumor in the groynes .

CHAP. XXXVII . De Renibus .

IF they bee wounded to the pelvis , clots of blood will come with the urin , great paine in the part affected , reaching to the groynes and testicles : if they passe to the pelvis , commonly deadly ; if but to Caruncula papillaris , curable .

Cure . Cure . If the passage be stopt with blood , as usually , it is with a grumous blood , anoint the pecten cum ol. Scorpion . & Amygd . Amar. and apply Catap. of pellitory , mallowes , and Saxifrage : For injection use this , ℞ Troch . de carab . cum aq. plantag. equiset . polygon . after incarne with Empl. sanctum . set downe pag. 175.

CHAP. XXXVIII . De Vesica .

THe urin commeth bloody and sparing : If in the bottome , the urin will fall into the belly , and cause a seeming dropsey ; paine will be communicated to the groynes and stones of men .

Those in the necke laterall parts , and above the groyne curable in other parts not .

Cure . Cure . Inwardly use this , ℞ Cydon . incis . Niiij . Equiseti . sumach . bacc . Myrti ana ℥ iij. ros. rub . sicc . pij . balaust . ℥ s. coq. ista in lb xij . aq. pluv . vel Fontan . ad 3. part . consumpt . ac colet . decoct . in quo dissol . syr. e sicc . ros. & Mel. rosar . ana ℥ vj. syr. Myrtini ℥ iij. gum . Tragac. ℥ s. Let them take none but this decoction till the tenth day . If there bee strength take heed of cold water ; outwardly apply Cypr. Terebinth . vitel . ov . & ol ovor . cum Croco vel Bals . Artif .

CHAP. XXIX . De Penis & matricis vul .

THe latter of these being wounded will appeare by blood issuing out of the privities , and paine will be about the groynes ; these are difficult , and must be dressed as the bladder ; as for them in the yard , they shall be handled when we come to treat of Lithotomia .

CHAP. XL. De Nervos . part .

Signe . THere insues Pulsation , inflammation , convulsion , raving , if not wholly divided , and at last mortification .

Cure in generall . Cure . First , let blood . Secondly , purge . Thirdly , use slender dyet , let the aire and medicament be warme .

If it be a Puncture , powre in ol. Terbinth . cum parum aq. vit. roule up the part with your linnen wet in water and vinegar ; if these ease not paine , then make crosse incision into the skin , and apply this ; ℞ ol. Tereb . ros. lumbric . vitel . ovor . anaʒiij . use it hot , or some Artif . Balsome ; if it be incised quite , it s cured by Sarcotickes .

If it be transverse wounded , apply the former medicaments , if they will not prevaile , divide it , and dresse it with anodynes , and roule it up .

If contused , use ol. Cham. vel rut. . If distorted , Emp. Paracel . If there be hardnesse , apply this , ℞ Emp. Nost. Anod . ℥ ij , ol. lil . ℥ j. styrac . Liq . ʒij . Misce . As for wounds of the tendons , they are cured aftert he same manner ; as also Ligaments , to which use ol. Mastic . vel Bals . Artif . aut natur . cum pul . Consolid . and upon them Empl. Paracel . Two things you are to observe ;

1. Forbeare all laughing and choler .

2. In these , and wounds of Nervous parts , use tents till the wound bee sufficiently purged , which is knowne when all symptomes are vanished .

CHAP. XLI . Vul. juncturarum .

ALL wounds of the joynts are dangerous , and frequently require bleeding , and purging , especially if in the upper parts , externally apply Bals . Artific . cum pul . Consol. which is ℞ Thur. sang . drac . Myrrh . Aloes Hepatic . Mastic . anaʒij . rad. symph . major . Centaur . borac . sarcocol . anaʒj . f. pul . or use Gallens , above apply Emp. Paracel . or ℞ furfur . macri . farin . Hord. & fabar . ana ℥ ij . flor. Cham. ana p. ij . lixiu . commun . lb j. acet . sambuc ℥ iiij . coq. Catap. ad . ung . popul . ol. ros. & Myrtil . ana ℥ . M. apply it warme , it may be applyed upon the plaister ; or this ; ℞ pul . rad. alth . ℥ s. betonic . flor. Cham. Melilot . ana ℥ j. farin . sem. lini . faenigraec . ana ℥ js. fabar . ʒj . f. Catapl . take heed of anger .

To conclude , note that wounds if deep either in armes or thighs , are dangerous , and need frequent bleeding and purging . Hitherto of Wounds , now of Fractures .

SECT. IV. CHAP. I. Fractures .

WHich is a solution in the head , parts , and deprehended by sense , the causes are the too violent assaults and stroakes of all externall things ; the maine differences are foure , Long ; Transverse ; Oblique , and Shattered .

The Signes are inequallity , Signes . as also feeling and hearing , a noise in the handling of the part , as also paine .

Prog. Prognost . In old persons , cholerick , neare the joynts , head , of bones , oblique , shattered , and with wounds and other great symptomes are hard to cure . In young persons the middle of bones and transverse are easie .

Cure . Cure . In which observe foure things : First , restore the bones . Secondly , keep them together . Thirdly , if wound or contusion be joyned , looke to it . Fourthly , prevent or remove the symptomes .

Having all things in readinesse , first , let two persons make extension by little and little , yet strongly , that being sufficiently done , reduce the bone to its naturall situation ; premising , you deferre in case there bee inflammation , till it be past .

Secondly , for the keeping it , to gather up no roulers at all , onely clouts , splints armed with tow or paste-board and junckes made of straw or bents , with caps and fillets ; for in simple fractures , the right placing of the bones , and keeping them so , is most part of the cure , rest also exceedingly conducing thereto : for medicaments they are either outward or inward ; for the first use a plaister made of bole , fine flower , white of egges , ol. of roses , and a little camphire , or ℞ Cerae ℥ iij. resin . adip . ovin . ana ℥ j. f. Cerat . Emp. diapal . or de min. may serve , Woodals restrictive is good , viz. ℞ bol. ℥ iij. alum . Thur. ana ℥ s. rad. Consolid . major . ʒij . lap . osteocollae ℥ js. f. pul . & cum alb. ovi , & vini aceti q. s. f. Catap. or this of Hildanus excellent , ℞ Empl. slotani ( vel diapal . ) ℥ iiij . pul . rad. symphy . major . ros. rub . Myrtil . anaʒij . lap . osteocollae pp. ʒvj . Misce lento igne cum modic . ol. ros. f. Empl. These medicaments are to be applyed three fingers above , and so much comming below the Fracture . For inward means ;

Use a thin dyet every day or two , procuring a stoole by clyster or suppository ; if a feaver happen , use cooling julips ; if that serve not , open a veyne on the contrary side . If it be needfull for the procuring of the callus , use this ℞ lap . ossifragi diligenter praepar . ℥ j. Cinam . electiʒiij . sacc . ℥ ij . f. pul . subtiliss . dos . ʒij . in broth every morning fasting , two houres after . This may be administred to children , and old , not to youth .

The member being bound up and situated , S. A. let it so remaine till the third day , unlesse symptomes hinder ; in simple fractures it may continue till the seventh , after that you may forbear , if nothing hinder ; six or ten dayes , ever being carefull to resist accidents , you may know the bone to be well set ; first , if paine be asswaged . Secondly , if to your seeling it be not rugged or bunchy . Thirdly , if it answer in length and thicknesse to the opposite sound part . Be sure to view it often , being subject to fall out by inconsiderate turnings and convulsive twitchings , which will be knowne by renewing of the paine , and inequality in the part .

Thirdly , if therewith , a wound be joyned you must so order it as that there may bee way for dressing of it , and yet care taken the part be kept steady ; which may be done by a strong cloath three or foure times double , which may once compasse the part and the edges thereof overmeeting at the wound , and upon it convenient splints , tyed on with filliting with a woodden or iron case for the part . Let the wound be dressed with lin. arcei , vel ℞ syr. e sicc . ros. Terebinth . ana ℥ ij . pul . rad. irios , aloes , mastic . farin . Hord. anaʒs . incorpor . & f. unguent . If the bone be foule , this will serve ; otherwayes , you may have recourse where its more largely handled in ulcers . For their drink ℞ aq. Coct . lb vj. sacc . ℥ iiij . succ . lim . ℥ j. Cinam . ʒij . Misce . The time of consolidation is uncertaine , for the most part the thigh requires forty or fifty dayes , the arme thirty or forty .

Fourthly , for accidents , if there be a phlegmon , contused or gangreen , cure them as in the proper Chapter ; if heat , excoriations and itchings , use unguent . Tripharmac . spread upon paper .

Thus much for Fractures in generall , only observe first , the binding of the part ; if it be too hard , besides the patients complaint , there wil be a hard tumor about the part , if well , a soft tumor , if too loose , none at all .

Secondly , if on the third day , or after , the ligatures seem loose , it s a good signe .

Thirdly , if the fractured bone stand forth in any part , it must be there more straitly pressed with boulsters and splints .

And lastly , after the seventh day , binde the part more strait ; for then symptomes are usually past .

Having delivered generall notions , we come to particular observations necessary to be known , in fractures of severall parts : premising what hath been said in the generall , may serve for Fractures in the armes , legges , and thighs , the last of which requires the more care , in as much as the bone naturally of it selfe is bowing ; Fractures in the Cranium , and the nose have also been already handled . We now come to them in the Jawes .

CHAP. II. The Jawes .

WHich is restored by putting your finger into the patients mouth , pressing them on the inside , and out , till they bee smoothly reduced in , which if it be necessary , use some extension ; if the teeth be shaken forth , put them into their right places , tying them to the sound with a thred . The splints applyed are to be of sole leather , being divided at the chin , let the ligature bee two fingers broad with foure ends , two being fastened to the crowne of the cap , the other to the same in the nape of the necke , you may know its well set by the order of the teeth , feed upon liquid things ; its united sometimes in twenty dayes .

CHAP. III. Of the Collar bones .

THese are restored three wayes : The first , is to draw the arme backward , and shoulder forward , and the Chyrurgion with his hand restoring them .

Secondly , to put a clew of thred into the arm pits , and presse the arme unto the ribs , and so reduce them .

Thirdly , lay him upon his backe , with a Tray under his shoulder with the bottome upward , pressing downe the shoulder till the end of the bones lying hid flye out . I have done successefully by setting the patient low , and causing one to set his knee against the shoulder , pulling it towards them , and so have set them . Here observe , as also in Fractures of the ribs ; if any splints of bones cause paine with difficulty of breathing , then open the part and take them forth . Here boulsters with splints , and good rouling is to be used , three boulsters are necessary , one on each side , the third & thickest upon the fracture . The rouler must be a hand breadth , and two els and a halfe long , and is to runne crosse wayes ; the callus grows in twenty dayes .

CHAP. IV. Of the Shoulder blades .

THese may be fractured in the ridge , broad parts , as also in the Articulation . It s knowne by a painfull inequallity , perceived by feeling . If the broader or thinner part be fractured , there is a cavity and pricking paine in that part , and numnesse troubles the arme , if the fragments pricke not , restore them , if they doe cause ill symptomes , open and take them out , and cure it , S. A.

Observe , if a Fracture happen in the Articulation , there is scarce any hope of recovery .

CHAP. V. Of the Breast bone .

THis is sometimes fractured , otherwhiles depressed , the Fracture is perceived by inequallity , and going in with noise at the thrust of the finger , spitting of blood , difficulty of breathing and cough argue both . To reduce either , the course is to be taken as in the collar bones , the Chyrurgion pressing the , ribs on both sides , and set the bone with his hand ; upon the part fitting medicins to asswage paine , and hinder inflammation , with fit boulsters and ligatures ; this being neare a noble part , is dangerous .

CHAP. VI. Of the Ribs .

WHich is either inward or outward ; the first is deadly , causing a more grievous pain then in the plurisie , and is increased after eating : the latter is easily discerned by the inequallity and noise upon touching . The restoring of them , if inwardly is , Let the patient lye on the sound side , and to the fractured part apply this ; ℞ Farin . Tritie . ℥ . Ie●byocoll . diss●l . in aq. feabios . & pap . errat . ʒ. pul . mastic . Thur. farin . volat . sang . dracon . gypsi ana q.s. Coq. in aq. papau . rub . ad just . Consist . & f. Emp. apply it hot upon strong cloath with two strings fastened to the middle , having stucke sometime , pull it suddenly with great violence , so the rib will follow , this is to be done so oft till he shall finde himselfe better , and breath more easily . But if pricking paine continue , you must make incision and take out the fragments that torment , and cure it S. A. observing that a fit dyet be prescribed , bleeding and purging be used If it may be done without intision , then anoint the whole side , cum ol. rosar . and apply this , ℞ farin . H●rd . ℥ iii. pul . ros. rub . ℥ . balaust . nuc . Cupres . gallar . rad. Tormentil . anaʒij . cum pose . & 〈◊〉 integre f. Emp. ad ol. ros . ℥ . applicetur repidum , till the eighth day let the patient drinke twice a day , aq. Frunellae & dentis Leonis part . eq . The simple fractures may be easily cured ; if upon either a Muscous tumor happen , which may be perceived by pressing , by no meanes neglect it , but if you can , resolve it by proper medicaments . If it degenerate into an abscesse open it speedily , lest the matter corrupt the bone , and so cure it ; otherwise there happens consumption and death .

CHAP. VII . Of the Back-bone .

SOmetimes they are broken , other while bruised or strained on the inside , which causeth many maligne symptomes , as palsie , &c. and after death . In this , you must make incision , and pull forth the officles that offend ; if you cannot do this you are to apply Topicks , ass waging pain and hindering inflammation ; If onely the processe be broken ; if incision be not required , reduce them , and so are they easily cured . After the same manner is restored , os sacrum or holy bone .

CHAP. VIII . Of the Rumpe-bone .

THese are to bee set by putting your finger into the patients fundament , and so thrusting it to the fractured place . By this meanes the fragments may be set in order , your other hand lying upon his backe , the patient must keep his bed all the time of the cure , and if he sit , it must bee in a perforated seat .

CHAP. IX . Of the Hip.

Signes ARe paine , Signes . cavity , and numnesse of the legge on the same side . If the splints of the bone be quite off , they must at the first by incision be taken away , having a care you hurt not the head of the muscles or vessels , If they be not broken off , reduce them smoothly and proceed S. A. For the Whirlebone of the Knee .

CHAP. X. The Whirlebone of the Knee .

After reduction , the legge is to be kept in a streight posture , that so the Knee may not be bowed , and fit medicaments ligat . and boulsters be applyed .

CHAP. XI . The bones of the hands and feet .

BEing fractured , are to be restored by laying and setting them upon a smooth table , and being extended , then reduced , only observe they are very painfull and require Anodyns , and the hand must after setting , alwayes have in it a Tenis-ball kept , left it lose the most fitting figure for the patients use and benefit .

One thing observe , if upon a fracture you feare a gangreen , then instead of your former prescribed medicaments , use cloaths diot in a good lixivium , wherein is boyled vulnerary herbes , as also for a time foment the part therewith .

SECT. V. CHAP. I. Dislocations .

WE are now arrived at the last branch of solution in the hard part , Defin. in which wee shall follow this method ; First , what it is , viz. It s the going out of the bone from its proper cavity , and so hindering voluntary motion .

Secondly , Causes . the Causes which are either 1. Internall , as excrementitious humors and flatulencies , which I have seen in divers . Secondly , externall falls , stroaks , slippings , &c. to these addes Pareus a third , which is hereditary , and not improbable .

Thirdly , Difer . the differences are First compleat , when altogether forth . Secondly , when not altogether . Thirdly , when only distorted . The first of these are fourefold , forward , backward , outward , inward ; these againe are either simple or compound .

Fourthly , Signes . the Signes are a Tumor in the part whither its fain , and hollownesse in the place from whence it s come , also pain and privation of motion .

Fifthly Prognosticks , in children , Prognost . and those that are young , and simple , easie , but hard if compound , painfull , inflamed , if long forth , and the part be extenuated .

Sixtly the Cure , Cure . in generall ; observe first , extension is to bee made till there be free space betwixt the dislocated bones , yet in some cases this is not needful , as you shall see in the shoulder .

Secondly , force it into its proper seat , which is knowne by a popping noise , ease of paine , and likenesse of parts , these are all necessary in some joynts .

Thirdly , apply fit medicines ( yet note simple luxations need no applications or ligations , but are happily cured without , as by experience I have found , besides the constant practice of Mr. Hailes in Northamptonshire , who in his time was most eminent and successefull in his practice , with whom I had much familiarity , by reason of a Cancer he had in his tongue , and chin . ) If any be necessary , such as are in Fractures may be applyed .

Fourthly , use ligations .

And fifthly , keep it in a sitting posture ; but these need not unlesse the luxation be compounded .

Lastly , remove symptomes , as paine and inflammation , onely observing that if these happen together before setting , let it alone till they be removed , as in the Treatise of Fractures . If it be old , then discussive fomentations must be frequently used , and after this Catap. ( having made gentle motion up and downe , too and againe ) ℞ rad. Althaeae ℥ vj Cucum . asin. . ℥ iij. fol. malu . Althaeae ana Mij . Cost . in aq. & Contus . add . farm . faenigraes . & sem. lini ana ℥ js. l. Cham. ℥ vj. lilior . ℥ ij . Misce , f. Carapl . and so with fit boulsters and ligatures , let it be bound up conveniently . Yet after all this , when it s performed , you will finde the motion of the part little or none , as I have observed .

