If the Burn be recent, and the Skin not exulcerated, Spirit of Wine or Brandy is to be immediately apply'd; or else an Ointment may be made with Oil of Olives, or bitter Almonds, Salt, the Juice of Onions, and Verjuice.
If the Skin be ulcerated, and little Bladders or Pustules arise, an Ointment may be compounded with the second Bark of Elder boil'd in Oil of Olives. After it hath been strain'd, add two parts of Ceruse or White-Lead, and one of Burnt Lead, with as much Litharge, stirr'd about in a Leaden-Mortar, to make a Liniment. But it is not convenient to take out the Grains of Powder that remain in the Skin, because they are apt to break, and to be more confounded or spread abroad; so that they must be left to come forth in the Suppuration.
When the Wound is superficial, and the Skin as yet whole, peel'd Onions with common Honey are an excellent Remedy; but if the Skin be torn, it is not to be us'd, by reason that the Pain wou'd be too great; in which case Oil of Tartarper diliquiumhath a very good effect.
If the Burn be accompany'd with a Fever, it may be allay'd with fixt Nitre, Nitreprepar'd with Antimony, and Gun-Powder taken inwardly, which are very effectual in their Operation. Crab's-Eyes prepar'd, and even some of 'em unprepar'd, are in like manner admirable Remedies.
As for external Medicaments, when the Burn is only superficial, take Onions and unslack'd Lime, quench'd in a Decoction of Rapes, and apply this Liquor very hot, with double Bolsters dipt therein. Or else take what quantity you please of quick Lime well wash'd, and pound it thoroughly in a Leaden-Mortar, with May-Butter without Salt, to make an Ointment, which maybelaid altogether liquid upon the affected Part: Or else,
Take as much quick Lime as you can get up between your Fingers at two several times; Milk-Cream and clarify'd Honey, of each about half the like quantity; let the whole be intermix'd to the Consistence of an Ointment, and apply'd: It is an approv'd Remedy; as also is the following;
Take unslack'd Lime, and put it into common Water, so as the Water may appear four or five Finger's breadth above it. After the Effervescence, pour in Oil of Roses; whereupon the whole Mass will be coagulated in form of Butter, and may be apply'd.
A good Lotion or Washing-Liquor may be prepar'd with the Juice of Garlick and Onions, in recent Burns; otherwise make use of this Ointment. Take an Ounce and an half of raw Onions, Salt, andVeniceSoap, of each half an Ounce; mingle the whole Composition in a Mortar, pouring upon it a sufficientquantity of Oil of Roses, to make a very good Ointment: Or else,
DissolveMiniumor Litharge in Vinegar, filtrate this Liquor, and add thereto a quantity of Rape-Oil newly drawn off, sufficient to give it the Consistence of a liquid Liniment; then stir it about in a Leaden-Mortar till it become of a grey Colour, and keep it for Use as an excellent Liniment: Or else,
Pound Crey-Fishes or Crabs alive in a Mortar to get their Blood, and foment the Part with it hot; it is a good Remedy: Otherwise intermix the pounded Crabs with May-Butter without Salt, and let 'em be boil'd up together, and scumm'd, till a red Ointment be made, which may be drawn off, or strain'd for Use. And indeed, all manner of Ointments, and other Medicinal Compositions wherein Crabs are an Ingredient, are true specificks against Burns made by Gun-Powder.
The Mucilages of the Seeds ofPsyllium, or rather those of Quince-Seeds prepar'd with Frog's Sperm, and a littleSaccharum Saturni, spread with a Feather upon the affected Part, have a wonderful Operation in Burns.
A Medicament compounded with one third part of the Oil of Olives, and two of the Whites of Eggs well beaten and mixt together, is a very simple and singular Remedy. Otherwise take half an Ounce of Line-seed-Oil infus'd in Rose-Water, with four Yolks of Eggs; beat 'em together, and let the whole be apply'd to the burnt Part.
If the Burn be very violent, and hath many Pustules,Etmullerusis of Opinion that theyought to be open'd, and that an Ointment shou'd be apply'd, which is made of Hen's-Dung boil'd in fresh Butter: Otherwise,
Take a handful of fresh Sage-Leaves, two handfuls of Plantane, six Ounces of fresh Butter without Salt, three Ounces of Pullet's-Dung newly voided, and the whitest that can be found; then fry the whole Composition for a quarter of an Hour; squeeze it out, and keep it for use: Otherwise,
Take two Ounces of sweet Apples roasted under Embers, Barly-Meal, and Fenugreek, of each half an Ounce, and half a Scruple of Saffron; let the whole Mass be mingled to make a Liniment or soft Cataplasm, which may serve to asswage Pain, and mollifie the Skin.
If the Wound be yet larger, and hath a Scab, open all the Pustules, and endeavour the two first Days to cause the Escar to fall off by the Application of a Liniment made of the Mucilages of Quince-Seeds steept in Frog's-Sperm, with fresh Butter, the Oil of White Lillies, and the Yolk of an Egg: Otherwise,
Make a Liniment with fresh Butter well beaten in a Leaden-Mortar, with a Decoction of Mallows, which being spread upon hot Colewort-Leaves, and apply'd to the Escar, it will fall off.
But if the Escar be too hard and obstinate, it is requisite to proceed to Incisions to make way for theSanies, lest a deep and putrid Ulcer shou'd be engender'd Underneath. As soon as the Humour is evacuated, the above-mention'dEmollient Medicines may be us'd, till the separation of the Escar; then the Ulcer may be consolidated with Digestives and Mundificatives; such as the Ointment of quick Lime with Oil of Roses, and the Yolks of Eggs. The white camphirated Ointments, and that of Alabaster, are also good for the same Purpose.
If a Gangrene ensueth, Sudorificks must be taken inwardly; such are camphirated Spirit of Treacle, the Essence and Spirit of Elder-Berries, the Spirit of Hart's-Horn with its own proper Salt, Treacle impregnated with the Spirit of camphirated Wine, Scorpion-Water, Hart's-Horn, Citron with Camphire, &c.
As for external Remedies in the beginning of the Gangrene, the Spirit of Wine apply'd hot is excellent; and yet better if Aloes, Frankincense, and Myrrh be intermixt therein. It ought also to be observ'd, that Camphire must always be mingled in the topical Medicines for the Cure of the Gangrene.
A Decoction of unslack'd lime, in which Brimstone hath been boil'd, withMercurius Dulcis, and the Spirit of Wine, is a very efficacious Remedy.
In a considerable Gangrene, after having made deep Scarifications, let Horse-Dung be boil'd in Wine, and laid upon the Part in form of a Cataplasm. This is an approved Remedy.
If aSphacelusbe begun, scarifie the Part, and apply thereto abundance ofUnguentum Ægyptiacumover and above the Ointments and Cataplasms already describ'd; remembringalways, that when the Gangrene degenerates into aSphacelus, all the mortify'd Parts must be incontinently separated or cut off from the sound.
