Who is a Surgeon?
A Person skill'd in curing Diseases incident to Humane Bodies by a
methodical Application of the Hand.
What are the Qualifications of a good Surgeon in general?
They are three in Number: viz. Skill in the Theory, Experience
in the Practical part, and a gentle Application of the Hand.
Why ought a Surgeon to be skilful?
Because without a discerning Faculty he can have no certainty in what
he doth.
Why must he be experienc'd?
Because Knowledge alone doth not endue him with a dexterity of Hand
requisite in such a Person, which cannot be acquir'd but by Experience,
and repeated Manual Operations.
Why must he be tender-handed?
To the End that by fit Applications he may asswage those Pains which
he is oblig'd to cause his Patients to endure.
What is Chirurgery or Surgery?
It is an Art which shews how to cure the Diseases of Humane Bodies by
a methodical Manual Application. The Term being derived from the
Greek Word Χεὶρ, signifying a Hand and Ἔργον, a
Work or Operation.
After how many manners are Chirurgical Operations usually
perform'd?
Four several ways.
Which be they?
I. Synthesis, whereby the divided Parts are re-united; as in
Wounds. II. Diæresis, that divides and separates those Parts,
which, by their Union, hinder the Cure of Diseases, such is the
continuity of Abscesses or Impostumes which must be open'd to let out the
purulent Matter. III. Exæresis, which draws out of the Body
whatsoever is noxious or hurtful, as Bullets, Arrows, &c. IV.
Prosthesis adds some Instrument or Body to supply the defect of
those that are wanting; such are Artificial Legs and Arms, when the
Natural ones are lost. It also furnishes us with certain Instruments to
help and strengthen weak Parts, such as Pessaries, which retain
the Matrix in its proper place when it is fallen, Crutches to
assist feeble Persons in going, &c.
What ought to be chiefly observed before the undertaking an
Operation?
Four things; viz. 1. What the Operation to be perform'd is? 2.
Why it is perform'd? 3. Whether it be necessary or possible? And 4. The
manner of performing it.
How may we discern these?
The Operation to be perform'd may be known by its Definition; that is
to say, by explaining what it is in it self: We may discover whether it
ought to be done, by examining whether the Distemper cannot be cur'd
otherwise: We may also judge whether it be possible or necessary, by a
competent Knowledge of the Nature of the Disease, the Strength of the
Patient, and the Part affected: Lastly, the manner of performing it may
be found out, by being well vers'd in the Practice of Surgery.
What are the Fundamental Principles of Surgery?
They are Three in number: viz. 1. The knowledge of Man's Body.
2. That of the Diseases which require a Manual Operation. 3. That of
proper Remedies and Helps upon every Occasion.
How may one attain to the Knowledge of Humane Bodies?
By the study of Anatomy.
How may one learn to know the Distempers relating to Surgery, and
the Remedies appropriated for them?
Two several ways; viz. 1. By the reading of good Books, and
Instructions receiv'd from able Masters of that Art. 2. By practice and
the Observation of what is perform'd by others upon the Bodies of their
Patients.
What are the Diseases in general that belong to Surgery?
They are Tumours, Impostumes, Wounds, Ulcers, Fractures, Dislocations,
and generally all sorts of Distempers whereto Manual Operations may be
applyed.
What are the Instruments in general which are commonly used in
Surgery for the curing of Diseases?
They are Five; viz. the Hand, Bandages, Medicines, the
Incision-Knife, and Fire.
What is the general Practice which ought to be observ'd in the
Application of these different helps?
Hippocrates teacheth us, in saying, that when Medicines are not
sufficient, recourse may be had to the Incision-Knife, and afterward to
Fire; intimating that we must proceed by degrees.
Are there any Distempers that may be cured by the Surgeon's Hand
alone?
Yes, as when a simple and small Dislocation is only to be reduced.
What do you call portable and not portable Instruments?
Portable Instruments are those which the Surgeon carries in his
Lancet-Case with his Plaister-Box; and not portable are those that he
doth not carry about him, but is oblig'd to keep at home; the former
being appointed for the ready help which he daily administers to his
Patients, and the others for greater Operations.
What are the Instruments which a Surgeon ought to have in his
Plaister-Box?
These Instruments are a good pair of Sizzers, a Razor,
an Incision-Knife streight and crooked, a Spatula, a
greater Lancet to open Impostumes, and lesser for letting Blood.
They likewise carry separately in very neat Lancet-Cases, a hollow
Probe made of Silver or fine Steel; as also many other Probes,
streight, crooked, folding, and of different thickness; a Pipe of
Silver or fine Steel, to convey the cauterizing Button to a remote
Part, without running the hazard of burning those that are near it;
another Pipe or Tube serving instead of a Case for
Needles, which have Eyes at one end for sowing; a Carlet,
or thick triangular Needle; a small File; a Steel Instrument to
cleanse the Teeth; a Fleam; a pair of crooked Forceps
to draw a Tooth; a Pelican; a Crow's Bill; several sorts of
Raspatories; a Hook to hold up the Skin in cutting,
&c.
What are the Instruments which a Surgeon ought to keep in his
Repository to perform the greater Operations?
Some of them are peculiar to certain Operations, and others are common
to all. The Instruments appropriated to particular Operations, are the
Trepan for opening the Bones in the Head, or elsewhere: The
Catheters or Probes for Men and Women afflicted with the Stone, or
difficulty of making Water. Extractors, to lay hold on the Stone
in Lithotomy, and to gather together the Gravel; large crooked
Incision-Knives, and a Saw, to make Amputations of the Arms
or Legs; great Needles with three Edges, to be used in making
Setons; small Needles to couch Cataracts; other
Needles; thin Plates and Buckles to close a
Hair-Lip, &c.
May not the Salvatory be reckon'd among the portable
Instruments?
Yes, because the Balsams, Ointments, and Plaisters contain'd therein,
are means whereof the Surgeon makes use to restore Health.
What is Anatomy?
It is the Analysis or exact Division of all the Parts of a
Body, to discover their Nature and Original.
What is requisite to be observ'd by a Surgeon before he goes about
to dissect a Body?
Two things; viz. The external Structure of the Body, and the
Proportion or Correspondence between the outward Parts, and those that
are within.
Why so?
Because without this exterior and general Knowledge, the Surgeon wou'd
be often mistaken in the Judgment he is to pass concerning a Dislocation
or Wound, inasmuch as it is by the Deformity which he perceives in the
Member, that he knows the Dislocation, as it is also by the means of the
Correspondence which the outward Parts have with the inward, that he is
enabled to draw any certain Consequences relating to a Wound, which
penetrates into the Body.
What is a Part?
It is that whereof the whole Body is compos'd, and which partakes of a
common Life or Sensation with it.
How many sorts of Parts are there in a Humane Body?
We may well reckon up Fifteen distinct Parts, which are the Bone, the
Cartilage, the Ligament, the Tendon, the Membrane, the Fibre, the Nerve,
the Vein, the Artery, the Flesh, the Fat, the Skin, the Scarf-Skin, the
Hair, and the Nails.
What is a Bone?
It is the hardest and driest Part of the whole Body, and that which
constitutes its principal Support.
What is a Cartilage or Gristle?
It is a yielding and supple Part, which partakes of the Nature of a
Bone, and is always fasten'd to its Extremities, to mollifie and
facilitate its Motion.
What is a Ligament?
It is a Membranous Contexture usually sticking to the Bones to contain
them; as also sometimes to other Parts, to suspend, and retain them in
their proper place.
What is a Tendon?
It is the Tail or Extremity of the Muscles, made by the re-union of
all the Fibres of their Body, which serves to corroborate it in its
Action, and to give Motion to the Part.
What is a Membrane?
It is a Nervous Part, the use whereof is to adorn and secure the
Cavities of the Body on the inside, and to wrap up or cover the
Parts.
What is a Fibre?
They are fleshy Lines of which the Body of a Muscle is compos'd.
What is a Nerve?
It is a long, white, and thin Body, consisting of many Fibres, enclos'd
within a double Tunick, and design'd to carry the Animal Spirits into all
the Parts, to give them Sense and Motion.
What is an Artery?
It is a Canal compos'd of Four Coats, that carreyth with a kind of
Beating or Pulse even to the very Extremity of the Parts, the Blood full
of Spirits, which proceeds from the Heart, to distribute to them at the
same time both Life and Nourishment.
What is a Vein?
It is a Canal made likewise of Four Tunicles, which receives the
Arterial Blood, to carry it back to the Heart.
What is Flesh?
It is a Part which is form'd of Blood thicken'd by the natural Heat;
and that constitutes the Body of a Muscle.
What is Fat?
It is a soft Body made of the Unctuous and Sulphurous part of the
Blood.
What is the Derma or Skin?
It is a Net compos'd of Fibres, Veins, Arteries, Lymphatick Vessels
and Nerves, which covers the whole Body to defend it from the Injuries of
the Air, and to serve as a universal Emunctory: It is very thin in the
Face, sticking close to the Flesh, and is pierc'd with an infinite number
of imperceptible Pores, affording a Passage to insensible
Transpiration.
What is the Epiderma, or Scarf-Skin?
It is a small fine Skin, transparent and insensible, having also
innumerable Pores for the discharging of Sweat, and other Humours by imperceptible Transpiration: It is extended
over the whole inner Skin, to dull its too exquisite Sense, by covering
the Extremities of the Nerves which are there terminated. It also renders
the same Skin even and smooth, and so contributes very much to
Beauty.
What is the Hair?
The Hairs are certain hollow Filaments planted in the Glandules of the
Skin, from whence their Nourishment is deriv'd. They constitute the
Ornament of some Parts, cover those which Modesty requires to be
conceal'd, and defend others from the injury of the Weather.
What is a Nail?
The Nails are a Continuity of the Skin harden'd at the end of the
Fingers, to strengthen and render them fit for Work.
How is the Humane Body divided before it is dissected, in order to
Anatomical Demonstration?
Some Anatomists distinguish it into Similar and
Dissimilar Parts, appropriating the former Denomination to all the
simple Parts of the Body taken separately, as a Bone, a Vein, a Nerve,
&c. but they attribute the Name of Dissimilar to all those
Members that are compos'd of many Similar or Simple Parts together; such
are the Arms, Legs, Eyes, &c. wherein are
contain'd all at once, Bones, Veins, Nerves, and other parts.
Others divide it into containing and contained Parts,
the former enclosing the others, as the Skull includes the Brain, and the
Breast the Lungs; whereas the contained Parts are shut up within others;
as the Entrails within the Belly, the Brain within the Skull,
&c.
Others again divide the whole Body into Spermatick and
Sanguineous Parts; the former being those which are made at the
time of Formation; and the latter all those that are grown afterward by
the Nourishment of the Blood.
Are there not also other Methods of dividing the Humane
Body?
Yes: Many Persons consider it as a Contexture of Bones, Flesh, Vessels
and Entrails, which they explain in four several Treatises, whereof the
first is call'd Osteology, for the Bones; the second
Myology, for the Muscles; the third Angiology, for the
Veins, Arteries and Nerves, which are the Vessels; and the fourth
Splanchnology, for the Entrails.
But lastly, the most clear and perspicuous of all the Divisions of the
Body of Man, is that which compares it to a Tree, whereof the Trunk is
the Body, and the Branches are the Arms and Legs. The Body is divided
into three Venters, or great Cavities, viz. the Upper, the
Middle, and the Lower, which are the Head, the Breast, and the lower
Belly. The Arms are distributed into the Arms properly so called, the
Elbow and Hands; and the Legs in like manner into Thighs, Shanks, and
Feet: The Hands being also subdivided into the Carpus or Wrist,
Metacarpium or Back of the Hand, and the Fingers; as the Feet into
the Tarsus, Metatarsus, and Toes. This vision is at present
follow'd in the Anatomical Schools.
Why is Anatomy usually begun with the Demonstration of the
Skeleton, or Contexture of Bones?
Because the Bones serve for the Foundation Connexion, and Support of
all other Parts of the Body.
What is the Skeleton?
It is a gathering together, or Conjunction of all the Bones of the
Body almost in their Natural Situation.
From whence are the principal differences of the Bones
derived?
They are taken from their Substance, Figure, Articulation, and
Use.
How is all this to be understood?
First then, with respect to their Substance, there are some Bones
harder than others; as those of the Legs compared with those of the
Back-Bone. Again, in regard of their Figure, some are long, as those of
the Arm; and others short, as those of the Metacarpium. Some are
also broad, as those of the Skull and Omoplatæ or
Shoulder-Blades; and others narrow, as the Ribbs. But with respect to
their Articulation, some are joined by thick Heads, which are received
into large Cavities, as the Huckle-Bones with those of the Hips; and
others are united by the means of a simple Line, as the Chin-Bones.
Lastly, with relation to their Use; some serve to support and carry the
whole Body, as the Leg-Bones, and others are appointed to grind the Meat,
as the Teeth; or else to form some Cavity, as the Skull-Bone, and those
of the Ribs.
What are the Parts to be distinguished in the Bones?
They are the Body, the Ends, the Heads, the Neck, the
Apophyses, the Epiphyses, the Condyli or
Productions, the Cavities, the Supercilia or Lips, and the
Ridges.
The Body is the greatest Part, and the middle of the Bone; the Ends
are the two Extremities; the Heads are the great Protuberances at the
Extremities; the Neck is that Part which lies immediately under the Head;
the Apophyses or Processes are certain Bunches or Knobs at the
Ends of the Bones, which constitute a Part of them; the Epiphyses
are Bones added to the Extremities of other Bones; the Condyli or
Productions are the small Elevations or Extuberances of the Bones; the
Cavities are certain Holes or hollow places; the Supercilia or
Lips are the Extremities of the Sides of a Cavity, which is at the End of
a Bone; the Ridges are the prominent and saliant Parts in the length of
the Body of the Bone.
How are the Bones join'd together?
Two several ways, viz. by Articulation and
Symphysis.
How many sorts of Articulations are there in the Bones?
There are generally two kinds, viz. Diarthrosis and
Synarthrosis.
What is Diarthrosis?
Diarthrosis is a kind of Articulation which serves for sensible
Motions.
How many kinds of Diarthroses, or great Motions are there?
There are Three, viz. Enarthrosis, Arthrodia, and
Ginglymus.
Enarthrosis is a kind of Articulation which unites two Bones
with a great Head on one side, and a large Cavity on the other; as the
Head of the Thigh-Bone in the Cavity of the Ischion or
Huckle-Bone.
Arthrodia is a sort of Articulation, by the means whereof two
Bones are join'd together with a flat Head receiv'd into a Cavity of a
small depth. Such is the Head of the Shoulder-Bone with the Cavity of the
Omoplata or Shoulder-Blade; and that of the Twelfth
Vertebra of the Back with the first of the Loins.
Ginglymus is a kind of Articulation which unites two Bones,
each whereof hath at their Ends a Head and a Cavity, whereby they both
receive and are received at the same time, such is the Articulation in
the Bones of the Elbow and the Vertebræ.
What is Synarthrosis?
Synarthrosis being opposite to Diarthrosis, is a close or
compacted Articulation, destitute of any sensible Motion.
How many sorts of Synarthroses, or close Articulations are
there?
There are Three. viz. Sutura, Harmonia, and
Gomphosis.
A Suture is that which joins together two Bones by a kind of
Seam or Stitch, or by a Connexion of their Extremities dispos'd in form
of a Saw, the Teeth whereof are reciprocally let one into another: Such
are the Sutures of the Skull-Bones.
Harmonia is the uniting of two Bones by a simple Line; as the
Bone of the Cheek with that of the Jaw.
Gomphosis is a kind of close Articulation, which unites two
Bones after the manner of Nails or Wooden Pins fixt in the Holes made to
receive them: Such is that of the Teeth in their Sockets.
What is Symphysis?
Symphysis is the uniting of two Bones by the interposition of a
Medium, which ties them very streight together, being also
threefold: Such is the Connexion of the Knee-Pan or Whirl-Bone of the
Knee, and the Omoplata or Shoulder-Blade.
Are not these three kinds of Articulations or Symphyses
distinguish'd one from another?
Yes; for tho' they are all made by the means of a third Body
intervening, which joins them together; nevertheless every one of these
various Bodies gives a different Denomination to its respective
Articulation: Thus the Articulation which is caus'd by a Glutinous and
Cartilaginous Substance, is properly call'd
Synchondrosis; as that of the Nose, Chin, Os Pubis,
&c. But an Articulation which is made by a Ligament is termed
Synncurosis, as that of the Knee-Pan. Lastly, that which is
wrought by the means of Flesh, bears the Name of Syssarcosis; as
the Jaw-Bones, the Os Hyoides, and the Omoplata or
Shoulder-Blade.
Have the Bones any sense of Feeling or Motion?
They have neither; for their sense of Pain proceeds from nothing else
but their Periostium, or the Membrane with which they are cover'd,
and their Motion is perform'd only by the Muscles that draw them.
Doth the Marrow afford any Nutriment to the Bones?
No, all the Bones are nourish'd by the Blood, as the other Parts; but
the Marrow is to the Bones what the Fat is to the Flesh; that is to say,
it is a kind of Oil or Unctuous Substance, which moistens, and renders
them less brittle.
Are all the Bones of the same Colour?
No, they follow the Temperament and Constitution of the Persons.
How many in number are the Bones of the Humane Skeleton?
There are two hundred and fifty usually reckon'd, viz. 61 in
the Head, 67 in the Trunk or Chest, 62 in the Arms and Hands, and 60 in
the Legs and Feet; but the true Number cannot be exactly determin'd, by
reason that some Persons have more, and others fewer; for some have more
Ossa Sesamoidea, Teeth and Breast-Bones than others:
Again, some have many indentings in the Lambdoidal Suture, and
others have none at all.
Can you rehearse the Number of the Bones of the Head?
There are Fifteen in the Skull, and Forty six in the Face.
The Fifteen of the Skull are the Coronal for the fore-part of
the Head; the Occipital for the hinder-part; the two
Parietals for the upper-part and each side; the two
Temporals for the Temples; the Os Sphenoides or
Cuneiforme, which closeth the Basis or bottom of the Skull;
the Os Ethmoides, or Cribriforme, situated at the Root of
the Nose; and the four little Bones of the Ear on each side, viz.
the Incus or Anvil; the Stapes or Stirrup; the
Malleolus or Hammer; and the Orbiculare or Orbicular
Bone.
Of the Forty six of the Face, Twenty seven are counted in the
Upper-Jaw, viz. the two Zygomatick, or the two Bones of the
Cheek-Knots; the two Lachrymal in the great Corners of the Eyes
toward the Nose; the two Maxillar, that receive the Upper-Teeth,
and which form part of the Palate of the Mouth, and the Orbits of the
Eyes; the two Bones of the Nose; the two Palate-Bones which are at its
end, and behind the Nostrils; the last being single is the Vomer,
which makes the Division of the lower part of the Nostrils; and there are
generally Sixteen Upper-Teeth. The Lower-Jaw contains Nineteen Bones,
viz. sixteen Teeth; two Bones that receive them; and the Os
Hyoides, which is single, and fix'd at the Root of the Tongue.
How are the Teeth usually divided with respect to their
Qualities?
Into Incisive or Cutters, Canine or Dog-Teeth, and
Molar or Grinders: There are eight Incisive, and four Canine,
which have only one single Root; as also twenty Molar, every one whereof
hath one, two, or three Roots.
Can you recite the Number of the Bones of the Trunk or
Chest?
There are generally thirty and three in the Spine or Chine-Bone
of the Back, viz. seven Vertebra's in the Neck, twelve in
the Back, five in the Legs, five, six, and sometimes seven in the Os
Sacrum, three or four in the Coccyx, and two Cartilages at its
end.
There are twenty nine in the Breast, viz. twenty four Ribs, two
Clavicles or Channel-Bones and commonly three Bones in the
Sternum. The Hip-Bones are likewise divided into three,
viz. Ilion, Ischion and Os Pubis.
Do you know the Number of the Bones of the Arms?
There are thirty and one Bones in each Arm, that is to say, the
Omoplata or Shoulder-Blade; the Humerus or Shoulder-Bone;
the two Bones of the Elbow call'd Ulna, and Radius; eight
little Bones in the Carpus or Wrist; five in the
Metacarpium or Back of the Hand; and fourteen in the Fingers,
three to every one except the Thumb, which hath only two.
Can you give us a List of the Bones of the Leg in their
Order?
There are thirty Bones in each Leg, viz. the Femur or
great Thigh-Bone, the Knee-Pan or Whirl-Bone on the top of
the Knee; the Tibia, greater Focile, or Shin-Bone; and the
Perone or Fibula, or lesser Focile, which are the
two associated Bones of the Leg; seven little Bones in the Tarsus;
five in the Metatarsus; and fourteen in the Toes; that is to say,
three to every one, except the great Toe, which hath only two.
Thus the Number of Bones of the Humane Skeleton amounts to two
hundred and Fifty, without reckoning the Sesamoides, the
Indentings of the Skull, and some others which are not always to be
found.
What is a Muscle?
It is the principal Organ or Instrument of Motion; or it is a Portion
of Flesh, wherein there are Veins, Arteries, Nerves, and Fibres, and
which is cover'd with a Membrane.
How many parts are there in a Muscle?
Three, viz. the Head, the Belly, and the Tail: The Head is that
part thro' which the Nerve enters; the Belly is the Body or Middle of the
Muscle; and the Tail is the Extremity, where all the Fibres of the Muscle
are terminated to make the Tendon or String which is fasten'd to the Part
whereto it gives Motion.
Have all the Muscles their Fibres streight from the Head to the
Tail?
No, some have them streight, others transverse, and others oblique or
circular, according to the several Motions to which they are
appropriated.
How many sorts of Muscles are there with respecting to their
Action?
There are two different kinds, viz. the Antagonists and
the Congenerate; the former are those that produce opposite
Motions; as a Flexor and an Extensor, a Depressor
and a Levator. The Congenerate are those that contribute to one
and the same Action; as when there are two Flexors or two Extensors, and
then one supplies the defect of the other; whereas when one of the
Antagonist Muscles is cut, the other becomes useless, and void of
Action.
How is the Action of a Muscle perform'd?
It is done by Contraction and Extension; the former causeth the Antagonist
to swell, and the other compels it to stretch forth in length.
What is Aponeurosis?
It is the continuity of the Fibres of a Tendon which makes a Connexion
that serves to strengthen the Muscle in its Motion.
How many Muscles are there appointed to move the Head, and which be
they?
The Head is mov'd by the means of fourteen Muscles, seven on each
side; of these, two serve to depress it, eight to lift it up, and four to
turn it round about.
The two Depressors are call'd Sternoclinomastoidei; they take
their Rise in the Sternum, at the Clavicles, and proceed obliquely
to join the Apophysis Mastoides.
Of the four Elevators on each side the first is the Splenius,
which begins at the five Vertebræ of the Back and the three lower
ones of the Neck, and ascending obliquely, cleaves to the hinder part of
the Head. The second, named Complexus or Trigeminus, having
its beginning as the Splenius, sticks in like manner to the hinder
part of the Head, and they form together a figure resembling that of S.
Andrew's Cross. The third is the Rectus Major, which
proceeding from the second Vertebra of the Neck, shoots forward to
join the hinder part of the Head. The fourth is the Rectus Minor,
which begins at the first Vertebra of the Neck, and ends likewise
in the hinder part of the Head.
The two Muscles on each side, which move the Head circularly, are the
Obliquus Major and Minor; the greater Oblique
taking its rise from the second Vertebra of the Neck, goes to meet
the first; but the lesser Oblique hath its Origine in the hinder
part of the Head, and proceeds to join the other obliquely in the first
Vertebra.
How many Muscles are there in the Lower-Jaw, and which be
they?
The Lower-Jaw hath twelve Muscles which cause it to move; that is to
say, six on each side, whereof four serve to close and two to open
it.
The first of the Openers is the Latus, which beginning at the
top of the Sternum, Clavicle, and Acromion, cleaves on the
outside to the bottom of the Lower-Jaw-Bone. The second of the Openers is
the Digastricus, which takes its rise in a Fissure lying between
the Occipital Bone and the Apophysis Mastoides, from whence it
passeth to the bottom of the Chin on the inside.
The first of the Shutters is the Crotaphites or Temporal
Muscle, which hath its Origine at the bottom, and on the side of the
Os Coronale, the Os Parietale, and the Os Petrosum,
from whence it is extended till it cleaves to the Apophysis
Coronoides of the Lower-Jaw, after having passed above the
Apophysis of the Zygoma: Its Fibres are spread from the
Circumference to the Center, and it is covered again with the
Pericranium, which renders its Wounds very dangerous; so that the
least Incisions as can be, ought to be made therein.
The second is the Pterygoideus or Aliformis Externus,
whose rise is in the Apophysis Pterygoides, from whence it sets
forward till it stick between the Condylus and the Coronal of the
Lower-Jaw.
The third is the Masseter, which hath two Sources or Beginnings,
and as many Insertions; the first Source thereof is at the Cheek-Knot or
Ball of the Cheek, and the second at the lower part of the Zygoma.
The first Insertion is at the outer Corner of the Jaw, and the second in
the middle part, by that means forming the Figure of the Letter X.
The fourth is the Pterygoideus or Aliformis Internus,
which hath its beginning in the Apophysis Pterygoides, and is
terminated in the inner Corner of the Jaw; so that Mastication or Chewing
is perform'd by the means of these four Muscles.
How many Muscles are there in the Face, and which be they?