Thus having done with generalls , which must bee both in Fractures and dislocations , as far as is necessary carryed to the particulars , we come to them : and first of luxation in the Jaw-bone .

CHAP. II. In the Jaw-bone .

THis is either on one side or both , which if not speedily set , may procure death . If onely on one side the chin is drawne aside . If both , it hangs forward towards the breast . To set them , put your thumbs lapped in linnen into the mouth , and with them presse hard downe the great teeth , and lift up the jaw with your finger underneath . Thus I restored an old woman , which came by yawning . Others put wedges of hassill or firre a finger thicke , casting a band about the chin , stand behinde the patient , and draw the chin towards them , and at the same time presse downe the wedges . After this , apply medicaments , if necessary , as also ligatures ; for dyet use liquid things .

CHAP. III. Collar bones .

IT s hard to be knowne , and as hard to be cured , as also easie to be mistaken ; they may be dislocated , inward , outward , and side waies . The restoring of them , is either by moving and extending the arme , or as is set downe in the Fractures of the same .

CHAP. IV. Of the Spondyls or Vertebra .

IF it bee of the first next the head , in which the chin is fastened to the necke , death follows , for those under all along are dangerous , and may be either strained or luxated , and that to both sides , outward , and inward ; the last most dangerous . If above the necke there will be a great paine , difficulty of breathing , and face looke blacke , to restore which , the patient being set low , let one lye with all his weight upon his shoulders , and the Chyrurgion taking his head about his eares betwixt his hands , and so shake and move it to every part till it be restored . Which being done , the paine will suddenly cease , and they be freely able to turne and move their necke ; if it be below the necke , and inward , Mr. Hailes cured one thus ; Hee tooke the party by both hands , and cast them over his shoulder , and with his backe parts gave a sudden jerke , bending forwards , and so reduced it . If it be outwardly , lay them upon a table with their face downward , having bound them about the flanckes with long towels , as also under the arm-pits , then make extension without violence , and with your hands laid upon the extuberation , force it in , taking care you hurt not the processes : As for that from an inward cause , it s absolutely uncurable , unlesse they be done at first with great care and diligence , Hildanus saith , if the luxation be compleat , its deadly .

CHAP. V. Of the Rumpe .

WHich being , dislocated , causeth such an impotency in the leg , that he cannot bring his heele to his buttockes , nor bend his knee , unlesse with great force . The cure is performed as in a Fracture in the same part .

CHAP. VI. Of the Ribs .

IT causeth if inward , difficulty of breathing , paine in bowing downe , or lifting up the body . To deliver from which the dislocation is speedily to be restored , and if the rib fall on the upper part of the Vertebra , the patient must hang with his armes upon some high doore , and then the rib is to be depressed downe into its cavity ; if it fall downe on the lower part of the Vertebra , the patient is to bend downward , setting his hand upon his knees , and then presse it in . If it be inward , its supposed incurable in these , as also in the Vertebra's is to be used besides Empl. fomentations ; as ℞ salu . Althaeae stor . Cham. Melilot . & Hyperic . ana Mj. Coq. pro from . after this anoint the part cum l. Lumbric . irin . lilior . ana ℥ ij . dialthaeae ℥ . ung . Agrip. ℥ s. Misce .

CAHP. VII . Of the Shoulder .

FOr the restoring of which divers wayes are used , that which most commonly was practised by Mr. Hailes ( whether dislocated inward , outward , or side-waies ) was this , he tooke the patients hand , & laid it in his neck , after with the right hand pressed his arme close to the ribs , and after suddenly thrust the elbow upward . This I have used , and as he , so I never failed . Some others , if inward , doe it upon a doore , ladder or coulestaffe , upon two mens shoulders , in these the patient is to be held by the arme , the head of the bone rightly placed on the instrument , and hee standing upon a stoole is to bee cast .

Of the Elbow .

This is hard to be reduced , unlesse speedily effected , whether it be backward , or forward , or side-wayes , it s to be set by setting the part into which the bone is falne upon your arme , and so endeavour to bend the arme ; by which it s reduced , as also the wrist ; this was the practice also of Mr. Hailes , but for the wrist some take by the hand near the joynt , the arm being held and so move the hand upwards and downewards , or sidewaies till it be restored , this I have practised .

CHAP. VIII . Of the Thigh or Hip.

IF it be dislocated inward , the share and groines sweat ▪ the buttocks are wrinkled , they cannot extend the leg without pain , nor stand upon their toes , their urin is suppressed . Cure . For the restoring of which , lay the patient upon a bench or table , in the midst of which , let there bee a pin of wood pretty thicke which must bee lapped with linnen cloaths ; the patient is so to bee situated that this pin be betweene his legs near the head of the luxated bone , and after make extension and force in the head of the bone to its place . Others use ligatures , by which making extension , having a round thing in the groyne , they speedily with violence bring in the patients knee , with leg inwards to the other , and so force it to its cavity .

If outward .

This is easily perceived , and if new , as easily reduced , by laying the party upon his face , and pressing it downe with your hands into the right place .

If forward .

The patient is to be laid on his sound side , and by ligature just extension being made with the hand , force in the bone .

If backward .

It must be reduced with extension after the same manner as when outward . Observe that all dislocations of the thigh which are old , are hardly or never reduced , and after all reducings of it , let there be rest commanded , it being bound up , lest it recidivate .

CHAP. IX . Of the Whirle-bone .

IT may be dislocated upward , downward , or side-wayes , it s to be restored to its place by the hand , Cure . the patient firmly standing , and so after medicines applyed , let it , with fitting boulsters , filling the ham , and ligatures , be bound up , and a case made to strengthen it , and so command rest as long as is convenient . Which being done , let the knee by little and little be bowed till it come to its proper motion , to it apply Emp. Paracel .

CHAP. X. Of the Knees .

THey may be dislocated inward , outward , and backward , seldome or never forward , you may know them by the debility of the joynt , and he cannot bring his heele to touch his buttocke ; for the two first , after due extension inforce them into their places ; for the third , take the patients leg between yours , he fitting upon a low stool , and so bring his leg forceably toward his buttocke ; if the last happen , lay him upon a table with his face upward , and force in the bone .

For the dislocation of the fociles , heele , and ankles ; what hath been said may serve , onely symptomes are to be specially eyed , the bones of the hand , singers , feet , and toes are to bee reduced , as is set downe in Fractures .

Thus having done with luxations ; wee come to some rare symptomes which happen after both Fractures and Dislocations ; as first , Atrophia or wasting of the part .

CHAP. XI . Atrophia or wasting of the part .

IT s occasioned either by idlenesse of the part , too hard ligature , or as Hildanus ; by Tumor possessing a joynt . If by too hard ligature , loose it . For the first , use Frications for halfe an houre , and then anoint it , cum ol. Amygd . d. ℥ ij . Cham. ℥ j. Misce . This doe morning and night ; this you may use for fifteen dayes ; after for as long , ℞ ol. Catellor . lumb. ana ℥ ij . ol. Amygd . ℥ iij. Misce . After for fifteen dayes more , ℞ ol. viol . olivar . ana ℥ js. pic. Naval . ℥ ij . ol. Amygd . d. ℥ j. f. Lt. before the anointing use this , foment . ℞ rad. bryon . lilior . Althaeae . ana ℥ iij. Coq. in juscul . Capitis , pedum & intestinorum vituli aut vervecis . Let this bee applyed two houres , night and morning ; if you suspect the originall of the nerves to bee obstructed , then use strong resolvers , as may be seen in palsie upon a wound ; as for the last , Hild. used first purging by phlegmagogues , after using the like decoct . and oyntments , as before . Note if by these meanes the part grow red , there is hope . Some apply dropax . I cured one by frications , bleeding on the same arme , and unguent . dialth .

CHAP. XII . Gibbosities , if in the loynes .

FIrst , anoint the whole backe ; and this , ℞ aq. granor . juniperi , sine vino distil . aq. salv . betonic . lavendul . ana ℥ ij . pul . rad. bistort . Tormentil . rosar . ana ℥ ij . misce f. q ; infusio . in ampulla magna per dies 8. vel 9. deinde per inclinationem a pulveribus seperata aq. ad usum reservetur . After anointing apply the following plaister , which is also excellent in Fractures ; ℞ Empl. slotani . ℥ v. Cer. flau . ℥ ij lap . osteocoll . ℥ ● . pul . rad. consolid . major . Ter. sig. anaʒiij . pul . balaustior . nuc . Cupress . rosar . ●dorifer . anaʒj . Misce lentissimo igne f. q ; Emp. cum ol. ros. aut mastic . q. s . Emp. slotano . ℞ axung . porc . rec . ℥ xij . ol. ros. rec Minij . ana ℥ xx . Calchitidis ustae ana ℥ ij . adip . cervi . ℥ iiij . Mastic . ●liban . ana ℥ ij . f. Emp. S. A. agitando bacillis salicis & succulentis . If there bee bunchings forth in other parts , by no meanes as the custome of some is , breake the member againe , but rather assay to waste what is superfluous by frictions , and resolving , foment . ung . and Emp. observing that the plaister upon Gibbosities in the loynes need not be removed in three or six dayes , though the backe and thigh may be anointed . Hildanus .

Thus having done with solution in hard parts , we shall put an end to the first part of Chyrurgery by handling Combustions , Ecchymosis , and Gangreens , the second frequently following Contusions , and the last may happen upon all solutions .

CHAP. XIII . Burnings or scalds .

FOr the causes and signes they are obvious , the difference is onely in the quantity . Prognost . The Prognosticks are these : If it bee small , and a body of good constitution , its easie . If deep to the veynes and Arteries in an impure body , and be in the groynes , belly , eyes , and parts of the head , and in children , hard , if in the intestines , death .

Before blysters arise , onions and salt beaten together , and applied is excellent , which I have often proved , or this , ℞ Caepae Crud . ℥ s. sal. sapon . ven. ana ℥ s. Misce & f. ung . cum ol. ros. & Amygd . d. If the party be strong , and the burne great , let blood , and purge ; as ℞ diacatholic . ʒvj . e succ . ros . ʒij . syr. ros. sol . ℥ ● . cum aq. Cichor . & buglos . f. pot . To ease paine , and to cure , this excellent , ℞ butyr . rec . in aq. ros. lot . ℥ iij ol. viol . de vitel . ovor . Amyg . d. ana ℥ ● . farin . Hord ℥ s. Croc. ℈ j. Mucilag . sem. Cydon . ℥ ● . ●er . q. s . f. ung . in mortario . In the face , and for children use this , often by mee tryed ; ℞ ol. ros . ℥ ij . aq. ros . ℥ j. alb. ovor . Nij . Misce diligenter . It s to be applyed often without linnen , I have used in other parts also . If in the groynes , ℞ ung . ros ℥ j. basilic . ℥ vj. ol. vitel . ovor . lilior . ana ℥ s. Myrrh . Aloes , anaʒ● . upon which apply this ; ℞ far . Hord. farbar . orobi ana ℥ pul ros . ℥ s. cum mel . ros. vel oxymel . f. Catap. To incarne , use this , ℞ pul . rad. vincitox . & Angelic . ana ℥ j. Myrrh . Mastic . oliban. lo● . scord . ana ℥ s. f. p ul . tenuis . ex quo cum s . q . succ . Nicotic . sanicul . vel pyrolae f. Troch . dry them in the shadow , and after powder them , this is excellent in putrid and venemous ulcers , as Anthrax . Gangrena & Cancer . Minsicht . highly commends alb. ovor . & ol. olivar . two parts of the first , and one of the last , and saith its wonderfull . Formuis his Ivy boyled in water . This I received as a secret ; and its effectuall ; ℞ plantag. Hederae terrest . ana Mj. Concis . & contund . & coq. in axung . aprin . ℥ iiij . deindè Colet . apply it after anointing upon a fine linnen cloath twice a day .

CHAP. XIV . Ecchymosis .

IT s an effusion of blood under the skin , and causeth blacknes , it being caused most frequently by contusions , sometimes by the mouths of the vessells being opened ; the blood sometimes poures it selfe inward .

For Prognosticks , if the blood be thin , and can be discussed , Prognost . it s well , otherwayes it may gangreen .

If it be great and much paine , Cure . let blood ( especially if you feare it fall inward , ) and purge as ℞ pul . lax . ℈ ij . syr. ros. com . cum rhab. sen. & agar . ℥ j. cum s . q . decocti agrimon . Cuscut . veronicae , & sem. anis . f. p. after give this ; ℞ rhei , Terr . sig. bol. opt . mum . anaʒ● . f. pul . dos . ʒj . in acet . vel oxycr at . Irish slate , or sperm . ceti . is good . This is excellent , ℞ conser . flor. genist . ʒs . Mum. ℈ ij . rhapontic . g. 25. sem. Nasturtii . hortens . ℈ j. Mis. cum oxyerat . f. bol. take it at the houre of sleep , & drink this upon it ; ℞ aq barbar . & nuc . viridis ana ℥ s. syr. acetos . Citrij . ʒx . ol. vitriol . q. s . ad gratam aciditatem , Misce f. julep . after use a clyster . Outwardly anoint the part cum ol. ros . and after it for foure or five dayes . If in the beginning , twice a day apply this ; ℞ far . Hord. & Fabar. ana ℥ ij . pul , ros . ℥ j. Coq. vino rub . parumque aceti ad . Catapl . add . ol. ros. parum & vitel . ovi cum alb. then if the blacknesse bee not gone , use this ; ℞ rad. Althaeae ℥ j. absinth . rosar . origani , agrimoni . flor. Cham. Melilot . Sambuc . ana Mj. sem. anisi . Cumin . faenugraec . ana ℥ j. incidant . & contund . indanturque sacculo , quem intertextum & vino rub . cum aq. incoctum apply it hot to the part three or foure times a day , after anoint with this , ℞ ol. Cham. aneth . lumbric . ana ℥ ● . anisi . subtiliss . pul . ʒij . f. Lt. thus Hildanus . Rad. sigil . Solom . if new , bruised , and applyed , if old , boyled in wine , is accounted the most efficacious remedy . I with good successe applyed Empl. Paracel . vel crocatum . If these doe not , use cups , and scarifie , which is excellent ; if it tend to a gangreen , cure as followeth . Observe in all contusions of the joynts , Catap. are better then oyntments .

CHAP. XV. Gangreen .

IT s a beginning or partiall mortification of the soft part , the causes as you have heard may be all sorts of solution , especially after wounds made by gunshot , and great contusions , &c. But besides there are internall causes , as from excesse , or malignity of humors , as also cold , &c.

Signes . Signes . If from inflammation , there is paine and pulsation , with a sudden changing of fiery red , into livid and blacke , which being pressed returnes not . If from cold , a sharpe , pricking , burning paine , and shining rednesse , seiseth suddenly upon the part , after it turnes livid , there is also a coldnesse and numnesse , and as if shooke with a quartane Ague . If from hard binding ; it s knowne by the hardnesse of the part , little pimples and blisters rise upon the skin . If from bits and punctures . Signes are as inflammation , and observe there may bee motion , though there be a gangreen , nay a mortification , if the heads of the muscles be not affected .

Prognosticks . Prognost . If the malignity bee not speedily withstood the part will perish , and will also infect the ad●acent parts , and the rather , if the humor first take hold on the bones , and inflammation proceeds from them , they are incurable frequently : but if the muscles and nerves bee not hurt the person young , and of good constitution being well handled in the beginning it may be cured . If from an afflux of venemous humors or of occult quality or abundance , as also in bodies affected with a dropsie , hardly cured .

Cure Internall . First , Cure . prescribe a convenient dyet , cold and dry .

Secondly , if plethoricke , let blood , and purge .

Thirdly , use cordialls to strengthen internall parts against putrid vapours , as ℞ lap . Bezoar . oss is de Cord. Cervi ana ℈ j. Margar. prep. . ℈ ij . C.C. usti , Terr . sig. anaʒ● . sacc . Cand ℥ s. Misce f. pul . dos . ʒj . cum aq. Cordiali , or this ; ℞ Confect . Alker . ℈ ij . in aq. vel decoct . Cinam . ℥ j. aq. Calend. buglos . ana ℥ s. syr. Caryoph . ʒvj . you may of these make Epithemes for heart and wrists , adding some vinegar ; if paine torment the head , use clysters and suppositories , and anoint with this , ℞ ol. ros. Nenuph . ana ℥ s. Camphor . opij dissol . in aq. betonic . dissol . ana g. vj . Misce f. lin. with it anoint the temples and forehead . Cordiall juleps every two or three houres , are to be exhibited , and diaphoreticks sometimes to be used .

Externall . First , defend the sound parts , and stay the flux , ℞ bol. Arm. terr. sig. ana ℥ s. misc . cum ac●to scord . apply this . Or this , ℞ far . Hord. ℥ iiij . bol. opt . alb . ℥ ij pul . gallar . nuc . cupress . Cortic. granat. anaʒjs caphur . ʒ j. cum oxymel . f. Catap. apply them higher then the part affected , and remove them often , and apply fresh .

Secondly , revell or derive the humors from the part affected by cups , leeches , as well as purge and bleed .