What is an Ulcer?
An Ulcer is a Rupture of the Natural Union of the Parts made a long while ago, which is maintain'd by theSaniesthat runs out of its Cavity; or an Ulcer takes its Rise from a Wound that cou'd not be well cur'd in its proper time, by reason of the ill quality of itsPusor corrupt Matter.
What difference is there between a Wound and an Ulcer?
It is this, that a Wound always proceeds from an external Cause, and an Ulcer from an internal, such as Humours that fall upon a Part; or else a Wound in growing inveterate degenerates into an Ulcer.
Whence is the difference of Ulcers deriv'd?
It is taken from the Causes that produce 'em, and the Symptoms or Accidents with which they are accompany'd. Thus upon Account of their Causes they are call'd Benign or Malignant, Great, Little, Dangerous, or Mortal; and by reason of their Accidents, they are term'd Putrid, Corrosive, Cavernous, Fistulous, Cancerous,&c.
Do Ulcers always proceed from external Causes, or from an outward Wound degenerated?
No they sometimes also derive their Origine from internal Causes, as the Acrimony of Humours, or their Malignant Quality; the Retention of a Splint of a Bone, and other things of the like Nature. These Ulcers are commonly call'd Primitive, and the others Degenerate.
What are Putrid, Corrosive, Cavernous, Fistulous and Cancerous Ulcers?
The Putrid Ulcer is that wherein the Flesh is soft and scabby, thePusandIchorbeing viscous, stinking, and of a cadaverous smell.
The Corrosive Ulcer is that which by the Acrimony and Malignity of itsSanies, corrodes, makes hollow, corrupts and mortifies the Flesh.
The Cavernous Ulcer is that the Entrance of which is streight and the bottom broad wherein there are many Holes fill'd with malignantSanies, without any callosity or hardness in its sides.
The Fistulous Ulcer is that which hath long, streight, and deep Holes, with much hardness in its sides; theSanieswhereof is sometimes virulent, and sometimes not.
The Cancerous Ulcer is large, having its Lips bloated, hard, and knotty, of a brown Colour, with thick Veins round about, full of a livid and blackish sort of Blood. In the bottom are divers round Cavities, which stink extremely, by reason of the ill Quality of theSaniesthat runs out from thence.
Are there no other kinds of Ulcers?
Yes, there are also Verminous,Chironian,Telephian, Pocky, Scorbutick, and others, which have much affinity with, and may well be reckon'd among the five Kinds already specify'd.
What are the means to be us'd in the curing of Ulcers?
Ulcers ought to be well mundify'd, dry'd and cicatriz'd; but with respect to the several Causes and Accidents that render 'em obstinate, and difficult to be cur'd, it is also requisite to make use of internal Medicines, which may restrain and consume 'em. If their sides grow callous, they are to be scarify'd, in order to bring 'em to Suppuration; and if there be any Excrescences, they must be eaten away with corroding Powders, such as that of Allom; or by the Infernal Cautery.
What are the Remedies proper to cleanse and dry up Ulcers?
To this Purpose divers sorts of Liquors may be us'd, as also Powders and Plaisters: The Liquors are usually made of Briony-Roots, the greater Celandine, Lime, and Yellow Water; a Tincture of Myrrh, Aloes and Saffron, and Whey, whereto is addedSaccharum Saturni; so that the Ulcers may be wash'd or bath'd with these Liquors; and very good Injections may be compounded of 'em.
The Powders are those of Worm-eaten-Oak, Allom, and Cinoper, the last of these being us'd by burning it, to cause the Fume to be convey'd to the Ulcer thro' a Funnel. The Country People often make use of Potter's-Earth to dry up their Ulcers, with goodSuccess; but then they must must be of a Malignant Nature.
The Plaisters areEmplastrum de Betonica,Diasulphuris,Dessiccativum Rubrum, and others; and the Ointments are such as these;
Take three Yolks of Egg, half an Ounce of Honey, and a Glass of Wine, and make thereof a mundifying Ointment, according to Art: Otherwise,
Take Lime well wash'd and dry'd several times, let it be mingled with the Oil of Line andBolus, and it will make an excellent Ointment to mundifie and dry; a littleMercury Precipitatemay be intermixt (if you please) to augment the drying Quality; andMercurius Dulcismay be added in the Injections.
For Ulcers in the Legs, and Cancerous Ulcers, take Plantain-Water and Allom-Water, or else Spirit of Wine,Unguentum Ægyptiacum, and Treacle; or else an Extract of the Roots of round Birth-Wort made in the Spirit of Wine. Gun-Powder alone dissolv'd in Wine, is of singular Use to wash the Ulcers, and afterwards to wet the Pledgers which are to be apply'd to 'em. But here are two particular and specifick Medicines to mollifie a Cancer.
TakeSaccharum Saturni, Camphire, and Soot; let 'em be incorporated with the Juice of House-Leek and Plantain, in a Leaden-Mortar; then make a Liniment thereof, and cover the Part affected as lightly as is possible to be done, as with a simple Canvass-Cloth, or a Sheet of Cap-Paper: Or else,
Take the destill'd Water of rotten Apples, and mingle it with the Extract of the Roots of round Birth-Wort made in Spirit of Wine; reserving this Liquor to wash the Part, and to make Injections.
The Signs of this Disease are a painful Distention of thePenisor Yard, and a scalding Pain in making Water, the Urine being pale, whitish, and full of Filaments or little Threads: Sometimes the Testicles are swell'd as well as theGlansandPræputium; and sometimes there is a Flux of a kind of Matter yellowish, Greenish,&c.
If there be a great Inflammation in the Yard, endeavours must be us'd to allay it by letting Blood; and afterward the Patient may take a cooling and diuretick Diet-Drink, as also Emulsions made with cold Seeds in Whey. A very good Decoction may be prepar'd in all places, and without any trouble, by putting a Dram ofSal Prunellainto every Quart of Water, whereof the Patient is to drink as often as he can: This Decoction is very cooling and diuretick; and the use of it ought to be continu'd till the Inflammation be asswag'd. Then some gentlePurges are to be prescrib'd in the beginning; such as an Ounce ofCassia, and as muchManna, infus'd in two Glasses of Whey, which are to be taken one or two Hours one after another.