There are two for the Forehead, call'd Frontal, whose Origine
is in the upper part of the Head, from whence they descend by streight
Fibres, until they are fasten'd in the Skin of the Forehead near the
Eye-Brows, where they are re-united: Their Action or Office is to draw
the Skin of the Forehead upward, whereto they stick very close.
There are also two others call'd Occipital, which have their
Beginning in the same place with the preceeding, but they descend
backward, and cleave to the Skin of the hinder part of the Head, which
they draw upward.
There are two Muscles to each Eye-Lid, one whereof is termed the
Attollens or Elevator and the other the Depressor.
The Elevator takes its rise in the bottom of the Orbit of the Eye, and is
fastned by a large Aponeurosis to the edge of the upper Eye-Lid.
The Shutter or Depressor, call'd also the Orbicular, hath its
Origine in the great Canthus, or Corner of the Eye, passeth over
the Eye-Lid upward, and is join'd to the lesser
Corner of the same Eye, being extended along its whole Compass.
The Eyes have each six Muscles, viz. four Recti and two
Obliqui; the Recti or streight Muscles are the
Elevator, the Depressor, the Adductor, and the
Abductor. The first of these call'd Elevator, or
Superbus, draws the Eye upward, as it is pull'd downward by the
Depressor or Humilis; the Adductor or
Bibitorius draws it toward the Nose, and the Abductor or
Indignarorius toward the Shoulder: All these small Muscles have
their Originals and Insertions in the bottom of the Orbit through which
the Optick Nerve passeth, and are terminated in the Corneous Tunicle, by
a very large Tendon.
The first of the Oblique ones is term'd the Obliquus Major, and
the other Obliquus Minor, because they draw the Eye obliquely.
These Muscles cause Children to squint when they do not act together. The
Obliquus Minor is fasten'd at the outward part of the Orbit near
the great Corner, and draws the Eye obliquely toward the Nose: But the
Obliquus Major is fixt in the inner part of the Orbit, and ascends
along the Bone to the upper part of the great Corner, where its Tendon
passeth thro' a small Cartilage nam'd Trochlea, and is inserted in
the little Corner with the lesser Obliquus Minor, to draw the Eye
obliquely toward the lesser Corner.
The Ear, altho' not usually endu'd with any sensible Motion,
nevertheless hath four Muscles, viz. one above, and three behind;
the first being situated over the Temporal, and fasten'd to the Ear to
draw it upward: The three others have their beginning in the
Mammillary Apophysis, and are terminated in the Root of the Ear,
to draw it backward.
There are also three Muscles in the inner part of the Ear, whereof the
external belonging to the Malleus or Hammer lies under the
exterior part of the Bony Passage which reacheth from the Ear to the
Palate of the Mouth, being fixt in a very oblique Sinuosity which is made
immediately above the Bone that bears the Furrow, into which is let the
Skin of the Tympanum or Drum. The internal Muscle lies hid in a
Bony Semi-Canal, in the Os Petrosum; one part of which Semi-Canal
is without the Drum, and clos'd on the top with a Passage that leads from
the Ear into the Palate. But the other part within the Drum advanceth to
the Fenestra Ovalis, and is inserted in the hinder part of the
Handle of the Malleus. The Muscle of the Stapes or Stirrup
is also hid in a Bony Tube, almost at the bottom of the Drum, and fixt in
the Head of the Stapes.
The Nose hath seven Muscles, that is to say, one common and six
proper; the common constitutes part of the orbicular Muscle of the Lips,
and draws the Nose downward with the Lip. Of the six proper Muscles of
the Nose, four serve to dilate it, being situated on the outside, and two
to contract it, which are placed in the inside.
The two first Dilatators of a Pyramidal Figure, take their rise in the
Suture of the Forehead, and are fasten'd by a large Filament to the
Alæ of the Nose. The two other Dilatators resembling a Myrtle-Leaf
have their Source in the Bone of the Nose, and are inserted in
the middle of the Ala.
The two Restrictors are Membranous, beginning in the internal part of
the Bone of the Nose and adhering to the inner Ala of the
Nostril.
The Lips have thirteen Muscles, viz. eight proper, and five
common: Of the proper there are four for the Upper-Lip, and as many for
the Lower: with two common for each, and the odd one.
The first of the proper of the Upper-Lip bears the Name of the
Incisivus, its Origine being in the Jaw, in the place of the
Incisive Teeth and its Insertion is in the Upper-Lip.
The second is the Triangulis, Antagonist to the former; its
Rise is on the outside, at the bottom of the Lower-Jaw; and it is
implanted in the Upper-Lip, near the Corner of the Mouth.
The third being the Quadratus, springs from the bottom of the
Chin before, and cleaves to the edge of the Lower-Lip.
The fourth is the Caninus, Antagonist to the Quadratus,
beginning in the Upper-Jaw-Bone and being terminated in the Lower-Lip
near the Corner of the Mouth.
The first of the common is the Zygomaticus, the Origine whereof
is in the Zygoma and its Insertion in the Corner of the Mouth, to
draw it toward the Ears; so that it is the Muscle which acts when we
laugh.
The second of the common is the Buccinator or Trumpeter, which
is swell'd when one sounds a Trumpet. It hath its rise at the Root of the
Molar Teeth of both the Jaws, and is extended quite round about the Lips.
The odd Muscle, or the thirteenth in number, is the Orbicular,
which makes a Sphincter round about the Lips to close or shut them
up.
The Uvula or Palate of the Mouth hath four Muscles, whereof the
two first are the Peristaphylini Externi, taking their rise from
the Upper-Jaw, above the Left Molar Tooth, and being ty'd to the Palate
by a thin Tendon.
The two others are the Peristaphylini Interni, which have their
beginning in the Apophysis Pterygoides on the inside, and likewise
stick to the Palate.
The Tongue, altho' all over Musculous and Fibrous, yet doth not cease
to have its peculiar Muscles, which are eight in Number.
The first of these is call'd Genioglossus, taking its rise in
the lower part of the Chin, from whence it is extended till it cleave to
the Root of the Tongue before, to cause it to go out of the Mouth.
The second is term'd Styloglossus, its Rise being in the
Apophysis Styloides, from whence it passeth to the side above the
Tongue, to lift it up.
The third bearing the Name of Basiglossus, commenceth in the
Basis or Root of the Os Hyoides, and thence insinuates it
self into the Root of the Tongue, to draw it back to the bottom of the
Mouth.
The fourth is the Ceratoglossus, deriving its Original from the
Horn of the Os Hyoides, and cleaving to the side of the Tongue to
draw it on one side: The Action of these Muscles of both sides together,
causeth an Orbicular Motion in the Tongue. To these some add a fifth Pair of
Muscles, call'd Myloglossus, which serves to draw it obliquely
upward.
What is the Action of the Os Hyoides in the Throat, and how
many Muscles hath it?
The use of the Os Hyoides is to consolidate the Root of the
Tongue; and it hath five Muscles on each side, which keep it as it were
hung up.
The first of these, call'd the Geniohyoideus hath its beginning
in the Chin on the inside, and adheres to the top of the Os
Hyoides, which it draws upward.
The second is the Mylohyoideus, whose Origine is in the inner
side of the Jaw, from whence it cleaves side-ways to the Root of the
Os Hyoides, which it draws upward, and to one side.
The third is the Stylohyoideus, which after it hath taken its
rise in the Apophysis Styloides, is fasten'd to the Horn of the
Os Hyoides, to draw it toward the side.
The fourth is the Coracohyoideus, which springing up from the
Apophysis Coracoides of the Omoplata, cleaves to the Root
and side of the Os Hyoides, to draw it downward and to the
side.
The fifth is the Sternomohyoideus, that hath its beginning in
the Bone of the Sternum on the inside and is inserted in the Root
of the Os Hyoides, which it draws downward.
How many Muscles hath the Larynx?
There are fourteen, viz. four Common, and ten Proper. The first
Pair of the Common is the Sternothyroideus or Bronchycus,
which proceeding from the inside, and the top of the Sternum,
ascends along the Cartilages of the Wind-Pipe, and is terminated in the
bottom of the Scutiformis or Buckler-like
Cartilage, which it draws downward. The second is the
Hyothyroideus, which ariseth from the Root of the Os
Hyoides, and is inserted in that of the Scutiforme. This
Muscle serves to lift up the Larynx, as also to dilate the bottom
of the Scutiformis, and to close its top.
The first Pair of the Proper is the Cricothyroideus Anticus,
which deriving its Original from the hinder and upper part of the
Cricoides, or Ring-like Cartilage, is fixt in the upper and
lateral part of the Scutiformis, to close or shut it up.
The second is the Thyroides.
The third is the Cricoarytenoideus Lateralis, which proceeds
from the side of the Cricoides within, and is fasten'd to the
bottom and side of the Arytenoides, which it removes to dilate the
Mouth of the Larynx.
The fourth is the Thyroarytenoideus, which arising from the fore-part on the inside of the
Scutiformis, is terminated on the side of the Arytenoides,
to close the Orifice of the Larynx.
The fifth is the Arytenoideus, which having its Source in that
place where the Cricoides is united to the Arytenoides is
inserted in its upper and lateral part, to close the Larynx.
How many Muscles hath the Pharynx?
It hath seven, the first whereof is the Oesophagieus, which
takes its rise from the side of the Scutiformis or Buckler-like
Cartilage, and passing behind the Oesophagus or Gullet, is
fasten'd to the other side of the Cartilage. It thrusts the Meat down by
locking up the Pharynx as a Sphincter.
The second named Stylopharingæus, springs from within the Acute
Apophysis of the Os Sphenoides, or Cuneiforme, and
is inserted obliquely in the side of the Pharynx, which it
dilates by drawing it upward.
The third, call'd Sphenopharyngæus, proceeds from the
Apophysis Styliformis, and is terminated in the side of the
Pharynx, which it dilates by drawing its sides.
The fourth Pair is the Cephalopharyngæus which ariseth from the
articulation of the Head with the first Vertebra, and closeth the
Larynx.
How many Muscles are there in the Neck, and which be they?
There are four Muscles in the Neck on each side, viz. two
Flexors, and two Extensors. The Flexors are the Scalenus
and the Rectus or Longus; and the Extenders are the
Spinatus and the Transversalis.
The Scalenus or Triangularis hath two remote Sources,
viz. one in the first Rib, and the other in the Clavicle, and is
fasten'd to the third and fourth Vertebra of the Neck.
The Rectus or Longus begins in the side of the four
upper Vertebra's of the Back, and is join'd to the upper
Vertebra's of the Neck, and the hinder part of the Head.
The Spinatus hath its Origine in the fourth and fifth upper
Vertebra's of the Back, and is fasten'd to all the six lower
Vertebra's of the Neck.
The Transversalis springs forth out of the upper
Vertebra's of the Back, and cleaves to the Extremity of the four
Vertebra's of the Neck.
How many Muscles are there in the Breast, and which be
they?
The Breast hath fifty seven Muscles, that is to say, thirty that serve
to dilate it, twenty six whose Office is to contract it, and the
Diaphragm or Midriff, which partakes of both Actions.
The thirty which dilate the Breast are equally plac'd to the number of
Fifteen, viz. the Subclavius, the Serratus Major
Anticus, the two Serrati Postici, and the eleven external
Intercostals.
The twenty six which contract the Breast are likewise equally rank'd
to the Number of thirteen on each side, viz. the
Triangularis, the Sacrolumbus, and eleven internal
Intercostals.
The Subclavian takes up the whole space between the Clavicle
and the first Rib: Its Original being in the internal and lower part of
the Clavicula, and its insertion in the upper part of the first
Rib.
The Serratus Major is a large Muscle having seven or eight
Indentings or Jaggs. It takes its rise in the interior Basis of the
Omoplata or Shoulder-Blade, and its Jaggings are inserted in the five
lower true Ribs, as also in the two upper spurious Ribs.
The Serratus Posticus Superior, begins with a large
Aponeurosis in the Apophyses of the three lower
Vertebræ of the Neck, and of the first of those of the Back; then
passing under the Rhomboid, it is join'd obliquely by four
Indentings to the four upper Ribs.
The Serratus Posticus Inferior, commences in like manner with a
large Aponeurosis in the Apophyses of the three lower
Vertebra's of the Back, and of the first of those of the Loins,
and is afterwards fasten'd by four Digitations to the four lower
Ribs.
The eleven External Intercostal Muscles are situated in the
spaces between the twelve Ribs passing obliquely and on the outside from
the back part to the fore part. They take their rise below the Upper Rib,
and have their Insertion above the lower Rib.
The Triangularis is the first of those that contract the
Breast, and possesseth the inward part of the Sternum: Its
Original is in its lower part, and its Insertion in the top of the
Cartilages of the two upper Ribs.
The Sacrolumbus hath its Source in the hinder part of the Os
Sacrum, as also in the Vertebra's of the Loins, and ascending
from thence, insinuates it self into the hinder part of the Ribs, to
every one of which it imparts two Tendons, one whereof sticks on
the outside, and the other on the inside. This Muscle is fleshy within,
and fibrous without.
The Eleven Internal Intercostals, contrary to the External,
derive their Original from the top of every lower Rib, and ascend obliquely
from the back-part to the fore-part, till they are join'd to the lower
Lip of every upper Rib: Thus these Internal Muscles, with the External,
form, by the opposition of their Fibres, a Figure resembling a
Burgundian Cross.
The Diaphragm or Midriff is esteem'd as the fifty seventh Muscle of
the Breast, and serves as well for its dilatation as contraction. It
separates the Thorax or Chest from the lower Belly, and is tied
circularly to all the Extremities of the Bastard Ribs, immediately under
the Xiphoides, or Sword-like Cartilage.
Modern Anatomists have discover'd that the Diaphragm is compos'd of
two Muscles, viz. one Upper, and the other Lower; so that the
Upper cleaves to the Extremities of the Spurious Ribs, and is terminated
in a flat Tendon in the middle, which hath been always taken for
its Nervous part. The Lower begins with two Productions, the longest
whereof being on the right side, ariseth from the three upper
Vertebra's of the Loins, and the other on the Left from the two
Vertebra's of the Back, till it is lost in the Aponeurosis
of the Upper Muscle.
How many Muscles are there in the Back and the Loins, and which be
they?
There are three in each side, viz. one for Flection, and the
other for Extension.
The Triangularis is the Flexor, taking its rise in the
hinder part of the Rib of the Os Ilion, and the inner part of the
Os Sacrum, in passing from whence it is joined to the last of the
Bastard Ribs, and to the transverse
Productions of the Vertebra's of the Loins.
The Extensors are the Sacer, and the
Semi-spinatus, which make the Waste streight, and are so
interwoven along the Back-Bone, that one would imagine that there were as
many Pairs of Muscles as Vertebra's, affording Tendons to
all.
The Sacer springs from behind the Os Sacrum, as also
from the hinder and upper Extremity of the Os Ilium, and is
inserted in the Spines of the Vertebra's of the Loins and
Back.
The Semi-spinatus hath its Source in the Spines of the Os
Sacrum, and is join'd to all the transverse Productions of the
Vertebra's from the Back to the Neck, being exactly situated
between the Sacer and the Sacrolumbus.
How many Muscles are there in the lower Belly, and which be
they?
There are generally ten, five on each side, that is to say, two
Obliqui, one ascending, and the other descending; one
Transversus, one Rectus, and two Pyramidal, of which last,
nevertheless, there is sometimes only one, and sometimes none at all.
The Obliquus Descendens, which is the first, hath its Original
by digitation in the sixth and seventh of the true Ribs, in all the
spurious Ribs, and in the transverse Apophyses of the
Vertebra's of the Loins, and comes near to the Serratus Major
Anticus of the Breast; from whence it proceeds to the external Rib of
the Os Ilion, and is terminated by a large Aponeurosis in
the Linea Alba or White Line, which separates the Muscles
that are on each side of the Abdomen or lower Belly.
The Obliquus Ascendens ariseth from its Source in the upper
part of the Os Pubis, and in the Ridge of the Hip-Bone, till it
cleaves to the Apophyses of the Vertebra's of the Loins in
the Extremities of all the Ribs, and in the Xiphoides or
Sword-like Cartilage, and is terminated in the White Line by a large
Aponeurosis.
The Rectus being situated between the Aponeuroses of the
Obliquus, takes its rise in the Cartilages of the Ribs, in the
Xiphoides and the Sternum, and enters into the Os
Pubis, having many nervous parts to corroborate it in its length.
The Transversus having its beginning in the transverse
Apophyses of the Vertebra's of the Loins, is fasten'd to
the internal Rib of the Os Ilium, and within the Cartilages of the
lower Ribs, and is terminated by a large Aponeurosis in the
Linea Alba, passing over the Rectus, and sticking to the
Peritonæum.
The Oblique Muscles, and the Transverse, have Holes toward the Groin,
to give Passage to the Spermatick Vessels of Men, and to a round ligament of the Matrix in Women; so that Ruptures or
Burstenness happen through these parts in both Sexes, although the Holes
of these three Muscles are not situated one over-against another.
The Pyramidal, so named by reason of its Figure, is situated in the
lower Tendon of the Rectus, its Origine being in the upper
and external part of the Os Pubis; but it is terminated in the
White Line, three Fingers breadth above the Pubes, and sometimes
even in the Navel itself. These Muscles are not found in all Bodies for
there are sometimes two, sometimes only one, and sometimes none.
The use of the Muscles of the lower Belly is to compress all the
contain'd parts, in order to assist them in expelling the Excrements.
How many Muscles are there in the Testicles?
They have each of them one, call'd Cremaster; this Muscle takes
its rise from the Ligaments of the Os Pubis, and by the dilatation
of its Tendon covers the Testicle, which it draws upward.
How many Muscles hath the Penis?
It hath two Pair, viz. the Erectores or
Directores, and the Dilatantes: The Erectores arise
from the internal part of the Os Ischion, under the beginning of
the Corpora Cavernosa, where they are inserted, and retake their
Fibres in their Membranes. The Dilatantes or Acceleratores
have their Source in the Sphincter of the Anus and slipping
from thence obliquely under the Ureter, are join'd to the Membrane
of the Nervous Bodies.
How many Muscles are there in the Clitoris?
It hath two Erectors which spring forth from the Protuberance of the
Os Ischion, and are inserted in the Nervous Bodies of the
Clitoris. There are also two others suppos'd to be its Elevators,
which proceed from the Sphincter of the Anus, and are
terminated in the Clitoris.
How many Muscles are there in the Anus?
There are three, viz. the Sphincter, and two
Levatores. The Sphincter is two Fingers broad, to open and
close the Rectum. This Muscle being double, is fasten'd in the
fore-part to the Penis in Men, and to the Neck of the
Matrix in Women, as also behind to the Coccyx, and
laterally to the Ligaments of the Os Sacrum, and the Hips.
The two Levatores arise from the inner and lateral part of the
Os Ischion, and are fasten'd to the Sphincter of the
Anus, to lift it up after the expulsion of the Excrements.
The Bladder hath also a Sphincter Muscle to open and
shut its Orifice.
How many ways doth the Omoplata or Shoulder-Blade move, and
what are its Muscles?
The Omoplata moves upward, downward, forward, and backward, by
the means of four proper Muscles, which are the Trapezius, the
Rhomboides, the proper
Levator, and the lesser Pectoral, or Serratus Minor
Anticus.
The Trapezius or Cucullaris hath its beginning in the
back part of the Occiput, or hinder part of the Head, in the
Spines of the six lower Vertebra's of the Neck, and of the nine
upper of the Back, in passing from whence it is implanted in the Spine of
the Omoplata or Shoulder-Blade, and the external part of the
Clavicula, as far as the Acromion. This Muscle produceth
many Motions by reason of its different Fibres, drawing the
Shoulder-Blade obliquely upward, downward, and forward.
The Rhomboides is situated over the Trapezius, its rise
being in the Apophyses of the three lower Vertebra's of the
Neck, and of the three upper of the Back, but it is afterward join'd to
the whole Basis or Root of the Omoplata, which it draws
backward.
The proper Levator commenceth in the Transverse
Apophyses of the four first Vertebra's of the Neck, by
different Progressions, but is afterward re-united, and inserted in the
upper Corner of the Omoplata, which it draws upward.
The lesser Pectoral, or Serratus Minor Anticus, is
situated under the great Pectoral, its rise being by Digitation or
Indenting in the second, third, and fourth of the upper Ribs, and its
Insertion in the Apophysis Coracoides of the Shoulder-Blade, which
it draws forward.
How many Motions are there in the Humerus, or Arm; which be
they, and what are its Muscles?
The Arm performs all sorts of Motions by the help of nine Muscles: For
it is lifted up by the Deltoides and the Infra-Spinatus; it
is depress'd by the Largissimus, and the Rotundus Major; it
is drawn forward by the Pectoralis Major, and the
Coracoideus; it is drawn backward by the Infra-Spinatus,
and the Rotundus Minor. It is drawn near the Ribs by the
Subscapularis, and its circular Motion is performed when all these
Muscles act together successively.
The Deltoides or Triangular hath its beginning in the
whole Spine of the Omoplata, the Acromion, and half the
Clavicula, and by its point cleaves with a strong Tendon to
the middle of the Arm.
The Infra-Spinatus takes its rise in the Cavity that lies above
the Spine of the Omoplata, which it fills, passing over the
Acromion, until it is join'd to the Neck of the Shoulder-Bone,
which it surrounds with a large Tendon.
The Largissimus, otherwise call'd Ani-scalptor, covers
almost the whole Back, proceeding from a large and Nervous Stock, in the
third and fourth lower Vertebra of the Back, the five
Vertebra's of the Loins, the Spine of the Os Sacrum, the
hinder part of the Lip of the Hip-Bone, and the external part of the
lower Bastard-Ribs, in passing from whence it insinuates it self into the
lower Corner of the Omoplata, as also into the upper and inner
part of the Humerus.
The Rotundus Major, or Teres Major, having its Origin in
the external Cavity of the lower Corner of the Omoplata, is
confounded with the Largissimus, and adheres with it by the same
Tendon to the upper and inner part of
the Humerus, a little below the Head.
The greater Pectoral hath its Source in half the
Clavicula, on the side of the Sternum; covers the fore-part
of the Breast, and is fasten'd by a short, broad, and nervous
Tendon, to the top of the Shoulder-Bone, on the inside, between
the Biceps and the Deltoides.
The Coracoideus or Coracobrachyæus, beginning in the
Apophysis Coracoides of the Omoplata or Shoulder-Blade,
adheres to the middle of the Arm on the inside, which with the
Pectoral it draws forward.
The Infra-Spinatus fills the Cavity which lies below the Spine
of the Omoplata, its Origine being in the lower Rib of the
Omoplata, from whence it passeth between the Spine and the
Rotundus Minor, to cleave to the Neck of the Shoulder-Bone, which
it embraceth, and draws backward.
The Rotundus Minor, or Teres Minor, proceeds from the
lower Rib of the Omoplata, and adheres to the Neck of the
Shoulder-Bone with the Infra-Spinatus to draw it in like manner
backward.
The Sub-scapularis or Immersus is situated entirely
under the Omaplata, proceeding from the internal Lip of the
Basis or Root of the same Omoplata, and being terminated in
the Neck of the Arm-Bone, which it causeth to lie close to the Ribs.
How many Motions are there in the Cubitus or Elbow, and what
are its Muscles?
The Cubitus or Ulna is endu'd with two sorts of Motions,
viz. that of Flection and that of Extension, the former
being perform'd by the help of two Muscles, that is to say, the
Biceps, and the Brachiæus Internus; and the later by eight
others, which are the Longus, the Brevis, the Brachiæus
Externus, and the Anconeus.
The Biceps is a Muscle with two Heads, one whereof proceeds
from the Apophysis Coracoides, and the other from the
Cartilaginous edge of the Glenoid Cavity of the Omoplata or
Shoulder-Blade: These two Heads descend along the fore-part of the Arm,
and are united in one and the same Body, from whence springs forth a
Ligament, which is inserted in a tuberosity situated in the upper and
fore-part of the Radius.
The Brachiæus Internus is a small fleshy Muscle, lying hid
under the Biceps, which takes its rise in the upper and fore-part
of the Humerus, and is implanted in the upper and inner-part of
the Radius, to bend the Elbow with the Biceps.
The first of the four Extenders is the Longus having two
Sources, viz. one situated in the lower Rib of the
Omoplata, near its Neck, and the other descending to the
hinder-part of the Arm, till it is tyed to the Olecranum or
Ancon, by a strong Aponeurosis, which is common thereto,
with the Brevis, and the Brachiæus Externus.
The Brevis or short Muscle of the Elbow arising from the hinder
and upper-part of the Humerus, is fasten'd to the Olecranum
with the Longus.
The Brachiæus Externus is a fleshy Muscle which proceeds from
the hinder part of the Humerus, and adheres to the
Olecranum with the Brevis and the Longus.
The Anconeus or Cubitalis being situated behind the Fold
of the Cubitus, is the least Muscle of all; it springs from the
Extremity of the Arm-Bone, at the end of the Brevis and the
Longus, and in descending is inserted between the Radius
and the Cubitus or Ulna, three or four Fingers breadth
below the Olecranum.
How many Muscles hath the Radius, and which are its
Motions?
The Radius is endu'd with a twofold Motion by the means of four
Muscles: Of these the Rotundus and Quadratus cause that of
Pronation, as the Longus and the Brevis that of
Supination.
The Pronator Superior Rotundus, or round Muscle of the
Radius, commenceth from the inner Apophysis of the
Shoulder-Bone, in a very fleshy Stock, and is terminated obliquely by a
Membranous Tendon in the middle and exterior part of the
Radius.