Thirdly , bring the part to its naturall temper by evacuating the blood , and other humors in it incompacted . If little by scarification ; if much by incision , taking care of the great vessells : to the scarifications apply small cups , but rather leeches ; after apply with stuphs , if the affect be superficiall , vinegar and salt ; if great and deep , use this hot , ℞ lixiu . fortis . aceti . opt . ana lb iij. scord . absinth . lupinor . contus . ana Ms. rad. Aristol . rotund . vincitox . ana ℥ s. sal. marin . ℥ iiij . Coq. ad consumpt . 3. part . in Colatur . dissol . Aloes . myrrh . pul . ana ℥ s. rursum semel atque iterum ebulliant . tandem ad . Mel. ros. ℥ j. spir. vini ℥ iij. Caphur . ʒj . misc . f. fot. or Woodall ; which is this ; ℞ lixiu . de cineribus lig. frax . gal . 4. Herb. Centaur . scord . Card. bened. absinth . rosmar . Hyperic . ana p. iij. flor. Cham. melilot . ana p. 1. f. decoct . ad 3. part . Consumpt . col . ad sal . Mij . vitriol . virid . lb s. spir. vini lb ij . Misce S. A. If you please , you may adde Myrrh , Al●es , and Caph. and leave out the vitriol . After the use of these for halfe an houre , apply into the incisions ung . Aegyptiac . with pledgets of tow , adding thereto spir . vini & oxymel . S. or Aegyptiacum alone , of which receive two descriptions , ℞ aerugi . ℥ v. mel . opt . ℥ xiiij . aceti vini ℥ vij . Coq. omnia simul donec f. ung . spissum & color is purpurei . vel ℞ Aerugin . ℥ iiij . mel . opt . & cum decoc● . absin●● & scord . despumat . lb j. aceti scillit . ℥ vj. Alum . sal. Amonia● . ana ℥ ● . succ . ru●ae , scord . utriusque & alliariae ana ℥ iij. Coq. ad spissi●udi Mel. deinde add . Theria● . op● . mit●rid . ana ℥ s. cap●urae ℥ ● . misce . It resists putrefaction ; diminisheth , & tempereth the maligne vapours arising from the gangreen , separateth the dead flesh from the living , and produceth a gentle and laudable escar ; if the affect be in scr●tum , this is excellent , as also in other parts ; ℞ vitrioli ℥ ● . summit . querc . Mj. Thur. ℥ ● . Cap●ur . ℥ ij . vini lb ijs . C●q . ad 3. part . consump . & Colet . upon these are to be applyed this following : ℞ farin . fab. Hord. & orob . ana ℥ iiij . lixiu . lb iiij . Co● . hoc ad Catap. consist . ad . oxymel . ℥ ij . ung . Aegypt . ℥ ● . Misce . Vel farin . ●upinor . le●tium fabarum , lolii . sal. Marin . ana ℥ iij. pul . summit . absinth . scord . utriusque , alliariae , rutae ana ℥ ● . Coq. in oxymel . S. & f. Catapl . re●rigerato adde Aloes , myrrh . ana ℥ j. aq. vitae ℥ iij. Misce . or this which hinders put●efaction , resolves , cleanseth , dryes up the virulent sanies , strengthens and easeth paine , ℞ far . Hord. fabar . orob . lentium lupinor . ana lb s. sal . commun . Mel. rosar . ana ℥ iiij . suc. absinth . marrhub . ana ℥ i●s . aloes mastic . myrrh . & aq. vitae ana ℥ ij . oxymel . s . q . s . f. Catap . Sometimes use actuall cauteries , which are excellent to hinder putrefaction of neighbouring parts , comforts the member being cold , resolves corrupted matter , and stayes blood flowing . Lay upon the escar the juice of leeks and salt beaten together , adding what may hasten the fall of the escar . Which being effected , mundifie and cleanse , cum ung . mixto i. e. ung . Basilic . & Aegyptiac● ana part aeq . or ℞ fari . ervi . rad. Aristol . rotund . irid . florent . vincit●x . Angelic . ana ℥ ● Theriac . ʒij . cum s q. Mel. re● . f. ung . But take heed cauteries bee not applyed to gangreen . Here might bee handled gangreens produced from various causes ; but its needlesse , if we consider the maine intention , which is to separate the dead from the living , and hindering further progresse . Besides , most Authors are silent therein . Hildanus herein hath done excellently , and some of his imitators . I shall therefore conclude with one observation of Riverius , which is this , being called to one , who through the ill opening of a veyne , had a gangreen possessed his arme , and ordinary meanes used , and yet not effectuall ; he caused the scarification formerly made to bee humected with spir. sulphur . which cauterised the mortified flesh , after hee fomented the whole part with Spirit of wine , in which the powder of Aloes and myrrh had been infused ; this was applyed very hot , then in great quantity hee strewed the part affected with the powder of myrrh and aloes , and upon it cloaths dipt in the foresaid spir. vini . In some houres by these , the arme in a miraculous manner came to its native colour , the tumor asswaged , the gangreen stayed , so that the next day the mortified flesh separated from the living ; after which , he applyed a digestive of the yolkes of egges , turpentine , and hony , and after proceeded according to Art . If the meanes prescribed will not prevaile , dismembring must bee used . But this belonging to the third part of Chyrurgery , wee for present shall wave it . And having run through the first Part , wee come to the second Part of Chyrurgery .

CHAP. I. The Second Part of CHYRURGERY .

WHICH is to separate parts unnaturally joyned these being few , we shall for brevities sake passe over generall notions which might be premised , and come to the particular operations , wherein may be observed what in the generall is omitted , onely they are such as are received in the wombe , or else accidentall after wound and ulcers , not carefully dressed . As after a wound in the eye-lids received at the siege of Banbury , which being not Art-like dressed , the eye-lids conglutinated , and so he delivered up as hopelesse of his sight recovery . But removing to Warwicke to me , I dividing them , he presently received that which hee supposed lost , and so was cured S.A.

Sometimes also the eye-lid may grow to the white which must be divided , care taken you cut not the white , therefore put in your probe ( being small and smooth ) betwixt the white and the lid , and so divide it with a crooked incision knife , after which , use the white of an egge , with some rose-water beaten together , and applyed upon a small pledget , which may hinder agglutination againe : as also it will be necessary , the Patient be often turning it up . Here also fitting Collyrium is to bee used , which you may finde set downe in the effects of the eyes .

Gums .

And here the dividing of the Gums in children may be handled , which though it cannot bee called an unnaturall union by reason of natures designe , and so generally happens to all ; yet when that designe comes to its period , and nature endeavours to thrust out the teeth , and the gums , from some cause hinders to the endangering of the life of the creature , then in some sense they may bee looked on , at least as continuing unnaturally joyned , and speedy helpe to be administred . Which is by dividing the gums with an incision knife , or a peece of gold , in those places where the teeth bunch out with a little swelling ; but this must bee done in time before mortall accidents , as consumption of the body , and convulsion ; by this meanes many may bee preserved , which otherwayes may perish .

CHAP. II. Ancyloglossis , or tongue-tied , or Contraction .

ANd this as Horstius saith , may either be by the default of the forming faculty , or else accidentall as in feavers . In children it hinders sucking or speaking , and in men when accidentall , it hinders volubility of speech , and a right pronunciation . You may perceive it in either by the shortnesse of the nervous ligament , which draws the end of the tongue inward . For the cure of the first , the ligament must bee divided broad wayes ( taking heed of the veynes and Arteries ) in two or three places , and after by the Nurses finger dipt in Mel. ros . often lifted up . If it grow together againe , as it often happens , divide it .

Sometimes you cannot effect this operation without great danger , then its most safe to passe through a needle and thred , which tye daily straiter , till it be broken ; if by accident , as in feavers , then use things humecting and mollifying , which is Horstius counsell in his Decads 4. Quest. 1.

CHAP. III. Eares .

THe passages of which may be unnaturally obstructed , and must be divided , the membranes obstructing , are either externall and obvious , or internall , and scarce to be seen ; the first may easily be divided , and afterward cicatrising medicins lapped about a pipe applyed . The second is dangerous , and is rather to be eaten away by eroding medicaments , taking speciall care of the drum of the eare .

CHAP. IV. Necke distorted .

THis happens most frequently in children from a defluxion , Cause . arising from a cold and moist distemper of the braine , which falling into the necke , Signe . sometimes produceth a great tumor , after which , a contraction and distortion . If taken in time , Prog. it may be cured , otherwise scarce perfectly .

The offending matter is to be evacuated , either with pills according to the age and strength of the patient , as if in children very young , ℞ pul . Arthritic . g. xv . Caryophyl . N. 1. cum aq. betonic . f. pil. or pil. Catholic . g. viij . vel x. or pil. ex alo . ros. or ℞ mercu . dul . g. vj. diagrid . g. iiij . fol. Auri N. 1. or a proper Apozeme . The pills may bee administred every third or fourth day , the Apozeme dayly . In those that are elder the doses may bee increased . Cure . Also there may bee used pil. Coch. vel de Agaric . Mesue . particular evacuations are to bee masticatories and Errhins , a Fontinell in the arme or Coronall suture is good .

For Topicks to the head , use lixivi . of Cephalicke herbes . Cephalicke powders , proper Emplaisters , as Ceroneum . To the neck is to be used Emollient fomentations , made of Mallows , Althaea , &c. Also unguents , Cataplas . or Emplas . of the same property , as ung . dialth . ol. lumbricor . vulpini , Empl. de Mucilag . Ciculae , &c. The flux being stayed , and the part affected sufficiently mollified , boulster and a fit instrument is to be used , by which the wrynesse may be amended . Some for this use cutting , of which operation I am ignorant , yet know divers have undergone it three or foure times , with little or no advantage .

CHAP. V. The Yard .

HEre are divers affects to bee handled , as first , the foreskin may sticke to the nut or glans , and then you are to divide it ( as hath been set downe in the eye-lid sticking to the white ) after with fit medicaments cured ; but note , that if it grow to in all places , it s not to be medled with .

Secondly , the glans may not be perforated , which is to bee opened with a lancet , and a small leaden pipe kept in till it bee well .

Thirdly , it s not rightly perforated , but only hath a small hole near the fraenum or ligament of the yard , so that the urin passeth not in a right line , neither can they procreate .

In this case extend the prepuce with the left-hand , and divide the glans to the hole , and use a pipe .

Fourthly , if its very little , the passage in children , in this rather use an elderne pith compressed and anointed cum ung rosac . then incision .

And lastly , the fraenum or bridle may bee too short , in which also the urin and semen cannot come forth direct . This is to be divided with much dexterity , and the wound cured , as others in the part .

CHAP. VI. Vulva .

IT may be shut up either by a membrane obvious , or else by the Hymen ; the first may be safely divided , the other is carefully to be performed . To this end an instrument is to be used to dilate the vulva that your worke may be discerned , and so done , taking heed that you hurt not the parts with your knife , after division , apply turunds dipt in the white of an egge and rose water , as also cloaths doubled dipt in the same , afterward symptomes being asswaged , use a leaden pipe of sufficient bignesse , length and thicknesse , anointed cum unguent . diapompholygos . If it happen that by a wound or ulcer , it s joyned , then after binding of them ; ( as for the stone ) divide it , and cure it as aforesaid .

CHAP. VII . The Fundament .

THis also may be unperforated in children , which is carefully to be divided a little , and after dilated with speculum ani , lest you hurt the sphincter muscle , after division , use a leaden pipe anointed with some discussive unguent .

CHAP. VIII . Fingers and Toes .

THese may bee so either from the wombe , or after by accident as upon wounds , especially burnes , unlesse the former be joyned by nerves , tendons and vessells , let them , as also those by accident bee divided . After with some restrictive powder cast on to stay bleeding , apply this , the white of egges mixed with rose and Plantaine water , with oyle of roses ; to the wrist apply a defensitive , and anoint the whole arme and hand , as also legge and foot with ol. ros myr●illor & lumbricorum , and so roule it up . The second day , use this digestive , ℞ Terebinth . lot . in aq. ros. & plantag. ℥ ● . ol. ros. & vitel . ovor . anaʒij . Croci ℈ s. vitel . ov . Nj. Misce , after incarne and cicatrise , S.A. And observe that in all these operations , if necessity requires , use fitting generall evacuations . Having briefly passed over the second Part , we come to the third Part of Chyrurgery .

SECT. I. CHAP. I. The Third Part of CHYRURGERY .

WHich is to remove things superfluous . And these are so either by their owne nature or by event ; the latter are divers : As first , a dead childe detained too long in the wombe , to the endangering of the mothers life .

Secondly , the falling of the small guts into the Scrotum .

Thirdly , the amputation of a member .

Fourthly , the extirpation of any part , as the breast .

Fifthly , blood offending either in quantity or quality .

Those that are so by nature , are either somewhat familiar to nature , or altogether adverse . Of the first sort , are first strumas and wens . Secondly , Cataracts , those adverse to nature , are stones in sundry parts of the bodies : of all which in order as briefly and methodically as we are able ; observing that under the former generall heads , divers particulars are contained . We shall beginne with things so by event ; And

First , of the extraction of children dead or alive , also a Mole and Secundine , whereunto wee shall adde the manner of bringing women to bed artificially and safely with ease : as also the Cesarean birth , and lastly , cast in the cure of some symptomes , which may happen upon some of these .

CHAP. II. Children dead or alive .

WE shall put the two first together , because a living childe , if the body be of too great a magnitude , or any part have extraordinary tumefaction , as Hydrocephalos , &c. it s the same way to be performed upon this account that one may bee saved . We shall not need to give the signes of a childe living , because manifest ; those of a dead , are these :

If neither the Chyrurgions hand , Signes . nor the mothers can perceive it move . If the water and secundine come forth , it s certainly dead . Againe it s more heavy in the wombe , and falls that way the mother inclines , great paine from the privities to the navell , with a perpetuall desire to make water , and goe to stoole , her privities are cold , and from her wombe filthy excrements are avoyded , and her belly swells .

It being knowne , Prognost . make speed to save the mother if her strength bee good . But if not , which is knowne by the smalnesse of her pulse , by her small , seldome , and cold breathing , cold sweats , death-like countenance , and extream parts cold . Let her alone with a Prognosticke of death .

For to helpe , Cure . First , all physicall meanes having beene used ; and proving not availeable , then it s to bee drawne forth by the hand , or if that cannot effect it , then by instrument the first way was often successefully used by Hildanus . Thus first , he gave a cordiall composed of the waters of Cinamon . Burrag . and Buglosse , with Confect . Alkermes , then put the woman in a sitting posture , and his hands being anointed with a L● . composed of the oyles of white lillies , and the fat of a hen and goose , and put it into the wombe , and drew forth the dead birth . In some , he used a bag of Emollients applyed to the privities , and anointed them with the foresaid oyntment , sometime before the operations , and for accident happening , after hee gave eight graines of Bezoar in aq. Cinam . s . vino distil . & Confect . alker . and wonderfully commends it .

If instruments must bee used , which is difficult , the room being warme , place her overwhart the bed with her hips up , and a hard boulster under them , and so put her into a posture , neither altogether sitting nor lying along on her back , her heels must be drawn up close to her hips , and with soft linnen roulers tyed , as in cutting for the stone , to which for concissenes , we refer you . Which being done cover the thighes and privities , with a warme cloath , then the Chyrurgion having his nailes pared , his rings off , his armes naked , ( and they and his hands well anointed with the foresaid oyntment ) gently draw the flappes of the necke of the wombe asunder , putting his hand up gently to finde out the situation and forme of the childe in the wombe , if the head bee towards the orifice , then turn it gently the feet forward , If both come together , draw it gently forth , if but one , tye it , and so goe along till you finde the other , having put that up which you tyed in the drawing forth ; Let the woman hold her breath , and have her mouth and nostrills stopped , that so shee may be helpefull .

Others may helpe by pressing the belly . If it be so great that it cannot bee turned , then a hooke is to be fastened either to the chinne , or rather to the hinder part of the head , for so the wind and humours being let forth , it by gentle pulling will bee the easiler extracted , if the breast be affected , fasten the hooke about the channell bone , if it be lower , take hold of the short ribs , or of pubes , if lower , put in a crooked knife , and cut them .

But note , these things are not to be done , unlesse the childe be dead , and the mother in great danger . And observe all the womans privities must bee well anointed to make them the more slippery .

I shall conclude this dreadfull operation with that saying of Sennertus , which he hath in Lib. 4. Part. 2. Sect. 6. Chap. 7. ( and which may serve this Clymate as well as that . )

Verum , in nostris regionibus nunquam aut certe rarissime foeminae tales operationes admittunt , sed potius rem omnem Deo , & Naturae committunt .

Which amounts to this , That women will seldome or never admit of these operations , but rather commit the businesse to God , and Nature . As for a Mola .

CHAP. III. A Mola .

WHich is produced from a great deale of blood cloying , Signes . a little ill disposed seed . It is hardly known , especially till the fourth moneth , after which , the motion of the Mole will be to that side ; the woman turnes her to like a stone , with trembling and beating ; the belly is sooner great , and more hard then in a true birth , and more troublesome to carry .

Againe , there appeares no milke in the breast ; there is also difficulty of breathing , paine in the backe and the groynes .

Take this for a Prognosticke , Prognost . If upon the comming away of the Mole there be great flux of blood , its dangerous . To extract it after its separated from the wombe must bee as is handled in a dead childe , onely the instrument must be the Griffons talon .

CHAP. IV. Secundine .