Afterward the Patient must be often purg'd with twelve Grains of Scammony, and fifteen Grains ofMercurius Dulcis; and these Purgations must be continu'd, till it appears that the Fluxes are neither yellowish nor greenish, nor of any other bad Colour. When they are become White, and grown Thready, they may be stopt with Astringents: Amber and dry'd Bones beaten to Powder, eighteen Grains of each, with one Grain ofLaudanum, the Composition being taken in Conserve of Roses, are very good for this Purpose.Crocus Martis Astringens, or else its Extract, taken from half a Dram to a whole Dram, in like manner performs the same Operation. As soon as theGonorrhæais stopt, to be certain of a perfect Cure, a Dram of theMercurial Panacæais to be taken, from fifteen to twenty Grains at a time, in Conserve of Roses. In the mean while, if a small Salivation shou'd happen, it must be let alone for the present, since it may be stopt at pleasure by the Purgations. When it is requisite to restrain theGonorrhæa,Mercurymust not be given any longer, in regard that it is a Dissolvent, which is only good when the Glandules of the Groin or Testicles are swell'd, or else when it is expedient to set theChaude-pissea running, after it hath been too suddenly stopt. At the same time that the Astringents are taken with the Mouth,Injections also are to be made into the Yard; such as are prepar'd withLapis Medicamentosus, of which one Dram is put into eight Ounces of Plantane-Water. All Astringents that are not Causticks, are proper for the Syringe.
They are round Ulcers, and hollow in the middle, which appear upon theGlansand thePræputium. To cure 'em, they must be touch'd with theLapis Infernalis, and brought to Suppuration by the means of red Precipitate mixt with the Ointment ofAndreas Crucius.Oleum Mercuriilaid on a Pledget or Bolster, is very efficacious to open Skankers, and consume their Flesh. The Patient must be well purg'd withMercurius Dulcisand Scammony, taking twelve or fifteen Grains of each in Conserve of Roses; and after these Purgations are sufficiently reiterated, he may take theMercurial Panacæa's. It is an excellent Remedy for all sorts of Pocky Distempers not yet consummated, or arriv'd at the greatest height of Malignity.
Bubo'sare gross Tumours or Abcesses that arise in the Groin, the perfect Maturity of which is not to be waited for in order to open 'em; because it is to be fear'd lest the corrupt Matter remaining therein too long, might be convey'd into the Blood by the Circulation, and so produce the grand Pox: Therefore it isnecessary to open 'em betimes with a Lancet, or else with a Train of potential Cauteries, if they are too hard. They ought to be Suppurated for a considerable time: The Patient must be well purg'd with Scammony andMercurius Dulcis: He must also take theMercurial Panacæa's.
This loathsome Disease begins sometimes with a virulentGonorrhæa, and a weariness or faintness at the same time seizeth on all the Members of the Body: It is usually accompany'd with Salivation and the Head-ach, which grows more violent at Night: Pricking Pains are also felt in the Arms and Legs, the Palate of the Mouth being sometimes ulcerated. If it be an inveterate Pox, the Bones are corrupted, andExostoseshappen therein; divers Spots with dry, round and red Pustules appear in the Skin; and the Cartilages or Gristles of the Nose are sometimes eaten up. But when this Disease is come to its greatest height of Malignity, the Hair falls off; the Gums are ulcerated; the Teeth are loose, and drop out; the whole Body is dry'd up; the Eyes are livid; the Ears tingle; the Nose become stinking; the Almonds of the Ears swell; theUvulaor Palate is down; Ulcers break out in the Privy-Parts; Bubo's arise in the Groin; as also Warts in theGlansandPræputium; andCondyloma'sin theAnus.
Indeed the Pox may be easily cur'd in the beginning; but when it hath taken deep Rootby a long Continuance, it is not extirpated without much difficulty, more especially if it be accompany'd with Ulcers,Caries, andExostoses; the Person afflicted with it being of an ill Constitution, and his Voice grown hoarse.
The Spring and Summer are the proper Seasons of the Year for undertaking the Cure of this Disease: In order to which, it is necessary that the Patient begin with a regular Diet, lodging in a warm place, and taking such Aliments as yield a good Juice; as Jelly-broath made with boil'd Fowl: Let him drink Sudorifick Decoctions, prepar'd with the Wood ofGuayacum,China-Root, andSarsaparella, and let him abstain from eating any thing that is high season'd: Let him take Clysters to keep his Body open; sometimes also he may be let Blood, and purg'd with half a Dram of Jalap, and fifteen Grains ofMercurius Dulcis. The Purgations may be re-iterated as often as it shall be judg'd convenient; and then the Patient may be bath'd for nine or ten Days, every Morning and Evening; during which time he may take volatile Salt of Vipers, the Dose being from six to sixteen Grains; or else Viper's-Grease from half a Dram to a whole Dram in Conserve of Roses.
Afterward it will be necessary to proceed to Fluxing, which is caus'd by the means of Frictions withVuguentum Mercurii, which is made of crudeMercurystirr'd about in a Mortar with Turpentine, and then the whole mingled with Hog's-Grease, one part ofMercurybeing usually put into two parts of Hog's-Grease. The Rubbing is begun at the Sole of the Feet,by a long Continuance, it is not extirpated without ascending to the Legs, and the inside of the Thighs; but the Back-Bone must not be rubb'd at all; When the Persons are tender, or of a weak Constitution, a single Friction may be sometimes sufficient. Thus the Patient must be rubb'd at the Fire, after he hath taken a good Mess of Broath; but I would not advise it to be done with more than one or two Drams ofMercuryat a time, without reckoning the Grease. Then the Patient must be dress'd with a Pair of Linnen-Drawers or Pantaloons, and laid in his Bed, where his Mouth may be lookt into from time to time, to see whether theMercuryhath taken effect; which may be easily known, by reason that his Tongue, Gums, and Palate swell and grow thick, his Head akes, his Breath is strong, his Face red, and he can scarce swallow his Spittle; or else he begins to Salivate.
If none of these Signs appear, the Rubbing must be begun again in the Morning and Evening; then if no Salivation be perceiv'd, for sometimes four or five Frictions are made successively, a littleMercurial Panacæamay be taken inwardly, to promote it. During the Frictions, the Patient is to be nourish'd with Eggs, Broaths, and Gellies; he must also keep his Bed in a warm Room, and never rise till it shall be thought fit to stop the Salivation, which continues twenty or twenty five Days; or rather till it becomes Laudable; that is to say, till it be no longer stinking, nor colour'd, but clear and fluid.
If a Looseness shou'd happen during the Salivation, it wou'd cease, so that to renew it,the Looseness may be stay'd with Clysters made of Milk and the Yolks of Eggs; and in case the Salivation shou'd not begin afresh, it must be excited with a slight Friction: But if it shoul'd be too violent, it may be diminish'd by some gentle Purge, or with four or five Grains ofAurum Fulminans, taken in Conserve of Roses.
Three or four Pints of Rheum are commonly salivated every Day in a Bason made for that purpose, which the Patient holds in his Bed near his Mouth, so as the Spittle may run into it. But if the Fluxing shou'd not cease of it self at the time when it ought, he must be purg'd to put a stop thereto. If any Ulcers remain in his Mouth, to dry 'em up, Gargarisms are to be often us'd, which are made of Barley-Water, Honey of Roses, or luke-warm Wine.
The Warts are cur'd by binding 'em, if a Ligature be possible, or else they may be consum'd with Causticks, such as the Powder of Savine, orAqua-fortis, by corroding the neighbouring Parts; sometimes they are cut, left to bleed for a while, and bath'd with warm Wine.
