The Compleat Surgeon Part 25

If the Pox were not inveterate, the Fluxing might be excited by the _Panacaea_ alone, without any Frictions: For after the Phlebotomy, {175} Purgations, and Bathings duly administer'd; the Patient might take ten Grains of the _Mercurial Panacaea_ in the Morning, and as many at Night; on the next Day fifteen Grains might be given, and the like quant.i.ty 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 quant.i.ty 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 _Panacaea_. This Course must be continually follow'd till the Salivation becomes Laudable, and the Symptoms cease.

_The manner of making the _Mercurial Panacaea_._

To prepare this _Panacaea_, 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 Gla.s.s 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 {176} 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 quant.i.ty 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 _Panacaea_ 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 Matra.s.s, 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 Gla.s.s Vial, or into a Stone-Jug, and let its Moisture evaporate gently over the Sand-Fire, till a white Ma.s.s remains; which you may pulverize in a Gla.s.s 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 {177} will arise on the top of the Matras; so that the Operation may be perform'd within the s.p.a.ce 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 _Panacaea_ is immediately compos'd, is made with sixteen Ounces of corrosive Sublimate, pulveriz'd in a Marble or Gla.s.s-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 Gla.s.s-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 {178} 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 quant.i.ty 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.

_Of the proper Composition of the _Mercurial Panacaea_._

Take what quant.i.ty you please of sweet Sublimate, reduce it to Powder in a Marble or Gla.s.s-Mortar, and put it into a Matras, three quarters whereof remain empty, and of which you have cut off the Neck in {179} 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 s.p.a.ce 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 Gla.s.s. 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 Matra.s.ses 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 Gla.s.s 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 Mariae_, 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 _Panacaea_ will appear at the bottom of the Cucurbite. If it be not {180} 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 Gla.s.s-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.

{181}

A

TREATISE

OF THE

DISEASES

OF THE

BONES.

CHAP. I.

_Of the Dislocation of the Bones._

_What are the Diseases incident to the Bones?_

They are five in number, _viz._ Dislocation, Fracture, _Caries_ or Ulcer, _Exostosis_, and _Nodus_.

_What is a Dislocation or Luxation?_

It is the starting of the Head of one Bone out of the Cavity of another, with an {182} Interdiction of the proper Motion of the Part: Or else it is the disjointing of two Bones united together for the Motion of a Part.

_How many causes are there of Dislocation in general?_

Two, that is to say, one violent, and the other gentle; thus the Dislocation is made violently in Falls, Strains, Knocks, and Blows; but it is done gently and slowly in Defluctions of Rheum; as also by an insensible gathering together of Humours between the Joints, and upon the Ligaments, the Relaxation or loosening of which gives occasion afterward to the Head of the Bone to go out of its place; whence this Consequence may well be drawn, _viz._ that a violent Dislocation usually depends upon an external Cause, and a gentle Dislocation upon an internal.

_After how many manners doth a Dislocation happen?_

Two several Ways; _viz._ the first is called compleat, total, and perfect; and the second incompleat, partial, and imperfect: But both may happen before, behind, on the inside, and without; and may also be simple or complicated.

_What are the signs of a perfect, total, and compleat Dislocation?_

It is when a hard Tumour or Swelling is perceiv'd near a Hole in the place of the Joint, great pain being felt in the Part, and the Motion of it abolish'd.

_What are the signs of an imperfect, partial, and incompleat Dislocation?_ {183}

It is when the Motion is streighten'd, and weaker than ordinary, so that some Pain is felt in the Joynt, and a Deformity may be discern'd therein, by comparing the hurt Part with the opposite which is found: This Dislocation is otherwise call'd a Sprain, when it proceeds from an external Cause; or else it is termed a Relaxation, when it happens by an internal.

_What is a simple, and what is a complicated Dislocation or Luxation?_

The Dislocation is properly simple, when it hath no concomitant Accidents; and it is complicated when accompany'd with some ill Symptoms or Accidents, such as Swellings, Inflammations, Wounds, Fractures, &c.