THough it might have beene placed after bringing women to bed ; yet because it may so fall out , it may come to handy operation , wee shall doe it here : there is two wayes of bringing it away , Physically , and Manually .

The first is rather to bee defired , Cure . and therefore I shall set downe onely Zacutus pul . praestantissimus ( as hee calls it ) ℞ Carabes tenuissime pulv . ʒj . Castor . ʒs . dictam pulegij . anaʒj . Cinamʒj . borac . ℈ js. Spicaenard . ℈ j. Myrrh . ℈ js. rub . tinctor . ℈ j. Croc. g. vj. f. pul . subtiliss . dos . ʒ js. cum sac . & vino alb. or this which I saw experimented .

Take sweet myrrh , ambar , and spermaceti , equall quantities to the quantity of a ʒjs . in white wine posset drinke ; after it came forth , I beheld it , and saw it had seated it selfe unto the wombe .

One thing I forgot , which should have beene set downe in Mola , that after endeavour to extract , and yet it proved fruitlesse by reason of a flux of blood . Zacutus gave these pills , ℞ Euphor . ʒj . f. pil. cum syr. Artemisiae foure times in the space of twelve dayes , three houres after supper , and they brought away eight Moles .

If it must bee done with the hand , it being anointed , is to be put up , and finding the navill string , follow it till you come to the Secundine , and it sticke , then shake it gently , and when it is loosed , draw it out .

CHAP. V. Of the easie and safe bringing women to bed .

AS for the easie and safe bringing women to bed , though it be most fit for the Midwife , yet it hath fallen out to be the practice of the Chyrurgion , therefore wee shall give briefe directions . It is not necessary to set downe foregoing signes , being so notoriously knowne to all .

When the time is come , put her in a convenient posture either in or upon her bed , or in a stoole for the same purpose , let her backe be pretty high , her legs wide , open and turned towards the hips , and if upon a bed , let her leane over a staffe placed overwhart the bed , or for a need upon a good-wives shoulders . Let her not labour too much before her strong paine commeth . If shee please shee may stand up , and leane when the pangs come .

Let sometimes her belly , other whiles her loynes be pressed downeward , remember your hand and her privities be anointed , cum ol. lilior . alb. Amygd . d. vitel . ovor . & lumbric . ana ℥ s. pingued . Anser . Capon . ana ℥ j. Misce . After this , ℞ far. faenugr . Cydonior . anaʒj . Croc. subtilis . pul . ℈ ij . aq. Artemis . ℥ j. post unicam ebul . add . ol. & pingued . f. q. ung . This may be used in the foresaid cases , as also if the water being come forth , hath left the wombe dry .

If the Infant come with its head forward presently following the flux of water , it is good , and so you may receive it . If it come with the feet forward , its difficult . If it come forth any other way it s to bee turned and drawne forth by the feet , after it is borne , take away the Secundine ( lest grievous symptomes happen ) as is afore set downe , then let her close her legges a crosse , lest she take cold , and roule up her belly with towells , and being laid in bed , give her some Capon-broath , or Caudle of white wine and saffron added ; keep the curtaine drawne , and doore and windowes shut ; you may to facilitate the birth , inwardly exhibit Confect . Alker . ℈ s. aq. Cinam . ℥ j. decoct . Agrimon . & veronic. ℥ js. Sacchari . q. s . ad . Croc. gr . vj. Balsa . Nat. is excellent , or ʒj . borac . in aq. Artemis . ℥ iij. sharpe clysters may bee here , if necessary , used , and neezings .

After the childe is brought to light , tye the navell with a double thred an inch from the belly , not too hard or too slack , and two fingers breadth above that , cut it off , and upon the Section apply a double linnen cloath dipped in ol. of Roses , or sweet Almonds , within few dayes after , that above the tye will fall off .

If the childe be weake , some apply this , vini maluatic . & aq. vit. part . aequal . calefiant . & in iis dissol . nuc . mosch . Observe you let not the dying part lye next to the belly , but lap it up , after wipe the Infant from all filth , and anoint with ol. ros. & myrtillor . Some wash with warme water and red wine , and after anoint it . If the mouth be furred , cleanse it with a rag dipt in ol. Amygd . d. mel . & Sacchar . you may give it a spoonfull of ol. Amygd . cum sac . Cand. If they have fretting of the bowells which is discerned by their crying , exhibit of new Aniseeds made into fine powder ℈ j. which I have seen succeed well . If it happen when they are a moneth or two old , you may give this clyster , R parietar , flor. Cham. ana M s. Coq. in brod . carnis , Colat. R ℥ iiij . vel 5. add . Mel. ros . ℥ j. vitel . ovi . ss. Misce f. enema .

CHAP. VI. Caesarean Birth .

THis is to cut forth a living childe , and though it bee seldome in practice , yet we shall touch at it . It hath beene commanded upon living subjects , by what warrant I know not .

I hope all will acknowledge , to doe it upon the dead to save the living , is Christian . Yet the operation hath also another profitable and necessary intention , which is to behold the Site of the child in the wombe , for those that are exercised either in the producing of living , or extracting of dead children .

It must be performed presently upon the mothers death , beginning your Section at the breast-blade in a circular manner to the privities , or neare it , not touching the bowells . Then the wombe being lift up is to be cut ( lest you hurt the childe ) with your knife ; and the infant to bee taken forth , which in appearance may seem dead , but may certainly be knowne to be alive by the beating of the Artery of the navell , and having taken aire , will move all his members . Because its weake , the Secundine must not bee removed , but rather if there bee any heat in it remaining , bee laid close to the region of the belly to stir up that heat againe in the Infant which seemeth to be decayed .

Having finished these hazardous operations , we at last come to the Symptomes .

CHAP. VII . Symptomes . Which shall onely be externall : And first of the tearing of the Privities and Fundament into one .

ITs first to bee stitched up in three or foure places , Cure . after put in linnen for the filling of the Privities , apply Bal. Artific . and upon it some Sarcoticke powder , and upon that this Catapl . ℞ rad. Consolid . major . ℥ ij . verbasci . Mj. Coq. ad mollitiem & Contund . f. Cataplas . the method of curing other wounds may be observed .

This is an unhappy accident , for when she comes to be delivered againe , it must be opened , owise she cannot be delivered .

CHAP. VIII . For the wrinkling of the Belly .

℞ LImacum rub . lb j. flor. Anthos ℥ jx . incidant . & ponantur . in olla . vitre . stop it close , Cure . and set it in horse dung forty dayes , then presse it and set it in the Sunne for three dayes , after anoint the belly with it , Capons grease is also good .

CHAP. IX . To dry up Milke .

IF necessary , Cure . effect thus , eat and drinke little , if it be required open the Saphaena , anointing with this ; ℞ ol. Myrtin . & rosar . ana ℥ iij. aceti ros . ℥ j. Misce . Use this foure times a day casting upon it pul . Myrtinus , and apply this , ℞ pul . Mastic . nuc . Moschat . anaʒij . nuc . cupress . ʒiij . balaust . myrtil . anaʒjs . Ireos florent . ℥ s. ol. Myrtin . ℥ iij. terebinth . venet . ℥ ij . Cerae nov. . q. s . f. Emp. some put under their arme-pits black wool . This also may be applyed , ℞ fol. salu . apij , rutae & chere , fol. incid . & misce cum acet . & ol. ros. apply it warm , internally may be used , Rhabar . pul . ℞ in aq. plantag .

If the breast grow hard , painfull and tumefied , then use this , fol. ℞ Medul . pan . alb. nov. lact. & ol. ros. f. Catapl . vel ℞ succ . Consolid . major . totius , cyat . dimidium , ovor . vitel . Niij . & cum farin . frument . q. s . f. Cat. add . ol. ros. vel ung . popul . vel Cer. alb. ℥ iiij . sper . ceti . ℥ ij . gum . galb . in acet . dissol . ℥ j. M. f. Empl. This easeth paine , dissolves hardnesse , and the coagulation of the milke , Empl. Crocat . is excellent also .

CHAP. X. Breast .

IF in the Breast there be little hard Tumors , Cure . they are to bee taken out as Cancers , and cured according to Art .

For the swelling of the feet , we are to apply discussing foment . and Catapl .

SECT. II. CHAP. I.

OTher Symptomes might here have been handled , but they more properly belong to the practice of physick , whither to we refer you ; and come to the second part of things superfluous by event ; in which may be handled all kinds of Ruptures . And here we shall set down such as are so in regard of similitude , as also properly so ; And begin with

Bronchocele . Bronchocele

It is a round tumor of the throat ingendred of phegmatick humors betwixt the Trachea Arteria , and the Cutis . Some of them covering the whole throat .

Sometimes they are hereditary , otherwhiles caus'd by the coldness of the air , drinking water , and eating such things as cause phlegm and wind ; the differences may be according to the various matter therein contained .

Such as are hereditary are uncurable , as also those that are great and inveterate : If small , or not of long standing , it 's curable .

Cure . Cure .

For universalls , what is prescribed in pituitous tumors , are here diligently to bee observed . The cure externall is either by Resolutives , Cauteries , or Incision . It 's true in the beginning astringents must be applyed , as Empl. contra Ruptur . for resolvers , a fomentation of Dill. Chamomel , Melilot , &c. boyled in white wine ; or rather a Lixiv made of wine-lees burnt : after apply Empl. de vigo cum Mercur . reduplic . vel Empl. diachil great , cum gum . Galb . et Bdell . dissol . in aceto Scill . vel Empl. dia Sulphur . & Balsam . ejusdem . Fluxing in this case is excellent .

If it cannot be resolved , then you must open it either by Cauteries or Incision , but rather the latter ; which being done , let the matter be speedily evacuated ; but if it cannot be done at once , then at divers times , and keep upon it some of the former Emplasters : Some passe through a needle and thred , and keep it in as a Seton ; if it be in Aristis , it 's to be handled as Atheoraema .

CHAP. II. Exomphalon vel Hern. Vmbilicalis .

IT is a Tumor of the navell , Exomphalon . caused either by the relaxation or breaking of the Peritoneum .

Signs . Signs .

If the caule be in the Tumor , it 's soft , and continues it 's naturall colour ; If the intestines , it 's soft , unequal , and returneth with noise ; If from blood , it 's like Aneurisma ; If of flesh , hard .

Prognostick . Prognost .

If great , it 's hard to cure ; if of the guts , caule , wind , or water , it may be cured ; if from flesh or blood , it 's not to be medled with .

Cure . Cure .

If from the caule or guts , force them into their proper place , after which apply this , ℞ bol. Arm. Sang. drac . Mastic . Sarcocol an . ʒ j. bislinga tegul . pul . an . ʒiij . resin . pin . ℥ is . alb. ov . & cerae , q. s . f. cerat . If it be large ; take up the skin after reduction , and bind it , and so let it fall , having first cut it off to the Ligature ; but before you binde it , passe through the needle two or three times , or as often as it 's needfull , and after cicatrize it . If it bee fleshy , or from blood , it 's uncurable ; if water or windy they are to be cured as shall be taught hereafter : You are to observe besides the medicament , there are fit ligatures and boulsters to be applyed , especially a girdle with a bunch for the navill .

Bubonocele , Bubonocele or Hern. Inguinalis .

It 's when the caule or intestines fall into the flank : if it be the O mentum , it returns in easily : If the intestines , there is a noise in the pressing of them .

Cure . Cure .

Of this wee shall not need to write much , because it 's the same with Enterocele and Epiplocele , onely differing in place and degrees ; and therefore onely observe that emollient and discussive fomentations are to be used ; after which , if it be the intestines , and cannot be reduced , give 5 or 6 pricks with a needle , which will dispatch the wind , and render them reducible ; but if hard faeces be in them that cannot be mollified , but the Patient is in danger of death , then , if strength be sufficient , incision must be used as shall be handled .

CHAP. III. Enterocele , & Epiplocele .

THERE is little difference in these , Enterocele . Epiplocele . the place affected being the same , onely the first is when the intestines fall into Scrotum , the latter when the Caule . The causes of both these and the former , are eating too much fruit , too much violence in exercises , and drinking water , riding great horses , strokes , vomiting , coughing , great travell , fals .

Signs . Signs .

The signs of the first is great Tumor unequall , sometimes hard ; if you assay to reduce them , there will be a murmuring noise .

The signs of the latter is also inequality , but more soft and slippery , neither doth it tumefie more by strainings of the breath .

Prognosticks . Prognost .

If the first be great , be inflam'd , have continued long forth , are very dangerous , if the part grow livid , and the excrements avoided at the mouth , & abound , is deadly ; if little , they may be cured ; for the latter , it 's hardly reduced : And herein sometimes the Peritoneum is broken , otherwhiles only relaxed : in the first , the tumor suddenly increaseth with sharp pain ; in the latter , tumefaction is by little and little and also small pains , yet pains return so often as the tumor is renewed by the falling down of either the guts or caule , which happen not the Peritoneum bring broken .

Cure . Cure .

Generall evacuations must here be used , good diet prescribed , after the intestines or caule must be reduced , and then so conserved that they again descend not , which requires long patience , otherwayes little successefull .

If there be need , first let blood , after purge cum diacath . vel purgans Catholic . use glysters : Then assay to reduce if it be the guts , the Patient lying on his back , his hips lying higher then his bead , put them up by little and little with your hand , pressing most on the part where it descendeth . If by abundance of wind the reduction is hindered , either give five or six pricks into the bowels with a needle , or else for two hours make fomentation with Aquavitae hot , and then put them up ; if the saeces hinder being indurated , then apply the Catap , of Pareus , which I experimented upon an ancient man , near 80 years old , who I found vomiting with such a stench , as I could scarce indure it ; yet though I prognosticated his death by the application of it , and casting in a glyster made of the decoct . cum diacathol . & sale , beyond all expectation either of his friends or my self , word was brought me his bowels was of themselves reduced , though there was much out . I conceive the saeces being mollified , the straining in his vomiting forced them up : the Catap. is this , ℞ rad. Althea & lilior an . ℥ ij . Som. lini & faenugr . an . ℥ s. fol. malu . viol . pacietar . an . Ms. Let them be boyled in fair water , ( I did it in milk ) afterwards beaten and drawn through a searse ( which I wanted ; ) adde thereto Butyr . S. s . & ol. Lilior . & Catap. apply it hot ; before you apply it , anoint the part cum ol. lilior . & Aneth . If , as it often happens , reduction cannot be , because the processe of the Peritoneum is not wide enough , then incision is to be made , as after you shall hear ; but if they bee reduced without incision , then use this fomentation for 15 or 20 dayes , ℞ Cort. granat. balaust . Sumach berber . nuc . cupress . gallar . media Cortic. quercus , an . ℥ j. flor. Cham. melilot , an . p. 1. Sem. anisi fenic . ul. . an . ℥ s. alum . ℥ ij . conquassentur & includantur in duobus sacculis inter punctis : boyl them in Smiths water and red wine , and apply them ; after use a Catap. of the same decoct . made up . farin . hord. aq. fabrer , an. ℥ j. pul . al●es Mastic . Mirtil & Sarcacol , an . ℥ s. bol. Arm. ℥ ij . Misce f. Catap. in this time : sometimes the bagge is to be left on , and the Cataplas . to be left off ; after proper Emplaysters are to be applyed , as this , ℞ Resin ℥ vj. Terebint . ℥ iij. Sang. drac . ol. ovor . an . ℥ ij . rad. Consolid , Major . Santil . rub . an . ℥ s. Croc. Martisʒvj . alum . usti . ʒj . f. Empl. This is to be noted , fit trusses are upon all applications to bee used , and the Patient to be kept in bed as long as necessary . For children some use a paper ball after reduction , wet in an astringent decoct . Others exhibit Loadstone finely powdered and given in apple or pap , and anointing the groines with hony , cast thereupon fine filed iron on it , and so bind it up . Fonseca exhibited , Chalyb prepar . ℈ j. cum diarrhod abbat . and outwardly upon a plaster cast the Loadstone in powder , and apply it : they are to be kept in bed 30 or 40 dayes . Internally may be exhibited , essent . Consolid . Maj. Coch. cum balsa . sal gem . gut . ij : to children lesse . vel ℞ rad. Sigil Salom Maj. rad Consolid . Maj. M j. lot . & contand . deind . coq in Zithi ( i. e. Cerevisia sine lupula ) lb iv . ad consum . demid . colat . & reserv . ad usum ; drink of it morning and night , this was given me for a secret : vel ℞ Sem. perfoliat . Cymini an . ℥ j. rad. Aron . rec . exsic . Acori aquat . Tormentil Consolid . major . an . ℥ s. Herb. uincia perunic . Saniculae pyrolae virg. Aureae pilosella Herniaris , Crassull major an . ℥ ij . ros. rub . balaust , galang . minor , caryoph . an . ʒj . incisa & crassiusculc contus coq. invino alb. gener . S. q. ad 3 et f. decoct . clara S. A. Let them take morning and night a good draught .

As for Epiplocele being reduced , Epiplocele . it 's cured as the former , removing plasters every 7 day for a month or six weeks together : Observe this , as they are to lye long , so their lying must be so as their head and shoulders may be lower then their hips and fundament .