When the Patient begins to rise, he must be purg'd, his Linnen, Bed, and Chamber being chang'd; and afterward his Strength is to be recruited with good Victuals, and generous Wine. If he were too much weaken'd, let him take Cow's-Milk withSaccharum Rosatum.
If the Pox were not inveterate, the Fluxing might be excited by thePanacæaalone, without any Frictions: For after the Phlebotomy,Purgations, and Bathings duly administer'd; the Patient might take ten Grains of theMercurial Panacæain the Morning, and as many at Night; on the next Day fifteen Grains might be given, and the like quantity at Night; on the third Day twenty Grains might be given both Morning and Evening; on the fourth Day twenty five Grains in the Morning, and as many at Night; and on the fifth Day thirty Grains in the Morning, and the very same quantity in the Evening; continuing thus to augment the Dose, till the Fluxing comes in abundance; and it may be maintain'd by giving every two or every three Days twelve Grains of thePanacæa. This Course must be continually follow'd till the Salivation becomes Laudable, and the Symptoms cease.
To prepare thisPanacæa, it is requisite to takeMercuryreviv'd fromCinnabar, because it is more pure thanMercurywhich is immediately dug out of the Mine. TheMercuryis reviv'd withCinnabar, after this manner: Take a Pound of artificialCinnabarpulveriz'd, and mingled exactly with three Pounds of unslack'd Lime, in like manner beaten to Powder: Let this Mixture be put into a Retort of Stone, or Glass luted, the third part of which at least remains empty; Let it be plac'd in a reverberating Furnace; and after having fitted a Recipient fill'd with Water, let the whole be left during twenty four Hours at least; then let the Fire beput under it by degrees, and at length let the Heat be very much augmented, whereupon theMercurywill run Drop by Drop into the Recipient: Let the Fire be continu'd till nothing comes forth, and the Operation will be perform'd generally in six or seven Hours: Then pour the Water out of the Recipient, and having wash'd theMercury, to cleanse it from some small quantity of Earth that may stick thereto, let it be dry'd with Cloaths, or else with the Crum of Bread: Thus thirteen Ounces ofMercurymay be drawn off from every Pound of artificial Cinnabar.
ThePanacæais made of sweet Sublimate, and the later of corrosive Sublimate: To make the corrosive Sublimate, put sixteen Ounces ofMercuryreviv'd from Cinnabar, into a Matrass, pour upon it eighteen Ounces of Spirit of Nitre; place the Matras upon the Sand, which must be somewhat hot, and leave it there till the Dissolution be effected: Then pour off this dissolved Liquor, which will be as clear as Water, into a Glass Vial, or into a Stone-Jug, and let its Moisture evaporate gently over the Sand-Fire, till a white Mass remains; which you may pulverize in a Glass Mortar, mingling it with sixteen Ounces of Vitriol calcin'd, and as much decrepited Salt: Put this Mixture into a Matras, two third parts of which remain empty, and the Neck of which hath been cut in the middle of its height; then fix the Matras in the Sand, and begin to kindle a gentle Fire underneath, which may be continu'd for three Hours; afterwards let Coals be thrown upon it till the Fire burn very vehemently, and a Sublimatewill arise on the top of the Matras; so that the Operation may be perform'd within the space of six or seven Hours. Let the Matras be cool'd, and afterward broken; avoiding a kind of Flower or light Powder, which flyes up into the Air as soon as this Matter is remov'd; whereupon you'll find nineteen Ounces of very good corrosive Sublimate; but the redScoriaor Dross which settleth at the bottom must be cast away as unprofitable. This Sublimate being a powerfulEscarotick, eats away proud Flesh, and is of singular use in cleansing old Ulcers. If half a Dram thereof be dissolv'd in a Pint of Lime-Water, it gives a yellow Tincture; and this is that which is call'd thePhagedonick-Water.
The sweet Sublimate, of which thePanacæais immediately compos'd, is made with sixteen Ounces of corrosive Sublimate, pulveriz'd in a Marble or Glass-Mortar, intermixing with it by little and little, twelve Ounces ofMercuryreviv'd from Cinnabar: Let this Mixture be stirr'd about with a Wooden Pestle, till the Quick-silver become imperceptible; then put the Powder, which will be of a grey Colour, into divers Glass-Vials, or into a Matras, of which two third parts remain empty; place your Vessel on the Sand, and kindle a small Fire in the beginning, the Heat of which may be afterward encreas'd to the third Degree: Let it continue in this Condition till the Sublimate be made; and the Operation will be generally consummatedin four or five Hours: whereupon you may break your Vial, and throw away as useless, a little light Earth that lies at the bottom. You must also separate that which sticks to the Neck of the Vials, or of the Matras, and keep it for Ointments against the Itch; but carefully gather together the white Matter which lies in the middle, and having pulveriz'd it, cause it to be sublimated in the Vials or Matras, as before. This Matter must also be separated again (as we have already shown) and put into other Vials to be sublimated a third time. Lastly, the terrestrial parts in the bottom, and the fuliginous in the Neck of the Vials, must be, in like manner, separated, still preserving the Sublimate in the middle, which will then be very well dulcify'd, and amount to the quantity of twenty five Ounces and an half: It is an Efficacious Remedy for all sorts of Venereal Diseases; removes Obstructions, kills Worms, and purgeth gently by stool, being taken in Pills from six Grains to thirty.
Take what quantity you please of sweet Sublimate, reduce it to Powder in a Marble or Glass-Mortar, and put it into a Matras, three quarters whereof remain empty, and of which you have cut off the Neck inthe middle of its Height: Then place this Matras in a Furnace orBalneumof Sand, and make a little Fire underneath for an Hour, to give a gentle Heat to the Matter, which may be augmented by little and little to the third degree: Let it continue in this state about five Hours, and the Matter will be sublimated within that space of time. Then let the Vessel cool, and break it, throwing away as unprofitable a little light sort of Earth, of a reddish Colour, which is found at the bottom, and separating all the Sublimate from the Glass. Afterward pulverize it a second time, and let it be sublimated in a Matras, as before: Thus the Sublimations must be reiterated seven several times, changing the Matrasses every time, and casting away the light Earth. Then having reduc'd your Sublimate to a very fine impalpable Powder, by grinding it upon a Porphyry or Marble Stone, put it into a Glass Cucurbite or Gourd, pour into it alkaliz'd Spirit of Wine to the height of four Fingers; cover the Cucurbite with its Head, and leave the Matter in Infusion during fifteen Days, stirring it about from time to time with an IvorySpatula. Afterward set your Cucurbite inBalneo Mariæ, or in a Vaporous Bath, make fit a Recipient to the Mouth of the Alembick; lute the Joints exactly with a moistened Bladder, and cause all the Spirit of Wine to be destill'd with a moderate Fire: Let the Vessels be cool'd, and unluted, and thePanacæawill appear at the bottom of the Cucurbite. If it be notalready dry enough, you may dry it up with a gentle Fire in the Sand, stirring it with an Ivory or WoodenSpatulain the Cucurbite it self till it be reduc'd to Powder. It may be kept for use in a Glass-Vessel, as a Remedy of very great Efficacy for all sorts ofVenerealDiseases, as also for Obstructions, the Scurvy,Scrophulaor Kings-Evil, Tettar, Scab, Scurf, Worms,Ascarides,inveterate Ulcers,&c.The Dose is from six Grains to two Scruples, in Conserve of Roses.