_What are the means proper to be us'd in a simple Dislocation?_

A speedy and simple reducing thereof, which is perform'd by stretching out the dislocated or luxated Member, and thrusting back the Head of the Bone into its natural place. Afterward the Joynt must be strengthen'd with a Fomentation made with Provence Roses, the Leaves of Wormwood, Rosemary, Camomile, St. _John_'s-Wort, and Oak-Moss boil'd in the Lees of Wine and Forge-Water, keeping the Part well bound up, and sustain'd in a convenient situation. But if any ill Consequence is to be fear'd, apply _Emplastrum Oxycroceum_, or _Diapalma_ dissolv'd in Wine.

_What is to be done in a complicated Dislocation?_ {184}

The Accidents must be first remov'd, and then the Bone may be set, which is impossible to be done otherwise; it being dangerous even to make an Attempt before, by reason of the too great Violence with which it is effected, and which would infallibly produce a Convulsion or a Gangrene.

_If the Dislocation be accompany'd with a Wound, must the Wound be cur'd before any Endeavours are us'd to reduce it?_

No, but the Symptoms of the Wound, which hinder the Operation, must be taken away, as the Swelling, Inflammation, and others of the like Nature; and then it may be reduc'd, and the Wound may be dress'd according to the usual Method.

_If the Dislocation be complicated with the Fracture, what is to be done then?_

It is necessary to begin with reducing of the Dislocation, and afterward to perform that of the Fracture, by reason of the Extension which must be made to reduce the Dislocation, which would absolutely hinder the Setling of the Fracture.

_How is the Inflammation and Swelling to be a.s.swag'd?_

With Linnen Cloaths dipt in Brandy and common Water, which must be often renew'd; or else with the Tops of Wormwood and Camomile, with Sage and Rosemary boil'd in the Lees of Wine, wherein the Bolsters and Bands are to be steep'd. But all Repercussives and Astringents must be avoided.

_How doth it appear that the Reduction is well perform'd?_ {185}

By the Re-establishment of the Part in its natural State; by its being free from Pain; by its regular Motion; and by its conformity to the opposite Part which is found.

_What Dislocations of Parts are most difficult to be reduc'd?_

They are those of the Thighs with the Huckle-Bones, which are almost never perfectly set; that of the first _Vertebra's_ is extremely difficult to be reduc'd; and those of the Lower-Jaw and Soles of the Feet are mortal.

The reducing of Dislocations is perform'd with greater facility in Infants than in Persons advanc'd in Years; but it becomes most difficult when it is deferr'd for many Days, by reason of the overflowing of the _Lympha_ and nutritious Juice.

If an Inflammation shou'd happen before the Member is reduc'd, nothing can be done till it be allay'd, as we have already intimated; but to prevent and mitigate it, the dislocated Joynt, and the neighbouring Parts, may be bath'd with luke-warm Wine, in which hath been boil'd the Tops of St.

_John_'s-Wort, Camomile, Rosemary, _Stoecas Arabica_, and other Ingredients of the like Nature; the Bands must be also steept in the same Liquor.

If an _Oedematous_ Tumour arise in the luxated Member after the Joint hath been set, it is requisite to take internal Sudorificks, and to apply Liniments made with the destill'd Oil of Tartar, and of Human Bones, which may be rectify'd with burnt Hart's Horn, or some other part of Animals, to take away its stink: Or else take yellow-Wax, and very white Rosin, {186} melt the whole Ma.s.s, and put into it white Amber and Gum _Elemi_, a sufficient quant.i.ty of each to make a Composition to be incorporated with Balsam of _Peru_; a Plaister of which may be prepar'd, and apply'd to the dislocated Member; but the Plaister must not be laid a cross, lest it shou'd contract the Part too much. The whole Member may be also anointed with Oil of St. _John_'s-Wort, or with the destill'd Oil of Turpentine; or rather with a simple Decoction of Nervous Plants in Wine.