As was said before , if they cannot be put up , because the passage is too narrow , or the faeces cannot be mollified , then incision is to bee made after this manner ; lay the Patient upon a form or table on his back , being bound thereto , make incision in the upper part of the Scrotum , touching not the guts ; then with your directory put in at the incision , & under the production of the Periton . with your knife make incision so much as is sufficient for your purpose up toward the belly , and after having made reduction , stitch up so much of the Peritoneum , as shall seem sufficient , that by the passage being made more strait , nothing may fall into Scrotum after cicatrization : This is not to bee done , unlesse strength be sufficient . Rupture . If a Rupture will not bee cured by these meanes by reason of the greatnesse of the brokennesse , or relaxation of the Peritoneum , ( and the patient will undergoe the danger ) then we are to use the last help , which have divers differences , as to be done either with the extraction of the stone , or without it ; that without it , is either with the hurt of the seed vessels , or without ; that without hurt is double , either by incision or cautery : I shall onely set down that in Pareus . Pareus . The Chirurgion is to make incision about the share bone , into which he shall thrust his directory conveying it long wayes under the processe of the Peritoneum : And by lifting up , separate it from the adjoyning fibrous and nervous bodies to which it adheres ; then presently draw aside the spermatick vessel with the cremaster or hanging muscle of the testicle ; which being done , draw the processe it self alone , aside , and take as much of it as is to lax with small mullets perforated in the midst , and with a needle having 5 or 6 threds , which thrust through as near as you can to the seed vessels and cremaster muscle , but the needle must also be drawn again into the midst of the remnant of the processe , taking up with it the lips of the wound ; then the thred must bee tyed on a strait knot , and so much must bee left after the needle is cut off as will hang forth of the wound ; and it is not to be drawn forth till there be sufficient concarnation ( lest labor prove vain ) then cure it according to art . To conclude , observe , that you in children doe not mistake the stone not yet fallen into Scrotum for a Rupture , which I know have been the fault of divers who have brought their children unto me to be cured .

CHAP. IV. Hydrocele .

WHich is a waterish tumor in Scrotum , Hydrocele . which groweth by little and little , sometimes distending the cod to a great bigness ; sometimes being gathered betwixt the two membranes that cover the stone , caused either from falls , blows , &c. or ill diet , cold , distemper of the liver , extinction of naturall heat .

Signs . Signs .

It 's cleare betwixt you and the light , not painfull , heavie , hard ; sometimes it appeares as a third stone , and will not be driven into the body .

Cure . Cure .

Twofold , either by resolving or incision . The first is thus performed , after opening a veine fitting , purging , ( cum jalop . Mercur. dul . vel purg . Catholicon ) using diureticks and diaphoreticks , as Sulph . Aurat . diap . Aureum vitae : apply resolvers , as ℞ farin . fabar . ℥ iij. Hord. ℥ j. Coq. in vino gener . ad form . Catapl . in fine admisce flor. Cham. melilot an . ℥ ij . s. ol. Cham. rosar . an . ℥ j. cum oxym . s . f. Catap. Fomentations , resolving is also here to be used ; if these prevail not , incision is to be made , and a tent put in armed with a digestive , and upon it apply Emp Basiliconis : let the incision be some half fingers breadth , and be kept long open till all the water be evacuated , in the interim purging . Some useth to draw a string through like a Seton in the lower part of Scrotum . If it bee in the membranes , make incision into the Lid of the Scrotum , taking heed to the Stone , and dresse it , S. A.

CHAP. V. Pneumatocele .

THis is a windy tumor in the Scrotum , Pneumatocele . generated by imbecillity of heat in the part .

Signs . Signs .

It 's hard , light , round , suddenly ingendred , resisting touch , the yard being greater in one place then another ; it causeth many evils .

Cure . Cure .

For internall , the same is to bee used as in Tumor ventosus . Externally , fomentation is to bee made , as ℞ Chamom . Rutae , Calaminth , Origan , Sabinae , Salviae , an . Ms. Som. cymini , bac . Laur. anisi . faeni , an . ℥ j. f. decoct . in Lixui claro pro fotu : after apply this Cataplas . ℞ Sterc . bovis lb j . Sulphur . cumini . an . ℥ ij . mel com . ℥ iiij . Misee f. Catap. vel Empl. de vig. cum mercur . anointing it cum ol. Euphorb . & Sambucin . Emp. de Melilot , & de bacc . Lauri is excellent . Observe there is no place for incision here .

CHAP. VI. Sarcocele .

A Fleshy Tumor in the Scrotum caused from grosse and viscid humors , Sarcocele . it often corrupteth the stone .

Signs . Signs .

It 's hard , unequall , and rough , painfull , often accompanyed with varices or swollen veins ; some not painfull .

Prognosticks . Prognost .

If in young ones , and in the beginning , it sometimes is cured ; if it be big , and got to the groins , it 's dangerous , but it 's alway most hardly cured .

Cure . Cure .

Mathiol saith , rad. anonidis taken in powder many months , hath cured . If medicines prevail not , then incise , first placing the sick in a fit posture : if the string of the testicle bee small , make incision into Scrotum to the Tumor , then separate it from the cod , thrusting a needle with a strong thred through it , and having tyed the Dedrin , cut it off , cauterizing that which is cut , and bringing forth the rupture , if any portion remain , cut it off , otherwayes it will come again ; apply to it and neighboring parts repercussives ; if inflammation and dolor happen , let blood , and rest 5 or 6 dayes .

CHAP. VII . Cirsocele .

IT s a tumefaction of the veins in Scrotum , Cirsocele . caused from grosse melancholy blood .

Signs are evident , Signs . hard to bee cured .

Cure . Cure .

First , purge melancholy cum confect . Ham. pul . Sanct. in seri lact. extrac . Hellebor nigr . excellent ; if need be bleed for externall ; and incision is set down in ulcus varicosum ; which method is to be here used .

CHAP. VIII . Hernia Humoralis .

IT 's a Tumor generated by the confused mixture of many humors in the cod , Hernia humoralis . or betwixt the tunicles that cover the stones ; if it continues long , it corrupts the testicles .

Cure . Cure .

It sometimes suppurates , and otherwhiles resolves : Purging and bleeding is here necessary ; vomiting is good . Externally , apply this , a Catapl . made cum vino art. flor. fabar . & ol. ros. vel Sambucin & parum cerae , so that the whole may come to 2 lb. to which adde oxymel ℥ 5 , 6 , 7 , or 8. and boyl it into a body , if it tend to suppuration , make your incision in the side of the cod , and cure it according to Art ; only observe this , they often become incurable Fistula's .

CHAP. IX . Ani procidentia .

IT s the out-comming or turning over of the great gut , Ani procidentia . caused by the laxation of the Sphincter muscle , being most common to children : Others , it 's the comming forth of intestina recta .

Signs are needlesse , Signs . it 's caused of too much straining , fluxes , strokes , sitting on cold stones .

Cure . Cure .

Abstain from much moist things , purge gently , and open a veine , if necessary , externally use this fomentation , with which two was cured , ℞ Chamom . vel potius flor. Cham. Mj. vini malnatic lb js. macerentur per hor. unam et alteram super carbones lento igne . Foment with linnen stuffes as hot as can bee suffered , after with the finger put it into its proper place , then with a spunge wet in the same decoct . and wrung forth , applyed hot to the fundament , and sit upon it , or ℞ fol. & flor. verbasc . alb. flor. melilot , rad. & fol. althaeae an . M j. Sem. lini faenugr . an . ℥ s. Coq. in lacte ●ec . and foment as formerly is set down ; after put it up , being anointed with ol. Murtin . & Laur. and bestrowed with pul . alb. graec . which is excellent : vel ℞ ros. rub . cortic . granator . nuc . Cypress Mastic . croc . mar . & plumbiusti an . ℥ s. nusceant & f. que pul . subtiliss . Suffumigations and astringent Cataplasms may here be used ; observe in the putting it up let the patient draw up his breath , when it 's up , let it bee diligently wiped , and a swath about the middle to bring the ligature betwixt his legges , and under it a spunge as before ; when the patient goes to stool , if he can , let him stand and take heed of too much straining .

CHAP. X. Vteri procidentia .

THe falling down of the womb being occasioned either by the relaxation or breaking of the ligaments ; Vteri procidentia . the causes are immoderate exercise , carrying too great burdens , dray 〈◊〉 away children or secundine , ●●●lent coughing , sneezing , falls , blowes , but most frequently over much humidity .

Signs . Signs .

Often both the urine and excrements are retained by the pressing of the womb both upon the bladder and intestin . rectum ; there is a weight and tumor in the mouth of the womb , pain in the entrals , loynes , os sacrum , hypogastrium & vulva .

Prognosticks . Prognost .

It s very bad if in old , or be inveterate in young , it 's dangerous , if by putrefaction of the nerves incurable ; if livid , it must bee cut off .

Cure . Cure .

Lay her on her back , with her hips up , and her legs drawn backward , with her knees spred abroad , then anoint it cum ol. Lilior . butyr . S. S. adeps Cap. then thrust it gently up with your fingers into its place , shee helping by drawing up her breath ; it being up , wipe away the oyntment with a soft cloth ; after apply this often proved , ℞ fol. plantog . Salicis . mespilorum querc . prunor . silvest. summit rub . rosar . an . M j. rad. tormentil . consol . Major bistort . an . ℥ j. balaust . nuc . cupress . an ℥ s. Sem. anisi ℥ js. incidant . contund . omnia grosso modo pro Sacculo intertexto ; this is to be tyed on : some apply an astringent decoct . as in Hern. intestinal . This is to be noted , if the bowels or bladder bee full , they are to bee discharged before it be put up . Severall men have had their severall devises which have proved successfull ; as Zacut tyed a mouse to the patients thigh , Zacut. which so frighted the woman , that the wombe of it self was reduced ; and after hee applyed Empl. contra rupturam . Rodericus by shewing a red hot iron , Rodericus and making her beleeve he would suddenly apply it to the wombe , and so cured . Pareus Pareus had his cork in figure like a little egge , covered with waxe and mastick , with a thread drawn through it , and so put it up into the womb . Dr. Wells Dr. Wells the same , in the form of an apple , covered with Bees wax , and put it up , this never failed him ; it will serve a thousand times . It being put up , keep her quiet in bed , and her hips up , with her legs acrosse for 8 or 10 days . If after all this it cannot be cured , but its black and stinking , binde as much as is necessary , and cutting it off , sear it with a cautery , for this may be without danger , after cure it S. A.

Thus having concluded the second branch of things superfluous by event , we come to the Third , and in it we begin with

SECT. III. CHAP. I. Amputation .

THIS is a dreadfull operation , Amputation . and a part may bee subjected to it , notwithstanding the diligence of the Chirurgion , which being sphacelated , must necessarily be amputated , lest life for want of it be removed .

In this foure things are to bee handled . First , the signes of a part subject to such an operation . Secondly , the place where . Thirdly , the manner how . Fourthly , how to conquer the Symptomes which usually follow the operation .

Signes . Signs .

If it look black , the part bee throughly dead , and cold as a stone ; if it smell strongly , so that it can hardly be indured , especially if ulcerated ; if a sanies , moistnesse , viscid green , or blackish flow from thence ; if void of sense and motion , they are to bee taken with these cautions : First , they may say they have sense when they feel it not . Secondly , motion may remain , by reason the head of the muscles are not affected ; and yet the part bee fit for Amputation , which delay not .

Secondly , the place where ; and this is either in the sound part , which ever hath been in most frequent use , and most practised : Or , secondly , in the corrupt part .

Thirdly , how it is to bee done : and here is to be considered , what is to be done before the operation ; 2 In ; 3 After . First , the body is to bee prepared by good diet ; as , yolks of egs , and bread tosted and dipped in muscadine . If it bee necessary , and time permit , which is seldome , use purging ; but especially thrice a day administer cordials ; as ℥ j. of this at a time , ℞ Lap. Bazar oss . de C.C. praep. an . gran. vj. C. C. ust. pr. ℈ j. Margar. praep . ℈ . confect . Alcher . ℈ ij . aq. Cinam . ℥ j. bugloss . calendul . an . ℥ js. Syr. de Succ. citrorum ℥ j. Misce . Secondly , have in readinesse a saw with two heads , a good dismembring knife , an incision knife , three or four rowlers of flannell , five or six yards long , three great stitching needles , large clouts , and some lesser , pledgets of tow , greater and lesser , dorsels and buttons , a large bowle with ashes , water and vineger bladders , and satchell for the member which prohibits blood , draws up the muscles , and keeps the Saw from the flesh . Secondly , in the operation draw up the muscles , then make a strong ligature , which strengthen with a strong mans hands to ingirt the part , especially pressing hard upon the place of the great vessels : This being done , with your dismembring knife speedily cut the flesh round to the bone ; if it bee in the legge , or below the elbow , with your incision knife divide the flesh betwixt the bones ; after with the back of your knife , the Periostium being removed , with your dismembring Saw take off the bone , as near the flesh as you can : If the party bee plethorick and strong , let it bleed a little , then stay it , which is done three ways . 1. By powders that cause an escar ; as this , ℞ Umber and unslaked Lime an . part equal , file them to powder , and reduce them to the form of a Liniment with the whites of egs , and the hair of an Hare ; vel ℞ farin . volital . ℥ vj. Sang. dracon . Thuris an . ℥ j. bel . Arm. orient . Ter. Sigill . an . ℥ s. gypsi ℥ j s. ranar. aquatilium pp. ℥ ij . misce cran . Human. ℥ j. pil. Lepor minutiss . incisor . ʒij . pul . alb. ovor . sole canicular . exsiccat . Spum . mar . spongiae non torrefact . an . ℥ j. Misce f. que pul . subtiliss . In wound of the throat to use these for the greater vessels , four buttons made up cum vini acet . & aq. is to bee armed with them , and applyed , upon which speedily apply a thick bed made of tow as before , and sp●ead with the restrictive ; this is to be fit for the member ; another made after the same manner , but so much larger as will reach an inch or two over every side round , is to be applyed , being first armed : Upon these a bladder , upon which make a ligature near the top an inch broad , upon that a linnen cloth doubled , ( observing to have buttons armed , to lay to the places where blood appeares ) then with your rollers bind up the member , and so blood will be stayed . Second way , is by applying the actuall cauteries , which alwayes have in a readiness , apply them to the mouths of the veines , ( having cleansed them from clotted blood ) once or twice at the most . The third is stitching , which is troublesome and dangerous , in which the vessels are to be taken up , and after bound . Above the place amputated ( as if in the legg , upon the knee ; if in the thigh , neare the groine ; if in the arm , upon the elbow , &c. ) is this defensative to bee applyed and removed every day , ℞ bol. Armen . Song . drac . Mastic . gypsi an . ℥ j. ol. ●os . myrtin an . ℥ j s. alb. ovor . N. ij . aceti q. s . f . ung . in Mortario . After this , which is the third thing , let it be dressed , if in Summer , on the 2 day ; if in Winter , the 3 or 4. for which have in readinesse stuphes of white wine , and a decent rouler ; with the white wine moisten those applications which are on , that they may bee the easilier removed ; which being done , besprinkle the vessels with the restrictives , and having 3 or 4 pledgets armed with white of egges , and restrictive cast upon it , and also applyed upon the vessel . Upon these , to the rest of the wound this digestive , ℞ Terbinth in aq. plantag. lot . ℥ iij. ol. ros. Amygd . an . ℥ j. an . ℥ j. gum . elemi dissolut . cum prodictis oleis & Colati ℥ s. Croci ℈ j. Misce f. ungen . adde vitel . ovi . This is not to be changed till digestion bee perfect ; but have a speciall care to use the restrictive every dressing as before , till danger of Hemorage be past . Upon these a plaster , and so roll it up , after it 's digested , then apply this which both mundifies and incarnes , ℞ Succ. apii , Scord. Arnoglossae Major . rutae an . ℥ iiij . coq. ad consisten . syrupi tum admisce farin . Lupinor . pul . rad. aristoloc . rotund . Angelic . vincetoxici , theriac . an . ℥ s. aq. vitae ℥ j. misce f. unguent . In stead of this , it being not to bee had , ung . Basil . maj . will serve : in the mean time , whilst you are thus busied , labor to bring the muscles together with the dry Suture , applying the plaster a fingers breadth from the lips of the wound , round about the member ; which after a day you may stitch . The plaster is this , ℞ farin . volatilis ℥ j. Mastic . thuris , Sang. drac . pul . rub . rosar . gum . Tragacant . an . ℥ ij . misce f. que pul . tenuiss . cui add . alb. ovi & aq. ros. q. s . ut crassitiem mellis adipiscatur glutinum . maneant inful . per noctem , sequento die , si nimis spissum iterum affunde aq. ros. quantum satis est : But sometimes through the abundance of matter it 's loosened : to remedy which , apply this ; ℞ rad. aristol . rotund . peucedani Irid. florent . cortic . pini . Lig. guajaci an . ℥ s. misce f. que pul . tenuiss . which cast upon the ulcer once or twice a day ; this dries without biting , and causeth the scales of the bones to fal , which will be within 30 or 40 dayes ; if proud flesh arise , either use this , ℞ alum . ustiʒij . Lap. ca●aminar plumb . usti , ceruss . an . ʒj . vitriol . calcinat . ʒs . misce , f. pul . tenuiss . Or rather this of Woodals , Woodals . which I have tryed , ung . Egyptiac . applyed very hot , and laying another pledget upon it , bind it up , dressing no more in 48 houres ; the next dressing use onely dry Lint , this also takes away the great sensiblenesse of the Ulcer : after cicatrize cum Emp. palmei de cerus . coct. ung . de siccat . rub . vel diapomph .

