The Compleat Surgeon Part 16

_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 aegyptiac.u.m_, 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.

{108}

_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_ {109} 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.

_Remedies for _Echymoses_, Contusions, or Bruises._

_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. {110}

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 Circ.u.mspection, which must be always prepar'd for Incision.

_Of phlegmonous Tumors or Impostumes, and of Remedies proper for 'em._

_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. {111}

_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 p.r.i.c.king 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 {112} 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 Haemorrhage; 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. {113}

_REMEDIES._