What are the Diseases incident to the Bones?
They are five in number,viz.Dislocation, Fracture,Cariesor Ulcer,Exostosis, andNodus.
What is a Dislocation or Luxation?
It is the starting of the Head of one Bone out of the Cavity of another, with anInterdiction of the proper Motion of the Part: Or else it is the disjointing of two Bones united together for the Motion of a Part.
How many causes are there of Dislocation in general?
Two, that is to say, one violent, and the other gentle; thus the Dislocation is made violently in Falls, Strains, Knocks, and Blows; but it is done gently and slowly in Defluctions of Rheum; as also by an insensible gathering together of Humours between the Joints, and upon the Ligaments, the Relaxation or loosening of which gives occasion afterward to the Head of the Bone to go out of its place; whence this Consequence may well be drawn,viz.that a violent Dislocation usually depends upon an external Cause, and a gentle Dislocation upon an internal.
After how many manners doth a Dislocation happen?
Two several Ways;viz.the first is called compleat, total, and perfect; and the second incompleat, partial, and imperfect: But both may happen before, behind, on the inside, and without; and may also be simple or complicated.
What are the signs of a perfect, total, and compleat Dislocation?
It is when a hard Tumour or Swelling is perceiv'd near a Hole in the place of the Joint, great pain being felt in the Part, and the Motion of it abolish'd.
What are the signs of an imperfect, partial, and incompleat Dislocation?
It is when the Motion is streighten'd, and weaker than ordinary, so that some Pain is felt in the Joynt, and a Deformity may be discern'd therein, by comparing the hurt Part with the opposite which is found: This Dislocation is otherwise call'd a Sprain, when it proceeds from an external Cause; or else it is termed a Relaxation, when it happens by an internal.
What is a simple, and what is a complicated Dislocation or Luxation?
The Dislocation is properly simple, when it hath no concomitant Accidents; and it is complicated when accompany'd with some ill Symptoms or Accidents, such as Swellings, Inflammations, Wounds, Fractures, &c.
What are the means proper to be us'd in a simple Dislocation?
A speedy and simple reducing thereof, which is perform'd by stretching out the dislocated or luxated Member, and thrusting back the Head of the Bone into its natural place. Afterward the Joynt must be strengthen'd with a Fomentation made with Provence Roses, the Leaves of Wormwood, Rosemary, Camomile, St.John's-Wort, and Oak-Moss boil'd in the Lees of Wine and Forge-Water, keeping the Part well bound up, and sustain'd in a convenient situation. But if any ill Consequence is to be fear'd, applyEmplastrum Oxycroceum, orDiapalmadissolv'd in Wine.
What is to be done in a complicated Dislocation?
The Accidents must be first remov'd, and then the Bone may be set, which is impossible to be done otherwise; it being dangerous even to make an Attempt before, by reason of the too great Violence with which it is effected, and which would infallibly produce a Convulsion or a Gangrene.
If the Dislocation be accompany'd with a Wound, must the Wound be cur'd before any Endeavours are us'd to reduce it?
No, but the Symptoms of the Wound, which hinder the Operation, must be taken away, as the Swelling, Inflammation, and others of the like Nature; and then it may be reduc'd, and the Wound may be dress'd according to the usual Method.
If the Dislocation be complicated with the Fracture, what is to be done then?
It is necessary to begin with reducing of the Dislocation, and afterward to perform that of the Fracture, by reason of the Extension which must be made to reduce the Dislocation, which would absolutely hinder the Setling of the Fracture.
How is the Inflammation and Swelling to be asswag'd?
With Linnen Cloaths dipt in Brandy and common Water, which must be often renew'd; or else with the Tops of Wormwood and Camomile, with Sage and Rosemary boil'd in the Lees of Wine, wherein the Bolsters and Bands are to be steep'd. But all Repercussives and Astringents must be avoided.
How doth it appear that the Reduction is well perform'd?
By the Re-establishment of the Part in its natural State; by its being free from Pain; by its regular Motion; and by its conformity to the opposite Part which is found.
What Dislocations of Parts are most difficult to be reduc'd?
They are those of the Thighs with the Huckle-Bones, which are almost never perfectly set; that of the firstVertebra'sis extremely difficult to be reduc'd; and those of the Lower-Jaw and Soles of the Feet are mortal.
The reducing of Dislocations is perform'd with greater facility in Infants than in Persons advanc'd in Years; but it becomes most difficult when it is deferr'd for many Days, by reason of the overflowing of theLymphaand nutritious Juice.
If an Inflammation shou'd happen before the Member is reduc'd, nothing can be done till it be allay'd, as we have already intimated; but to prevent and mitigate it, the dislocated Joynt, and the neighbouring Parts, may be bath'd with luke-warm Wine, in which hath been boil'd the Tops of St.John's-Wort, Camomile, Rosemary,Stœcas Arabica, and other Ingredients of the like Nature; the Bands must be also steept in the same Liquor.
If anOedematousTumour arise in the luxated Member after the Joint hath been set, it is requisite to take internal Sudorificks, and to apply Liniments made with the destill'd Oil of Tartar, and of Human Bones, which may be rectify'd with burnt Hart's Horn, or some other part of Animals, to take away its stink: Or else take yellow-Wax, and very white Rosin,melt the whole Mass, and put into it white Amber and GumElemi, a sufficient quantity of each to make a Composition to be incorporated with Balsam ofPeru; a Plaister of which may be prepar'd, and apply'd to the dislocated Member; but the Plaister must not be laid a cross, lest it shou'd contract the Part too much. The whole Member may be also anointed with Oil of St.John's-Wort, or with the destill'd Oil of Turpentine; or rather with a simple Decoction of Nervous Plants in Wine.
If the Bone be put out of its place by a coagulated sort of Matter like Mortar or Plaister, Resolutives and Attenuants are to be us'd, such as the volatile Spirit of Tartar prepar'd with the Lees of Wine, volatile Spirit of Tartar destill'd with Nitre in a Retort with a long Neck, or Spirit of Tartar prepar'd by Fermentation with Tartar, and its properAlkali: This last is the best of all, and the use thereof ought to be continu'd. The volatile Salt of Human Bones is also very efficacious; but it is necessary to begin first with the taking of Laxative and Sudorifick Medicines, appropriated according to the respective Circumstances. The Spirit of Earth-Worms may be also apply'd outwardly, which is made by Fermentation, and may be often laid on the Part either alone, or with the Spirit ofSal Ammoniack.