CHAP. II. The second way of Amputation . which is in the corrupt part .

THis is onely to bee performed when the Sphacelus or mortification hath taken up its limits , or else moves very slowly ( and not when it moves speedily ) here purging may be admitted , and longer preparation made for the operation , which is thus performed .

Having your instruments ready as formerly , with cauterizing irons both broad and round , with two persons to hold both parts of the member strongly and steady , then make Amputation as before , as near the sound part as you can , but not too near : after the member is taken off , then with your Incision knife take as much of the mortified flesh away as you can , and then superficially run over the dead flesh with a cautery ; as also therwith heal the end of the bone , and after make fomentations for half an hour with a good lixivium ( as described in a gangrene ) not too hot : which being done , apply woollen stuffes to the part , warm ; and so bind it up : The second dressing doe the like , cutting off the dead slough with scissers ; and forgetting not to heat the bone . Thus doe till the putrid flesh fall , then dresse it according to Art . At last in the

Fourth place , wee are come to the Symptomes : As , 1 Syncope . 2 A Convulsion . 3 Pain . 4 Hemorage . 5 Fever . 6 Frensie : all which wee have formerly handled in the Treatise of wounds , and other places , and therefore need not to be again recited . Sometimes abscesse is produced ; for which , and easing pain , ℞ medul. pan . alh . ℥ vj. rad. Altb. ℥ ij . pul . Sem. lini fenigraec . an . ℥ j. ficuum N. vjs . cum decoct . rad. Althaeae , f. Catap. adde in fine butyr . recent . axung . porcinae . rec . ℥ js. vitel . ovor . N. ij . croc . ℈ j s. apply it warme to quench thirst . ℞ aq. rosar . buglos . borag . viol . an . ℥ iiij . Syr. violar . ℥ iiij . mis. vel aq. luiul . lb ij. syr. lim . viol . an . ℥ q. ol. vitr . gut . xii . If it be needful , use nourishing glysters made of broth and yolks of egges , with saffron , mace and cinnamon .

As for the cutting of a finger or two , it 's best done by cutting mullets , which takes away the flesh and bone at once ; with these may also be taken away superfluous fingers . Thus having passed over these dangerous operations , we come to that which is of no lesse consequence : Which is the

CHAP. III. Extirpation .

OF a Cancerous tumor or Ulcer possessing any part , Extirpation . ( and therwith , if it be necessary , the part it self , as the breast ) the signes of both which , with their prognosticks are set down pag. 82. This operation is not to bee attempted where the Cancer hath taken too deep rooting ; as if it enter into the pit of the eye , so far that the root cannot be come at ; or if it have entred into the mouth , and withall possesseth the most part of the face , when it hath made its passage into the capacity of the breast , or adheres so close that it cannot be separated ; also if it bee great , and in the arm-pits , it 's not to be touched ; but if they be loose , or have not taken too deep rooting , they may bee taken away ; which is usually performed two wayes , either by Causticks , or by Incision . I shall not speak much to the first , having said something in the place forecited , onely commend unto you a French experiment , which is to be used if ulcerated , which is this , ℞ aq. fortis ℥ j. sublimat . crud . ℥ iiij . Sal. Ammoniac . ℥ ij . Arsenic . ʒj . ponatur in Alembicum et distil . ad siccitatem : add . acet . distil . iterum donee materia ad pastae consistentiam redeat . It 's thus to be applyed , first wash the Cancer with hot wine and linnen clothes , rubbing it hard ; afterward having a Plaster spread of the paste upon a six doubled cloth , not altogether so big as the Tumor , apply it , and let it there remain for 24 houres ; this causeth an eschar bigger then the medicine , which brings away the Cancer ; which is afterward to be cured S. A. Hee saith it causeth severall symptomes but such as are beneficiall , as fever , vomiting , and fluxes , if I forget not . This is worthy to bee noted , though not so properly here placed , that he cured really one , and palatively another with a medicament composed with rose , plantain , and red poppy waters , and honey of roses . But we come to Exterpation by way of Incision , which though it bee proper for ulcerated Cancers , yet more in such tumors : And this may be done either by incision first , and then Cauterized , or else done both together : Or else by Incision with application of astringents onely ; which is good , though the other may seem more rationally proper unto this account ; that the Cautery bridles more the malignity of the matter ; as also if any small portion of the Cancer remain , it may come to fall with the Eschar . Your Cautery must bee fitted to the part you exterpate . If the Cancers be small , and not ulcerated , but are loose , and may b●● freed on every side from the flesh , then Incision , as shall be declared , and astringent powders may serve ; but this is to bee observed before these operations are attempted , the body is to be prepared with Apozemes fittings , or magistrall Syrups dissolved in sutable water ; and after purge , and then sweat , and then purge again , withall opening a veine , and apply the Leeches . Your Apozeme may be this , or the like , ℞ rad. Cichor . cum toto Mj. rad. petroselin . faenicul . an . ʒij . polypod . q. ℥ s. Cortic. frangul . ℥ j. Cortic. Cappar . & Tamaris . an . ʒj s. Herb. Scolopend . veronic. betonic . fumar . Scabios . an . M s. flor. borag . bugles . rorismar . betonic . summit . thym . & majoran . an . p. 1 : Sem. anis . faenicul . an . ʒ ij . Coriand . praep . ʒj . passul . Corinth . ℥ s. decoq. in s . q. aq & 3. part . vini ad consumpt . medietatis ; hujus Apoz . ℞ ℥ ijs . in quibus insund . per noct. rhei electiʒj . Agaric . Troch . & turbith . an . ℈ ij . sol . Sen. ʒij . Sem. anisi & Cremor . Tartar . an . ℈ ij . maneant per noctem in infus . in loco tepido deindè f. express . add . Syr. de polyp . ℥ j. aquae Cinnam . ʒj . f. po● . Having pu●ged the body thus 3 or 4 dayes , take of the Apoz . alone twice aday , three houres before dinner , and so long before supper for 5 or 6 dayes , in the mean while open a veine in the left arme , and apply the Leeches ; then purge again divers times with the same Apoz . & extrac . Hel. nigr . after sweat for 14 dayes eum aur. vitae vel Sulp. aurat . diaphor . or ℞ Lign . Sassafr . ℥ ij . Guaiac . Sarsepar . an . ℥ j. Cinnam . ℥ s. projiciantur in poculum stanneum aut . terreum & affunde aq. clarae lb iiij . claudatur quam diligentissime vesica madida primo ; dende linteo ne quid . expiret . tandem f. dec●ct . per horas sex aut 8. in duplici vase , nec autem illico aperiendum est poculum sed expectandum donec per se sit frigefactum . do . ℥ iiij . twice a day ; after which purge the body again ; having thus prepared the body , make in readinesse pledgets , b●ulsters , and roulers , and needles , astringent powders as in Sphacelu● described , and Cauteries according as you intend to operate . If you are to extirpate some off , or all the part , then take hold of it , either with your left hand , or else with Forceps for that purpose , ( made round in compasse ) and presently excise it ; which being done , speedily apply your Cautery , having , as much as time and strength gives leave , pressed out the blood which lies in the swollen veines : but you had better doe it with a knife for the purpose made red hot , and so doe two works at once : after which dresse it up with medicines appeasing dolor , and cause the Eschar to fall , anointing all the part cum ol. ros. & mirtill . Now you may know the Cancer is exterpated , if after the Eschar is fallen quite , or become laudable , the paine and symptomes bee allayed , and when the flesh growes like graines of pomgranat . The other way is this , first cut the skin , and separate it from the Cancer , as also the parts to which it adheres , either with a knife , or rather if you can , with your nayls ; after which , either passing a needle and thred through it , and so holding it up , cut it out , or else following the former course , with your fingers pull it out ; for thus may you know more assuredly you have not left any remaining ; after apply your astringent powder with white of egges , vel ℞ farin . volatil . ʒs . bol. orient . Ter. sigill . an . ℈ iiij . pul . alb. ovor . exsiceat . in sol . ʒj . pilor . leporis minutiss . incisor . ℈ j. Corall . praep . ℈ ij . Misce f. pul . The next day apply a digest , then incarnate , and to seal it up , ℞ Tutiae papaver . pul . gum . maror . Alum . usti an . ℈ j. Misce . And upon this a thin plate of lead , by these operations they may bee removed from the severall parts of the body .

CHAP. VII .

AS for Cancer in the lip , you may , Cancer in the lip . passing a needle and thred through them , cut it off with either a knife or pair of scissers , afterward cure it as a Hare-lip . To conclude , that Cancers may be excised safely , is confirmed abundantly by Hildanus for the encouragement of the yong Chirurgion . I shall briefly set down an observation of my own : A poor man of Barford , neer Warwick aged nee● 80. came to me , with an ulcerated Cancer on his left leg , the in side , upon the calf ; after severall applications , and all fruitlesse , I resolved upon Extirpation ; and therefore according as his strength would bear , gave him for 3 or 4 days ℈ j. of pul . solut . in mace ale ; after which having passed through a needle and thred , I took it off , being after in weight , as I take it , above a pound , I stayed the blood with an astringent powder , and cured it ; but after it broke forth lower , and fell into the hands of a woman , who though she did what she could , the man died .

SECT. IV.

NOw wee are come to the last branch of things superfluous by event , which is blood offending either in quantity or quality ; which is done by opening a vein , leeches , or cups with scarifications . Concerning how blood offends in quantity or quality , and when , with the signes , we have set down briefly pag. . and therefore shall passe to those particular wayes by which it 's removed : And first of

Phlehotomy .

THe opening of a vein by Incision : Phlehotomy . In which consider , First , how to open a vein . Secondly , the ends why . Thirdly , the persons upon whom . Fourthly , the time when . Fifthly , how to remove accidents .

In the first , consider , that the patient be set in a light place , either so by nature , or art ; then make you ligature a little above the elbow very hard , having before rubbed his arm well with your hand ; after bid him gripe his hand hard , with his thumb in it ; then with your own hand bringing up the blood beneath to the elbow , clap your thumb hard upon the veine to be opened , and make your Incision acrosse , which is most usuall , ( though I have seen and performed length wayes ) taking heed to the Artery under the Basilica , and the nerve under the Median : after they have bled sufficiently , untie the ligature , laying upon the orifice a little dry Lint , and upon that a plaster and a boulster , and so tye it up ; many onely use the Lint and boulster , and think it the best way . Observe , if after you have made the orifice , it presently spin forth , and yet after stay again , then slacken your ligature a little till it come more freely , and bee sure his garment bee not too strait about the place where they are put up , lest that hinder . If your veines to bee opened be in the tongue or head , make your ligature in the neck . If in the hands or feet , it must bee done with hot water : Observe , if in the arm , the patient is to have a staffe in his hand , and thereon keep his hand in motion .

Secondly , the ends why , as also the time when , falls out to be the Physitians share to appoint most commonly , yet wee shall a little touch it . In generall , it 's for the evacuating of blood offending in quantity and quality , and in this sense it may be called an universall remedy or magnum remedium ; more particularly in a few things , ( for it would be endlesse to name all ) first , to lessen the abundance of blood , as in plethorick bodies when troubled with inflammations . Secondly , for diversion or revulsion . Thirdly , to draw down , as in obstructio Men. Fourthly , for alteration , as in fevers , to take out the hot , cool the rest . Fifthly , to prevent diseases imminent ; noting this , you give a glyster before bleeding , unlesse the body be open , but it 's more safe in this case to purge before ; in brief , it 's necessary in all humorall diseases , especially if putrified , excellent in those that are from blood , and in those wherein the breathing , speech , and voice is hindered , especially if done it time .

Thirdly , for the persons upon whom , with which we may joyn the quantity ; for the first there is some controversie : Some say , from 7 , yea 3 , to 80. Others from 14 , to 80. I have done it with good successe at 7. for the quantity , it 's to be according to the strength of the Patient , and greatnesse of the disease .

Fourthly , the time when . If it be only for preservation of health , then the spring , & in a morning is , fittest though in autumn it may also be performed . If it be to prevent diseases , then is the time most suitable when such diseases reign ; this is good when malignant diseases are abroad . If it be to cure , then any fit opportunity is to be taken , which may bee most usefull , any hour day or night , may be taken in the first ; it 's best to open a vein the Moon being in the second Quarter ; the 1 and 3 may be used , but the last Quarter is the worst . Here may be added what veins are commonly opened : As in the head , vena frontis , puppis , temporalis , Auricularis , ocularis , Nasalis , Labior . Ranul . and the Jugulars , much commended by Hildanus and Zacutus . Hildanus Zacutus In the arm the Cephalica , Mediana , Hepatica . In the hand the first betwixt the thumb and first finger . 2 Salvatell . 3 Hurnis brac●ii situate in the middle finger . The vein of the fundament : In the legs , paplita , saphena , seiatica , medium , this is under the bending of the foot .

Fifthly , we come to the Symptomes : as first , if after you have struck the vein , it begin suddenly to swell , apply a cloth dipt in cold water till it be down . If a nerve be hurt you must apply things that ease paine ; and when the veine is closed up , keep the Orifice open and apply such things as in the cure of punctured nerves . Sometimes there grow through some default Tumor , to which apply a Catap. of Emollient and Anodines ; these medicaments are so frequently set down , that they need not to be repeated ; if Syncop . then lay them upon their back , or rub their lips with salt .

As for opening an Artery , it may safely be done first rubbing it that it may appear the more ; and after it 's opened , and as much spirits as are sufficient extracted , you may apply Gallen-powder , vid. page 15.

CHAP. V. Cupping-glasses .

THese are to bee applyed to severall parts of the body ; Cuppinp-glasses . if it be possible , let generall evacuations precede ; if the blood bee thick , foment the part first with hot water , and rub it long with a hot cloth , then an houre or two after apply them . Cuppings must goe before scarification , though they may bee applyed either with or without . If with scarification , it 's to evacuate ; if not , to divert : they are applyed to severall parts : 1 In the neck , to divert from the head , face , eyes , and mouth . 2 In the midst of it , for shortness of breath , cough , &c. 3 Under the chin , and sides of the neck , for pain and Ulcers of the mouth , Megrome . And 4 on the shoulders for diseases of the throat . 5 Reines , for Apostumes and pains there , and in the Liver . 6 In the Arm , for pains in those parts . 7 Thighs , to procure the courses . 8 Under womens breasts to stop them . 9 To the Hypchond . to stay bleeding at the nose . And 10 to the navill , for the Cholick , they are to be applyed with flax stuck in the bottom , with soft wax , and set on fire , or having been dipt in hot water ; for scarifications , if the blood be thick , let them be deep ; then the Cups are to bee applyed again , and so both may bee reiterated according to need . After you have done , you may apply ol. rosar . cerat . ros. vel butyr . rec .

CHAP. III. Lceches .

THese are to be applyed , Leeches . where Cups cannot be set , as to Hemerods , vulva , gummes , lips , nose , fingers ; as also , they may bee used to old sores in scarific . after Gangrenes : They are to bee applyed handling them with a fine cloth , the part being made cleane with milk ; if you would have them fall off , cast upon them salt ; if you would have them suck more then they are able , cut off their tailes . You are to choose those that are in clear water , whose heads are little , bodies small , red bellyed , their backs rayed like threds of gold ; they are to bee kept 12 or 13 dayes before they can be applyed . You may keep them a whole yeare , by changing the water every 3 , 4 , or 10 dayes , adding some crummes of bread . Now to conclude , if the blood be red , it 's good ; if it appeare white , yellow , or livid , it demonstrates phlegme , choler , melancholy , and those to be purged ; if it flow out gently and cleave to your fingers , it shews obstructions , and therefore sweat ; if it be thin , and long before it thicken , in which the fibers presently vanish , it discovers crudity and weaknesse of the liver ; if there be spume or froth , it 's a sign hot predominates in the humors ; if the serous be immoderate , it manifests the infirmnesse of the Liver , and weaknesse of the Kidneys ; if fat bee in the blood , which is raw , it indicates those persons , if they bee fat , they shall grow more fat ; if they be leane , it prognosticates colliquation ; if it be of bad smell , it a signe of great putrefaction and corruption . Thus having done with things superfluous by event , we come in the next place to those that are so of their own nature . And these are of two sorts . First , those that are familiar to nature . Secondly , those altogether adverse . Under the first of those is comprehended ; First ,

PART . III. SECT. V. CHAP. I. Lupia , or Wenns , and Ganglion .

THey are round Tumors of the nervous parts and head , without pain , Lupiae , Wenns , Ganglion . yet they differ ; for the first is hard , the other is soft ; the Ganglion moving onely to the sides , but Lupia every way ; they are most commonly incompassed with a Cystis , which is the cause of their motion ; some of these are great , others little .

The causes are blows , Causes . falls from high places , and strains ; as also by humors flowing to the part : The signs are in the distinction .

If they bee great , use good diet , Cure . and purge ; if small and new , break them with your hands , ( which I have done successesully ) I mean , the Cystis , and after rub it well ; which being done , apply a plate of Lead besmeard with Mercury for 10 dayes ; it 's to bee applyed with a plaster , and so it will stick the better ; this way hath cured divers , though they could not be broken . Some advise to annoint before with this , R. Cerus . resin . pini . ol. veter . Amoniac . galb . an . ℥ j. f. unguent . Riverius in his Obser. Com. cured three with Sorrell leaves rosted under the embers , Riverius . and applyed for many dayes .