The Pronator Inferior Quadratus, springing forth from the
bottom and inside of the Cubitus, is fixt in the lower and outward
part of the Radius by a Tail as large as its Head. This Muscle
lying hid under the others near the Wrist, is that which jointly with the
Rotundus, turns the Arm with the Palm of the Hand downward, which
is the Motion of Pronation.
The Longus is the first of the Supinators, whose Origine
is three or four Fingers breadth above the external Apophysis of
the Arm-Bone; from whence it passeth along the Radius, and cleaves
to the inner-part of its lower Apophysis.
The Brevis, or the second of the Spinators arising from
the lower part of the Inferior Condylus, and the external of the
Humerus, is twisted round about the Radius, going forward
from the hinder-part till it is united to its upper and forepart. This
Muscle, with the Longus, serves to turn the Arm and the Palm of
the Hand upward, and produceth the Motion of Supination.
How many sorts of Motions belong to the Wrist, and what are its
Muscles?
Two several Motions are perform'd by the Wrist, viz. one of
Flection, and the other of Extension, three Muscles being appropriated to
the former, and as many to the later: But it ought to be observed, that a
strong Ligament, call'd the Annular, appears here, which,
surrounding all the Tendons of the Muscles as it were a Bracelet,
holds them together, and elsewhere serves to unite the two Bones of the
Elbow. The three Flexors or Bending Muscles of the Wrist are the
Cubitæus Internus, the Radiæus Internus, and the
Palmaris.
The Cubitæus Internus derives its Original from the part of the
Arm-Bone, passeth under the Annular Ligament, and is ty'd by a thick
Tendon to the small Bone of the Wrist, which is plac'd above the
others.
The Radiæus Internus proceeds from the same place with the
Cubitæus, and is fasten'd to the first Wrist-Bone which supports
the Thumb. It lies along the Radius, and passeth under the
Annular Ligament.
The Palmaris is reckon'd among the Flexors of the Wrist,
although situated in the Palm of the Hand. It ariseth from the inner
Process or Knob of the Arm-Bone, and is united by a large
Tendon to the first Phalanges of the Fingers, slipping
under the Transverse or Annular Ligament and sticking under the
Skin of the Palm of the Hand.
The three extending Muscles of the Wrist are the Cubitæus
Externus, and the Radiæus Externus or the Longus, and
the Brevis.
The Cubitæus Externus taking its rise from the hinder-part of
the Elbow, passeth under the Annular Ligament, and adheres to the
upper and outward-part of the Bone of the Metacarpus that stayeth
the little Finger.
The Radiæus Externus, or the Longus, having its Origine
in the edge of the lower part of the Arm-Bone, slides from thence along
the Radius on the outside, extends it self under the
Annular Ligament, and cleaves to the Wrist-Bone, which stayeth the
Fore-Finger.
The Brevis or short Muscle of the Wrist springs from the
lower part of the same Edge; afterwards it runs along the Radius,
passeth under the Annular Ligament, and is terminated in the Bone
of the Carpus or Wrist, which stayeth the Middle Finger. But we
must take notice, that besides these six Muscles, there is also Caro
quædam quadrata, or a square piece of Flesh under the
Palmaris, which seems to arise from the Thenar, and sticks
to the eighth Wrist-Bone. It is supposed that this Musculous piece of
Flesh serves with the Hypothenar of the little Finger, to make
that which is call'd Diogenes's Cup.
How many Motions are there in the Fingers, and what are their
Muscles?
The Fingers are bent, extended, and turn'd from one side to the other
by the means of twenty-three Muscles, whereof ten are proper, and
thirteen common: The former are those that serve all the Fingers in
general, and the other those that are particularly serviceable to some of
them: The Common are the Sublimis, the Profundus, the
common Extensor, the four Lumbricales, and the six
Interossei.
The Sublimis or Perforatus, arising from the internal
part of the lower Process of the Humerus or Shoulder-Bone is
divided into four Tendons, which run below the Annular
Ligament of the Wrist, and are inserted in the second Phalanx of
the Bones of the four Fingers, after having stuck in passing to those of
the first Phalanx, to help to bend it. It is also observed that
every one of these Tendons hath a small cleft in its length, to
let in the Tendons of the Profundus.
The Profundus or Perforans lies under the
Sublimis, deriving its Original from the top of the Cubitus
and Radius. It creeps along these two Bones, and is divided into
four Tendons, which pass under the Annular Ligament, and
slip into the Fissures of the Tendons of the Sublimis, to
adhere to the third Phalanx of the Fingers, which they bend with
the Sublimis: So that these two Muscles make together the bending
of the Fingers.
The Extensor Magnus is that which extends the four Fingers. It
springs from the external and lower Process of the Arm-Bone, and is
divided into four flat Tendons, which pass under the
Annular Ligament, and cleave to the second and third
Phalanx of the Fingers.
The four Lumbricales or Vermiculares are in the Palm of
the Hand, to draw the Fingers to the Thumb: They proceed from the
Tendons of the Profundus, and the Annular Ligament,
extend themselves along the sides of the Fingers and are inserted in
their second Articulation, to cause the drawing toward the Thumb.
The three Interossei Interni, and the three Externi, are
situated between the four Bones of the Metacarpium, as well on the
inside of the Hand as without: They have their beginning in the Intervals
or Spaces between the Bones of the Metacarpium, are united with
the Lumbrical, and fixt in the last Articulation of the Bones of
the Fingers, to produce the Motion of drawing back or removing from the
Thumb.
The Thumb is mov'd by five particular Muscles; one whereof serves to
bend it, two to extend it, one to remove it from the Fingers, and another
to draw it to them.
The Flexor of the Thumb takes its rise from the upper and inner
part of the Radius, passes under the Annular Ligament, as
also under the Thenar, and adheres to the first and second Bones
of the same Thumb to bend it.
The two Extensors of the Thumb are the Longior and the
Brevior: The former proceeding from the upper and outward part of
the Cubitus, ascends above the Radius, and is ty'd with a
forked Tendon to the second Bone of the Thumb. The Brevior
hath the same Origin with the Longior, keeps the same Track,
passes under the Annular Ligament, and is terminated in the third
Thumb-Bone.
The Thenar removes the Thumb from the Fingers, and forms that
part which is call'd the Mount of Venus: It hath its Source in the
first Bone of the Carpus or Wrist, and the Annular
Ligament, and is inserted in its second Bone.
The Antithenar draws the Thumb to the other Fingers, having its
Origine in the Bone of the Metacarpus, that stayeth the middle
Finger, and its Insertion is in the first Bone of the Thumb.
The Muscle which serves to extend the Fore-Finger, is call'd
Indicator: It proceeds from the middle and outer part of the
Cubitus, and is fixt by a double Tendon in the second
Articulation of the Fore-Finger, as also in the Tendon of the
great Extensor of the Fingers.
That which draws the Fore-Finger to the Thumb is term'd
Adductor: It commenceth in the fore-part of the first Thumb-Bone,
and is terminated in the Bones of the Fore-Finger.
That which removes the Fore-Finger from the Thumb is known by the Name
of Abductor, which arising out of the external and middle part of
the Bone of the Elbow, and passing under the Annular Ligament,
cleaves to the Lateral and outward part of the Bones of the
Fore-Finger.
The Little-Finger hath two proper Muscles, viz. an
Extensor and an Abductor.
The Extensor springs from the lower part of the Condylus
of the Arm-Bone, and is fasten'd by a double Tendon in the second
Articulation of the Little-Finger, and in the Tendon of the
Extensor of all the others.
The Abductor, call'd also Hypothenar, hath its beginning
in the small Bone of the Wrist, which is situated over the others, and is
terminated in the first Bone of the Little-Finger on the outside.
What are the Motions of the Thighs?
The Thigh performs five kinds of Motions; for it is bent, extended,
drawn within side and without, and turn'd round: All these Motions are
produc'd by the means of fourteen Muscles, viz. three
Flexors, three Extensors, three Adductors, three
Abductors, and two Obturators for the Circular Motion.
The Flexors of the Thigh are the Psoas, Iliacus,
and Pectineus.
The Psoas or Lumbaris is situated inwardly in the
Abdomen, on the side of the Vertebra's. It proceeds from
the transverse Apophyses of the two lower Vertebra's of the
Back, and of the upper of the Loins, and lying on the inner Face of the
Os Ilion, sticks to the lesser Trochanter or
Rotator.
The Iliacus Internus hath its Origine in all the Lips of the
inner Cavity of the Os Ilion, and being joyn'd by a Tendon
to the Lumbaris, is inserted with it in the lesser
Trochanter.
The Pectineus takes its rise from the fore-part of the Os
Pubis, and is united before to the Thigh-Bone a little below the
lesser Trochanter.
The Extensors of the Thigh are the Glutæus Major,
Medius, and Minimus.
The Glutæus Major springs forth out of the lateral part of the
Os Sacrum, as also the hinder and outer part of the Os
Ilion and Coccyx, and enters into the Thigh-Bone, four Fingers
breadth below the great Trochanter or Rotator, being the
thickest of all the Muscles of the Body.
The Glutæus Medius, deducing its Original from the hinder and
outward part of the Os Ilion, is inserted three Fingers breadth
below the great Trochanter.
The Glutæus Minimus ariseth from the bottom of the Cavity of
the Os Ilion, and is fasten'd to a small Hole near the great
Trochanter.
The Adductors of the Thigh are the Triceps Superior,
Medius, and Inferior.
The Triceps Superior hath its beginning in the top of the Os
Pubis, and is terminated in the top of a Line, which is on the inside
of the Thigh.
The Triceps Medius proceeding from the middle of the Os
Pubis, is inserted in the Thigh-Bone a little lower than the
Triceps Superior.
The Triceps Inferior hath its Source in the bottom of the Os
Pubis, and is implanted in the Thigh-Bone, a little lower than the
Triceps Medius. Some Anatomists make only one Muscle of these
three, attributing thereto three Originals and three Insertions. These
Muscles serve to draw the Thighs one against another.
The Abductors of the Thigh are the Iliacus Externus, or
Pyriformis, the Quadratus, and the Gemelli.
The Pyriformis arising from the upper and lateral part of the
Os Sacrum, and the the Os Ilion cleaves to the Neck of the
great Trochanter.
The Quadratus or square Muscle of the Thigh takes its Origine
from the external Prominence of the Os Ischion, and adheres to the
outward part of the great Trochanter.
The Gemelli or Twin Muscles arise from two small Knobs in the
hinder-part of the Ischion and insinuate themselves into a small
Cavity in the Neck of the great Trochanter.
The Circular Motion of the Thigh is performed by the means of two
Muscles, named the Obturatores Externi and Interni.
The Obturator Internus springs from the inner Circumference of
the Oval Hole of the Ischion and its Tendons passing
between the two Gemelli are inserted in a small Cavity at the Root
of the great Trochanter or Rotator.
The Obturator Externus ariseth from the outward Circumference
of the same Hole of one Ischion, and is terminated in the side of
the other near the great Trochanter.
What are the Motions of the Leg, and what are its Muscles?
The Leg is mov'd four several ways, that is to say, it is bent,
extended, and drawn inward and outward, by the means of eleven Muscles
viz. three Flexors, four Extensors, two
Adductors and two Abductors.
The three Flexors of the Leg are the Biceps, the
Semi-nervosus, and the Semi-membranosus.
The Biceps hath two Heads, the longer whereof cometh out of the
bottom of the Prominence of the Ischion, and the other from
the middle and exterior part of the Femur, and is terminated in
the outward and upper part of the Epiphysis of the Perone
or Fibula.
The Semi-nervosus hath its Origine in the Knob of the
Ischion, and is join'd backward to the top of the Epiphysis
of the Tibia. These three Muscles are plac'd in the back-part of
the Thigh below the Buttocks.
The four Extensors of the Leg are the Rectus, the
Vastus Internus, the Vastus Externus, and the
Crureus.
The Rectus or streight Muscle of the Leg takes its rise from
the fore-part and the bottom of the Ilion, and descends in a right
Line: It covers with its Tendon, which is common to the three
following, the whole Knee-Pan, and adheres to the top of the
Tibia, on the fore-part.
The Vastus Internus, being situated on the inside of the Thigh,
hath its beginning in the top of the Thigh inwardly, and a little below
the lesser Trochanter or Rotator: Afterward it is ty'd to
the Tibia by a large Tendon, common thereto with the
preceeding.
The Vastus Externus is plac'd on the outside of the Thigh,
springing from the top and the fore-part of the Femur, being
united by the same Tendon with the two preceeding.
The Crureus proceeds from the top, and the fore-part of the
Thigh-Bone, between the two Trochanters; then covering the whole
Bone, it is also fasten'd to the Leg-Bone with the three preceeding
Muscles, after having cover'd the Knee-Pan with their common Tendon,
which serves likewise as a Ligament to the Knee.
The two Adductors of the Leg are the Sartorius and the
Gracilis.
The Sartorius or the Longissimus draws the leg inward,
deriving its Original from the upper Spine of the Ischion;
from whence it descends obliquely thro' the inside of the Thigh, and
cleaves to the top on the inside of the Tibia.
The Gracilis hath its Origine in the fore-part at the bottom of
the Os Pubis, and its Insertion in the top of the Tibia on
the inside.
The two Abductors of the Leg are the Fascia lata, and
the Poplitæus.
The Fascia lata, or the Membranosus, is as it were a
kind of large Band, which covers all the Muscles of the Thigh. It
proceeds from the outward Lip of the Os Ilion, is ty'd by a large
Membrane to the top of the Perone or Fibula and sometimes
descends to the end of the Foot.
The Poplitæus, or Sub-poplitæus, arises from the lower
and external Condylus of the Thigh-Bone, passeth obliquely from
the outside to the inside, till it is lost in the upper and inner part of
the Leg-Bone under the Ham.
What are the Motions of the Foot, and what are its Muscles?
The Foot performs two Motions by the help of nine Muscles, as being
bent by two, and extended by seven.
The two Flexors are the Crureus Anticus, and the
Peronæus Anticus.
The Crureus or Tibiæus Anticus, is plac'd along the
Tibia, and takes its rise from its upper and fore-part: Afterward
it is bound by two Tendons to the first Os
Cuneiforme, or Wedge-like Bone, and to that of the Metatarsus
or Instep, which stayeth the great Toe, after having pass'd under the
annular Ligament.
The Peronæus Anticus springs from the middle and outward-part
of the Perone or Fibula, and insinuating it self thro' the
Cleft which is under the external Malleolus before, sticks to the
Bone of the Metatarsus that supports the little Toe.
The seven Extensors of the Foot are the two Gemelli, or
the Soleus, the Plantaris, the Crureus Posticus, and
the two Peronæi Postici.
The Gemelli are the Interior and the Exterior;
the former having its Source in the inner Condylus, and the other
in the outward and lower of the Thigh-Bone; from whence they extend
themselves till they are fasten'd to the Talus or Ankle-Bone by a
Tendon common to them, with the two following.
The Soleus ariseth from the top on the back-part of the
Leg-Bone and Perone, and confounding its Tendon with that
of the Gemelli, sticks close to the Talus.
The Plantaris, which lies hid between the Gemelli and
the Soleus, hath its Origine from the Exterior Condylus of
the Thigh-Bone; then uniting its Tendon with the preceeding, it
adheres to them; and this common Tendon is call'd Chorda
Achillis.
The Crureus or Tibiæus Posticus, springs from the
back-part of the Leg-Bone, from whence extending it self downward, it
passeth thro' the Fissure in the Internal Malleolus, and cleaves
to the inner-part of the Os Scaphoides.
The Peronæi, or Fibulæi Postici, are otherwise call'd
the Longus and the Brevis, whereof one proceeds from the
upper and almost fore-part of the Perone, terminating in the
upper-part of the Bone, that supports the great Toe in the
Metatarsus, and the other from the lower part of the
Perone, adhering in like manner to the Bone with which the little
Toe is sustain'd.
With what Motions are the Toes endu'd, how many Muscles have they,
and which be they?
The Toes are bent and extended, as also drawn inward and outward, by
the means of twenty two Muscles, of which sixteen are Common, and six
Proper. The former are two Flexors, two Extensors, four
Lumbricales, and eight Interossei. The first Flexor
is nam'd Sublimis, and the other Profundus.
The Sublimis or Perforatus derives its Original from the
lower and inner-part of the Talus and is fixt in its proper place
by four cleft Tendons, which are inserted in the upper-part of the
Bones of the first Phalanx of the four Toes. It is situated under
the Sole of the Feet.
The Profundus or Perforans hath its beginning in the top
and back-part of the Leg-Bone and Perone, slips under the
Malleolus Internus thro' the Sinus Calcaris, and makes four
Tendons which pass thro' the Fissures of the Tendon of the
Sublimis, and cleaves to the Bones of the last Phalanx of
the Toes, to bow them.
The first Extensor is call'd the Common, and the other
the Pediæus.
The Common Extensor, or the Longus, takes its rise from
the top and fore-part of the Tibia in the place of its joyning
with the Perone or Fibula, and divides it self into four
Tendons, which after having pass'd under the Annular Ligament, are
inserted in the Articulations of every Toe.
The Pediæus or the Brevis, being plac'd over the Foot,
proceeds from the Annular Ligament, and the lower-part of the
Perone, and sends forth four Tendons, which are fixt to the
first Articulation of the four Toes on the outside, Thus this Muscle,
together with the Longus, causeth their Extension.
The four Lumbrical Muscles of the Toes arise from the
Tendons of the Profundus, and a Mass of Flesh at the Sole
of the Feet. They are joyn'd by their Tendons with those of the
Interossei Interni, and adhere inwardly to the side of the first
Bones of the four Toes, to incline them toward the great Toe.
The Abductors, or those Muscles that remove the Toes from the
great Toe, are the eight Interossei, whereof four are call'd
Externi, and as many Interni. The former take their rise in
the Spaces between the Bones of the Metatarsus, and are terminated
outwardly in the side of the first Bones of the Toes. The Internal lie in
the bottom of the Foot, and take up the Spaces between the five Bones of
the Metatarsus. They arise from the Bones of the Tarsus,
and the Intervals between those of the Metatarsus, and are
implanted with the four Lumbricales inwardly, in the upper-part of
the Bones of the first Phalanx of the four Toes.
Of the six Proper Muscles of the Toes, there are four appointed for
the great Toe, which cause it to perform the Motions of Flexion, Extension, and drawing forward or backward.
The two others are the Adductor of the second Toe to the great
Toe, and the Abductor of the little Toe, call'd
Hypothenar.
The Proper Flexor of the great Toe, arises from the top of the
Perone or Fibula, on the back part, passeth thro' the
Ancle-Bone on the inside to the sole of the Foot, and is fasten'd to the
Bone of the last Phalanx.
The Proper Extensor of the great Toe springs from the middle of
the fore-part of the Perone, passeth over the Foot, and hath its
Insertion in the upper-part of the Bone of the great Toe.
The Proper Adductor of the great Toe, or the Thenar,
taking its rise inwardly on the side of the Talus, the Ossa
Schaphoidea and Innominata, extends it self over the
outward-part of the Bone of the Metatarsus, which stayeth the
great Toe, and adheres to the top of the second Bone of the great Toe,
which it draws inward.
The proper Abductor of the great Toe, or the Antithenar,
draws it toward the other Toes. It derives its Origine from the Bone of
the Metatarsus, which supports the little Toe, slides obliquely
over the other Bones, and cleaves to the first Bone of the great Toe on
the inside.
The Adductor appropriated to the second Toe hath its Source in
the first Bone of the great Toe, on the inside, and sticks close to the
Bones of the second Toe, which it draws to the great Toe.
The Abductor of the little Toe, or the Hypothenar,
proceeds from the outward part of the Bone of the Metatarsus, that
stayeth the little Toe, and is inserted in the top of the little Toe, on
the outside, to remove it from the others.
| A List of all the Muscles in the Humane Body. |
| The Fore-head hath two Muscles | 2 |
| The hinder-part of the Head | 2 |
| The Eye-Lids | 4 |
| The Eyes | 12 |
| The Nose | 7 |
| The Ears on the outside | 8 |
| The Ears on the inside | 6 |
| The Lips | 13 |
| The Tongue | 8 |
| The Uvula, or Palate of the Mouth | 4 |
| The Larynx | 13 |
| The Pharynx | 7 |
| The Os Hyoides | 10 |
| The Lower Jaw | 12 |
| The Head | 14 |
| The Neck | 8 |
| The Omoplatæ or Shoulder-Blades | 8 |
| The Arms | 18 |
| The Elbows | 12 |
| The Radii | 8 |
| The Wrists | 12 |
| The Fingers | 48 |
| The Breast, or the Parts of Respiration | 57 |
| The Loins | 6 |
| The Abdomen or lower Belly | 10 |
| The Testicles | 2 |
| The Bladder | 1 |
|
The Penis | 4 |
| The Clitoris | 4 |
| The Anus | 3 |
| The Thighs | 30 |
| The Legs | 22 |
| The Feet | 18 |
| The Toes | 44 |
| | Total 425 |
What is the Structure of the Nerves?
The Nerves are round white Bodies enclos'd in a double Membrane,
communicated to them from the two Meninges of the Brain: Their
Office is to convey the Animal Spirits into all the Parts.
Where is the Root and first beginning of all the Nerves?
All the Nerves take their Original from the Medulla Oblongata,
and that of the Spine.
How is the distribution of them made thro' the whole Body?
It is directly perform'd by Conjugations or Pairs, whereof one goes to
the Right-hand, and the other to the Left: There are nine Pairs of them
that proceed from the Medulla Oblongata and enter into the Skull;
and a Tenth that comes from the Marrow which lies between the Occipital
and the first Vertebra of the Neck. It passeth thro' the Hole of
the Dura Mater, thro' which the Vertebral Artery enters, to
distribute its Branches into several Parts.
To what Use are the nine Pairs of Nerves appropriated, which
proceed from the Root of the Brain?
They are chiefly design'd for the Senses, and also for the Motion of
their Organs, of which the Ancients discover'd only seven.
The first Pair of Nerves is call'd the Olfactory, and serves
for the Smelling.
The second Pair is the Optici or Visorii Nervi, and
bestows upon the Eyes the Faculty of seeing.
The third is term'd Motorii Oculorum, being serviceable for the
Motion of the Eyes.
The fourth Pair is nam'd Oculorum Pathetici, which shews the
Passion of the Mind in the Eyes, whereto it imparts a String as well as
to the Lips.
The fifth is call'd the Gustative, and appropriated to the
Taste, because it sends Twigs more especially to the Tongue, as also to
the Fore-head, Temples, Face, Nostrils, Teeth, and Privy-Parts.
The Sixth is likewise for the Taste, and goes to the Palate.
The seventh is the Auditive Nerve, that enters into the Os
Petrosum, where it divides it self into many Branches, which when
gone forth, are distributed to the Muscles of the Tongue, Lips, Mouth,
Face, Fore-head, Eye-Lids, &c.
The eighth is the Os Vagum, or wandering Pair, which is united
to the Intercostal Nerve, as also to the Recurrent, Diaphragmatick,
Mesenterick, &c.
The ninth Pair, after having form'd a Trunk with the eighth,
disperseth its Twigs several ways, whereof one is join'd with the Twig to
the tenth, to be distributed together into the Muscle
Sternohyoideus, and into the Tongue.
The Intercostal and Spinal are not Pairs of Nerves, but
only Branches or Twigs of other Pairs.
What is the Distribution and Use of the thirty Pairs of Nerves that
proceed from the Spinal Marrow?
There are seven that go forth from the several Vertebra's of
the Neck, twelve from those of the Back, five from the Loins, and six
from the Os Sacrum, according to the following Progression.
The first of the seven Pairs of Nerves of the Neck proceeds from
between the Occipital Bone and the first Vertebra, nam'd
Atlas, its Fibres being lost in the Muscles of the hinder-part of
the Head and Neck.
The second Pair springs from between the first and second
Vertebra of the Neck; the Fibres whereof are lost in the Muscles
of the Head, and in the Skin of the Face.
The third Pair issueth from between the second and third
Vertebra of the Neck; and its Fibres are lost in the Flexor
Muscles and Extensors of the Neck.
The fourth, fifth, sixth, and seventh Pairs proceed from between the
Vertebra's, as before, but their Fibres are lost in the Neck of
the Omoplata, in the Arm, and in the Diaphragme or Midriff.
Here it ought to be observ'd by the way that the Arms receive Branches
not only from the four last Pairs of the Nerves of the Neck,
but also from the two first Pairs of the Back, which are extended even to
the end of the Fingers: Whence it happens that in the Palsie of the Arms,
Remedies are usually apply'd to the Vertebra's of the Neck; and
that in Phlebotomy or letting Blood, care must be taken to avoid pricking
the Nerve, which accompanies the Basilick Vein in the Elbow.
The twelve Pairs of Nerves that have their Beginning from between the
Vertebra's of the Back, are each of them divided into two
Branches, as the others; and their Branches are distributed in like
manner to the Muscles of the Breast, and to those of the Back and
Abdomen.
The five Pairs which take their Rise from between the
Vertebra's of the Loins, have thicker Branches than the others,
and the distribution of them is made to the Muscles of the Loins,
Hypogastrium, and Thighs.
Of the six Pairs of Nerves that proceed from the Os Sacrum, the
four Upper with the three Lower of the Loins, send forth Fibres of Nerves
to the Thigh, Leg, and Foot; and the two last Pairs impart Nerves to the
Anus, Bladder, and privy Parts.
What is the Structure of the Arteries?