If a dislocated Bone be not set in good time, aCoagulumor kind of curdled Substance is form'd in the Cavity, which hinders the reducing of it to its place; but thisCoagulummay be dissolv'd with the following Medicament, before you attempt to set the Bone. Take onepart of the destill'd Oil of Human Bones, two parts of fœtid Oil of Tartar; mingle the whole, and add quick Lime to be destill'd in a Retort: Let the Parts be fomented with this Oil.
If the Dislocation happen'd by the Relaxation of the Ligaments, recourse may be had to universal Sudorificks taken inwardly; as also to such Medicines as are full of an unctuous and volatile Salt, particularly Aromatick Oils, and Spirit ofSal Ammoniack. In the mean while Aromaticks, Resolutives, and moderate Astringents may be apply'd outwardly.
What is the Fracture of a Bone?
It is the Division of the Continuity of its Parts.
After how many different manners may a Bone be broken?
Three several ways,viz.cross-wise, side-wise, in its length, and perhaps in Shatters or Splinters.
By what means may a Bone be fractured?
It may happen to be done by three sorts of Instruments,viz.such as are fit for bruising, cutting, or wresting; that is to say, a Bone may be divided in the Continuity of its proper Parts, by Contusion, Incision, or Contorsion.
How is the Fracture of a Bone discover'd?
Divers ways,viz.by the ill Disposition of the Part, which becomes shorter; by its want of Motion; by its flexibility or pliantness elsewhere than in its Articulations; by the unevenness that may be perceiv'd in its Continuity; by the cracking which is heard; sometimes also by the shooting forth of one of its ends thro' the Flesh which it hath open'd; and lastly by a Comparison made thereof with the sound Part on the other side, as that of the Right Arm with the Left.
What kind of Fracture is most difficult to be discern'd?
It is that which happens in the length of the Bone, commonly call'd a Cleft or Fissure, which gives occasion to very great Symptoms when it is unknown: But it may be found out by the Pain and Swelling felt at the bottom of the Cleft in touching it; besides the Conjectures which may be made from the Relation of the Person who hath had a Fall, and might have heard the cracking of the Bone.
What sort of Fracture is most difficult to be cur'd?
The shattering or splitting of a Bone in Pieces, by reason of the great Number of Splints which daily cause new Pains and Suppurations.
What is a simple and what is a complicated Fracture?
The simple Fracture is that whereby the Bone is broken, without any other Accident; and the complicated Fracture is that which is follow'd by some Accident; as that in which there is a splitting of the Bone in pieces, orwhere the Bone is broken in two several places, or else when the Fracture is accompany'd with a Luxation, a Wound, an Inflammation, or other Circumstances of the like Nature.
Are old Men or Children most subject to these Fractures of the Bones?
Old Men, because their Bones are drier; whereas those of Infants are almost Cartilaginous, and yield or give way to the violence offer'd to 'em; from whence proceed the sinkings and hollowness that happen in their Skulls, especially in the Mould of their Heads, or elsewhere; for which a Remedy is found out by the means of Plaisters, Splints, and Bandages, fitted to the shape of the Parts. It is also on the same Account that Bones are more easily broken in the Winter than in the Summer.
In what Parts are the Fractures of Bones most dangerous?
They are those that happen in the Skull and Joints; in the former by reason of the Brain; and in the latter in regard of the Nervous Parts.
What Course is to be taken by a Surgeon who is sent for to cure a Fracture?
He ought to do three things, that is to say, at first he must incessantly endeavour to reduce it, to the end that Nature may re-unite the Parts with greater Facility, and that its Extremities may be brought together again with less trouble, before a Swelling, Inflammation, or Gangrene happen in the Part. Afterward he is to use means to retain the Parts in their proper Figure, andnatural Situation, and to prevent all sorts of Accidents.
How is the setting of a broken Bone to be perform'd?
When the Fracture is Cross-wise, it must be reduc'd by Extension and contra-Extension; and when it is in length, the Coaptation or bringing together again of the Sides, is only necessary.
What is to be done in a Fracture complicated with a Wound?
The Operator must first reduce it, and then administer the other Helps, as in a simple Fracture.
How may it be known that the reducing of the Fracture is well perform'd?
When the Pain ceaseth; when the Part hath resum'd its natural Shape; when no Unevenness is any longer perceiv'd therein; and when it is conformable to the sound Part on the other side.
What are the Signs which shew that the Splints remain in the Fracture after it hath been reduc'd?
They are the secret and continual Workings of the Fibres, or twitchings, that are felt by Intervals in the Part, with great Pains, which are the Indications of an Abcess arising therein; and when a Wound is join'd to the Fracture, the Lips of it are puff'd up, and become more soft and pale, the purulent Matter abounding also more than ordinary.
When the Splints appear, must they be drawn out by force?
By no means; for great care ought to be taken to avoid all manner of violent Operations; it being requisite to wait for their going out with the purulent Matter; or at most to facilitate their Passage by the use of Injections of the Tincture of Myrrh and Aloes; by the application ofEmplastrum Andreæ Crucii, and by the help of theForceps.
How is a simple Fracture to be dress'd, after it hath been reduc'd?
The Parts are to be strengthen'd and consolidated with Liniments ofOleum Lumbricorum, or of Oil of St.John's-Wort mingled with Wine, Brandy, orAqua-Vitæ;with Fomentations of Red Roses, Rosemary, and St.John's-Wort boil'd in Wine; and withEmplastrum contra Rupturam, orde Betonica, carefully wrapping up the broken Member, but after such a manner that the two Extremities may not cross one another; and that a small Space may remain open between both. Afterward the Splints and Bands are to be apply'd, taking care to avoid binding 'em too hard, and to take 'em off every three Days, in order to refit 'em, to abate troublesome Itchings, and to give Air to the Part; by these means preventing the Gangrene, which might happen by the Suffocation of the natural Heat. If the Thighs or Legs are broken, Scarves are to be us'd to support and stay 'em in the Bed.
What space of time may there be allow'd for curing the Fracture of a Bone?
The Cure will take up more or less time, according to the variety of the Parts, or the different thickness of the Bones: Thus to formtheCallusof the broken Jaw-Bone, twenty Days may well be allotted; for that of the Clavicle, or that of the Shoulder-Bone, twenty four; for that of the Bones of the Elbow, thirty; for that of the Arm-Bone, forty; for that of the Wrist-Bone, and those of the Fingers, twenty; for that of the Ribs, twenty; for that of the Thigh-Bone, fifty; for that of the Leg-Bone, forty; for that of the Bones of theTarsusand Toes, twenty.
What ought to be done in particular to promote the formation of theCallus?