If they bee in such places where strong expressions cannot be made , yet the former meanes will serve , or this ; ℞ Gum. Amoniac . bdel . galb . an . ℥ iij. liquifiant in acet . vin. & trajiciantur per Setaceum add . ol. lilior . & laurin . an . ℥ j. aq. vitae parum , pul . irios sal . Amoniac . sulphur . viv . vitriol . Roman . an . ʒs . f. Emplast . but if they cannot be resolved , they must bee opened with a knife or cautery ; and if the latter , after the membrane is wasted by Egyptiac . vel pul . praecip . & alum . usti ; then follow the cure ex L.A. When they are very great , and cannot becured , by the foresaid meanes ; they must be taken away with handy operation , if so be they bee not situated on , or near great vessels , and cleave too close to the adjacent parts ; then take up the skin , and make incision , and with your directory drawn many times about betwixt the skin and it , divide them even to the root , ( your directory is to be thick ) then the former incision being made down to the root , make another incision overthwart , which being done , draw the skin from the Cystis , ( beginning at each corner ) to the root , with your singers covered with a fine linnen cloth , or else a rasor , if need require . And observe , though the vessels which feed it be small , yet at the bottome they are great , and will cause a flux of blood , which let bee stayed as you have heard , first binding ( if you can ) the root of the Wen with a piece of whipcord , or many threds doubled , and let the end hang forth untill it fall away of its one accord ; this is to bee remembred , so much of the superfluous skin is to bee cut off , and onely so much left remaining , as will cover the part which is to bee stitched , and with a tent kept in it till it bee perfectly cleansed ; if any of the Cystis bee left , bee sure it bee eaten away by fit medicines ; after all which let it be cured S. A. Those that are small at the roots , may be straitly tyed , and so cut off . Those near the jugular veines in the arm-pits , groins , and under the hambs , are very dangerous .

CHAP. II. Atheroma .

A Tumor in which is matter like Rice pottage , Atheroma . or curds , it 's long in figure , and with pressing it goes in slowly , and returns not suddenly ; it 's soft , without pain , yet harder then Meliceris .

Meliceris .

It 's a Tumor sost , subtle , Meliceris . and clear , it takes the impression easily , and returnes as speedily , being round in figure ; the matter in it is like hony in colour and confistence , and besides a gravelly hard matter , the hardest of the three to cure .

Steatoma .

The matter in this is like greas , Steatoma . it 's hard in pressing , goes in slowly , and returns not hastily , being large at the root ; besides , the accustomed matter is sometimes found bones , cotton , and such like .

The generall signes of all is , Signs . they come by little and little , without either pain or inflammation preceding .

The causes are strokes , falls , Causes . violent exerci●es , great eating and drinking , plenty of phlegmatick humor occasioned by ill diet . The places they possess commonly , are the hands , head , joynts , and divers parts of the face .

In which wee shall joyne them together , being no great difference ; The first is cured by incision and eating forth . The second , resolution with the former : The last by incision only . For resolution ; if it have place , use this : ℞ Labdan . bdell. galban . Amoniac . propolios , Terebinth an . part . aequal . ●●el ℞ pic. naval . ℥ j. Amoniac . sulph . an . ℥ s. mise . But they are best cured by either Incision , Cauteries , actuall o● potentiall . The Tumor being opened , and the Cystis discovered , which will appear white , you must separate the same gently from the flesh , and with your iustrument pluck it forth , with what is contained in them ; if there remain any portion of the bla●●er , eate away , as hath been taughe , but with disc●etion , for fear of inflammation ; if you open it with the Cauteries , make your orifice according to the magnitude of the Tumor , and evacuate the matter by degrees , and after cure S.A. Sometimes they are complicated with veines , nerves , and arteries , as also tendons , of which you must have a speciall care , and be more dextrous in the operation .

CHAP. III. Hydracium , Ficus & Talpa .

THe first is white pointed and waterish ; the second red , Hydrac . Ficus , & Talpa . round , hard , and painfull , and matery seed like figs ; the third is larger then both the former , and hath in it little moisture ; these have the same production with the former , yet have no Cystis .

If necessary , Cure . use generall evacuations . pils are good , to them may be outwardly applyed this , ℞ Caepar . sub cineribus coctar . vitel . ovor . ad . durit . coct. an . N. iij . axung . vel butyr . S.S. lb s. rad. althaeae ad mollitiem coctar . & minut . contus . lb j. Mis. f. Catap. and apply it before they be perfectly ripe ; open them , after which mundifie and incarne S. A. they sometimes foul the Cranium , then you are to use the method as in Lue Venerea .

CHAP. IV. Strumas , or Scrophulas .

MOst commonly possesse the throat , Strumas , or Scrophulas . being their Tumors in the glanduls , inclosed in a Cystis movable , and round also , may bee separated from the skin .

The cause is phlegme , Canse . sometimes joyned with melancholy , as also crasse and crude diet , drunking ill waters , they are sometimes few , otherwhile many .

Those which are few in number , Prognost . moveable and superficiall , may resolve or bee taken forth by incision , or if they break , by Cansticks ; those that are hard , fixed , and maligne ; as also neare the Trachea , great and complicated with veines are dangerous , it frequently possesseth the hands , feet , elbows , and other parts which I have seen and cured .

First , matter offending must bee evacuated , diet of light digestion prescribed , bleeding if necessary appointed ; for purging , use pul . Arthritic . cum ziuzib . every week , once or twice , bleeding after the first day : Others prescribe this as excellent , ℞ Turbith . gum . Hermodact . an . ℥ ij . rad. utriusque Scrophular . ℥ j. rad. Angelic . majorʒj . sol . sen. orient . ℥ j. Scam . crud . ℈ iiij . f. pul . take it in syrupe of Roses ʒij . or according to the age and strength of the patient , adde Mercur . dul . give this every other day , for 15 dayes together : For children , a purging Nectar may bee provided for 15 or 20 dayes together ; sometimes , if you see cause , intermit . This course I have found successefull : to consume the matter , aq. flor. rusci is good ; vel . rad. rusci . ʒj . iridis gr. x. cum vin. dulc. for 40 dayes . Sweating is profitable with this ; ℞ Sarsaepar . ℥ j. flor. betonic . p. 1. fol. Agrimon . & veronic. an . M s. macer . hor. 20. in aq. Font. lb iiij . deind . coq. ad consum . 3. part . in vase bene clauso dainde colatu . moderat . calid . & sacc . dulcor . give ℥ iij. hor. 6. mane . Sleep upon it if you can , or else lye still two houres and sweat : The second may bee provided for ordinary drink . These pils are good , ℞ Mas . pil. coch : ʒij . Hier. cum Agaric . ʒi . Trochis . alhand. Mirrh . verae an . ℈ s. ol. faenic . dulc. gut . j. eum syr. Staechad . q. s . f. pil. . After which this , ℞ Butterbure , so many leaves as may bee steeped in the following liquor , the powder of Woodlice a spoonfull , of the stone of a horse a spoonfull , boyle them in two quarts of old Ale , till a quart be consumed , after straine it , and put it into a bottle , and drink four spoonfulls first and last : vel ℞ Jalapae alb. flor. & fol. betonic . Sanicu . Tussilag . Artemis . quinque fol. fol. cichor . an . Mj. gly cyrrh . sem. anis . & faenicul . an . ℥ j. passul . major . lb s. Minor . ℥ iiij . coq. omnia in aq. Font. lb x. lento igne ad consumpt . ½ colat . dis . ℥ iiij . in the morning , and so much at foure a clock in the afternoon .

For externalls , Empl. devigo . cum mercur . quadrupl . vitriol . Roman gum . Ammoniac . an . ℥ ij . cum Tereb . f. Empl. The place may be fomented first with a spunge dipt in aq. Calc . viv . vel ℞ rad. Althaeae , brion . scrophular . maj. et ebuli an ℥ j. flor. Cham. Melilot . Sambuc . Ebuli an . Mj. sem. anisi , faenugr . an . ℥ s. coq. in aq. ad consumpt . 3 part . Apply it hot for half an houre , after anoint it with this ; ℞ Vng . dialthae . ℥ ij . ol. lilior . alb. pingued . gallinae , anseris , ursi , et humani an ℥ s. aq. vitae ℥ j. Misce f. Lin. Then apply Empl. ciculi , or the former , a fume of Lap. pyrit . extinct . in acet . is good ; the top of the funnell must be fitted to the part upon which you may apply this , ℞ Empl. de vig. cum Mercur. quadruplic . ℥ j. vitriol . rom . ʒj . If it break , wash it , with verjuice and butter , and dresse it with caustick medicament if there bee need ; otherwise cure it as other Ulcers S. A. If they bee in places convenient , cut them out ; if they come to suppuration , open them not till they bee throughly suppurated , unlesse the part be subject to corruption .

CHAP. V. Cataract .

IT 's the obstruction of the pupill of the eye by a hard and congealed humor , Cataract . this humor is the aqueous offending in quantity or quality ; if in quantity , it either by the increase or decrease of it , which is known by the dilatation or constriction of the pupil ; if from the quality , it is thickened and condensated , and this vulgarly is called a Cataract .

If they be of the colour of rusty iron , Cure . or white like pearles , or an ashy green like Sea water , or chesnut , they are curable ; if of the colour of chalk , black , or yellow , not . If from acute Fevers , Peripneumony , Phrensie , and pain in the head , it 's hard : if it bee new , and not confirm'd , it may be discussed , otherwhise not . If ready To Couch , shut the whole eye , and ●ub gently the lid of the ill eye ; if spred and come round again , it may bee couched , otherwise not , Gal. 1. de Sympt . causis , Cap. 2.

Is twofold : First , physicall , Cure . River , prax . Med. Tom. 2. pag. 33. saith , hee cured some in principio , yea , though fifty years aged , with universall evacuations , a sweating diet , and vesicatories , without any externall applications ; in this first purge the whole body , especially the head , is exactly to be evacuated , and the humor in the pupill discussed , if you perceive it come from the stomach , vomit , if not purge Cum pil. Catholic . vel ℞ sen. Mund. ℥ s. sem. faenic . ʒj . fol. beton . euphra . an . Ms. Liquir . ʒiij . Coq. in aq. ad ℥ iij. in Colat. dissol . diaphaenic . ʒvj . Syr. ros . ℥ j. f. pot . After which a proper Apozeme will doe well , and then purge with pils as in Opthal . for externalls , use this , ℞ aq. Euphra . Chelidon . ros. cum medic . aqua vit. vel ℞ aq. Chelidon . Maj. ℥ vj. Croc. Metal . ʒj . infund . simul . of this drop 3 or 4 drops , 3 or 4 times a day , this is excellent .

If it cannot bee dissolved , then we are to use the needle , which is done thus , turn the eye toward the nose , and thrust in the needle boldly in the middle space betwixt the lesser corner and the horny coat , just against the midst of the Cataract , bringing it from above downward beneath the Pupil , there keep it for some short time ; when it abides firmly , draw back the needle gently , after apply the white of egges , with rosewater , and a little alum ; then binde up both the eyes , and apply a restrictive on the forehead ; let his head lie high , use liquid meats ; after the former manner dressing it once aday for 12 or 15 dayes , moving the head and teeth as seldome as is possible . Let it bee done in a morning . It wil be convenient after the Patient is well , to prevent reciduvation , to use purges , and open a fontinell .

There are divers other effects , which though it be not so proper , we shall insert here , because we are treating of the eyes .

CHAP. VI. Oculi procidentiae .

THe signs are evident for cure , Oculus procidentia . after general evacuations , and particular , binde up the eye with a decoction of Sloes , which I have tryed , vel ℞ fol. cupress . ℥ s. flor. Cham. ʒij . Thur. Mastic . an . ʒj . f. Sacc . in aq. madefact . and apply it , using defensatives to the forchead ; if this will not do , it must be taken out and cured S. A.

CHAP. VII . Vnguis Oculi .

IF inveterate , Vnguis Oculi . thick , and broad , it 's difficult to take away ; that which covereth the whole Pupil is not to be touched .

After universals , Cure . if in Principio , use aq. Euphra . & Sacc . vel succ . faenic . rec . extr. & balsam . Peruvi . gut . j. admista . after oyl of Linnen . or the skins of eggs macerated in vineger , and dryed and made into powder , and used ; if these prevail not , use manuall opperation , which perform thus , keep the eye open with speeul . oculi ; then lift the naile up , with a little silver hook , taking hold of the middle , after passe a needle and thred through to hold it up , then diligently separate it , taking heed of Cornea & Adnata .

CHAP. VIII .

AS for Grando & Hordeolum Tumors upon the eye lids , Grando & hordeolum the first being round and clear , and the other not , are to bee cured either by resolution , maturation , or incision .

For Rhyas & Encanthes , Rhyas & Encanthes . the first a decrease , the second an increase of the Glandul in the great corner of the eye ; they are thus to bee handled : The first hath frequently joyned with it a continuall flux of teares ; which cure with this , ℞ aloes , Thur. an . ʒj . Sang. drac . ℥ s. ros. rub . & granat. Sumac . an . ℈ j. aq. ros . lb j. bul . ad quart . partis consumpt . f. instar Collyrii .

For the second , it 's hardly cured if great and old , it must be by incision , which is dangerous , if it cannot bee taken a●vay cum alum . vel vitriol . usto ; take heed lest in your cutting you cause a haemorrbagia or blindnesse ; for the itching of those glanduls , use this , ℞ Tutiae praep. cum aq. ros. Misce .

CHAP. IX . Hudatis .

IT 's a certain fatty substance lying under the skin of the upper eye lid ; Hudatis . it 's incident to children of humid natures .

If pressed , Signs . it leaves a pit , it cannot be lifted up , the eyes look red , and flow with teares , they cannot endure the light .

If it be new and small , Cure . it may bee cured by anointing it with fasting spittle every morning , or foment cum decect . absinth . flor. Cham. & sem. faenugr . after apply Empl. diachyl . cum Amoniac . dissol . in aceto , add . sal. Amoniac . & irios parum ; then cut it forth , and if vehemency of pain hinder not , put in salt to consume the matter , and dry and strengthen . Lastly , use alb. ov . cum aq. ros. the treadings onely , which are excellent in wounds , and all pains in the eyes .

CHAP. X.

IF things fallen into the eyes offend , either lick them forth , or with a peece of a fine spunge tyed to the end of your Probe , wipe them forth , moistening it cum aq. ros . If there be great pain , apply defensatives to the forehead , use cups , purge , let blood , vesicatories : To the eye use this , ℞ mucilag . Cydon . aq. ros. & plantag. extr. Lac. mulier . an . ℥ ij . Caphur . & croc . an . ʒj . s misce floleri . Upon the eye apply this , ℞ rad. althaeae minutiss . incis . & con●use flor. & fol. betovic . Euphrag . chamaemel . Melilot . an . M j. Sem. faenugr . con●us ℥ s. incidant . minutim , Misceque omnia & f. Sacculi intersuti . Apply it ( being boiled in milk ) warm 3 or 4 times a day : this got out iron rust that otherwise could not bee effected .

For strokes upon them , apply this , ℞ farin . fabar . fol. plantag. ros. & cum aq. f. Catapl . putting into the eye Pigeons blood , which is excellent ; upon it you may apply rotten apple , cumlac Mulier , which easeth pain admirably .

SECT. VI. CHAP. I.

THUS having put an end to things superfluous , which are familiar to nature ; wee come to the last branch ( of the third part ) which is things adverse to nature ; as , stones in any part of the body , but especially in the bladder . For stones in all other internall parts , they are not within the compasse of this operation with any safety , though some think those in the kidneys may bear it ; those that are in the externall parts are with Tumor , and therefore may be accordingly cured : Therefore wee shall here briefly handle ,

CHAP. II. Lithotomia .

HIldanus in his accurate Discourse concerning this Subject , Lithotomia . before the operation , prepares the body by purging , bleeding , baths , &c. It 's good , but yet good operators have performed their work either without , or little ; however , I shall briefly set down what is necessary . And begin with the Causes

Which are either efficient , as the preternaturall heat of the inward bowels ; or materiall , which is a grosse and slimy phlegme : It 's true , other humors with this may bee commixed , and salt and tartar may supernaturally adde to the coagulation .

There is with the urine mixed a crasse , viscid , and white humor , which standing , cleaves to the urinall ; pain in pissing , strangury , pain , and itching at the end of the prepuce ; much thirst , the Chirurgion putting his finger at the fundament , he may perceive a hardnes , but the surest way is to search with the Cathetar , being anointed cum ol. Amygd . d. in the putting of this , let the Patient be in a stooping posture , leaning against somthing with his back , with his knees a foot asunder , put it in gently , you shall know there is a stone by an obscure sound .

In which consider ; first , things to be done before : Secondly , in : Thirdly , after .