The Arteries are long and round Canals, consisting of four sorts of
Tunicks or Membranes, which have their Rise from the left Ventricle of
the Heart, from whence they receive the Blood, and convey it to all the
Parts of the Body for their Nourishment.
What is the Construction of these four Tunicks or Membranes of the
Arteries?
The first being thin and Nervous in its outward Superficies, is in the
Inside a Plexus or Interlacement of small Veins and Arteries, and
Fibres of Nerves, which enter into the other following Tunicks, to
nourish them.
The second sticking close to the former, is altogether full of whitish
Glandules, that serve to separate the serous Particles of the Blood.
The third is intirely Musculous, and interwoven with Annular
Fibres.
The fourth is very thin, and hath its Fibres all streight.
Whence proceeds the Pulse or beating of the Arteries?
It is deriv'd from the Heart, and exactly answers to its Motion of
Diastole and Systole.
By what Name is the first Trunk of the Arteries call'd, and what is
the Effect of the Distribution made thence to the whole Body?
The first Trunk of the Arteries is nam'd Aorta, or the thick
Artery, which proceeds immediately from the left Ventricle of the
Heart, whereto it communicates before its departure from the
Pericardium, one or two small Branches call'd the Coronary:
Afterward it is divided into two Branches, whereof one goes upward, and
is term'd the Ascending Artery; and the other downward, under the
Denomination of the Descending Artery.
The Ascending Artery ariseth upward along the Aspera
Arteria or Wind-Pipe, to the Clavicles, and is there divided into two
Branches, call'd the Subclavian Arteries, one whereof goes forward
to the Right side, and the other to the Left; and they both send forth on
each side divers Branches, which take their Names from
the several Parts, whereto they are distributed; such are the
Carotides or Soporales Interni & Externi, which pass to
the Head; the Mediastina; the Intercostal; the
Axillar, and others.
The Descending Artery, before its departure from the Breast,
affords certain Branches to the Pericardium, Diaphragm, and lower
Ribs; afterward it penetrates the Diaphragm, and constitutes seven double
Branches. The first is of those that are call'd Cœliack, and
which go to the Liver and Spleen. The second Branch contains the Upper
Mesenterick. The third the Emulgent, which pass to the Reins.
The fourth the Spermatick, which are extended to the Genitals. The
fifth the Lower Mesenterick. The sixth the Lumbar. And the
seventh the Muscular. But assoon as the great Trunk is come
downward to the Os Sacrum, it divides it self into two thick
Arteries nam'd the Iliack, which are distributed on both sides,
each of them making two Internal and External Branches, which likewise
impart Sprigs or lesser Arteries, to the Bladder, Anus,
Matrix, and other adjacent Parts: Then the Master-Branch forms the
Crural Arteries on the inside of the Thighs, which are
communicated by multiplying their Number even to the ends of the Toes, in
passing over the External Ancle-Bones of the Feet.
What is the Structure of the Veins?
The Veins are long and round Canals made of four kinds of Tunicks or
Membranes, whose Office it is to receive the Blood that remains after the
Nourishment is taken, and to carry it back to the Heart to be reviv'd.
What is the Form of the four Tunicks that make the Canals of the
Veins?
The first is a Contexture of Nervous and streight Fibres. The second
is a Plexus of small Vessels that carry the Nourishment. The third
is all over beset with Glandules thro' which are filtrated the serous
Particles of the Blood contain'd in the Vessels of the second Tunicle.
The fourth is a Series of Annular and Musculous or Fleshy Fibres.
Which are the most numerous, the Arteries or the Veins?
The Number of the Veins exceeds that of the Arteries; and there are
scarce any Arteries without Veins accompanying them.
Where is the Beginning and Original of all the Veins?
All the Veins have their Root in the Liver, and two of the three great
Trunks that proceed from thence, are call'd Vena Portæ, and
Vena Cava; and the third is twofold, viz. the
ascending and the descending.
The Vena Portæ is distributed to all the Parts contain'd in the
lower Belly, and terminated in the Fundament; where it makes the Internal
Hæmorrhoidal Veins.
The Vena Cava is immediately divided into two thick Branches,
one whereof ariseth upward to the Right Ventricle of the Heart, and forms
the ascending Vena Cava; as the other goes downward to the Feet,
and constitutes the descending.
What is the Distribution of the ascending Vena Cava?
It perforates the Diaphragm, goes to the Heart, and ascends from
thence to the Clavicles, after having communicated to the Midriff in
passing, a small Branch call'd the Phrenicus; as also one or two
to the Heart, nam'd the Coronary; and some others to the upper
Ribs, besides the single Branch, term'd Azygos, only on the right
side. But the Trunk of the ascending Vena Cava, being once come up
to the Clavicles, is divided into two Branches, well known by the Name of
the Subclavian, one whereof Shoots forth toward the Right side,
and the other toward the Left; and they both make various Ramifications
like to those of the thick ascending Artery, by producing the
Cervicalis or Soporalis, and the Internal and External
Jugulars that go to the Head; as also the Axillars, which
pass to the Arms and Shoulders, forming the Cephalick, the
Median, and the Basilick on the inside of the Elbow.
The descending Vena Cava in like manner accompanieth the
Ramifications of the Aorta, or thick descending Artery, to the
fourth Vertebra of the Loins, where it sends forth two Branches,
nam'd the Iliack, one whereof goes to the Right side, and the
other to the Left, both inwardly and outwardly; imparting divers Twigs or
lesser Branches to all the Parts contain'd in the Abdomen or lower
Belly, even as far as the Fundament, where it makes the External
Hæmorrhoidal Veins. Afterward the outward Branch of the
Iliack descends in the Thigh, to form the Crural, and
others, as far as the Saphæna, together with those that are
situated at the end of the Feet.
What is the clearest Division of the Human Body into various Parts,
and that which is most followed in the Anatomical Schools?
It is that which constitutes three Venters, that is to say, the
Upper, the Middle, and the Lower, which are the Head, the Thorax
or Breast and the Abdomen or lower Belly, together with the
Extremities, which are the Arms and Legs.
What is the lower Belly?
It is a Cavity of the Body that contains the nourishing parts, as the
Reins, the Bladder, and all those that are appropriated to Generation in
both Sexes.
What is to be consider'd outwardly in the lower Belly?
Its different Regions, and the several parts therein contain'd.
What are these Regions?
They are the Epigastrick, the Umbilical, and the
Hypogastrick.
What is their Extent?
It is from the Xyphoides or Sword-like Cartilage to the Os
Pubis, the division whereof into three equal Parts, constitutes the
three different Regions; the Epigastrium being the first upward,
the Umbilicus the second, and the Hypogastrium the third.
What Are the Parts contain'd in the Epigastrium, and what
Place do they possess therein?
The Parts contain'd in the Epigastrium are the Liver, the
Spleen, the Stomach, and the Pancreas or Sweet-bread, which lies
underneath: The Stomach takes up the middle before, the Liver being
plac'd on the Right side, and the Spleen on the Left; so that these two
sides of the Epigastrick Region, are call'd the Right and Left
Hypochondria.
What Parts are there contain'd in the Umbilical Region, and what is
their situation?
They are the most part of the thin Intestines or small Guts,
viz. the Duodenum, the Jejunum, and the
Ileon, which have their Residence in the middle, where they are
encircled with a Portion of the two great Guts, Cæcum and
Colon, that take possession of the Sides, otherwise call'd the
Flanks. The Reins or Kidneys are also in this Place, above, and somewhat
backward.
What Parts are there contain'd in the Hypogastrium, and of
what Place are they possest?
The greater part of the thick-Guts, Cœcum, and
Colon, are enclos'd therein, with the entire Rectum; there
is also a Portion of the Ileon, which hides it self in the sides
of the Ilia, or Hip-Bones: In the middle under the Os
Pubis, the Bladder is situated on the Gut Rectum in Men, and
the Matrix in Women lies between the Rectum and
Bladder.
After what manner is the opening of a Corps or dead Body perform'd
at a publick Dissection?
It is begun with a Crucial Incision in the Skin from underneath the
Throat downward, traversing from one side to another in the Umbilical
Region; then this Skin is pull'd off at the four Corners, and the
Panicula Adiposa is immediately discover'd: Under this Fat lies a
Fleshy Membrane, call'd Membrana Carnosa; and after that, the
common Membrane of all the Muscles of the lower Belly. Thus we have taken
a View of what Anatomists commonly term the five Teguments, that
is to say, the Epiderma or Scarf-Skin, the Derma or true
Skin, the Panicula Adiposa, the Panicula Carnosa or
Membranus Carnosa, and the common Membrane of the Muscles.
The five Teguments being remov'd, we meet with as many Muscles on each
side, viz. the descending Oblique, the ascending Oblique, the
Transverse, the streight, and the Pyramidal, by the means whereof the
Belly is extended and contracted. Afterwards appears a Membrane nam'd
Peritonæum, which contains all the Bowels, and covers the whole
lower Belly, being strongly fasten'd to the first and third
Vertebra's of the Back. The Fat skinny Net which lies immediately
under the Peritonæum, is call'd Epiploon and
Omentum, or the Caul; it floats over the Bowels, keeping them in a
continual Suppleness necessary for their Functions, maintains the Heat of
the Stomach, and contributes to Digestion.
It remains to take an Account of the Bowels viz. the Stomach,
Mesentery, Liver, Spleen, Kidneys, Bladder, and Guts, together with the
Parts appointed for Generation, which in Men are the Spermatick
Vessels, the Testicles, and the Penis; and in Women, the
Spermatick Vessels, the Testicles or Ovaries, the Matrix, and its
Vagina or Neck.
What is the Stomach?
It is the Receptacle of the Aliments or Food convey'd thither thro'
the Oesophagus or Gullet, which is a Canal, or kind of streight
Gut that reacheth from the Throat to the Mouth of the Stomach. The
Stomach it self is situated immediately under the Diaphragm or
Midriff, between the Liver and the Spleen, having two Orifices, whereof
the Left is properly call'd Stomachus, or the Upper, and the Right
(at its other Extremity) Pylorus, or the lower Orifice. Its Figure
resembleth that of a Bag-Pipe, and the greater part of its Body lies
toward the Left side. It is compos'd of three Membranes, viz. one
Common, which it receives from the Peritonæum; and two Proper; the
two uppermost being smooth, and the innermost altogether wrinkled.
What is the Pancreas or Sweet-bread?
It is a Fat Body, consisting of many Glandules wrapt up in the same
Tunicle, being situated under the Pylorus or lower Orifice of the
Stomach: It helps Digestion, and hath divers other uses; but its
principal Office is to separate the serous Particles of the Blood, to be
convey'd afterward into the Gut Duodenum, by a Canal or Passage,
nam'd the Pancreatick. This Juice serves to cause the Chyle to
ferment with the Choler, in order to remove the grosser Particles from
those that ought to enter into the Lacteal Vessels.
Into how many sorts are the Guts distinguish'd?
There are two sorts, viz. the thin and the thick.
How many thin or small Guts are there?
Three; that is to say, the Duodenum, the Jejunum, and
the Ileon.
How many thick Guts are there?
Three likewise; viz. the Cœcum, the Colon,
and the Rectum.
Why are some of them call'd thin Guts, and others thick?
Because the thin are smaller, being appointed only to transport the
Chyle out of the Stomach into the Reserver; whereas the thick are more
large and stronger, serving to carry forth the gross Excrements out of
the Belly.
Are the six Guts of an equal length?
No, the Duodenum, which is the first of the thin Guts, is only
twelve Fingers breadth long. The Jejunum, being the second, so
call'd because always empty, is five Foot long: The third is nam'd
Ileon, by reason of its great Turnings which oblige it to pass to
the Os Ilion, where it produceth a Rupture; it extends it self
almost twenty Foot in length.
The first of the thick Guts, known by the Name of Cœcum,
is very short, and properly only an Appendix or Bag of a Finger's
length. That which follows is the Colon, being the largest of all,
and full of little Cells, which are fill'd sometimes with Wind and other
Matters that excite the Pains of the Colick. It encompasseth the thin
Guts, in passing from the top to the bottom of the Belly, by the means of
its great Circumvolutions, and is from eight to nine Foot long. The last
is the Rectum or streight Gut, so nam'd, because it goes
directly to the Fundament: It is no longer than ones Hand, but it is
fleshy, and situated upon the Os Sacrum, and the Coccyx or
Rump-Bone.
What is the Peristaltick Motion of the Guts?
It is the successive Motion and Undulation, whereby the Guts
insensibly push forward from the top to the bottom, the Matters contain'd
in them; and that Motion which on the contrary is perform'd from the
bottom to the top, is term'd the Antiperistaltick as it happens in
the Iliack Passion, or twisting of the Guts, call'd Domine
Miserere, by reason of its intolerable Pain.
What is the Mesentery?
It is a kind of Membrane somewhat fleshy, which is join'd to the Spine
in the bottom and middle of the Belly, and by its folding, keeps all the
Guts steady in their place; it is all over beset with red, white, and
Lymphatick Vessels; that is to say, those that carry the Blood, Chyle,
and Lympha, which serves to cause this last to run more freely,
and to ferment. Three notable Glandules are also observ'd therein, the
greatest whereof lies in the middle, and is nam'd Asellius's
Pancreas; the two other lesser are call'd Lumbar Glandules, as
being situated near the Left Kidney. From each of these Glandules
proceeds a small Branch; and both are united together to make the great
Lacteal Vein, or Thoracick Canal. This Tube conveys the
Chyle along the Vertebra's of the Back to the Left
Subclavian Vein; from whence it passeth into the ascending Vena
Cava, and descends in the Right Ventricle of the Heart, where it assumes
the form of Blood; from whence it passeth to the Lungs thro' the
Pulmonary Artery; then it returns to the Heart thro' the
Pulmonary Vein, and goes forth again thro' the Left Ventricle of
the Heart, between the Aorta or great Artery, to be afterward
distributed to all the Parts of the Body. This is the ordinary Passage
for the Circulation of the Chyle, and the Sanguification of the
Heart.
What is the Liver?
The Liver, being the thickest of all the Bowels, is plac'd in the
Right Hypochondrium, at the distance only of a Fingers breadth
from the Diaphragm; its Figure much resembling that of a thick piece of
Beef: It is Convex on the outside, and Concave within; its Substance is
soft and tender, its Colour and Consistence being like coagulated Blood:
It is cleft at bottom, and divided into two Lobes, viz. one
greater, and the other less: Its Office is to purifie the Mass of Blood
by Filtration; and it is bound by two strong Ligaments, the first whereof
adheres to the Diaphragm, and the second to the Xiphoides or
Sword-like Cartilage. Two great Veins take their Rise from hence,
viz. the Vena Portæ, and the Vena Cava, which form
innumerable Branches, as it were Roots in the Body of the Liver. The
Gall-Bladder is fasten'd to the hollow part thereof, and dischargeth its
Choler into the Gut Duodenum, thro' the Vessels that bear the Name
of Meatus Choledochi, or Ductus Biliares. This Choler is
not a meer Excrement, but on the contrary of singular Use in causing the
Fermentation of the Chyle, and bringing it to perfection.
What is the Spleen?
The Spleen is a Bowel resembling a Hart's Tongue in shape, and
situated in the Left Hypochondrium, over-against the Liver: Its
length is about half a Foot, and its breadth equal to that of three
Fingers; its Substance being soft, as that of the Liver, and its Colour
like dark coagulated Blood: It is fasten'd to the Peritonæum, Left
Kidney, Diaphragm, and to the Caul on the inside; as also to the Stomach
by certain Veins, call'd Vasa Brevia; nevertheless these Ligatures
do not hinder it from wandering here and there in the lower Belly, where
it often changeth its place, and causeth many dreadful symptoms by its
irregular Motions. Its Office is to Subtilize the Blood by cleansing and
refining it.
What are the Reins?
The Reins or Kidneys are Parts of a Fleshy Consistence, harder and
more firm than that of the Liver and Spleen: They are both situated in
the sides of the Umbilical Region, upon the Muscle Psoas, between
the two Tunicks of the Peritonæum; but the Right is lower than the
Left: Their Shape resembleth that of a French Bean, and they
receive Nerves from the Stomach, whence Vomitings are frequently
occasion'd in the Nephritical Colicks: They are fasten'd to the Midriff,
Loins, and Aorta, by the Emulgent Arteries; as also to the
Bladder by the Ureters. The Right Kidney likewise adheres to the
Gut Cæcum, and the Left to the Colon. Their Office is to
filtrate or strain the Urine in the Pelves or Basons, which they
have in the middle of their Body on the inside, and to cause it to run thro'
the Vessels call'd Ureters into the Bladder.
Immediately above the Reins on each side, is a flat and soft Glandule,
of the thickness of a Nut; they are nam'd Renal Glandules, or
Capsulæ Atribiliariæ, because they contain a blackish Liquor,
which (as they say) serves as it were Leaven for the Blood, to set it a
fermenting.
What is the Bladder?
It is the Bason or Reserver of Urines, of a Membranous Substance as
the Stomach, being plac'd in the middle of the Hypogastrick Region; so
that it is guarded by the Os Sacrum behind, and by the Os
Pubis before: Two Parts are to be distinguish'd therein, viz.
its Bottom and Top; by its Membranous Bottom it is join'd to the Navel,
and suspended by the means of the Urachus, and the two Umbilical
Arteries which degenerate into Ligaments in adult Persons: As by its
fleshy Neck, longer and crooked in Men, and shorter and streight in Women
it cleaves to the Intestinum Rectum in the former, and to the Neck
of the Womb in the latter. Lastly, its Office is to receive the Urines to
keep them, and to discharge them from time to time.
What are the Genitals in Men?
They are the Spermatick Vessels, the Testicles, and the Penis.
The Spermatick Vessels are a Vein and an Artery on each side; the former
proceeding from the Aorta, or thick Artery of the Heart; and the
other from the Branches of the Vena Cava of the Liver. These
Arteries and Veins are terminated in the Body of the Testicles, which
are two in Number, enclos'd within the Scrotum.
The Office of the Testicles is to filtrate the Seed, which is brought
thither from all the parts of the Body, thro' the Spermatick Vessels,
called Præparantia, and afterwards to cause it to pass thro'
others nam'd Deferentia, to the Vesiculæ Seminales, from
whence it is forc'd into the Ureter, thro' two small and very
short Canals.
The Penis or Yard is a Nervous and Membranous Part, well
furnish'd with Veins and Arteries, containing in the middle the Canal of
the Ureter: Its Extremity, which consists of a very delicate and
spongy sort of Flesh, is call'd Balanus, or Glans, and the
Nut, the Skin that covers it being nam'd the Præputium, or the
Fore-Skin. Thus by the means of this swell'd Part, and stiff thro' the
affluence of the Spirits, the Male injects his Seed into the
Matrix of the Female, to propagate his Kind.
What are the Parts appropriated to Generation in Women?
They are the Spermatick Vessels, the Ovaries or Testicles, and the
Matrix. The Spermatick Vessels are a Vein and an Artery on each
side, as in Men: The Ovaries or Testicles, situated on the side of the
bottom of the Matrix, are almost of the same bigness with those of
Men, but of a round and flat Figure. The Vesiculæ, or little
Bladders which they contain, are usually term'd Ova or Eggs by
Modern Anatomists; and the Vessels that pass from these Testicles or
Ovaries to the Cornua of the Uterus, are call'd
Deferentia or Ejaculatoria.
The Matrix, Uterus or Womb, is the principal Organ of
Generation, and the place where it is perform'd, resembling the Figure of
a Pear with its Head upward, and being situated between the Gut
Rectum and the Bladder: It is of a fleshy and membranous
Substance, retain'd in its place by four Ligaments, fasten'd to the
bottom; whereof the two upper are large ones, proceeding from the Loins,
and the two lower round, taking their Rise from the Groin, where they
form a kind of Goose-Foot, which is extended to the Os Pubis, and
the flat part of the Thighs; which is the cause that Women are in danger
of Miscarrying when they fall upon their Knees.
The Exterior Neck of the Womb, call'd Vagina, is made almost in
form of a Throat or Gullet, extending it self outwardly to the sides of
the Lips of the Pudendum, and being terminated inwardly at the
internal Orifice of the Matrix, the shape whereof resembleth that
of the Muzzle or Nose of a little Dog. The outward Neck of the womb is
fasten'd to the Bladder and the Os Pubis before, and in the hinder
part to the Os Sacrum: Between the Lips of the Pudendum lie
the Nymphæ, which are plac'd at the Extremity of the Canal of the
Bladder, to convey the Urines; and somewhat farther appear four
Caruncles, or small pieces of Flesh, at the Entrance of the
Vagina, which when join'd together make the thin Membrane call'd
Hymen.
What is the Breast?
It is a Cavity in which the Heart and the Lungs are principally
enclos'd.
What is to be consider'd outwardly in the Breast?
Its extent, and the situation of the Parts therein contain'd.
What is its extent?
It is extended from the Clavicles to the Xiphoides, or
Sword-like Cartilage on the fore-part, and bounded on the hinder by the
twelfth Vertebra of the Back, having all the Ribs to form its
Circumference, and the Diaphragm for its Bounds at bottom, separating it
from the Abdomen or lower Belly.
What is the situation of the Parts contain'd in the Breast?
The Lungs take up the upper Region, and fill almost the whole Space,
descending at the distance of two Fingers breadth from the Diaphragm; the
Heart is situated in the middle, bearing its Point somewhat towards the
Left side, under the Lobes of the Lungs, which are divided by the
Mediastinum that distinguishes them into the Right and Left
Parts.
How is the Breast Anatomiz'd or open'd?
After the dissection of the five Teguments, and the removal of the
Muscles, as in the lower Belly, the Anatomist proceeds to lift up the
Sternum or Breast-Bone, by separating it from the Ribs; then it is
laid upon the Face, or else entirely taken away, to the end that the
internal Parts of the Breast may be more clearly discover'd; whereupon
immediately appear, the Heart, the Lungs, the Diaphragm, and the
Mediastinum, which sticks to the Sternum throughout its
whole length.
What is the Heart?
It is a most noble Part, being the Fountain of Life, and the first
Original of the Motion of all the others; on which account it is call'd
Primus vivens, & ultimum moriens; that is to say, the
first Member that begins to live, and the last that dies.
What Parts are to be consider'd in the Heart?
Its fleshy Substance, with all its Fibres turn'd round like the Skrews
of a Vice; its Basis, Point, Auricles, Ventricles, large Vessels,
Pericardium and Ligatures or Tyes: The Basis is the
uppermost and broadest part; the Point is the lowermost and narrowest
part; the two Auricles or small Ears being as it were little Cisterns or
Reservers, that pour the Blood by degrees into the Heart, are situated on
each side above the Ventricles. The Ventricles, which are likewise two in
Number, are certain Cavities in its Right and Left Sides. The large
Vessels are the Aorta or great Artery, and the Vena Cava
together with the Pulmonary Artery and Vein. The Pericardium is a
kind of Bag fill'd with Water, wherein the Heart is kept; which is fasten'd
to the Mediastinum by its Basis, and to the large Vessels
that enter and go out of its Ventricles.
What are the Terms appropriated to the continual beating of the
Heart?
They are Diastole and Systole, from whence proceed two
several Motions, the first whereof is that of Dilatation, and the other
of Contraction, communicated to all the Arteries which have the same
Pulse.
To what use serves the Water contain'd in the
Pericardium?
It prevents the drying of the Heart by its perpetual Motion.
What are the Lungs?
They are an Organ serving for Respiration, of a soft Substance, and
porous as a Sponge, being all over beset with Arteries, Veins, Nerves,
and Lymphatick Vessels, and perforated with small Cartilaginous Tubes,
that are imparted to it from the Wind-Pipe, and are call'd
Bronchia. Their Natural Colour is a pale Red, and marbl'd dark
Brown; and their whole Body is wrapt up in a fine smooth Membrane, which
they receive from the Pleuron. They are suspended by the
Wind-Pipe, by their proper Artery and Vein, and by the Ligatures that
fasten them to the Sternum, Mediastinum, and frequently to
the Pleuron it self: They are also divided into the Right and Left
Parts by the Mediastinum; having four or five Lobes, whereof those
on the Left side cover the Heart. Their continual Motion consists in
Inspiration, to take in the Air, and Expiration, to drive
it out. The Larynx makes the Entrance of the Wind-Pipe into the
Lungs, and the Pharynx that of the Oesophagus or Gullet, at
the bottom of the Mouth to pass into the Stomach.
What is the head?
It is a bony Part, that contains and encloseth the Brain within its
Cavity.
What is most remarkable in the outward parts of the Head?
The Temporal Arteries, the Crotaphitæ, or Temporal Muscles, and
the Sutures of the Skull.
Why are these things considerable?
The Temporal Arteries are of good Note, because they are expos'd on
the outside, lying even with the Skin. The Crotophite Muscles are
so likewise, in regard that they cannot be hurt without danger of
Convulsions, by reason of the Pericranium with which they are
cover'd. And the Sutures, because the Meninges of the Brain
proceed from thence to form the Pericranium.
What is the Pericranium?
It is a Membrane that lies under the thick hairy Skin of the Head, and
immediately covers the Skull.
What are the Meninges?
They are two Membranes that enclose the Substance or Marrow of the
Brain.
What is a Suture?
It is a kind of thick Seam or Stitch, that serves to unite the Bones
of the Skull.
How many sorts of Sutures are there?
There are two sorts, viz. the true, and the false or
Bastard.
What are the true Sutures?
They are three in number, namely the Sagittal, the
Coronal, and the Lambdoidal.
What is the disposition or situation of the true Sutures?