The fractur'd Part must be rubb'd withOleum Lumbricorumand Spirit of Wine heated and mingled together: The Decoctions of Agrimony, Sayine, and Saxifrage are also to be us'd, and theLapis Osteocollais a Specifick: It is usually given in great Comphrey-Water, or in a Decoction of Perewinkle made with Wine, and is often re-iterated.
What is a Fracture of theCraniumor Skull?
It is a Wound of the Head complicated with a Fracture of the Skull-Bone.
After how many manners may the Skull be fractur'd?
Three several ways,viz.by Contusion, by Incision, and by Puncture.
What is the most dangerous of these Fractures?
It is that which happens by Contusion; because the Concussion and Commotion is greater.
Do all the Fractures of the Skull require the use of the Trepan?
No, the Fractures must be deep which stand in need of the help of such an Instrument; for those that are superficial may be cur'd by a simple Exfoliation.
What is that deep Fracture, wherein the use of the Trepan is absolutely necessary?
It is that which is made in the two Tables of the Skull, penetrating to theMeningesof the Brain; upon which at that time the Blood is diffus'd, and must be taken away by the Operation of the Trepan.
How may it be discover'd that the two Tables of the Skull are broken?
By the Eyes, and by Ratiocination.
Are not the Eyes sufficient alone, and are they not more certain than Ratiocination?
Yes; but forasmuch as things are not always seen, there is often a necessity of making use of rational Deductions to find out that which the Eyes cannot discern.
When doth it happen that the Eyes alone discover the Fracture?
When the Wound is large and wide, so that it may be immediately view'd.
When doth it happen that Ratiocination supplies the defect of the Eyes?
When the Wound is so small that the Bone cannot be seen, and nothing appears but the Accidents.
What are the Accidents or Signs of the Fracture of the Skull?
They are a dimmness of the Sight, and loss of the Understanding, which happen at the very Moment when the Fall or Blow is receiv'd; with the Phlegmatick Vomittings that follow soon after: These Signs are call'dUnivocal. And there are others that bear the Name ofEquivocal, and which confirm the former; as a Flux of Blood thro' the Nose, Eyes, and Ears, redness of the Eyes, heaviness of the Head, and puffing up of the Face; as also afterward Drowsiness, Shivering of the whole Body, Fever,Deliriums, Convulsions,&c.
Must all these Signs appear before a Determination can be made of the necessity of using the Trepan?
No, it is sufficient to have the Univocal Signs to make a Crucial Incision in the place of the Wound, and to lay bare the Bone, in order to observe the Fracture, which sometimes is so fine, that the Operator is oblig'd to make use of Ink, which insinuates it self into the Cleft, and of a particular Instrument, with which the black Line that hath penetrated to the bottom, cannot be rubb'd out; whereas it may be easily defac'd when the Fracture is only superficial.
How long time is commonly spent before the appearing of the Accidents?
In the Summer Season they appear in three or four Days, and at the latest in seven; in Winterthey are slower, and sometimes do not happen till the fourteenth Day: But at the end of this term, it may be affirm'd that the Trepan is often unprofitable.
What is requisite to be done in a doubtful Occasion; Must the Trepan be apply'd or omitted?
The Surgeon is to have recourse to his own conscientious Discretion, which ought to serve as a Guide, and requires that we should always act according to the known Rules of Art; insomuch that after having well consider'd the Accidents, with all the Circumstances of the Wound, if there be no good grounds for the undertaking of the Operation, it is expedient to desist, and in this case to have deference to the Advice of other able Surgeons of the same Society, rather than to rely too much upon his own Judgment, to the end that he may be always secure from all manner of Blame.
Is the Trepan apply'd upon the Fracture?
No; but on one side of it, and always in a firm place.
What Course is to be taken when a Fracture is found in a Suture?
A double Trepan is to be made, and apply'd on each side of the Suture, by reason of the overflowing of the Blood, which may happen therein.
What Method ought to be observ'd in the curing of the Wounds of the Head, and Fractures of the Skull?
In simple Wounds of the Head, it is necessary only to make use of Balsams, and to lay over 'emEmplastrum de Betonica. When there is a Contusion either in thePericranium, or in the Skull, the Wound must be kept open till after the Suppuration or Exfoliation.
When there is only a Bunch without any Wound or Accident, it must speedily be dissolv'd with Plaister or Mortar, Chimney-Soot, Oil of Olives, and Wine, laid upon the Part between two Linnen-Rags; or else with Soot, Spirit of Wine, and Oil of St.John's-Wort, wherein the Bolsters are soakt, to be in like manner apply'd with a Band.
Wounds of the Head accompany'd with a Fracture, absolutely require the application of the Trepan, wherein it is requisite to make use of Oil of Turpentine to be dropt upon the Membrane of the Brain; or else Spirit of Wine mingled with Oil of Almonds, and not with the Oil or Syrrup of Roses; and to endeavour to cause a plentiful outward Suppuration.
Besides, it must not be neglected to enjoyn the wounded Person to be let Blood both before and after the Operation, if he hath a Fever or a Plethory; and more especially it is to be remember'd to cause his Body to be kept open at least every other Day, with Clysters, obliging him to keep a good Diet, and to avoid all violent Agitations both of Body and Mind, abstaining from eating Flesh till the Fourteenth Day. All manner of Venery and Conjugal Embraces, which prove fatal at this time, are to be prohibited during forty Days, to be counted from the Day of the Operation; as they are also in all other considerable Wounds.
What isCaries?
It is the Putrifaction of the Substance of the Bone, or else its Ulcer or Gangrene.
Whence doth theCariesof the Bone derive its Original?
It proceeds from an internal and external Cause; the former being that which hath been produc'd at first in the Substance of the Bone; and the other that which takes its Rise from an inveterate Ulcer in the Flesh, which hath communicated its Malignity to the Substance of the Bone, and by that means corrupted it.
How is theCariesknown which proceeds from an inward Cause?
By the continual and violent Pains which are felt before, and continue for a long time without diminution; as also afterward by the alteration of the Flesh that covers the Bone, and which becomes soft, spongy, and livid.
By what means is aCariesthat derives its Origine from an outward Cause, discover'd?
By the quality of the purulent Matter that issueth out of the Ulcer in the Flesh, which is blackish, Unctuous, and extremely stinking; as also by the help of the Probe, that discoverethasperity or roughness in the Bone when it is laid bare.
What Means are to be us'd in order to cure aCariesproceeding from an external Cause?
The Powder of Flower-de-luce may be us'd, and it is sufficient for that purpose, when theCariesis superficial; but it is necessary to takeOleum Guyaci, and to soak Bolsters therein, to be laid upon the Ulcer when it is deep; or elseAqua-Vitæor Brandy, in which have been infus'd the Roots of Flower-de-luce, Cinnamon, and Cloves. Lastly, the actual Cautery, which is Fire, must be apply'd thereto.
What is to be done when theCariesproceeds from an internal Cause?