For the first , having certaine knowledg of a stone , then consider the greatnesse ; If it be very great , it cannot but procure death ; the greatnesse is known , if it hath been long in generating , if there bee a great weight , and by putting you finger in the Fundament , before you goe about the work , let th● body for certain dayes be prepared by keeping an accurate diet , using this for his drink ; ℞ Agrimon . ve ronic . an . M s. Liquir . ℥ s. incida●● & decoq. in lb iij. aq. Font. ad 3 part . Consumpt . add . Cinam . ʒvi . Sacc . ℥ js. the pot wherein it 's decocted , is to be very well stopped , Lac. Amygd . d. is excellent . Purge gently in children , cum syr. ros. vel Cichor . cum rbabarb . If they be grown up , add elect . è Succ. rosar . If of ripe yeares , some proper purge ; a magistrall syrupe for the purpose is this , ℞ rad. Cichor . Lapat . acut . polypod . an . ʒj . Liquiritʒij . Herb. seabios . agrimon . veronic. an . M s. flor. 3 cord . an . p. 1. Sem. anis . ʒij . fol. sen . ℥ iij. ecq . in aq. ut colatura redeat . ad . lb j. inqua infundant . & macerent . per noct. rbabar . ℥ s. Agar . Troch . rec . Tereb . gum . an . ʒij . deind . ebull . unam aut alteram horam exprimat fortit . & cum Syr. ros. ℥ vij . Sacc . miscellan. f. Syr. Proportion the dose according to strength , exhibit it in the decoct . of Agrimo . p. vel aq. End . After sufficient purging , if it bee necessary , let blood , ( onely if any accustomed evacuation be stopped , as Hemerod . & mensium , let them first be procured . If the stone be great , use this bath , ℞ rad. Althaeae malu . an . ℥ ij . fol. althaeae , malu . viol . paristar . flor. Cham. Melilot an . M j. Sem. anisi , Melilot , aneth . lini . faenugr . an . ℥ j. incidant . & contund . omnio grosse modo , coq. pro semicupio . This is to be used for four dayes before operation two houres after Supper , from which let him go to his bed , and having rested half an houre , let him bee anointed with this , ℞ cl. Amygd . d. Lilior . alb. Scorpior an . ℥ j. pingued . capon . anseris , an . ℥ s. ung . dialth . ʒij . Misce f. Linim . a bag of the same herbs boyled , may in stead of the bath be used , applyed to the Perinaeum , and those parts .

The Spring time is the best for the operation , and it 's more safely performed on young then old .

Secondly , for what is to be done in having in a readinesse Catheters , Probes , Conductor , Itinerarium , Specula , Pincers , small hooks of all sizes , Astringent powders , ℞ owlers , Spunges , and Cordialls . Let the Patient be placed on a firm Table , with a sheet many times doubled laid under his buttocks , and a pillow under his loynes and back , so that hee may lie half upright ; with his thighs lifted up , and his legs and heels drawn back to his hips ; then having a strong long Rowler of four fingers broad , use it thus , let it be rowled at both ends , let an Attendant hold one side of the rowler very hard in the hinder part of the Patients neck ; and then goe with the other end over the Patients left arm hole , and under the left arm towards the right hip , and over the fore-part of the thigh , whence carry it below the knee , and thence bring it again to the externall part of the thigh , and so to the sole of the foot , and thence again above the thigh ; and so under the knee , and thence again upwards towards the loynes ; then goe up with it towards the left arm hole , that so thou mayst bring it from under the left arm to the neck , where thou shalt deliver that end of the rowler to bee held by the attendant ; and taking the end which hee holds , thou shalt bring , it over the right arm-pit , first forward , and then backward under the arms towards the left thigh , that both ends of the rowler may meet crosse wayes upon the back , whence thou shalt carry it above the hip and thigh , downwards to the knee , and above the shins , thigh , and under the sole of the foot , and so again to the hip , and over the loynes to the right arm hole , after the form used on the left side , that both the ends of the rowler may bee knit together upon the neck , surely . Being thus bound , have two strong men on each side of him , two whereof may hold him by the knees and feet , and two by the arm holes and hands . After this , let the Chirurgion thrust in his Directory for that purpose , which will be a guide to him for making his incision ; let it be carryed to the left side , and let him who standeth on the Patients right hand , with his left hand lift up his Scrotum ; make your incision a fingers breadth from the fundament , on the left side the Perinaum , not exceeding the bigness of your thumb , for it 's afterward inlarged with the Dilator . If the stone be found great . If it be possible , let it be drawn out whole , if it cannot , it must bee broke : But after incision , before you take out your Directory , thrust in the Conductor upon the Directory to the very stone ; after take out the Directory , that so the yard may bee free . This done , thrust in the Hamulus by the open side of the Conductor ; the Conductor being drawn forth , then the stone to bee brought down by two of the fingers of the left hand put into the fundament , to bee caught by the Hamulus , and so drawn out , let some also crush the belly gently to further the falling of the stone to the neck of the bladder . After the great stones are drawn forth , then with your spoon cleanse the bladder of the gravell and clotted blood ; but this may be omitted , if the Patients strength will not bear it , the orifice being to bee kept open ; the same way may be extracted stones from women and children , onely in women the fingers is to be put in vulva , ( unlesse in maids ) and the Catheter may be strait . Children may be held on a mans lap . As soon as the bladder is discharged , let the ligature be unloosed , and the Patient laid in his bed , apply to the wound a Tent armed with the white of eggs , and an Astringent powder , which put to the very bladder , upon this a boulster dipt in the white of an egge , rose and plantane waters beat together . Anoint the belly , navill , loynes , and all the parts about with this , ℞ ol. ros. viol . an . ℥ ij . Amygd . d. ovor . butyr . rec . an . ℥ j. misce . and so let it bee bound up . At night let it be dressed again , if hee have not urin'd , as before , and so for three or four dayes , till danger of bleeding be past ; then use this digestive , ℞ Cer. nov. . ʒj s. gum . elem . Terebinth . clar . an . ℥ j. colophon . ℥ s. ol. amygd . d. ovor . an . ℥ j. dissolvant . igne lentiss . & per col . colat . admisicroc . pul . subtilis . ℈ ij . bujus unguent . ℞ ℥ j. vitel . ov . ol. ros. q. s . ut formam acquirat liquidam . Anoint your tent , with this , and with it , and the yolk of an egge mixed and spred upon a cloth ; and upon that ( after anointing ) a boulster as before , adding onely a little rose vineger . after a while a silver pipe is to bee used ; and follow the cure according to art .

Some symptomes here may bee annexed , but those that are common to other wounds shall not bee handled : Yet this observe , a strict diet is to be observed , and the belly kept open ; and if the body be yong and plethorick , a vein opened after the third day , which prevents most symptomes , therefore first to bee handled , Is ,

CHAP. III.

WHen the stone sticks in the ureters , this is dangerous ; for this prescribe a convenieni diet , let his drink bee that prescribed of Agrim . &c. use glysters , as ℞ rad. alth . mal . an . ℥ j. sol . alth . malu . viol . Mercur. an . M s. parietar . Mjs. flor. Cham. Melilot , Sambuc . an . M s. Sem. anisi , lini , fanicul . faenugr . an . ʒij . incidant . & contund . omnia postea f. decoc . in aq. Font. lb iiij , ad consumpt . 3 part in colat : ℥ x. dissol . butyr . rec . ol. lilior . Lumbric . an . ℥ j. vitel . ovor . N. ij . Sal. ʒij . f. Enem . use it at least once a day . Inwardly exhibit ol. Amygd d. cum . Syr. de alth . & aq. loctis Nephritic . Anointing the loynes with the oyntment prescribed page 364. after applying Cataplasmes of what you make your glyster of ; if he be subject to vomit , give him a gentle one ; as , ℞ Agaric . ℈ ij . rad. rapha . Asari . an . ʒj . flor. roris . p. 1. coq. in aq. ad . ℥ vj. add . Syr. acetos . ℥ ij . Misce . Leeches here may bee proper , yet purging saith Hildanus is not to be administred , though I have seen it , with wonderfull effect used . If rest be wanting , ℞ aq. lactuc. parietar . an . ℥ j s. Syr. de pap . ℥ j. althaeae Fer. ℥ s. confec . alker . ℈ j. Misce , & exhib . hor. somni .

CHAP. IV. Retention of the stone in the yard .

THis is similar and proper to the former matter ; if it can neither bee driven forth by the hand , nor forced back with your Catheter , or broken with a small Piercer , it 's to be cut forth , which is to be made not upon the ureter , but near it , till you come to the stone , which if it cannot be thrust forth , is to be drawn forth with an instrument with the handle ; after handle the wound according to artt , having care that proud flesh grow not inward , which to prevent , use a wax candle , or a leaden fillet anointed cum vng . diapomphol . upon the dressing outwardly apply this ; ℞ far. hord. . ℥ iiij . pul . ros. rub . balaust . an . ʒj . eoq . in s . q. aq. parieta . ad form . Catapl . add oxym s . ℥ j , vitel . ovi unius .

PART . IV.

CHAP. I. SECT. I.

HAving passed over the 3 first parts of Chirurgery , we come to the last , which is the supplying the defects of the body : And these are either of the body it self , as the restoring of the Nose , Eares , and Lips ; or of some other matter , as the Eyes , Hand , &c. artificially made ; the former of these are here never practised ( though amongst the Bononians ) they being so difficult and painfull ; and if one did consider the preparations necessary , the symptomes that fall out , the dangers that may happen by the least neglect , it would altogether bee left , considering therewithall that there may be other more easie way used . But to come to the

CHAP. II. Restoring of the Nose .

FIrst scarifie the callous edges of the Nose , Restoring the Nose . after make an incision on the arm into the muscle Biceps , as large as is requisite , into which put the nose , and binde the Patients head unto his arm for 40 dayes , which being agglutinated , cut as much out of the arm as may make the nose , fashioning it in every thing accordingly ; the Patient is onely to be fed with Panadoes and other liquid things ; the Lips and Eares are to be taken also from the same place ; the last is the most dangerous , by reason of great flux , the quantity of the flesh being more to restore the eare then any , and therefore the incision to bee more large . But to conclude , this first branch , if ever patience be requisite in any operation of Chirurgery , then much more in this , a man would be loath to be in little ease a day , much more a hundred ; if any would know more of these operations , let him peruse Gaspar Talicotius .

As for defects to be supplyed by those things which are no wayes of the nature of the body ; wee shall take them in order , and begin with the

CHAP. V. Eyes .

WHich must bee made of silver or gold , Eyes . and inamelled , fit for the cavity ; Two or three is necessary ; these are to be put in , or taken out at pleasure ; the most exquisite is thought to be made in France .

CHAP. IV. Nose .

BEing lost , Nose . may bee restored artificially , the matter of it may be gold , silver , paper , and linnen clothes glewed artificially coloured , it must be bound and stayed with little thred unto the hinder part of the head or hat , if there be any of the upper lip wanting , it may also be added .

CHAP. V. Teeth .

IF they be broken , struck out of their places , or drawn , Teeth . and so cause deformity , and hinder pronunciation ; then you may have some made of ivory , and put into the place , and fastened to the other with a silver wyer or silk .

CHAP. VI. Palat.

IT happeneth often that part of the bone of the Palat , Palat. either by gunshot , or Lues Venerea is removed , so that the Patient cannot pronounce his words distinctly , but obscurely and snuffling ; to amend this , there must bee a gold or silver plate prepared , the thicknesse of a French Crown , a little bigger then the cavity it self , in the form of a dish , in the inner part of which must a little spunge bee fastened ; this spunge is to bee put into the cavity , which with the moisture comming from the brain being wet , will cause it swell and fill the cavity ; and so keep up the Palat , as if it stood of it self .

CHAP. X. Tongue .

PArt of this may be cut off , Tongue . Pareus . and so cause dumbnesse : Pareus hath an observation of it , and how helped ; the sum of which is this : The tongue being part cut off , an instrument of wood was neatly cut , having two parts ; the upper part the thicknes of a Nine pence , the lower as thick as a six pence ; the upper part is to bee held between the cutting teeth , that it cannot come forth of the mouth , or be seen ; the lower part is to bee put hard to the rest of his tongue , close to the membranous ligament which is under it ; and thus may they speak .

CHAP. VIII . Eares .

IF it be but in part gone , Eares . then in that which remains make many holes , and with lead let them bee cicatrized ; after having the rest of the ear artificially made , is to bee fastened by those holes ; but if it be totally gone , another must be made of paper or leather , artificially , and so with laces fastned to the top or hinder part of the head on a cap ; or else by a wyer fitted from it for the hinder part of the neck .

CHAP. VI. Yard .

THose that have them cut off close to the belly , Yard . prepare a pipe made of wood or latin , let the hole which is through it bee as big as a finger , and a wide brink at top ; which when you have need apply to the Os Pectinis .

CHAP. IX . Hands .

IT sometimes happeneth by reason of some tendons and nerves being cut , Hands . the hand cannot be lifted up ; for which an instrument is to be made of a strong plate of Latin , lined in the inner side with silk , or such lik , it 's to be placed on the wrist , that it may come to the palm of the hand , or first joynt of the singers , it must bee tyed on with strings : the instrument is to come almost about the wrist ; an instrument may also be made for the thumbs or finger ; if need bee artificiall hands may also bee made , as also Leggs , the former are seldome of use , the other frequent ; some of these are made fast in the form of sound Leggs ; others small all downward from a little under the seat where the stump of the Legg is to lye ; they are to bee tyed on to the thighs with fit boulsters , and small pillows for the knee to rest upon .

Thus by Divine assistance wee have passed through the Four parts of Chirurgery : And shall now speak somthing of Encearing and Embalming ; and so concluding our Chirurgery work , enter upon an Appendix .

SECT. II. CHAP. I. Encearing and Embalming .

ALL our former Discourse hath had a living body for its subject , Encearing and Embalming . though hurt ; Here we are to deale with it having paid its last debt to nature , and having undergone its greatest incounter , is overcome by the King of terror , Death , and so lyes breathlesse ; where it 's not only a certain prognostick of our following after , but also a monitor to prepare for the like condition , for after death there is no place found for repentance ; something might bee said for laudablenesse of it both from Authors , Jewish , Christians , and Heathen : I set the Jew in the front , because as farre as is discovered , they were the first practicers of it ; but we need not mention these , having ( which is most warrantable ) Scripture instances .

For the first , there needs little to be discoursed for after the passages of the body , is well stopt up , either with hurds alone , or dipt in the composition prepared for the cear-cloth , and upon them cloaths applyed , dipt in the same , and after lapped up in 1 , 2 , or 3 cearcloths , which may be either of sheets , or new cloth made for that purpose ; if but in one , cord the body before ; but if two or three , cord it upon the first . Some before the stopping of the passages use sharp glysters of wine , vineger , or salt water , and so hang up the body with the hands , that so the excrement may issue out , and so renew the glysters .

But for Embalming , having all things in a readinesse , as fit instruments , spunges , stuffes , linnens , &c. then embowel the corps , removing all the part contained in the belly , breast , and head , letting them presently be buried , ( saving the heart , which is to be embalmed with the body : ) Unless it happen the Corps to bee embalmed bee distant from the place it s to be interred , and the friends desire they may be brought thither , then follow this course , ( which I took with the bowels of the Right Honorable Robert Lord Brooke ) I caused the Cooper to make a strong light barrell fit for to contain them , and to pitch it within very well ; which being done , I put in all the bowels , &c. into it , with bran and some salt ; then hee putting on the head , I caused him to pitch it well , after anointed the top with oyles after described , and so it kept till the time of his interring , without any offence , which was a month or six weeks time . After you have freed the venters , and dryed them cleane from all the blood with cloaths and spunges , then you may wash them Cum acet . vini , in qu. infund . absinth . rutae , colocynthid . add . alum . and good store of salt , and some Aloes : the whole body may bee washed with spunges dipt in Aqua-vitae and strong vineger ; the venter is to be filled with this or the like : ℞ Calam. Aromatic . irid . flor. Aristo . rot. Caryophyl . styrac . calam . benion . Ladan . Myrrh . Aloes , lb s. caryophyl . piper . nuc . Mosch . cinam . an . ℥ iiij . fol. Sice . Majoran , origan , calaminth . Scordii , pulegii , absinth . salu . rorismar . Lavendul . Chamaemel , an . M iiij . rosar . balaust . an . p. vj. Calc . viv . & gypsi , an . lb j . f. omnium pul . If the quantity bee not sufficient , double it , amongst you may cast in some Ol. spicae Terebinth . & Rhodium ; having filled the Cavities , sow them up close . Some make Incision in the armes , back , leggs , thighs , hipps , especially in those places where the great vessels lyes ; and having washed them well in the foresaid vineger , fill them with the powder , and sow them up ; after all which is done , then anoint the corps over Cum ol. Cham. rosar : Aneth . an . lb s. Terebinth , lb. j. Ol. Spic . ℥ iiij . Ol. Caryophyl , Thymi , an . ℥ j. Rhodii ℥ s. Misce . Upon this strow some of the powder , and then lap it up in 2 or 3 double of cear-cloth ( having first with cords and whipcord corded all the body , armes , yea fingers , if you make any incisions into them ) one after another . Upon the first cording , as this , ℞ Colophon . lb x . Resin . pini , Thur. an . lb vj . Aloes , Myrrh . Commun an . lb ij. Styrac . Mastic . an . lb s. gum . Arabic . Tragacanth . an . ℥ vj. Cerae lb iiij . ol. aneth . ros . an . lb s. Spic . ℥ iiij . Ol. Caryoph . ℥ j. & ping . ov . q. s . f. Cer. You may make a mixture with Coloph . pitch , rossin , fran . and waxe , adding what Oyles you please : dip your sheets in it , and use them ; in the mean , while you are thus employed , burn something in the Room which may cause a pleasant savor .

Having thus ended the Chirurgicall Discourse , we leave it , and and you , to the Blessing of God .