The Sagittal is streight, beginning in the middle of the
Fore-head, and sometimes at the root of the Nose, and being terminated
behind, at the joining of the two Branches of the Lambdoidal
Suture.
The Coronal appears in form of a Crown, passing to the middle of the
Head, and descending thro' the Temples, to finish its Circumference in
the Root of the Nose.
The Lambdoidal Suture is made like an open Pair of Compasses,
the Legs whereof are extended toward the Shoulders; and the Button is in
the top of the Head backward.
What are the Bastard Sutures?
They are those that are call'd Squamous or scaly.
What is the disposition of natural situation of these false
Sutures?
They are plac'd at the two sides of the Head, and make a Semi-Circle
of the bigness of the Ears, round the same Ears.
What difference is there between the true and spurious
Sutures.
The true Sutures are made in form of the Teeth of a Saw, which enter
one into the other; and the false or Bastard ones are those that resemble
the Scales of Fishes, which are join'd together by passing one over the
other.
What is the Use of the Sutures?
The Ancients were of Opinion, that they were made to hinder the
Fracture of one Skull-Bone from passing thro' the whole Head; but there
is more reason to believe that they have the three following Uses, that
is to say, 1. To promote the transpiration of the Brain. 2. To give
Passage to the Vessels that go to the Diploe. 3. To retain the
Meninges, and to support the Mass of the Brain, which is cover'd
by them.
What are the Names of the Bones that compose the Skull?
The Bone of the fore-part of the Head is call'd Sinciput, or
the Fore-head-Bone, as also the Frontal or Coronal Bone.
The Bone of the hinder-part, enclos'd within the Lambdoidal
Suture, is term'd the Occipital. The two Bones that form the
upper-part, and are distinguish'd by the Sagittal Suture, bear the Name
of Parietals, one being on the Right side, and the other on the
Left. And those behind the Ears are call'd Temporal,
Squamosa, or Petrosa. These also are distinguish'd into the
Right and Left Temporals, and are join'd to the bottom of the Parietal by
a bastard squamous Suture.
What is most remarkable in the thickness of the
Skull-Bones?
The Diploe, which is nothing else but a Plexus or
Contexture of small Vessels, that nourish the Bones, and in the middle of
their thickness make the distinction of the first and second Tablature of
the Bones; whence it sometimes happens that an exfoliative Trepan, or
Semi-Trepan, is sufficient, when the first of these two Tables is only
broken, the other remaining entire.
Is the Brain which is preserv'd in the Skull all of one Piece, or
one equal Mass?
No, it is distinguish'd by the means of the Meninges into the
Brain it self, and the Cerebellum or little Brain; the Brain,
properly so called, takes up almost the whole Cavity of the Skull, and
the Cerebellum is lodg'd altogether in the hinder-part, where it
constitutes only one entire Body; whereas the former is divided into the
Right and Left Parts by the Meninges, which cut it even to the
bottom; whence these Foldings are call'd Falx; i. e. a
Scythe or Sickle.
What is chiefly remarkable in the Substance of the Brain?
The Ventricles or Cavities which are found therein, together with the
great Number of Veins, Arteries, Lymphatic Vessels, and Nerves, that
carry Sense to all the Parts of the Body, and Spirits for their
Motion.
An exact Historical Account of all the Holes of the Skull, and the
Vessels that pass thro' them.
To attain to an exact Knowledge of all the Holes with which the inside
of the Basis of the Skull is perforated, they are to be consider'd
either with respect to the Nerves, or to the Sanguinary Vessels.
There are nine Pairs of Nerves that arise from the Medulla
Oblongata, and go forth out of the Skull through many Holes hereafter
nam'd.
The first Pair is that of the Olfactory Nerves, appropriated to
the Sense of Smelling, which are divided below the Os Cribiforme,
or Sieve-like Bone, into divers Threads, that passing into the Nose
through many Holes with which this Bone is pierc'd, are distributed to
the inner Tunick of the Nose.
The second Pair is that of the Optick or Visual Nerves, that
pass into the Orbits of the Eyes, thro' certain peculiar Holes made in
the Os Sphenoides, or Wedge-like Bone, immediately above the
Anterior Apophysis Clinoides.
In the Portion of the Os Sphenoides, that makes the
Basis of the Orbit, lies a Fissure about seven or eight Hairs
breadth long, which is to be observ'd chiefly at the bottom, that is to
say, below the Hole, thro' which the Optick Nerve passeth; where it is
almost round, and larger than at the top, where it is terminated in a
very long and acute Angle.
There are many Pairs of Nerves that enter into the Orbit thro' this
Fissure, viz. 1. The third Pair, call'd the Motorii
Oculorum. 2. The fourth Pair, nam'd Pathetici, by Dr.
Willis. And 3. The whole sixth Pair. Besides these three Pairs,
which go entire thro' this Cleft, there is also a Passage for the upper
Branch of the foremost Fibre of the fifth Pair, which the same renowned
Physician calls the Ophthalmick Branch. Beyond the lower-part of
the said Fissure, toward the hinder-part of the Head, is to be seen in the
Os Sphenoides on each side, a Hole that doth not penetrate the
Basis of the Skull, but makes a kind of Ductus, about an
Hair's breadth long, which is open'd behind the Orbit on the top of the
Space between the Apophysis Pterygoides, and the third Bone of the
Jaw; thro' this Ductus runs the lower Branch of the foremost Fibre
of the fifth Pair.
About the length of two Hairs breadth beyond these Ductus's, we
may also discover in the Os Sphenoides, or Wedge-like Bone, two
Holes of an Oblong and almost Oval Figure, which are plac'd in the
hindermost sides of that of the Os Sphenoides, and gives passage
to the hindermost Fibre of the fifth Pair.
The Hole thro' which runs the Auditory Nerve, that makes the
seventh Pair, is in the middle of the hinder-part of the Os
Petrosum, that looks toward the Cerebellum: This Hole being
very large, is the Entrance of a Ductus that is hollow'd in the
Os Petrosum, and which sinking obliquely from the fore-part
backward, for the depth of about two Hairs breadth, forms as it were the
bottom of a Sack, the lowermost part whereof is terminated partly by the
Basis of the Cochlea, and partly by a Portion of the Mouth
of the Vestibulum. At the bottom of this Ductus are many
Holes, but the most considerable is that of the upper-part, thro' which
passeth a Portion of the Auditory Nerve. This is also the Entrance of
another Ductus made in the Os Petrosum, which is open'd
between the Apophysis Mastoides and Styloides: These other
Holes afford a Passage to the Branches of the soft Portion of the same
Auditory Nerve.
Below this Ductus there is a remarkable Hole form'd by the
meeting of two hollow Cuts the larger whereof is in the Occipital Bone
and the other in the lower-part of the Apophysis Petrosi: From the
middle of the upper-part of this Hole issueth forth a small Prominence or
bony Point, whereto is join'd an Appendix of the Dura Mater, which
divides the Hole into two parts; so that thro' the foremost Orifice
passeth the Nerve of the eighth Pair, and that which is call'd the
Spinal Nerve. We shall have occasion hereafter to shew the Use of
the hinder Orifice.
Near the great Hole of the Occipital Bone from whence proceeds the
Medulla Oblongata, we may observe a Hole almost round and oblong
thro' which passeth the Nerve of the ninth Pair. This Hole is entirely
situated in the Occipital Bone, and making a little Way in the Bone
passeth obliquely from the back-part forward. In the inside of the Skull
this Hole is sometimes double, but its two Entrances are re-united in the
outward-part of the Skull; and the two Branches that form the Origine of
this Nerve and which pass thro' these two Holes, are likewise re-united
at their Departure, These are the Passages of the nine Pairs of Nerves
that proceed from the Medulla Oblongata, and it remains only to
show that Paths thro' which the Intercostal Nerve goes forth, as also
that of the tenth Pair. The Intercostal runs out of the Skull thro' the
Ductus that gives Entrance to the Internal Carotick Artery.
As for the tenth Pair, in regard that it ariseth from the Marrow which is
enclos'd between the Occipital Bone and the first Vertebra, it goes
forth thro' the Hole of the Dura Mater, where the Vertebral Artery
enters.
To know well the Holes thro' which the Vessels that belong to the
inner-part of the Head enter, and issue forth, it is requisite to
distinguish them into those which are distributed to the Dura
Mater, and those that are appointed for the Brain. The Vessels of the
Dura Mater, are Branches of the Carotick or Vertebral
Arteries.
In the Os Sphenoides, or Wedge-like Bone, behind the Hole thro'
which passeth the hindermost Fibre of the fifth Pair of Nerves lies
another small Hole, almost round, that gives Entrance to a Branch of the
External Carotick Artery, which in entring, immediately adheres to
the Dura Mater, and forms many Ramifications to overspread the
whole Portion of this Membrane, which covers the sides, and the
upper-part of the Brain.
At the bottom and top of the lateral outward part of the Orbit of the
Eye, above the acute Angle, for want of the Os Sphenoides, there
is a Hole thro' which passeth an Artery, being a Twig of a Branch of the
Internal Carotick, which is diffus'd in the Eye, and distributed
to almost the whole Portion of the Dura Mater, that covers the
fore-part of the Brain.
The Vertebral Artery in entring into the Skull, furnisheth it on each
side with a considerable Branch, which is dispers'd throughout the whole
Portion of the Dura Mater that covers the Cerebellum.
As for the Veins that accompany these Arteries, they almost all go out
of the Skull thro' the same Holes where the other enters.
There are four thick Arteries which convey to the Brain the Matter
with which it is nourish'd, and that whereof the Spirits are form'd,
viz. the two Internal Caroticks, and the two
Vertebrals.
The Internal Carotick Arteries enter into the Skull thro a
particular Ductus made in the Temporal Bone, the Mouth thereof
being of an Oval Figure and situated in the outward part of the
Basis of the Skull, before the Hole of the Internal
Jugular. This Ductus extends it self obliquely from the
back-side forward, and after having made about three Hairs breadth in
length, is terminated in the hinder-part of the Os Sphenoides. The
Artery traverseth the whole winding Compass of this Ductus, which
resembles the Figure of the Roman Letter S, and at the Mouth of
the same Ductus runs under the Dura Mater along the sides
of the Os Sphenoides to the Anterior Apophyses Clinoides,
where it riseth up again, to perforate the Dura Mater, and to
adhere to the Root of the Brain. These Vessels, in like manner, after
their departure from the Bone of the Temples to the place where they
pierce the Dura Mater, make a second Circuit in form of the
Roman Character S. At the place where these Carotick
Arteries penetrate the Dura Mater, they send forth a thick Branch,
which enters into the Orbit of the Eye, by the lower-part of the Hole,
thro' which the Optick Nerve hath its Passage.
The Vertebral Arteries proceeding from the Holes of the
transverse Apophyses of the first Vertebra, turn about in
passing under the upper oblique Apophyses of the seven
Vertebra's: Afterward they perforate the Dura Mater, and
running under the Marrow, enter into the Skull thro' the Occipital Hole;
then inclining one toward another, they are re-united, and form only one
single Trunk.
The Veins that bring back the Blood from the Substance of the Brain,
are emptied into the Sinus's of the Dura Mater, which are
all discharg'd into those that are call'd Lateral, which last go
out of the Skull immediately under the Nerves of the eighth Pair, thro'
the hinder-part of the Hole made by the meeting of the Occipital
Bone, and the Apophysis Petrosa. These Lateral Sinus's fall
into the Internal Jugulars, which are receiv'd into a considerable
Sinking hollow'd on each side in the outward, part of the Basis of
the Skull, which is nam'd the Pit or Hole of the Internal
Jugular.
In the upper and hinder-part of the Hole, from whence the lateral
Sinus's issue forth, is to be seen an opening in the Extremity of
a Ductus, the Mouth whereof lies behind the Condyli, which
are on the sides of the Occipital Trunk: This Ductus is extended
about the length of two Hairs breadth in the Bone, and the Canal enclos'd
therein is open'd immediately into the Vertebral Sinus: So that
one might affirm it to be as it were its Original Source. Whence it
appears that the Blood contained in the lateral Sinus's is emptied
thro' two places; the greater Portion thereof descending in the
Jugulars from the Neck, and the other in the
Vertebral Sinus's: Sometimes those Ductus's are four only
on one side, another while both are stopt up, and the Blood contain'd in
the lateral Sinus's is discharg'd into the Internal
Jugulars.
Behind the Apophysis Mastoides on each side is a remarkable
Hole, thro' which passeth a thick Vein, which brings back part of the
Blood that hath been distributed to the Teguments and Muscles, which
cover part of the Occiput or hinder-side of the Head: This Vein is
open'd into the lateral Sinus's at the place where they begin to
turn about. But in the Heads of some Persons, this Hole is found only on
one side, and even sometimes not at all, in which case the Blood
contain'd in the Vessels falls into the External Jugulars, with
which the Branches of this Vein have a Communication.
In each Parietal Bone on the side of the Sagittal
Suture, at a little distance from the Lambdoidal, appears a Hole,
thro' which passeth a Vein, that brings back the Blood of the Teguments
of the Head, and dischargeth it self into the upper Longitudinal
Sinus. These Holes are sometimes on both; and then the Blood
contain'd in the Branches of this Vein runs into the External
Jugulars.
In the middle of the Sella of the Os Sphenoides, we may
observe one or two small Holes thro' which (according to the Opinion of
some Modern Anatomists) the Lympha contain'd in the Glandula
Pituitaria is thrown into the Sinus of the edge of the
Os Sphenoides; nevertheless it is certain, that these Holes are
fill'd only with Sanguinary Vessels, which carry and bring back the Blood
of the Bones and Membranes, whereof those Sinus's are compos'd;
besides that, these Holes are rarely found in adult Persons.
Between the Spine of the Coronal Suture and the Crista
Galli, is a Hole which serves as an Entrance for a Ductus,
which sinks from the top to the bottom, the length of about two Hairs
breadth in the thickness of the inner Table of the Coronal: The
Root of the upper Longitudinal Sinus is strongly implanted in this
Hole, which also affords a Passage to some Sanguinary Vessels appointed
for the Nourishment of this inner Table.
Many other small Holes are found in divers places of the Basis
of the Skull; the chief whereof are those that are observ'd in the
Apophysis Petrosa, and give Passage to a great number of Vessels
that serve for the Nutriment of that part of the Temporal Bone which is
call'd the Tympanum, or Drum: The other Holes are principally
design'd for the Vessels that are serviceable in the nourishing of divers
parts of the Basis of the Skull.
After what manner is the opening of the Head or Skull
perform'd?
It is done by sawing it asunder round about and above the Ears; then
it is taken off, after having before cut off the Hair, and made a Crucial
Incision in the Skin from the fore-part to the hinder, and from one Ear
to the other; as also after having pull'd off and laid down
the four Corners to the bottom.
How is the Brain anatomiz'd?
It is done by cutting it Superficially, and by Leaves, in order to
discover by little and little the Ventricles, Vessels, and Nerves, with
their Original Sources, &c. Or else it is taken entire out of the
Skull, (the Nerves having been before examin'd) and laid down; so that
without cutting any thing, all the parts of the Brain may be set in their
proper places, to find out those that are sought for.
What is a Strap?
It is a kind of Band commonly made use of for the Extension of the
Members in the reducing of Fractures and Luxations; or else in binding
Patients, when it is necessary to confine them, for the more secure
performing of some painful Operation: These sorts of Ligatures have
different Names, according to their several Uses, and often
bear that of their Inventer.
What is the Matter whereof these Straps are compos'd?
They may be of divers sorts, but are usually made of Silk, Wooll, or
Leather.
What is a Swathing-Band?
It is a long and broad Band, that serves to wrap up and contain the
Parts with the Surgeons Dressings or Preparatives.
Of what Matter are these Swathing-Bands made?
They are made at present of Linnen-Cloth but in the time of
Hippocrates, were made of Leather or Woollen-Stuff.
How many sorts of Swathing-Bands are there in general?
There are two sorts, viz. the Simple and Compound; the former
are those that are smooth, having only two ends; and the other are those
which are trimm'd with Wooll, Cotton, or Felt, or that have many Heads,
that is to say, Ends, fasten'd or cut in divers places according as
different Occasions require.
What are the Conditions requisite in the Linen-Cloth, whereof the
Swathing-Bands are made?
It must be clean, and half worn out, not having any manner of Hem or
Lift.
What are the Names of the different Swathing-Bands?
There are innumerable, but the greater part them take their
Denominations from their Figure or Shape; as the Long, Streight,
Triangular, and those which have many Heads, or are trimm'd.
What is A Bandage?
It is the Application of a Swathing-Band to any Part.
How many sorts of Bandages are there?
As many as there are different Parts to be bound; some of them being
Simple, and others Compound: The former are those that are made with an
uniform Band; as the Bandage call'd the Truss, and divers other
sorts: The Compound are those that consist of many Bands set one upon
another, or sew'd together; or else those that have many Heads. They have
also particular Names taken from the Inventers of them, or from their
Effect; as Expulsive Bandages to drive back, Attractive to
draw forward, Contentive to contain, Retentive to restrain,
Divulsive to remove, Agglutinative to rejoin, &c.
There are others whereto certain peculiar Names are appropriated; as
Bridles for the lower Jaw, Slings for the Chin, the back
part of the Head, Shoulder, and Perinæum; Scapularies for
the Body, after the manner of the Scapularies of Monks; Trusses
for Ruptures; Stirrups for the Ankle-Bones of the Feet, in letting
Blood, and upon other Occasions. Lastly, there are an infinite Number of
Bandages, the Structure whereof is learnt by Practice, in observing the
Methods of able Surgeons, who invent them daily, according to their
several Manners; and the first Ideas of these can only be taken in
reading Authors that have treated of them.
What are the general Conditions to be observ'd in the Bandages?
There are many, viz. 1. Care must be taken that the Bands be
roll'd firm, and that they be not too streight nor too loose. 2. They are
to be untied from time to time in Fractures, they must also be taken away
every three or four Days, to be refitted. 3. They must be neatly and
conveniently roll'd, that the Patient may not be uneasie or
disquieted.
What ought to be observ'd in fitting the Bolsters?
Care must be taken to make them even, soft, and proportionable to the
bigness of the Part affected; to trimm them most in the uneven places,
that the Bands may be better roll'd over them, and to keep them
continually moisten'd with some Liquor proper for the Disease as well as
the Bands.
In treating of every Disease in particular, we shall shew the
manner of making the particular Bandage that is convenient for
it.
What is a Tumour?
A Tumour is a rising or bloated Swelling rais'd in some part of the
Body by a Setling of Humours.
How is this setling of Humours produc'd?
Two several ways, viz. by Fluxion and
Congestion.
What is the Setling by Fluxion?
It is that which raiseth the Tumour all at once, or in a very little
space of time, by the Fluidity of the Matter.
What is the Setling by Congestion?
It is that which produceth the Tumour by little and little, and almost
insensibly, by reason of the slow Progress and thickness of the
Matter.
Which are the most dangerous Tumours, those that arise from
Fluxion, or those that derive their Original from Congestion?
They that proceed from Congestion, because their thick and gross
Matter always renders 'em obstinate, and difficult to be cur'd.
Whence do the differences of Tumours proceed?
They are taken, first, from the Natural Humours, Simple,
Mixt, and Alter'd: Simple, as the Phlegmon,
which is made of Blood, and the Erysipelas of Choler; Mixt,
as the Erysipelas Phlegmon, which consists of Blood mingl'd with a
Portion of Choler; or the Phlegmonous Erysipelas, which proceeds
from Choler intermixt with a Portion of Blood: Alter'd, as the
Melia which is compos'd of many Humours, that can not be any
longer distinguish'd by reason of their too great Alteration.
Secondly, the difference of Tumours is taken from their likeness
to some other thing, as the Carbuncle and the Talpa, the former
resembling a burning Coal, and the other a Mole, according to the
Etymology of their Latin Names. Thirdly, From the Parts
where they are situated; as the Ophthalmy in the Eye and the Quinsey in
the Throat. Fourthly, from Disease that causeth 'em, as Venereal
and Pestilential Buboes. Fifthly, from certain Qualities found in
some, and not in others; as the Encysted Tumours, which have their
Matter clos'd within their proper Cystes or Membranes, and so of
many others.
How many kinds of Tumours are there that comprehend at once all the
particular Species?
They are four in Number, viz. the Natural Tumours, the
Encysted, the Critical, and the Malignant.
What are natural Tumours?
They are those that are made of the four Humours contain'd in the Mass
of the Blood, or else of many at once intermixt together.
What are the four Humours contain'd in the Mass of the
Blood?
They are Blood, Choler, Phlegm, and Melancholy, every one whereof
produceth its particular Tumour: Thus the Blood produces the
Phlegmon, Choler the Erysipelas, Phlegm the Oedema,
and Melancholy the Scirrhus. The Mixture of these is in like
manner the Cause of the Erysipelatous Phlegmon, the Oedomatous
Phlegmon or Phlegmonous Erysipelas, and the Phlegmonous
Oedema, according to the quality of the Humours which are
predominant, from whence the several Tumours take their Names.
What are the Encysted Tumours?
They are those the Matter whereof is contain'd in certain
Cystes, or Membranous Bags; as the Meliceris, and the
Struma or Kings-Evil.
What are Critical Tumours?
They are those that appear all at once in acute Diseases, and
terminate them with good or bad Success.
What are Malignant Tumours?
They are those that are always accompany'd with extraordinary and
dreadful Symptoms, and whose Consequences are also very dangerous; as the
Carbuncle in the Plague.
What are Impostumes or Abcesses, Breakings out and
Pustules?
Indeed, it may be affirm'd, that all these kinds of Tumours scarce
differ one from another, except in their size or bigness; nevertheless,
to speak properly, by the Names of Impostumes or Abcesses are understood
gross Tumours that are suppurable, or may be dissolv'd, and by those of
Breakings out and Pustules, only simple Pusteal Wheals, or small Tumours,
that appear in great Numbers, and which frequently do not continue to
Suppuration; some of them consisting of very few Humours, and others
altogether of dry Matter.
What difference is there between a Tumour and an Impostume or
Abcess?
They differ in this particular, that all Tumours are not Impostumes
nor Abcesses; but there is no Impostume nor Abcess that is not a Tumour:
As for Example, Wens and Ganglions are Tumours, yet are not
Abcesses nor Impostumes; whereas these last are always Tumours in regard
that they cause Bunches and Elevations.
What ought a Surgeon chiefly to observe in Tumours, before he
undertake their Cure?
He ought to know three things, viz. 1. The Nature or Quality of
the Tumour. 2. The time of its formation and 3. Its
situation: The Quality of the Tumour is to be known, because the Natural
one is otherwise handl'd than that which is Encysted, Critical or
Malignant. As for the time of its Formation, it is four-fold, viz.
the Beginning, Increase, State, and Declination, wherein altogether
different Remedies are to be apply'd. The Situation of the Tumour must be
also observ'd, because the dressing and opening of it ought to be as
exact as is possible, to avoid the meeting with an Artery or neighbouring
Tendon.
How many ways are all the Tumours that are curable,
terminated?
They are terminated after two manners, viz. either by
dissolving 'em, or by Suppuration.
Are not the Scirrhus and the Esthiomenus or Gangrene,
two means that sometimes serve to terminate and cure Impostumes?
Yes, but it is done imperfectly, in regard that a Tumour or Impostume
cannot be said to be absolutely cur'd, as long as there remains any thing
of the Original Malady, as it happens in the Scirrhus, where the
Matter is harden'd by an imperfect dissolving of it, or when the
Impostume degenerates into a greater and more dangerous Distemper, as it
appears in the Esthiomenus or Gangrene that succeeds it.
Which is the most effectual means of curing Impostumes, that of
dissolving, or that of bringing them to Suppuration?
That of dissolving 'em is without doubt the most successful, and that
which ought to be us'd as much as is possible; nevertheless some Cases
are to be excepted, wherein the Tumours or Abcesses are
Critical and Malignant; for then the way of Suppuration is not only
preferable, but must also be procur'd by all sorts of means, even by
opening; which may be done upon this occasion, without waiting for their
perfect Maturity.
What are the Precautions whereto a Surgeon ought to have regard
before he undertake the opening of Tumours?
He must take care to avoid cutting the Fibres of the Muscles, and in
great Abcesses, to cause all the corrupt Matter to be discharg'd at once,
to prevent the Patient's falling into a Swoon.
Ought the opening of Tumours always to be made longitudinally, and
according to the direct Course of the Fibres?
No, it is sometimes necessary to open 'em with a Crucial Incision,
when they are large, or when a Cystis or Membranous Vehicle is to
be extirpated.
How many sorts of Matter are there that issue forth in the
Suppuration of Tumours?
There are four sorts, viz. the Pus, Ichor,
Sanies, and Virus.
What isPus?
It is a thick Matter, and white as Milk.
What is Ichor?
It is a thick Matter like the Pus, but of divers Colours.
What is Sanies?
It is a watery Matter that riseth up in Ulcers, almost after the same
manner as the Sap in Trees.
What is Virus?
It is a kind of watry Matter, being whitish, yellowish, and greenish
at the same time; which issueth out of Ulcers, very much stinking, and is
endu'd with corrosive and malignant Qualities.
How many general Causes are there of Tumours?
There are three, viz. the Primitive, the Antecedent, and the
Conjunct: The Primitive is that which gives occasion to the Tumours; as
for Example, a Fall or a Blow receiv'd. The Antecedent is that which
supplies it with Matter, such is the Mass of Blood that thickens and
maintains the Phlegmon. Lastly, the Conjunct Cause is the
overflowing Blood or Matter, which immediately forms the Tumor.
