The Compleat Surgeon Part 15

_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 is_Pus_?_

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_?_ {103}

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 Ma.s.s 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 diminis.h.i.+ng the Plethory of the Blood, and cooling the whole Ma.s.s 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?_ {104}

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.

CHAP. III.

_Of Natural Tumours._

ARTICLE I.

_Of the _Phlegmon_ and its Dependancies._

_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. {105}

_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.

REMEDIES.

_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.

{106}

_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 Gla.s.s, 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 a.s.swag'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 Ma.s.s 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 {107} 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 Gla.s.s 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 b.u.t.ter, and a little Leaven or Yeast. The Plaister _Diasulphuris_ is also most excellent either alone, or, if you please, mixt with _Diachylon_ and _Basilicon_.