The Flesh must be open'd to give Passage to theSaniesthat runs out of the ulcerated Bone, to the end that Exfoliation may be procur'd; and if the Ulcer hath not as yet laid open the Bone on the outside, the Trepan ought to be apply'd; but the Ulcer orCariesmust be afterward handled, as we have even now declar'd.
What isExostosis?
It is the Swelling of a Bone made by the settling of a corrupt Humour in its proper Substance.
What isNodus?
It is a kind of gummy and wavering Tumour, which is form'd by the settling of a gross Humour between the Bone and thePeriosteum.
AreExostosesandNodus's suppurable Tumours?
Yes, because they sometimes produce Ulcers and Gangrenes in the Bone, which are call'dCaries, proceeding from an internal Cause; nevertheless they are generally dissolv'd by Frictions withUnguentum Griseum, or by the application of Plaisters of Tobacco, orEmplastrum de Vigo quadruplicato Mercurio; taking also to the same purpose internal Diaphoretick and Sudorifick Medicines, with convenient Purgatives.
What is a Vesicatory?
The Name of Vesicatory may be attributed to every thing that is capable of raising Bladders or Blisters in the Skin; nevertheless in Surgery, by a Vesicatory is understood a Medicament prepar'd withCantharidesorSpanishFlies dried, which are beaten to Powder, and mingled with Turpentine, Plaisters, Leaven, and other Ingredients.
In what places, and after what manner are Vesicatories usually apply'd?
They are apply'd every where, accordingly as there is occasion to draw out or discharge some Humour from a Part: In Defluxions of Rheum upon the Eyes or Teeth, they are laid on the Neck and Temples; in Apoplexies, behind the Ears; and so of the rest, observing always to make Frictions on the places where theApplication is to be made, to the end that the Vesicatory may sooner take effect.
How long time must the Vesicatory continue on the Part?
The Blisters are generally rais'd by 'em within the space of five or six Hours; yet this Operation depends more or less upon the fineness of the Skin; and when the Bladders or Blisters appear, it is requisite to deferr the openning of 'em for some time, to the end that Nature may have an Opportunity to introduce a new Scarf-Skin, by which means the Pain may be avoided that would be felt, if the Skin were too much expos'd to the Air.
What is a Cautery?
It is a Composition made of many Ingredients, which corrode, burn, and make an Escar on the Part to which they are apply'd.
How many sorts of Cauteries are there in general?
There are two kinds,viz.the Actual and the Potential; the former are those that have an immediate Operation; as Fire, or a red-hot Iron; and the others are those that produce the same Effect, but in a longer space of time; such are the ordinary Cauteries compos'd of Caustick Medicaments.
Which are the most safe, the Actual or the Potential Cauteries?
A distinction is to be made herein; for Actual Cauteries are safest in the Operation, because they may be apply'd wheresoever one shall think fit, as also for as long a time, or for any purpose: Whereas the Potential cannot beguided after the same manner. But in Hæmorrhages the Potential Cauteries are most eligible, by reason that the Escar produc'd by 'em not being so speedily form'd, the Vessels are better clos'd, and they are not so subject to open again when it falls off; as it often happens in the Fall of an Escar made by Fire.
In what places are Cauteries usually apply'd?
In all places where an Attraction is to be made, or an Intemperature to be corrected, or a Flux of Humours to be stopt, by inducing an Escar on the Part: However they are commonly laid upon the Nape of the Neck, between the first and secondVertebra; on the outward Part of the Arm in a small Hole between the MuscleDeltoidesand theBiceps; above the Thigh, between the MuscleSartor, and theVastus Internus; and on the inside of the Knee, below the Flexors of the Leg; observing every where that the Cautery be plac'd near the great Vessels, to the end that it may draw out and cleanse more abundantly.
What is the Composition of the Potential Cauteries?
They may be made with quick Lime, Soap, and Chimney-Soot; or else take an Ounce ofSal Ammoniack, two Ounces of burntRomanVitriol, three Ounces of quick Lime, and as many of calcin'd Tartar; mingle the whole Mass together in aLixiviumof Bean-Cod Ashes, and cause it to evaporate gently to a Consistence: Let this Paste be kept for use in a dry place, and in a well-stopt Vessel. Or else the Silver-Cautery, orLapis Infernalismay be prepar'd after the following manner:
Take what quantity you please of Silver, let it be dissolv'd with thrice as much Spirit of Nitre in a Vial, and set the Vial upon the Sand-Fire, to the end that two third parts of its Moisture may evaporate: Then pour the rest scalding-hot into a good Crucible, plac'd over a gentle Fire, and the Ebullition being made, the heat of the Fire must be augmented, till the Matter sink to the bottom, which will become as it were an Oil: Afterward pour it into a somewhat thick and hot Mould, and it will coagulate, so as to be fit for Use, if it be kept in a well-stopt Vial. This Cautery is the best; and an Ounce of Silver will yield one Ounce and five Drams ofLapis Infernalis.
What is a Seton?
It is a String of Silk, Thread, or Cotton, threaded thro' a kind of Pack-Needle, with which the Skin of a Part is to be pierc'd thro', to make an Ulcer therein, that hath almost the same effect as a Cautery.
What is most remarkable in the Application of a Seton?
It ought to be observ'd, that the String must be dipt in Oil of Roses, and that one end of it must always be kept longer than the other, to facilitate the running of the Humours.
In what Parts is theSeton tobe apply'd?
The Nape of the Neck is the usual place of its Application, altho' it may be made in any part of the Body where it is necessary. It sometimes happens that a Surgeon is oblig'd to use a kind of Seton in such Wounds made with a Sword, or by Gun-shot, as pass quitethro' from one side to the other; then the String or Skain must be dipt in convenient Ointments or Medicinal Compositions; and as often as the Dressings are taken away, it will be requisite to cut off the Part soakt in the Purulent Matter, which must be taken out of the Ulcer.
What is a Cupping-Glass?
It is a Vessel or kind of Vial, made with Glass, the bottom whereof is somewhat broader than the top, which is apply'd to the Skin to cause an Attraction. There are two sorts of these Cupping-Glasses,viz, the Dry, and the Wet; the former are those that are laid upon the Skin without opening it; and the latter those that are apply'd with Scarification.
In what Diseases are Cupping-Glasses us'd?
In all kinds where it is necessary to make any Attraction; but more especially in Apoplexies, Vapours in Women, Palsies, and other Distempers of the like Nature. But the Applications of Cupping-Glasses are altogether different; for in Apoplexes they are generally set upon the Shoulders or upon theCoccyx; in Vapours upon the inside of the Thighs; and in Palsies upon the Paralytick Part it self.
What is a Leech?
It is an Animal like a little Worm which sucks the Blood, and is commonly apply'd to Children and weak Persons, to serve instead of Phlebotomy: Leeches are also us'd for the discharging of a Defluxion of Humours in any Part; as also in the Hæmorrhoidal Veins when they are too full; in theVaricesand in several parts of the Face.
What choice ought to be made of Leeches?