What regard ought to be had to these three sorts of Causes in the
Cure?
The Primitive Cause may be prevented by avoiding the Falls, Blows, or
other Hurts, and the Antecedent by diminishing the Plethory of the Blood,
and cooling the whole Mass by Phlebotomy. The Conjunct Cause, which is
the overflowing of the Blood, may be also remov'd in dispersing it by
dissolving, or else in discharging it by Suppuration.
What is a Crisis?
It is a sudden setling of Humours, which happens in Diseases, whereby
they are usually terminated.
How are these Critical Setlings effected?
By the Strength of Nature, which either expels the peccant Humours
thro' the Belly, or carries them to the Habitude of the Body; for in the
former she causeth Fluxes of Humours, Urine and Blood; as in the other
she excites Sweatings, Tumours, and even a Gangrene it self.
In what Parts do the Critical Tumours usually arise?
In the Glandules, which the Ancients call'd the Emunctories of
the Brain, Heart, and Liver; for they gave the Name of Emunctories of the
Brain to the thick Glandules which lie under the Ears, that of the
Emunctories of the Heart to those that are under the Arm-Pits; and that
of the Emunctories of the Liver to those under the Groin. Now Malignant
Tumours may arise in all these parts, but the Venereal happen only in the
Groin.
What is a Phlegmon?
It is a red Tumour occasion'd by the Blood diffus'd in some part,
wherein it causeth extension, pain, and heat with beating.
Are Aneurisms and Varices, which are Tumours, made by
the Blood, to be reckon'd among the Phlegmons?
No, because the Blood that forms the Aneurisms and
Varices is not extravasated nor accompany'd with Inflammation, but
only a Tumour of Blood proceeding from the Dilatation of the Arteries and
Veins.
May Echymoses or Contusions consisting of extravasated
Blood, be esteem'd as Phlegmons?
By no means, in regard that it is not sufficient that the Blood be
extravasated for the producing of a Phlegmon; it must also cause
Pain, Heat, and a Beating, with Inflammation, which is not to be found in
the Echymoses, except in great ones, after they have been
neglected for a long time; where the corrupted Blood ought to be let out
immediately, to prevent the Inflammation, overmuch Suppuration, and many
other ill Consequences.
Is the Phlegmon always compos'd of pure Blood?
No, it may happen sometimes to partake of Choler, Phlegm, or
Melancholy; on which account it is nam'd an Erysipelatous,
Oedomatous, or Scirrhous Phlegmon, always retaining the
Name of the predominant Humour, which is the Blood; and so of the
others.
What are the Remedies proper for a Phlegmon?
They are of two sorts, viz. General and Particular; the former
having regard to the antecedent cause, and the other to the conjunct. The
Phlegmon is cur'd in its antecedent Cause, by Phlebotomy or
letting Blood, by good Diet, and sometimes by Purgations, by which means
the Plethory, Heat, and Alteration of the Blood is diminished; But
Fomentations, Cataplasms and Plaisters facilitate the Cure in the
conjunct cause, either by dissolving the Tumour, or bringing it to
Suppuration.
At what time is the Opening of a Vein necessary?
In the Beginning and Increase.
What are the Remedies proper to be us'd immediately upon the first
appearing of the Tumour?
They are Resolvents and Anodynes; such as those that are prepar'd with
Chervil boil'd in Whey, adding a little Saffron to wash the Tumour, and
soak the Linnen Cloaths apply'd thereto, which are often renew'd, and may
be laid on with the Chervil.
Or else take the Urine of a healthful Person, wherein is boil'd an
Ounce of Saffron for a Glass, and bath the Tumour with it.
The Sperm of Frogs is also made use of to very good purpose, either
alone, or with Lime-Water and Soap mixt together; or Oak-Leaves and
Plantane beaten small, and apply'd. But Care must be more especially
taken to avoid cooling Medicines, Oils, and Grease, which are pernicious
in great Inflammations.
What ought to be done in the increase of the Tumour and
Pain?
They are to be asswag'd by mollifying and dissolving; to which end a
Cataplasm or Pultis is to be made with the Leaves of Elder, Wall-wort or
Dwarf-Elder, Mallows, Violet-Plants, Camomile, and Melilot; whereto is
added beaten Line-seed; causing the whole Mass to be boil'd in Whey, and
allowing to every Pint, or thereabout, a Yolk of an Egg, twenty Grains of
Saffron, a quarter of a Pound of Honey, and the Crum of white Bread, till
it comes to a necessary Consistence. Or else take Cow's Dung instead of
the above-mention'd Herbs, and mix with it all the other
Ingredients, to make a Cataplasm, which must be renew'd at least every
twelve Hours.
What is to be done in the State?
If the Tumour cannot be dissolv'd (as was intended) it must be brought
to Suppuration by Cataplasms, consisting of these Ingredients,
viz. Garlick, White Lillies roasted under Embers, Milk, and
Unguentum Basilicon.
Or else only take a Glass of Milk, in which an Ounce of Soap is
dissolv'd, to wet the Linnen apply'd to the Tumour; and let it be often
reiterated: Otherwise make use of Sorrel boil'd with fresh Butter, and a
little Leaven or Yeast. The Plaister Diasulphuris is also most
excellent either alone, or, if you please, mixt with Diachylon and
Basilicon.
What is to be done in the Declination after the
Suppuration?
The Ulcer must be at first gently dry'd with a Plaister of
Diasulphuris or Diachylon, and afterward that of
Diapalma may be us'd, and Ceruse or White Lead.
What Method is to be observ'd in case there be any Disposition
toward a Gangrene?
It is requisite during the great Inflammation to make use of good
Vinegar, in an Ounce whereof is dissolv'd a Dram of White Vitriol, with
as much Sal Ammoniack, to bath the Tumour: Or else take the
Tincture of Myrrh and Aloes, with a little Unguentum Ægyptiacum,
and afterward make a Digestive of Turpentine, the Yolk of an Egg, and
Honey, mingling it with a little Spirit of Wine, or Brandy, if there
remains any Putrifaction or Rottenness.
Remedies for Aneurisms and Varices.
What is to be done in order to cure an Aneurism?
When it is little, as that which happens after an Operation of
Phlebotomy or letting Blood ill perform'd, it may be sufficient to lay
upon the affected Part a thin Plate of Lead, or else a Piece of Money or
Counter wrapt up in a Bolster, and to bind it on very streight: But a
Piece of Paper chew'd is much better for that purpose.
If the Anuerism be considerable, an Astringent Plaister may be
us'd, such as the following.
Take Bolus, Dragon's Blood, Frankincence, Aloes, and
Hypocystis, of each a Dram; mingle the whole with two beaten Eggs,
and add Wax to give it the consistence of a Plaister, which may be
apply'd alone, or mixt with an equal Portion of Emplastrum contra
Rupturam, always making a small Bandage to keep it on. Emplastrum
de Cicuta hath also a wonderful effect.
When the Aneurism is excessive, it is absolutely necessary to
proceed to a Manual Operation, the manner whereof shall be shewn
hereafter in the Treatise of great Operations.
What is requisite to be done in the Varices?
Varices are not generally dangerous, but even conduce to the
preservation of Health; nevertheless, if they become troublesome by
reason of their greatness, and the Pains that accompanie 'em, they may be
mollify'd with the following Remedy.
Take the Mucilages of the Seeds of Psyllium and Line, of each
two Ounces; of Populeon two Ounces; Oleum Lumbricorum &
Hyperici, of each one Ounce; and of the Meal of Wheat one Ounce,
adding Wax to make the Consistence of a Plaister; part of which spread
upon Linnen or Leather, must be apply'd to the Varix, and ty'd
thereto with a small Band.
If the Blood abound too much, it may be discharg'd by the Application
of Leeches, or by a Puncture made with a Lancet: Afterward lay upon the
Part a Piece of Lead sow'd up in a Cloth, and let it be kept close with a
proper Bandage. Otherwise you may make use of an Astringent, such as
this.
Take a Pomegranate, cut it in pieces, and boil it with as much Salt as
may be taken up with the Tip of your Fingers, in a Gallon of strong
Vinegar; then dip a Spunge in this Vinegar, apply it to the Varix,
bind it on, and continue the use of it twice a Day for a Month
together.
How are Echymoses to be treated?
All possible means must be us'd to dissolve 'em, by laying Slices of
Beef upon the Part, renewing 'em very often, or applying Linnen Rags dipt
in Spirit of Wine impregnated with Saffron.
They may be also dissolv'd with the Roots of Briony grated and apply'd
thereto, or else with Plaister or Mortar, Soot, Oil of Olives and
Unguentum Divinum, a Mixture whereof being made, is to be put
between two Rags, and laid upon the Tumour or Swelling.
If the Echymosis happens in a Nervous Part, Balsam of
Peru may be us'd, or, for want thereof, Oleum Lumbricorum
& Hyperici, with luke-warm Wine, with which the Bolsters must
be soak'd, to be laid upon it.
When the Echymosis is great, and much Blood is diffus'd between
the Skin and the Flesh, the safest way is to make an Opening to let it
out, lest a too plentiful and dangerous Suppuration should ensue, or even
a Gangrene it self. However, a Surgeon ought to proceed in the curing of
an Echymosis in the Face with great Circumspection, which must be
always prepar'd for Incision.
What are the Tumours or Impostumes that partake of a
Phlegmon?
They are the Bubo, Carbuncle, Anthrax,
Furunculus, Phyma, Phygeton, Panaritium or
Paronychia, Burn, Gangrene, and Kibe or Chilblain.
What is a Bubo?
A Bubo is a Tumour which ariseth in the Groin, being
accompany'd with Heat, Pain, Hardness, and sometimes a Feaver.
What is a Carbuncle?
A Carbuncle is a hard Swelling, red, burning, and inseparable from a
Fever: It is cover'd with a black Crust or Scab, that afterward falls off
at the Suppuration, leaving a deep and dangerous Ulcer, and which
sometimes doth not suppurate at all.
What is an Anthrax?
The Anthrax is very near the same thing as the Carbuncle, only
with this difference, that the latter always appears in the Glandulous
Parts, and the Anthrax every where else.
What is a Furunculus?
It is a kind of Boil, or benign Carbuncle, which somewhat resembles
the Head of a Nail, and is on that Account call'd Clou by the
French, causing Pains, as if a Nail were driven into the
Flesh.
What is a Phygeton?
The Phygeton is a small, red, and inflam'd Exuberance, situated
in the Miliary Glandules of the Skin, where it causeth a pricking Pain,
without Suppuration.
What is a Phyma?
The Phyma appears after the same manner as the Phygeton,
and suppurates.
What are the Remedies proper for all these sorts of phlegmonous
Tumours and Impostumes?
They are Cataplasms and Plaisters Anodyn, Emollient, Resolvent, and
Suppurative, which are us'd proportionably as in the
Phlegmons.
What is a Gangrene, Sphacelus, or
Esthiomenus?
The Gangrene and Sphacelus signifie the same thing,
nevertheless are commonly distinguish'd; the former being a Mortification
begun, and the Sphacelus an entire or perfect Mortification;
call'd also Necrosis and Sideratio. An Esthiomenus
is a Disposition to Mortification, discover'd by the softness of the
Part; and a Gangrene is defin'd to be a Mortification of a Part,
occasion'd by the Interception of the Spirits, and the
Privation of the Natural Heat.
What are the causes of a Gangrene in general?
Every thing that can hinder the Natural Heat from exerting it self in
a Part; as strong Ligatures, astringent or resolvent Medicines, not
conveniently us'd in great Inflammations; a violent Hæmorrhage; or Old
Age, whereby the Spirits are exhausted; the bitings of Mad Dogs;
excessive Cold, &c.
By what Signs is the Gangrene known?
It is discover'd by the livid Colour of the Skin, which departs from
the Flesh, the softness, coldness, and insensibility of the Part; and
sometimes by its dryness and blackness, from whence exhales a cadaverous
Stench, with Sanies issuing forth after Punctures or
Scarifications made therein. Lastly, a Gangrene is perceiv'd by the cold
Sweats, Swoonings, Syncope's, and Delirium's that invade
the Patient, and which are all the Fore-runners of approaching Death.
Is a Gangrene only found in the Flesh, and soft Parts of the
Body?
It happens also in the Bones; and is then call'd Caries.
How is this Caries or Gangrene of the Bone discover'd, when
it lies hid under the Flesh?
It is known by the black Colour of the Neighbouring Flesh, the Stink
of the Sanies that comes forth, the intolerable Pains felt
thereabouts, which are fix'd and continual before the Impostume and Ulcer
appear; but when the Ulcer is made, a kind of roughness may be perceiv'd
in the Bone.
What are the Remedies proper for a Gangrene?
They are those that take away the mortify'd and corrupt Parts,
and recall the Natural Heat; both which Indications are exactly answer'd
in the Extirpation of what is already corrupted, with the Incision-Knife;
and the Restauration of the Natural Heat by the following Remedies.
Take an Ounce of good Vinegar, steeping therein a Dram of White
Vitriol, with as much Sal Ammoniack: Let it be us'd in bathing the
Part; and apply thereto Bolsters well soak'd in the same Liquor. This
Remedy is convenient in the first Disposition toward a Gangrene: Or, if
you please, you may make use of the Yellow Water, which is made with
Corrosive Sublimate and Lime-Water; taking, for Example, half a Dram of
Corrosive Sublimate to be infus'd in a Pint of Lime-Water.
But a Tincture of Myrrh and Aloes is more efficacious, wherein
Unguentum Ægyptiacum is steep'd; or else Lime-Water kept for that
purpose, in which have been boil'd two Ounces of Sulphur or Brimstone,
with two Drams of Mercurius Dulcis; adding four Ounces of Spirit
of Wine, to make an excellent Phegedænick Water, with which the
Part may be bathed, and the Bolsters soak'd.
If the Gangrene passeth to the Bone, the Ulcer must be immediately
cleans'd with Brandy, and Euphorbium afterward put into it, laying
also some upon the Bolsters, and abstaining from all
sorts of Oils and Greases. But if these Remedies prove unprofitable,
recourse is then to be had to the Incision-Knife, Fire, or Amputation;
the manner of performing which several Operations, is explain'd
hereafter.
What are Kibes or Chilblains?
They are painful Tumours, which are often accompany'd with
Inflammation; they happen more especially in the nervous and outward
Parts, as the Heel, and are so much the more sensibly felt, as the Air
and Cold are more sharp and Vehement.
What is to be done in order to cure these Kibes or
Chilblains?
The Heel or affected Part must be wash'd and dipt in Wine boil'd with
Allum and Salt, whereof a Cataplasm may be afterward made, by adding Meal
of Rye, Honey, and Brimstone. The Juice of a hot Turnep apply'd with
Unguentum Rosatum, is also very good, or Petroleum
alone.
What is a Panaritium?
Panaritium or Paronychia, is a Tumour which generally
ariseth in the Extremity of the Fingers, at the Root of the Nails: It is
red, and accompany'd with very great Pain, even so exquisite, that the
whole Arm is sensible thereof, insomuch that a Fever sometimes ensues,
and a Gangrene; the Humour being contain'd between the Bone and the
Periosteum, or that little Membrane with which it is immediately
invested.
What Remedies are convenient for the curing of
Panaritium?
Anodyn Cataplasms are to be first apply'd, that is to say, such as
serve to asswage excessive Pain, as that which is compos'd of Millk,
Line-seeds beaten, large Figs, the Yolk of an Egg, Saffron, Honey and
Oleum Lumbricorum, with the Crum of white Bread. Afterward you may
endeavour to dissolve it, by applying Oil of Almonds, Saccharum
Saturni, and Ear-Wax, or else Balsam of Sulphur. The Plaister of
Mucilages, and that of Sulphur or Brimstone, dissolv'd in Wine, is also a
most excellent Resolvent and Anodyn.
If it be requisite to bring this Tumour to Suppuration, white Lillies
roasted under Embers may be added to the preceeding Cataplasm; or else a
new Cataplasm may be made with Sorrel boil'd, fresh Butter, and a little
Leaven.
What is a Burn?
A burn is an Impression of Fire made upon a Part, wherein remains a
great deal of Heat, with Blisters full of serous Particles, or Scabs,
accordingly as the Fire hath taken more or less effect.
What are the Remedies proper for a Burn?
A Burn is cur'd by the speedy Application of fresh Mud re-iterated
many times successively; by that of peel'd Onions, Unguentum
Rosatum, and Populeon, mixt with the Yolk of an Egg and
unslack'd-Lime: Cray-Fishes or Crabs pounded alive in a Leaden-Mortar;
and a great Number of other things.
If the Burn be in the Face, you may more especially take the Mucilages
of the Seeds of Quinces and Psyllium, and Frog's-Sperm, of each
an equal quantity, adding to every four Ounces twenty Grains of
Saccharum Saturni. This Composition may be spread on the Part with
a Feather, and cover'd with fine Brown Paper. It is an admirable and
approved Receipt.
If the Burn hath made an Escar or Crust, it may be remov'd with fresh
Butter spread upon a Colewort or Cabbage Leaf, and apply'd hot. But in
Case the Scab is too hard, and doth not fall off, it must be open'd, to
give passage to the Pus or corrupt Matter, the stay of which would
occasion a deep Ulcer underneath. The same Method is to be observ'd in
the Pustules or Blisters, two Days after they are rais'd, applying also
the Ointment of quick Lime, Oil of Roses, and Yolks of Eggs.
What is an Erysipelas?
An Erysipelas, commonly call'd St. Anthony's Fire, is a
small Elevation produc'd by a Flux of Choler dispers'd and running
between the Skin and the Flesh. It is known by its yellowish Colour,
great Heat and Prickings.
What are the Remedies proper for an Erysipelas?
An Erysipelas that ariseth in the Head and Breast is not
without danger, and the Cure of it ought to be undertaken with great Care
in the Application as well of internal as external Remedies: For it is
requisite to take inwardly a Dose of the Diaphoretick Mineral,
Crabs-Eyes, Egg-shels, Powder of Vipers, and other Medicines; as also
Potions that have the like Virtues, such as the following. Take four
Ounces of Elder-Flower-Water, adding thereto a Scruple of the volatile
Salt of Vipers or Hart's-Horn with an Ounce of Syrrup of red Poppies.
Phlebotomy or Blood-letting hath no place here, unless there be a
great Plethory, but frequent Clysters are not to be rejected, viz.
such as are made of Whay, Chervil, Succory, and Violet-Plants, adding a
Dram of Mineral Crystal dissolv'd with two Ounce of Honey of Violets.
As for outward Applications, Linnen-Rags dipt in the Spirit of Wine
impregnated with Camphire and Saffron, are to be laid upon the Tumour,
and renew'd as fast as they are dry'd. An equal quantity of Chalk and
Myrrh beaten to Powder, may also be strew'd upon a Sheet of Cap-Paper
over-spread with Honey, and apply'd to the Part.
If the Heat and Pain grow excessive, take half a Dram of Saccharum
Saturni, twenty Grains of Camphire, as much Opium, with two
Drams of red Myrrh, to be infus'd in a Gallon of White-Wine: Let this
Liquor be kept to soak the Cloaths that are laid upon the
Erysipelas, and often renew'd. But to dress the Face, a Canvass Cloth may be
us'd, which hath been dipt in a Medicine prepar'd with a Gallon of
Whey, two Yolks of Eggs, and a Dram of Saffron.
Moreover amidst all these Remedies, it is necessary to oblige the
Patient to keep to a good Diet, and to prescribe for his ordinary Drink a
Diet-Drink made of Hart's-Horn, the Tops of the lesser Centory, Pippins
cut in Slices with their Skins, and Liquorish; a little good Wine may be
also allow'd, with the Advice of the Physician.
What are the Tumours or Impostumes that partake of the Nature of an
Erysipelas?
They are the dry and moist Herpes, the former being that which
is call'd the Tetter or Ring-Worm; and the other a kind of
yellow-Bladders, Pustules, or Wheals, that cause itching, and raise small
corroding Ulcers in the Skin: To these may be added divers sorts of Scabs
and Itch.
The Remedies prescrib'd for the Erysipelas may be us'd for both
these kinds of Herpes; as also Lotions or Bathing-Liquors made of
Lime-Water, and a Decoction of Wormwood and Sal Ammoniack,
allowing half a Dram to four Ounces of Liquor. Or else take half a Dram
of Sal Saturni, and put it into a Glass of the Decoction of
Fumitory or Chervil. You may also make use of the Oil of Tartar per
deliquium, to make a Liniment either alone, or mingl'd with the
above-mention'd Decoctions.
What is the Oedema?
It is a white soft Tumour, with very little sense of Pain, which
ariseth from the Settling of a pituitous Humour.
What are the Remedies proper for an Oedema?
They are Fomentations, Cataplasms, Liniments, and Plaisters.
The Fomentations are made with Bundles of Wall-Wort or Dwarf-Elder,
thrown into a hot Oven after the Bread is bak'd, and sprinkled with Wine:
Afterward being taken out smoaking, they are unty'd, open'd, and wrapt
about the Part, putting a warm Linnen Cloth over 'em. This Operation is
to be re-iterated; and by this means the Humour is dissolv'd thro'
Transpiration by Sweat.
The Cataplasms are compos'd of Camomile, Melilot, St.
John's-Wort, Sage, Wall-Wort, Pellitory of the Wall, Roots of
Briony and Onions, all boil'd together in White Wine with Honey, adding,
if you please, a few Cummin or Fennel Seeds beaten. Cataplasms are also
made of Horse-Dung and the Seeds of Cummin beaten, which are boil'd in
strong Vinegar, and mixt with Barly-Meal to the Consistence of Pap.
The Plaisters are prepar'd with an Ounce of Diapalma, half on
Ounce of Martiatum, a Pint of Oil of Lillies, half an Ounce of
Cummin-Seeds powder'd, half a Dram of
Sal Ammoniack, and an Ounce of yellow Wax to make a
Consistence.
If any hardness remains, the Plaister of Mucilages may be apply'd, or
that which is made of the Gums Bdellium, Ammoniack, and
Galbanum, dissolv'd in Vinegar. But Care must be taken not to omit
the Purgatives of Jalap to the quantity of a Dram in a Glass of
White-Wine; or of half an Ounce of Lozenges of Diacarthamum, which
are effectual in drawing out the bottom of pituitous and serous Humours
that nourish the Oedema's.
What are the kinds of Tumours that partake of the Nature of an
Oedema?
They are the Phlyctæna, the Emphysema, the
Batrachos or Ranunculus, the Wen, the Talpa, the
Bronchocele, the Ganglion, the Fungus, the Scurf,
the Scrophula or King's-Evil, and all sorts of Dropsies both
general and particular.
What are Phlyctæna's?
They are Pustules or Blisters fill'd with a white and somewhat
yellowish Humour.
What is an Emphysema?
It is a kind of flatuous Tumour, wherein Wind is contain'd, with a
little slimy Phlegm.
What is a Batrachos or Ranunculus?
It is a Blister fill'd with slimy Water, that ariseth under the Tongue
near the String, and in French is call'd Grenouillette, or
the little Frog; which is the same with its Greek and
Latin Names.
What is a Wen?
It is a Tumour consisting of thick plaistry Phlegm, which is reckon'd
among the Encysted.
What is a Talpa?
It is a soft and very broad Tumour, which usually appears in the Head
and Face, containing a white, thick and pituitous Matter.
What is a Bronchocele?
It is a bunch'd Tumour which ariseth in the Throat, and causeth it to
swell extremely; being compos'd of thick Phlegm mix'd with a little
Blood, and ranked among the Encysted Tumours.
What is a Ganglion?
It is a very hard Tumour, void of Pain and wavering, produc'd by thick
Phlegm: But it is always found upon some Nerve or Tendon.
What is a Fungus?
It is a spungy Tumour that grows upon Tendons bruis'd or weaken'd by
some Hurt.
What is the Scurf?
It is a whitish and scaly Tumour rais'd in the Skin of the Head by a
viscous and mixt Phlegm, having its Root in the bottom of the Skin.
What is the Scrophula or King's-Evil?
Scrophulæ or Strumæ, commonly call'd the
King's-Evil, are Tumours that generally shew themselves in the
Glandules of the Neck, and in all those Parts where there are any. They
consist of a viscous, serous, and malignant Phlegm, The Source or Root
whereof is suppos'd to be in the Glandules of the Mesentery. They are
also of the number of the Encysted Tumours.
What is the Dropsie?
It is a soft Tumour occasion'd by the setling of abundance of serous
Matter in the Parts where it appears.
How many sorts of Dropsies are there?
There are three general Species, viz. the
Ascites, Tympanites, and Leucophlegmatia.
What is an Ascites?
It is a kind of Dropsy that forms the Tumour or Swelling of the
Abdomen or lower Belly, by a Mass of Water.
What is a Tympanites?
It is a kind of Dropsy, which in like manner causeth a Tumour or
Swelling in the lower Belly, with this difference, that a great deal of
Wind is mixt with the Water, which renders the Tumour transparent, and
sounding, as it were a Drum; whence this Disease hath taken its Name.
What is the Dropsy call'd Leucophlegmatia?
It is a Tumour, or, to speak more properly; a general Swelling or
Bloating of all the other Parts of the Body, as well as of the lower
Belly. It is produc'd by a viscous and mucilaginous sort of Phlegm;
whence it happens that the Print of the Fingers remains in those places
that have been press'd.
What are the particular kinds of Dropsies?
They are those that are incident to different Parts, of which they
bear the Names; as the Hydrocephalus, which is the Dropsy of the
Head; the Exomphalus, of the Navel, and the Hydrocele of
the Scrotum. There is also a Dropsy of the Breast, and that of the
Matrix.
