The Compleat Surgeon Part 20

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. {132}

_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 Circ.u.mstances 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 p.r.i.c.kings, &c.

As for the Remedies, they may be sought for among those that have been already prescrib'd for Tumours.

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CHAP. VI.

_Of the Scurvy._

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 {134} 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 Antis...o...b..tick Herbs; _viz._ Cresses, Spinage, Parsly-Roots, Sparagus, Smallage, _Scorzonera_, Scurvy-Gra.s.s, _&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 Pa.s.sion.

The following Remedies taken inwardly are very good for the Scurvy, _viz._ the Tincture of Flints from ten Grains to thirty; Diaph.o.r.etick Antimony, from six Grains to thirty; sweet Sublimate, from six Grains to thirty; _Mars Diaph.o.r.eteus_, 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-gra.s.s, 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 _Guyac.u.m_, 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 {135} _Mercury_ Precipitate, from four to ten Grains; _Mercurial Panacaea_, 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 Const.i.tutions, _viz._ Decoctions of Scurvy-Gra.s.s, _Lepidium_, a.r.s.e-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-Gra.s.s, 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-s...o...b..tick Plants; as of Spirit of Scurvy-Gra.s.s 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 a.s.swage the Pains of the Members, Bathings and Fomentations are to be us'd; and a {136} 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-Gra.s.s, Camomile, _&c._

Against the s...o...b..tick 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-s...o...b..ticks.

The Spots may be fomented with Decoctions of Aromatick and Anti-s...o...b..tick Herbs and Nitre. For the Ulcers of the Legs, pulverize an equal quant.i.ty 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-Gra.s.s, 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. {137}

To mitigate the Pains in the Head, take twenty or thirty five Drops of the Tincture of Amber, in Anti-s...o...b..tick Spirits or Waters.

The difficulty of Respiration may be remov'd by a Medicinal Composition made of two Drams of an Anti-s...o...b..tick 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-Gra.s.s, 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-s...o...b..tick Plants.

For Leanness, Goat's-Milk with the Spirit of Scurvy-Gra.s.s may be us'd, and other Waters drawn from Anti-s...o...b..tick 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 _Hotel-Dieu_ at _Paris_, and apply'd to Spots and callous Swellings that arise in the Legs.

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A

TREATISE

OF

_Wounds, Ulcers, and Sutures_.

CHAP. I.

_Of Sutures._

Sutures or St.i.tches 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 Haemorrhages, 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 St.i.tches, are streight and crooked Needles, {139} with waxed Thread; and these Sutures are of four sorts, _viz._ first the _Intermittent St.i.tch_ for transverse Wounds; the second for the Hare-Lip; the third, commonly call'd the _Dry St.i.tch_, for superficial Wounds; and the fourth, term'd the _Glover's St.i.tch_.

The Intermittent St.i.tch 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 pa.s.s'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 s.p.a.ce, 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 St.i.tching, 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 {140} if the Inflammation continue, the Threads are to be cut by pa.s.sing 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.