What are the Remedies proper for all these sorts of Tumours or
Dropsies?
They are in general all those that are agreeable to the Oedema,
which are variously us'd, as Liniments, Fomentations, Cataplasms, and
Plaisters: Internal Medicines ought also to be much consider'd, as
Diaphoreticks, Sudorificks, and Purgatives, when they are assisted by a
regular Diet.
A Decoction of the Roots of Briony with Cinnamon and Liquorish,
provokes Urine very much; as well as a Decoction of Turneps and Carrets,
and an Infusion of Sage in White-Wine.
What is a Scirrhus?
It is a hard unmoveable Tumour, almost altogether void of Pain, and of
a livid dark Colour; which is form'd of a Melancholick Humour, frequently
succeeding Phlegmons and Oedema's that have not been well
dress'd with convenient Remedies.
How is a Scirrhus cur'd?
By mollifying or dissolving it, and seldom by bringing it to
Suppuration.
It may be mollify'd by the application of a Cataplasm or Pultis,
compos'd of the Leaves of Violet-Plants, Mallows, Beets, Elder, Rue, and
Wormwood, with Camomile-Flowers, Horse-Dung, Cow-Dung,
and White Lillies. The whole Mass is to be boil'd together in Wine,
afterward adding Honey and Hogs-Lard, to make a Cataplasm thereof with
the Crum of White Bread.
It is dissolv'd with Plaisters compos'd of those of Diachylon,
Melilot, and Mucilages, to which is added Oleum Lumbricorum, and
Flower of Brimstone. To render the Remedy more effectual, Oil of Tobacco
may be also mixt with it, and Gum Ammoniack dissolv'd in
Vinegar.
Furthermore, these Topical or outward Medicines are to be accompany'd
with others taken inwardly, which serve to prepare the Humours for
convenient Evacuations; Such are Crab's-Eyes, the Decoctions of
Sarsaparilla, the use of good Wine, and light Meats of easie
Digestion.
What are the Tumours that partake of the Nature of a
Scirrhus?
They are the Polypus, Carcinoma, Sarcoma,
Natta, and Cancer.
What is a Polypus?
It is an Excrescence of fungous Flesh arising in the Nostrils: But
Hippocrates confounds the Carcinoma and Sarcoma with
the Polypus, of which he says they are only a Species.
What is the Natta?
It is a Tumour or Excrescence of Flesh that appears in the Buttocks,
Shoulders, Thighs, Face, and every where else, the various Figures of
which cause it to be call'd by different Names. For one while it
resembleth a Gooseberry, at another time a Mulberry, and at another time
a Melon or Cherry. Sometimes also these Swellings are like Trees, Fishes,
Birds, or other sorts of Animals, according to the ardent desire that
Women with Child have had for things that they cou'd not obtain when they
longed for 'em.
What are the Remedies proper for the Polypus, and other
kinds of Excrescences of the like Nature?
The Polypus may be cur'd in the beginning, but it is to be
fear'd lest it degenerate into an incurable Cancer, when it hath been
neglected or ill dress'd.
Besides the general Remedies, which are letting Blood a little, and
reiterated Purgations, with an exact Regulation of Diet, there are also
particular Medicaments which dry up and insensibly consume the
Excrescence; as a Decoction of Bistort, Plantain, and Pomegranate-Rinds
in Claret-Wine, which is to be snuff'd up the Nose many times in a Day,
and serves to soak the small Tents that are put up therein, as also often
to cool the Part, adding a little Allum and Honey.
The Patient must sometimes likewise keep in his Mouth a Sage-Leaf,
sometimes a piece of the Root of Pellitory of Spain; and at
another time Tobacco or some other thing of this Nature, which causeth
Salivation. If the Tumour continues too long, and doth not yield to the
above-mention'd Remedies, it is necessary to proceed to a Manual
Operation, which is very often perform'd with good
Success.
As for the Natta's, it is most expedient not to meddle with 'em
at all; nevertheless these Marks which Infants bring along with 'em into
the World, are frequently defac'd by an Application of the After-Burdens,
whilst they are as yet warm, as soon as their Mothers are deliver'd.
What is a Cancer?
It is a hard, painful, and ulcerous Tumour, produc'd by an adult
Humour, the Malignity whereof can scarce be suppress'd by any
Remedies.
How many sorts of Cancers are there?
There are two kinds, viz. The Primitive and the Degenerate; the
Primitive Cancer is that which comes of it self, and appears at first
about the bigness of a Pea or Bean, which nevertheless doth not cease to
cause an inward Pain, continual, and pricking by intervals; during this
time it is call'd an Occult Cancer; but when grown bigger, and open'd, it
bears the Name of an Ulcerated Cancer; which is so much the less capable
of being cur'd or asswag'd, as it makes it self more conspicuous by its
dreadful Symptoms, or concomitant Circumstances.
The Degenerate Cancer is that which succeeds an obstinate and
ill-dress'd Tumour or Impostume, and which becomes an Ulcerated Cancer,
without assuming the Nature of a blind or occult one.
What Remedies are requisite to be apply'd to a blind Cancer?
In regard that it cannot be known in this Condition without
difficulty, it is often neglected; nevertheless it is a Matter of great
Moment to prevent its Consequences, more especially by a good Diet, and
by general Remedies, which may gently rectifie the intemperature of the
Bowels: Afterwards Baths may be prescrib'd, together with the use of Whey
Asses-Milk, and Specificks in general, as Powders of Crab's Eyes, Vipers,
Adders, and others. As for Topical Remedies, none are to be administer'd,
except it be judg'd convenient to apply to the Tumour a Piece of Lead
rubb'd with Quick-silver; all others serving only to make the Skin
tender, and apt to break. The Patient may also take for his Drink Water
of Scorzonera and Hart's-Horn, with the Flowers of Bugloss or
Borage, and Liquorice: Or else Quick-silver-Water alone, boiling an Ounce
of it in a Quart of Water every time, the Quick-silver always remaining
at the bottom of the Vessel.
What are the Remedies for an ulcerated Cancer?
Besides the general ones, that are the same with those of the blind
Cancer, there are also Topical, which may take place here. The Powders of
Toads, Moles, Frogs, and Crabs calcin'd, cleanse the Ulcers perfectly
well. A Decoction of Vipers and Crabs may serve to bath 'em, and some of
it may be taken inwardly. Detersives made of Lime-Water, or Whey
clarify'd, and boil'd with Chervil are very good; and (if you please) you
may add Camphire or Saccharum Saturni.
If the Pains grow violent, recourse is to be had to Laudanum,
one or two Grains whereof may be given in a little Conserve of Roses.
When the Cancer is situated in the Glandules or Flesh, the Extirpation of
it may also be undertaken with good Success.
As for the manner of handling Degenerate Cancers, respect must be
always had to the kind of Tumour, from whence it deriv'd its
Original.
What is an Encysted or Bastard Tumour or Impostume?
It is that which is made of a Setling of mixt and corrupt Humours, the
Matter whereof is contain'd in certain proper Cystes or Membranous
Bags.
What are the kinds of these Tumours?
They are the Steatoma, the Atheroma, the
Meliceris, the Wen, the Bronchocele, and the
Scrophula or King's-Evil.
How is the difference between these Tumours discern'd?
The Steatoma is known by its Matter resembling Suet; as that of
the Atheroma resembleth Pap; and that of the Meliceris is
like Honey: These three Tumours cannot be well distinguish'd on the
outside, in regard that they do not change the natural Colour of the
Skin, which equally retains in all three the print of
the Fingers that press it. But the Bronchocele is discover'd by
the Place and Part which it possesseth; that is to say, the Throat; as
also by its somewhat hard consistence without the Alteration of the Skin.
The Scrophulæ or King's-Evil Swellings are known by their unequal
Hardness, and their situation in the Glandules, either in the Neck,
Arm-pits or elsewhere, without alteration likewise of the Skin.
Want is the Method to be observ'd in curing these sorts of
Tumours?
An Attempt is to be made to dissolve 'em, as in all the others;
nevertheless the safest way is to bring 'em to Suppuration, and to
extirpate the Cystes, which are apt to be fill'd again after the
Dissipation of the Humour.
What are the Medicines proper to dissolve these Tumours?
They are all such as may be us'd for the Oedema and
Scirrhus; but the Specificks or particular Remedies are these:
Take Rosemary, Sage, Wormwood, Elder, great Celandine, Camomile,
Melilot, St. John's-Wort, and Tobacco; boil 'em in White-Wine with
Soot and Mercurial Honey, adding, thereto Cummin-seeds beaten, and
Oleum Lumbricorum, to make a Cataplasm, which is to be renew'd
twice a Day. Afterward if the Tumour be not dispers'd, you may apply the
following Plaister, which hath an admirable Effect.
Take an equal Portion of the Plaister of Diachylon,
Devigo, and four times as much Mercury, and Emplastrum
Divinum; let 'em be dissolv'd together; then intermix Saffron, and
Oil of Tobacco, to make a Plaister with the whole Mass, which may be
spread upon thin Leather, and apply'd to the Tumour, without taking it
off only once every eighth Day, to cool it; so that it must be laid on
again after having wash'd and bath'd the Part with warm Urine or
Brine.
But it is to be always remember'd that external Remedies take effect
only imperfectly, unless they are assisted by internal, such as in this
case are reiterated Purgations, join'd with a regular Diet.
What are the Remedies proper to excite Suppuration?
To this purpose those may be us'd that serve in other kinds of
Tumours: But as for the extirpation of the Cystis, it is done by
dividing the Tumour into four Parts, by procuring Suppuration, and by
consuming the Bag by little and little. The Bronchocele alone will
not admit this Extirpation, by reason of the great Number of Nerves,
Veins, and neighbouring Arteries amidst which the Tumour is settl'd.
However Bronchotomy, or opening the Throat, may be perform'd;
which is an Operation peculiar to this Tumour.
What difference is there between Critical, Malignant, Pestilential,
and Venereal Tumours?
It consists in these particular circumstances, viz. that
Critical Tumours or Impostumes are indifferently all such as are form'd
at the End or Termination of Diseases, in whatsoever Place or Part they
appear.
Malignant Impostumes or Tumours are those that are obstinate, and do
not easily yield to the most efficacious Remedies.
Pestilential Impostumes or Tumours are those that are accompany'd with
a Fever, Swooning, Head-ach, and Faintness: They usually arise in the
time of a Plague or Pestilence, and are contagious.
Venereal Tumours or Impostumes are those that appear only at the
bottom of the Groin, and are the product of an impure Coitus.
However, the Critical Impostume may be Malignant, Pestilential, and
Venereal; the Malignant Impostume may be neither Critical, nor
Pestilential, nor Venereal: But the Pestilential and Venereal Tumours are
always Malignant.
What are the ordinary kinds of Critical Tumours or
Impostumes?
They are the Anthrax, the Boil, the Phlegmon, and the
Parotides or Swellings in the Almonds of the Ears.
What are the kinds of Malignant Tumours or Impostumes?
They are the Cancer, the Scrophula or King's-Evil; and
others of the like Nature.
What are the kinds of Pestilential Tumours or Impostumes?
They are Carbuncles that break out every where; a sort of
Anthrax which appears under the Arm-pits, and Bubo's in the
Groin.
What are the kinds of Venereal Tumours or Impostumes?
They are Botches or Bubo's and Cancers that arise in the Yard; as also
Wens and Condyloma's in the Fundament.
What is the difference between a Pestilential and a Venereal
Buboe?
They may be distinguish'd by their Situation, and respective
Accidents; the Pestilential lying higher, and the Venereal lower:
Besides, a Fever, Sickness at the Heart, and an universal Faintness or
Weakness, are the ordinary concomitant Circumstances of the former;
whereas the Venereal Buboe is always the consequence of an impure
Coitus, and is attended with no other Symptoms than those of
common Tumours, viz. Pain, Heat, Shootings or Prickings,
&c.
As for the Remedies, they may be sought for among those that have been
already prescrib'd for Tumours.
This Disease is known by the Ulcers of the Mouth, which are very
stinking; as also by excessive Salivation, great Pains in the Head,
Dizziness, frequent Epilepsies, Apoplexies, and Palsies. The Face, being
of a pale red, and dark Colour, is sometimes puff'd up or bloated,
inflam'd, and beset with Pustules: The Teeth are loose and ake, the Gums
are swell'd, itch, putrifie, exulcerate, and are eaten with the Canker;
and the Jaw is almost unmoveable: The Members are bow'd, and cannot be
extended: The Patients become stupid and drowsie, so that they fetch
their Breath with difficulty, are obnoxious to Palpitations of the Heart
and Coughs, and fall into Swoons: The Ulcers sometimes are so malignant,
that their Cheeks are entirely eaten up, and their Teeth seen: They are
also much inclin'd to Vomitting, Looseness, and Gripes; and their
Entrails are swell'd: They have red and livid Pustules on their Belly and
Privy-parts, which sometimes break out into Ulcers; their whole Body
being dry'd, &c.
This Disease may be easily cur'd in the beginning; but when it is
grown inveterate, and invades the Bowels, it becomes incurable; as well
as when it is the Epidemical Disease of the Country, or the
Persons afflicted with it, are old, or well advanc'd in Years.
In undertaking the Cure, it is requisite to begin with a good Diet,
and to sweeten the Blood, let the Patient take the Broth of boil'd Fowl;
eating Pullets and Eggs; in the Broth may also be put divers sorts of
Antiscorbutick Herbs; viz. Cresses, Spinage, Parsly-Roots,
Sparagus, Smallage, Scorzonera, Scurvy-Grass, &c. Let
him eat nothing that is high season'd, nor acid or sharp; let him drink
pure Claret, without any adulterate Mixture; let him use moderate
Exercise and Rest; Lastly, let him keep his Mind sedate, and free from
all manner of violent Passion.
The following Remedies taken inwardly are very good for the Scurvy,
viz. the Tincture of Flints from ten Grains to thirty;
Diaphoretick Antimony, from six Grains to thirty; sweet Sublimate, from
six Grains to thirty; Mars Diaphoreteus, from ten Grains to
twenty; Crocus Martis Aperitivus, from ten Grains to two Scruples;
prepar'd Coral, from ten Grains to one Dram; Volatile Spirit of Sal
Ammoniack, from six Drops to twenty; Water of Cresses, from fifteen
Drops to one Dram; Spirit of Scurvy-grass, from ten Drops to one Dram;
Tincture of Antimony, from four Drops to twenty; Oily Volatile Sal
Ammoniack, from four Grains to fifteen; Spirit of Guyacum,
from half a Dram to a Dram and a half; Vitrioliz'd Tartar, from
ten Grains to thirty; the Volatile Salt of Tartar, Urine, Vipers,
and Hart's-Horn, of each from six Grains to fifteen; the Spirit of Gum
Ammoniack, from eight Drops to sixteen; White Mercury
Precipitate, from four to ten Grains; Mercurial Panacæa, from six
Grains to two Scruples. We shall shew the manner of compounding 'em in
our Treatise of Venereal Diseases.
It is also expedient to give Emollient and Detersive Clysters to the
Patient at Night going to bed, his Body being always kept open with
convenient Diet-drinks: Afterward let him take gentle Sudorificks, such
as are made of the Decoctions of Fumitory, wild Cicory, Dandelion,
Hart's-Tongue, Scabious, the lesser House-Leek, Germander, Borage,
Scorzonera-Root, and Polypody, with Flowers of Broom, Elder, and
Marygold.
These are stronger for cold Constitutions, viz. Decoctions of
Scurvy-Grass, Lepidium, Arse-smart, the lesser Celandine,
Wormwood, little House-Leek, Trifolium Febrinum, Angelico,
Juniper-Berries, &c.
Convenient Decoctions to wash the Mouth may be made with Sage,
Rosemary, Hyssop, Oak-Leaves, Scurvy-Grass, Cresses, Tobacco, Roots of
Bistort, Aristolochy or Birth-Wort, Tormentil, Flower-de-Luce,
Balaustia or Pomegranate-Flowers, Red Roses, &c.
To corroborate the Gums, Gargarisms are made of Anti-Scorbutick
Plants; as of Spirit of Scurvy-Grass two Drams, one Scruple of Spirit of
Vitriol, one Scruple of common Salt, four Ounces of Rose-Water and
Plantane-Water. But if the Gums are putrefy'd, they are to be rubb'd with
Honey of Roses, and some Drops of Spirit of Salt.
To asswage the Pains of the Members, Bathings and Fomentations are to
be us'd; and a Decoction of Saxifrage taken inwardly,
with some Grains of Laudanum is good for that Purpose.
To allay the Gripes, Clysters may be given with Whey, Sugar, Yolks of
Eggs, Syrrop of Poppies, and Oils of Earth-Worms, Scurvy-Grass, Camomile,
&c.
Against the Scorbutick Dropsy, take the Essence of Trifolium
Febrinum and Elicampane, from twenty four Drops to thirty, and
continue the use thereof.
Milk taken inwardly hinders Vomitting; and a Broth or Gelly of Crabs
sweetens the Blood. The Looseness may be stopt with the Essence of
Wormwood, and Spirit of Mastick; as also the Fever with Febrifuges
and Anti-scorbuticks.
The Spots may be fomented with Decoctions of Aromatick and
Anti-Scorbutick Herbs and Nitre. For the Ulcers of the Legs, pulverize an
equal quantity of Saccharum Saturni, Crocus Martis, Myrrh,
and Mercurius Dulcis, and lay it upon the Bolsters that are to be
apply'd to the Sores.
To mollifie the sharpness of Acid Humours, this is a good Remedy:
Prepare half an Ounce of Spirit of Scurvy-Grass, two Drams of tartariz'd
Spirit Ammoniack, a Dram of the Tincture of Worms. Take thrice a
Day fifteen or twenty Drops of this Liquor, in a Decoction of the Tops of
Firr.
Against the Tubercles, take two Handfuls of the Flowers of Camomile
and Elder, three Drams of Briony-Root, and an Handful of White-Bread
Crum; Boil the whole Composition in Milk, and make Cataplasms thereof.
To mitigate the Pains in the Head, take twenty or thirty five Drops of
the Tincture of Amber, in Anti-scorbutick Spirits or Waters.
The difficulty of Respiration may be remov'd by a Medicinal
Composition made of two Drams of an Anti-scorbutick Water, two Drams of
the Essence of Elicampane, and half a Dram of the Spirit of Gum
Ammoniack; take three or four Spoonfuls thereof several times in a
Day.
To prevent the putrefaction of the Gums, take one Dram of the Tincture
of Gum Lacca, three Drams of the Spirit of Scurvy-Grass, with
fifteen or twenty Drops of Oil of Tartar made per Deliquium, and
rub the Gums with this Composition many times in a Day. Brandy in which
Camphire is infus'd, or Spirit of Wine, is likewise a most excellent
Remedy; as also all Lotions or Washes made with the Waters or Decoctions
of Anti-scorbutick Plants.
For Leanness, Goat's-Milk with the Spirit of Scurvy-Grass may be us'd,
and other Waters drawn from Anti-scorbutick Plants. The Apozemes or
Decoctions of Endive, Cicory, Sorrel, Becabunga, and Snail-Water,
are in like manner very good for the same purpose.
Ointment of Styrax is frequently us'd in the Hospital call'd
Hôtel-Dieu at Paris, and apply'd to Spots and callous
Swellings that arise in the Legs.
Sutures or Stitches are made only in recent, and as yet bleeding
Wounds, when they cannot be re-united by Bandage, as are the transverse;
provided there be no Contusion, nor loss of Substance, nor great
Hæmorrhages, as also that the Wounds were not made by the biting of
venomous Beasts, that there be no violent Inflammations, and that the
Bones are not laid open; because generally 'tis necessary to cause 'em to
be exfoliated; neither is this Operation to be perform'd in the Breast,
by reason of its Motion.
The Instruments proper for the making of Stitches, are streight and
crooked Needles, with waxed Thread; and these Sutures are
of four sorts, viz. first the Intermittent Stitch for
transverse Wounds; the second for the Hare-Lip; the third, commonly
call'd the Dry Stitch, for superficial Wounds; and the fourth,
term'd the Glover's Stitch.
The Intermittent Stitch is that which is made at certain separated
Points, according to the following manner: After having taken away all
extraneous Bodies out of the Wound, let a Servant draw together its Sides
or Lips; and let a Needle with waxed Thread be pass'd thro' the middle
from the outside to the inside, several Points being made proportionably
to its length. It is requisite to pierce a good way beyond the Edge of
the Wound, and to penetrate to the bottom, lest any Blood shou'd remain
in the Space, that might hinder the reuniting.
If the Wound hath Corners, the Surgeon begins to sow there; and before
the Knot is made, causeth the Lips of the Wound to be drawn exactly close
one to another: The Knots must be begun with that in the middle, and a
single one is first made on the side opposite to the running of the
Matter; laying upon this Knot (if it be thought convenient) a small
Bolster of waxed Linnen, on which is tied a Slip-Knot, to the end that it
may be untied if any bad Accident should happen. If a Plaister be apply'd
to the Wound after the Stitching, a small Bolster is to be laid over the
Knots, to prevent their sticking to the Plaister. In case any
Inflammation happens in the Wound, the Knots may be loosen'd and ty'd
again when the Symptoms cease: But if the Inflammation
continue, the Threads are to be cut by passing a Probe underneath: When
the Wound is clos'd, the Threads are cut in like manner with a Probe; and
in drawing 'em out, a Finger must be laid near the Knot, lest the Wound
should open again.
To make the second sort of Stitch for the Hare-Lip, a small streight
Needle is pass'd into the sides of the Wound, and the Thread is twisted
round the Needle, by crossing it above at every Stitch.
To form the Dry Stitch in very superficial Wounds, a piece of
new Linnen-Cloth is to be taken, wherein are made Digitations, or many
Corners; the Selvedge or Hem ought to be on the side of these Corners or
Digitations; and a small Thread-Lace is ty'd to every one of 'em.
Afterward this Cloth is dipt in strong Glue, and apply'd about a Finger's
breadth from the Edges of the Wound; so that a piece thereof being stuck
on each side, the Laces may be ty'd together, to cause the Lips of the
Wound to meet.
To make the Glover's Stitch, the Operator having drawn together
the Lips of the Wound, holds 'em between two Fingers, passeth a Needle
underneath 'em, and soweth 'em upward all along, after the manner of
Glovers.
What is a Wound?
A Wound is a recent, violent, and bloody Rupture or Solution of the
Natural Union of the soft Parts, made by a pricking, cutting, or bruising
Instrument.
What ought to be observ'd before all things in the curing of
Wounds?
It is requisite to take notice of their differences, as well as of the
Instruments with which they were made; to the end that Consequences may
be drawn from thence for the Application of proper Remedies.
From whence arise the differences of Wounds, and which be
they?
They are taken either from their Figure or Situation: With regard to
their Figure, they are call'd Long, Broad or Wide, Triangular Great,
Little, Superficial, or Deep; and with respect to their Situation, they
are term'd Simple, Complicated, Dangerous, or Mortal.
What is a Simple and a Complicated Wound?
A Simple Wound is that which only opens the Flesh, and hath no other
concomitant Circumstances; but a Complicated Wound, on the contrary, is
that which is attended with grievous Symptoms, as Hæmorrhages, Fractures
of Bones, Dislocation, Lameness, and others of the like Nature.
What is a dangerous and mortal Wound?
A dangerous Wound is that which is complicated the Accidents whereof
are dreadful: As when an Artery is open'd or prick'd, when a Nerve or
Tendon is cut, or when the Wound is near a Joynt and accompanied with a
Dislocation or Fracture. A mortal Wound is that which must be inevitably
follow'd by Death; as is that which is situated deep in a principal Part
necessary for the Preservation of Life.
What are the Parts wherein Wounds are mortal?
They are the Brain, the Heart, the Lungs, the Oesophagus or
Gullet, the Diaphragm, the Liver, the Stomach, the Spleen, the small
Guts, the Bladder, the Womb, and generally all the great Vessels.
Wherein doth the Cure of Wounds consist?
In helping Nature readily to procure the reuniting of the Parts that
have been divided, after having taken away or asswag'd every thing that
might cause an Obstacle.
What are the things that hinder the speedy reunion of the
Parts?
They are extraneous Bodies found therein, as Bullets, Flocks, and
Pieces of Wood or Stone, &c. As also sometimes the Accidents which
attend 'em; as an Hæmorrhage or Flux of Blood, Inflammation,
Esthiomenus or Mortification, Hypersarcosis, or an
Excrescence of Flesh, Dislocation, the Fracture of a Bone, the Splinter
of a Bone, & sometimes a contrary Air.
What are the Remedies proper for stopping an Hæmorrhage or
Flux of Blood?
The common Remedy is a kind of Cataplasm, made up with the Powders of
Aloes, Dragons-Blood, Bole Armenick and Whites of Eggs, which are mix'd
together and laid upon the Wound. But the following is an excellent
one.
Take two Ounces of Vinegar, a Dram of Colcothar, two Drams of
Crocus Martis Astringens; beat the whole together, steeping
Muscus Quercinus therein; then throw upon it the Powder of
Mushrooms, or of Crepitus Lupi: Apply this Remedy, and you'll soon
stop the Hæmorrhage, taking Care nevertheless to bind the Part
well, otherwise the Astringents do not readily take Effect.
To this Purpose you may also make use of Cobwebs, Mill-Dust, and the
Powder of Worm-eaten Oak; or else take Oven-Soot mixt with the Juice of
the Dung of an Ass or Ox, adding only thereto the White of an Egg.
Besides these Remedies there are also actual and potential Cauteries,
or simple Ligatures, which are infallible. Indeed the actual Cautery is
not always sure; because when the Escar made by the Fire, falls off the
Hæmorrhage breaks out again as before: but the potential Cautery is
almost always successful; such as the following.
Take about an equal Quantity of Vitriol and Powder of Mushrooms; apply
'em upon a little Lint to the Place where the Blood issueth forth, and
you'll see it stop immediately: But Care must be taken to avoid touching
a Nerve or Tendon; by reason that the Vitriol is apt to excite
Convulsions.
How is the Inflammation and Mortification of a Wound
Suppress'd?
If the Inflammation proceeds from the Presence of an Extraneous Body,
it must be taken away as soon as possible with a Pair of Forceps, and if
from the Quantity of Pus or corrupt Matter, it must be let out.
But in case the Inflammation ariseth from extreme Pains, they are to be
asswaged with Cataplasms or Pultises and anodyn Liniments, such as those
that have been already prescribed in the Cure of the Phlegmon: or
else the Part may be bath'd with Camphirated Spirit of Wine, mixt with as
much Water: Saccharum Saturni infus'd in Lime-water, performs the
same Effect, and the Water of Crabs alone is admirable in its
Operation.
Against the Esthiomenus or Mortification, make use of Wine
boil'd with Wormwood, St. John's Wort, Rosemary and Aloes; or else
take the Tincture of Aloes and Myrrh, or Spirit of Wine alone impregnated
with Camphire and Saffron.
What is to be done in Case a Convulsion happens by reason of a
wounded Nerve or Tendon?
If the Convulsion be caus'd by the Presence of an Extraneous Body that
bruiseth the Part it must be taken away; and if from the wounding of a
Nerve, pour into the Wound some Drops of the Oil of Lavender distill'd,
which in that Case is of singular Use; this Oyl may be also taken
inwardly in an appropriated Liquour, such as a Decoction of Wormwood
and the Tops of the lesser Centory. Balsam of Peru us'd in the
same Manner, is an excellent Remedy, and the Oyls of Worms, Snails, St.
John's-Wort and Turpentine are frequently apply'd with good
Success.
If the Convulsion proceeds from the Biting of some venomous Creature,
Cupping-Glasses or Leeches are to be immediately applied, putting into
the Wound Treacle with the Spirit of Wine or even Fire it self, and
leaving to the Physician's Care the Prescription of other vulnerary
Remedies proper to be taken inwardly.
What is to be done to draw the Extraneous Bodies out of a
Wound?
When they cannot be taken away with the Fingers or Forceps, the
Patient must be set in the same Station or Posture wherein he was when he
receiv'd the Wound, in order to get some farther Light to discover 'em;
or else such Plaisters may be us'd as are endu'd with an Attractive
Quality: Particularly this:
Take an Ounce of Treacle, half a Dram of Gum Ammoniack, one
Dram of Bdellium, and two Drams of Bore's Grease, adding a Quarter
of a Pound of Wax to make 'em up into the Form of a Plaister. It is
reported that Hare's Grease alone hath the same Effect, and that it goes
for a Secret among the Surgeons but you may (if you please) mix it with
Ointment of Betony. However it hath been observed that Leaden Bullets may
sometimes remain in a Man's Body, during his whole Life-time without
doing any Harm.
How are Excrescences to be taken away?
They may be consum'd with Powder of Allom, Unguentum
Ægyptiacum, or Lapis infernalis.
After having remov'd every thing that hinders the reuniting of the
Lips of a Wound, what is to be done to attain thereto?
The Re-Union in Wounds is properly the Work of Nature; but it may be
promoted by putting into 'em a little Balsam of Peru, and drawing
together their Lips with the Fingers. Afterwards the Lips must be kept
closed with a Bandage, a Glutinous Plaister or a dry Stitch, provided the
Wound be only superficial, hindring the Air from penetrating into it. For
Want of Balsam of Peru, an excellent one may be made with the
Flowers here specified.
Take the Flowers of Henbane, St. John's-Wort, and Comfry and
let 'em be digested in the Sun during the whole Summer-Season in the Oyl
of Hemp-seed, which Oyl, the longer it is kept, proves so much the
better, if it be set forth in the Sun every Summer, the Vessel that
contains it being well stop'd. There is also the Balsam of Balsams, or
the Balsam of Paracelsus call'd Samech.
To avoid the exposing of Wounds to the Air, it is requisite to cover
'em over the Dressings with some sort of Plaister, which is usually
termed the Surgeon's Plaister, such is that which is effectual in
Dissolving, corroborating and allaying Pain or Inflammation.
Take the Mucilages of the Roots of great Comfrey and Fenegreek, half a
Pound of Ceruse or white Lead, two Drams of Crude Opium, one Dram
of Camphire, as much of Saffron, two Drams of Sandarack, one of the Oyl
of Bays, one half Pound of Rosin, and as much
Turpentine and Wax. Boil all these Ingredients together in a sufficient
Quantity of Lin-seed-Oyl, and make a Plaister according to Art.
In great Wounds it is expedient to lay over the Dressings a Cataplasm
or Pultiss, such as this:
Take the Leaves and Flowers of Camomile, and Melilot, the Tops of
Wormwood, common Mallows and Marsh-Mallows, with the Seeds of Line and
Cummin powder'd: Then boyl the whole Composition in Wine, and add thereto
Barly-Meal, to give it a due Consistence. If there be any Cause to fear a
Gangrene, you may also intermix Saffron, Myrrh and Aloes with Spirit of
Wine.
Is it necessary to put Tents into all Wounds, and to make use of
Digestives and Suppuratives?
No: It is sufficient to procure the Re-uniting of the Parts simply by
the Means of Balsam in small Wounds; because they ought not to be brought
to Suppuration: so that Digestives and Suppuratives are only necessary in
great Wounds, and those that are accompanied with Contusion, avoiding the
ill Custom of some Country-Surgeons, that stuff up their Wounds too much
with Tents and Pledgets, whereas they might well be content with simple
Bolsters or Dossels which shou'd be dipt in the ordinary Digestive
composed of Turpentine and the Yolks of Eggs with a little Brandy, or
else with the Tincture of Myrrh and Aloes.
Suppuration may also be promoted by mundifying and quickening the
Wound, especially if the Bolsters be steep'd in the following
Composition.
Take half an Ounce of Aloes and Myrrh powder'd, two Drams of Sal
Saturni, twenty Grains of Sal Ammoniack, the same quantity of
beaten Cloves, a Dram of Queen of Hungary Water and half an Ounce
of Unguentum Basilicon, and let the whole Mass be mingled
together.
In fine, the whole Mystery consists in well cleansing the Wounds with
a Linnen Cloth, or with the Injections of the Tinctures of Myrrh and
Aloes; or with simple Decoctions of Wormwood, Scordium or
Water-Germander, Bugle, Sanicle and Hore-Hound in White-Wine; as also by
prescribing the Vulnerary Decoctions of Powder of Crab's-Eyes, and
Saccharum Saturni, to be taken inwardly, to consume the acid
Humours, which are a very great Obstacle that hinders the speedy cure of
Wounds.
What are the Vulnerary Plants, the Decoctions of which is to be
taken inwardly?
They are Alchymilla or Lion's-Foot, Ground-Ivy, Veronica
or Fluellin, St. John's-Wort, Wormwood, Centory, Bugle, Sanicle,
Chervil, and others. The Broth of Crabs may also be prescrib'd, which is
an excellent Remedy, and may serve instead of a Vulnerary Potion.
Sometimes Sutures or Stitches contribute very much to the re-uniting
of the Lips of Wounds, when they cannot be join'd by Bandage.
What ought first to be consider'd in a Wound of the Head?
Two things, that is to say, the Wound it self, and the Instrument with
which it was made; for by the Consideration of the Wound, we may know
whether it be Superficial or Deep; and by that of the Instrument, we are
enabled to make a truer Judgment concerning the Nature of the same
Wound.
What is a Superficial, and what is a Deep Wound in the
Head?
That is call'd a Superficial Wound in the Head, which lies only in the
Skin; and that a Deep one which reacheth to the Pericranium,
Skull, or Substance of the Brain.
What is to be apply'd to a Superficial Wound?
It is cur'd with a little Queen of Hungary Water; or else with
a little Balsam, laying upon it the Surgeon's Plaister, or that of
Betony. But if the Wound or Rent be somewhat large, it must be clos'd
with a Stitch.
What is to be done to a Deep Wound?
If it be situated in the Pericranium, the Wound must be kept
open, waiting for Suppuration; but if it enter the Skull, an Enquiry is
to be made, whether there be a Simple Contusion, or a Fracture also. In
the Contusion it is necessary to wait for the Suppuration, and the fall
of the Splint, and to keep the Wound open; as in the Fracture, to examine
whether it be in the first Table only, or in both; it is known to be only
in the first, by the Application of an Instrument, and of Ink, as also in
regard that there are no ill Symptoms; but a Fracture in both Tables
shews it self by the Signs; and it may be found out by making a Crucial
Incision in the Flesh, to discover the Fissure.
What are the Signs of the Fracture of the two Tables of the Skull,
and of the overflowing of the Blood upon the Membranes of the
Brain?
They are the loss of the Understanding at the very Moment of receiving
the Wound; an Hæmorrhage or Flux of Blood thro' the Nose, Mouth, or Ears;
drowsiness and heaviness of the Head, and more especially Vomitting of
Phlegm; from whence may be inferr'd the necessity of making use of the
Trepan.
What Consequence may be drawn from the Knowledge of the Instrument
with which the Wound was made?
It is according to the Quality of this Instrument; as it is proper to
cut, prick, or bruise; if it be cutting, the Wound is more Superficial,
and not subject to a great Suppuration: If it be pricking, the Wound is
deeper, but of small Moment: If it be a battering or bruising Instrument,
the Wound is accompany'd with Contusion, producing a great Suppuration,
besides the Concussion and Commotion of the Part, which are inseparable,
and often cause very dangerous Symptoms.
Inferences may be made also from the disposition of the wounded
Person; for a strong robust Man may better bear the Stroke than a weak
one; and even Anger causeth an Augmentation of Vehemency; so that all
such Circumstances are not to be despis'd, in regard that they give
occasion to profitable Conjectures.
What particular Circumstance is there to be observ'd in undertaking
the Cure of Wounds in the Face?
It is, that a more nice Circumspection is requir'd here than
elsewhere, in abstaining from Incisions, as well as in making choice of
proper Medicines, which must be free from noisome Smells; and it is in
this Part chiefly that Balsams are to be used, avoiding Suppuration, to
prevent Scars and other Deformities.
What is to be observ'd in Wounds of the Breast?
Two things, viz. whether they penetrate into the Cavity of the
Thorax or not, which may be discover'd by the Probe, and by a
Wax-Candle lighted, and apply'd to the Entrance of the Wound, obliging
the Patient to return to the same Posture wherein he receiv'd the Hurt,
as also to keep his Nose and Mouth shut: For then the Flame may be
perceiv'd to be wavering, the Orifice of the Opening being full of Bubbles; a Judgment may be also made from
the running out of the Blood.
What is to be done when it is certainly known that the Wound
penetrates into the Cavity of the Breast?
It is necessary to examine what Part may be hurt, by considering the
situation of the Wound, and its Symptoms: If the Lungs are pierc'd, a
spitting of froathy Vermilion-colour'd Blood ensues, with difficulty of
Respiration, and a Cough. If any of the great Vessels are open'd, the
wounded Person feels a Weight at the bottom of his Breast, is seiz'd with
cold Sweats, being scarce able to fetch his Breath, and Vomits Blood,
some Portion whereof issueth out of the Wound. If the Diaphragm or
Midriff be cut in its Tendinous Part, he is suddenly hurry'd into
Convulsions: And if the Heart be wounded either in its Basis or
Ventricles, he falls into a Swoon, and dies incontinently.
But if the Probe doth not enter, and none of the above-mentiond
Symptoms appear, it may be taken for granted that the Wound is of no
great Consequence.
What is to be done when the Wound penetrates into the Chest, yet
none of the Parts are hurt, only there is an Effusion of Blood over the
Diaphragm?
It is necessary to make an Empyema, or otherwise the diffus'd
Blood in corrupting, wou'd inevitably cause an Inflammation, Gangrene,
and Death it self.
What is an Empyema?
It is an Operation whereby any sorts of Matter are discharg'd with
which the Diaphragm is over-spread, by making a Puncture or Opening in
the Breast.
What is to be done to know the quality of a Wound made in the lower
Belly?
It is requisite to make use of the Probe, to observe the situation of
the Wound, and to take notice of all the Symptoms: For by the help of the
Probe, one may discover whether it hath penetrated into the Cavity or
not, after having enjoyn'd the Patient to betake himself to the same
Posture wherein he was when he first receiv'd the Wound: By its situation
a Conjecture may be made that such a particular Part may be hurt; and by
a due Examination of the Symptoms, one may attain to an exact Knowledge.
As for Example; It is known that one of the thick Guts is open'd, when
the Hurt is found in the Hypogastrium, and the Excrements are
voided at the Wound; as it is certain that one of the thin Guts is
pierc'd, when the Wound appears in the Navel, and the Chyle issueth forth
from thence; and so of the others.
What Method ought to be observ'd in curing Wounds in the lower
Belly?
It is expedient at first to prevent letting in the Air, and to dilate
the Wound, in order to sow up the perforated Gut, and afterward to restore it to its place; as also to bind
the Caul, which is let out at the opening, and to cut it off, lest in
putrifying it should corrupt the neighbouring Parts. Then these Parts may
be bath'd with Lees of Wine, wherein have been boil'd the Flowers of
Camomile and Roses with Wormwood: The Powders of Aloes, Myrrh, and
Frankincense may be also thrown upon 'em; and the Wound must be sow'd up
again to dress it on the outside, the Patient in the mean time being
restrain'd to a regular Diet. But Clysters must be forborn on these
Occasions, especially when one of the thick Guts is wounded, making use
rather of a Suppository or laxative Diet-Drinks, to avoid dilation and
straining.
These Wounds are always bruis'd and torn, with the loss of Substance,
and commonly with the splitting and breaking of a Bone: They are red,
black, livid, and inflam'd, not being usually accompany'd with an
Hæmorrhage: They are generally round, and streighter at their Entrance
than at their End; at least if they were not made with Cross-Bar-Shot, or
Quarter-Pieces.
When these Wounds penetrate into the Substance of the Brain, or Marrow
of the Back-Bone, or into the Heart, Pericardium, great Vessels,
and other noble Parts, Death always inevitably follows, and often happens
at the very Instant. But one may undertake the Cure of those that are
superficial, and which are made in the Neck, Shoulders, Arms, and all
other parts of the Body.
For the better curing of these sorts of Wounds, it is requisite to be
inform'd of the Quality of the Fire-Arms by which the Wounds were made,
in regard that a Musquet is more dangerous than a Pistol, and a Cannon
much more than a Musquet; as also to examine their situation and
concomitant Accidents; for by how much the more complicated they are, so
much the greater is the danger. Then the Patient must be set (as near as
can be) in the very same Situation and Posture wherein he remain'd when
the Wound was receiv'd, in order to discover the direct Passage of the
Wound by the help of the Probe, with which a search is to be made,
whether a Bullet, or any other extraneous Bodies, as Wood, Flocks,
Linnen, or Stuff as yet stick in the Wound; so that Endeavours may be
us'd to take 'em out thro' the same Hole where they enter'd, care being
more especially had to avoid making Dilacerations in
drawing 'em out: But if the Operator hath endeavour'd to no purpose to
remove these extraneous Bodies, let him make a Counter-Opening in the
opposite Part, where he shall perceive any hardness, nevertheless without
touching the Vessels; thus the Incision being made, he may readily draw
'em out with his Fingers, or some other Instrument.
If the Bullet sticks so far in a Bone that it cannot be taken away
without breaking the same Bone, it is more expedient to let it lie
therein; but if the Leg or Arm-Bones are very much split or shattered,
then the Amputation of 'em becomes absolutely necessary. The Pain and
Inflammation of the Part may be asswag'd by letting Blood, topical
Anodyns, cooling Clysters and Purgations; but in case much Blood hath
been already lost, Phlebotomy must be omitted. The Clysters may be made
with Decoctions of Mercury, Mallows, Beets, a Handful of Barley and Honey
of Roses.
Some Surgeons are of Opinion that the Patient ought to be purg'd every
other Day, and even on the very same Day that he receiv'd the Wound, if
his Strength will permit; however very gentle Purges are to be us'd upon
this occasion, such as Cassia, Manna, Tamarins, Syrrup of Violets, and
that of White Roses.
In the mean while Anodyns may be compounded to mitigate the Pain; as
Cataplasms or Pultisses made with the Crum of white Bread, Milk, Saffron,
the Yolk of an Egg, and Oil of Roses us'd hot; which last Ingredient is
of it self a very good Anodyn. But to asswage great Inflammations, Oil of
Roses, the White of an Egg and Vinegar
beaten all together, may be laid on the neighbouring Parts.
At first it is necessary to apply spirituous Medicines to the Wound,
and Pledgets steep'd in camphirated Brandy, are admirable for that
purpose; but if there be a Flux of Blood, styptick Waters, or other
astringent Remedies may be us'd, still remembring that all these
Medicaments must be apply'd hot.
To promote the Suppuration of these contused Wounds, a Digestive may
be made of Oleum Rosatum, the Yolk of an Egg, and Venice
Turpentine.
If the Wound be in the Nerves, Tendons, or other Nervous Parts, it is
requisite to use spirituous and drying Medicines, never applying any
Ointments, which will not fail to cause Purtrefaction in those Parts: But
a Cataplasm may be made with Barley-Meal, Orobus, Lupins and
Lentils boil'd in Claret, adding some Oil of St. John's-Wort.
The Balsam of Peru, Oil of Turpentine destill'd, Oil of Wax,
destill'd Oil of Lavender, Oleum Philosophorum, Oil of Bays
destill'd, Balsam of St. John's-Wort, Spirit of Wine, and Gum
Elemi, are excellent Medicaments for the Nerves: Or else,
Take four Ounces of Unguentum Althææ with a Dram and a half of
destill'd Bays; mingle the whole Composition, and apply it: Or else,
Take an Ounce of destill'd Oil of Turpentine, a Dram of Spirit of
Wine, and half an Ounce of Camphire; let all be intermixt, and dropt into
the Wound: Or else,
Take a Scruple of Euphorbium, half an Ounce of
Colophonia, and a little Wax; let 'em be mingl'd together, and
apply'd very hot to the Nervous Parts.
If the Wounds are deep, Injections may be made with this Vulnerary
Water, which is very good for all sorts of Contusions, as also for the
Gangrene and Ulcers.
Take the lesser Sage, the greater Comfrey, and Mugwort, of each four
Handfuls; Plantane, Tobacco, Meadowsweet, Betony, Agrimony, Vervein, St.
John's-Wort, and Wormwood, of each three Handfuls; Fennel,
Pilewort Bugle, Sanicle, Mouse-Ear, the lesser Dazy, the lesser Centory,
and All-heal, of each three Handfuls; three Ounces of round Birth-Wort,
and two Ounces of long: Let the whole Composition be digested during
thirty Hours, in two Gallons of good White-Wine, and afterward destill'd
in Balneo Mariæ, till one third part be consumed.
If a Gangrene happens in the Part, Spirit of Mother-Wort may be put
into it, which is compounded with two Drams of Mastick, Myrrh,
Olibanum, and Amber, and a Quart of rectify'd Wine, the whole
being destill'd.
This Fomentation may be apply'd very hot to very good purpose,
viz. an equal quantity of Camphirated Wine and Lime-Water, with
three Drams of Camphire.
This is also an excellent Cataplasm: Take a Pint of Lye, and as much
Spirit of Wine, half an Handful of Rue, Sage, Scordium, and
Wormwood, a Dram of each of the Roots of both sorts of Birth-Wort, and
two Drams of Sal Ammoniack. Let the whole
Composition be boil'd till a third Part be consum'd; adding half a Dram
of Myrrh and Aloes, and a little Brandy.
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 Tartar per diliquium hath a very good
effect.
If the Burn be accompany'd with a Fever, it may be allay'd with fixt
Nitre, Nitre prepar'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 may be laid 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, and Venice Soap, of
each half an Ounce; mingle the whole Composition in a Mortar, pouring
upon it a sufficient quantity of Oil of Roses, to make a very
good Ointment: Or else,
Dissolve Minium or 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 of Psyllium, or rather those of
Quince-Seeds prepar'd with Frog's Sperm, and a little Saccharum
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, Etmullerus
is of Opinion that they ought 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 the Sanies, lest a deep and putrid
Ulcer shou'd be engender'd Underneath. As soon as the Humour is
evacuated, the above-mention'd Emollient 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,
with Mercurius 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 a Sphacelus be begun, scarifie the Part, and apply thereto
abundance of Unguentum Ægyptiacum over and above the Ointments and
Cataplasms already describ'd; remembring always, that when the
Gangrene degenerates into a Sphacelus, 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 the Sanies that 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 its Pus
or 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, the
Pus and Ichor being viscous, stinking, and of a cadaverous
smell.
The Corrosive Ulcer is that which by the Acrimony and Malignity of its
Sanies, 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 malignant
Sanies, 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; the Sanies whereof 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 the Sanies
that 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 added Saccharum 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 good Success; but then they
must must be of a Malignant Nature.
The Plaisters are Emplastrum 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 and Bolus, and it will make an excellent Ointment
to mundifie and dry; a little Mercury Precipitate may be intermixt
(if you please) to augment the drying Quality; and Mercurius
Dulcis may 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.
Take Saccharum 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 the Penis
or 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 the Glans and Præputium; 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 of Sal Prunella into 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 gentle Purges are to
be prescrib'd in the beginning; such as an Ounce of Cassia, and as
much Manna, 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 of Mercurius 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 of
Laudanum, 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 the Gonorrhæa is stopt, to be
certain of a perfect Cure, a Dram of the Mercurial Panacæa is 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 the Gonorrhæa,
Mercury must 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 the
Chaude-pisse a 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 with Lapis
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 the
Glans and the Præputium. To cure 'em, they must be touch'd
with the Lapis Infernalis, and brought to Suppuration by the means
of red Precipitate mixt with the Ointment of Andreas Crucius.
Oleum Mercurii laid on a Pledget or Bolster, is very efficacious
to open Skankers, and consume their Flesh. The Patient must be well
purg'd with Mercurius Dulcis and Scammony, taking twelve or
fifteen Grains of each in Conserve of Roses; and after these Purgations
are sufficiently reiterated, he may take the Mercurial 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's are 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 is necessary 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 and Mercurius
Dulcis: He must also take the Mercurial Panacæa's.
This loathsome Disease begins sometimes with a virulent
Gonorrhæa, 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, and
Exostoses happen 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; the Uvula or Palate is down; Ulcers break out in the
Privy-Parts; Bubo's arise in the Groin; as also Warts in the Glans
and Præputium; and Condyloma's in the Anus.
Indeed the Pox may be easily cur'd in the beginning; but when it hath
taken deep Root by a long Continuance, it is not
extirpated without much difficulty, more especially if it be accompany'd
with Ulcers, Caries, and Exostoses; 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
of Guayacum, China-Root, and Sarsaparella, 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 of Mercurius
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 with Vuguentum Mercurii, which is made
of crude Mercury stirr'd about in a Mortar with Turpentine, and
then the whole mingled with Hog's-Grease, one part of Mercury
being 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 of Mercury at 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 the Mercury hath 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 little Mercurial
Panacæa may 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 of Aurum 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, or
Aqua-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 with Saccharum Rosatum.
If the Pox were not inveterate, the Fluxing might be excited by the
Panacæa alone, without any Frictions: For after the Phlebotomy,
Purgations, and Bathings duly
administer'd; the Patient might take ten Grains of the Mercurial
Panacæa in 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 the Panacæa. This Course must be continually
follow'd till the Salivation becomes Laudable, and the Symptoms
cease.
To prepare this Panacæa, it is requisite to take Mercury
reviv'd from Cinnabar, because it is more pure than Mercury
which is immediately dug out of the Mine. The Mercury is reviv'd
with Cinnabar, after this manner: Take a Pound of artificial
Cinnabar pulveriz'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 be put under it by
degrees, and at length let the Heat be very much augmented, whereupon the
Mercury will 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 the Mercury, 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 of
Mercury may be drawn off from every Pound of artificial
Cinnabar.
The Panacæa is made of sweet Sublimate, and the later of
corrosive Sublimate: To make the corrosive Sublimate, put sixteen Ounces
of Mercury reviv'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 Sublimate will 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 red Scoria or Dross which
settleth at the bottom must be cast away as unprofitable. This Sublimate
being a powerful Escarotick, 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 the Phagedonick-Water.
The sweet Sublimate, of which the Panacæa is 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 of Mercury reviv'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 consummated in 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 in the middle
of its Height: Then place this Matras in a Furnace or Balneum of
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 Ivory Spatula.
Afterward set your Cucurbite in Balneo 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 the Panacæa will appear at the bottom of the Cucurbite. If it
be not already dry enough, you may dry it up with
a gentle Fire in the Sand, stirring it with an Ivory or Wooden
Spatula in 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 of Venereal Diseases, as also for Obstructions, the Scurvy,
Scrophula or Kings-Evil, Tettar, Scab, Scurf, Worms,
Ascarides, inveterate Ulcers, &c. The Dose is from six
Grains to two Scruples, in Conserve of Roses.