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
_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 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 _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 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 {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 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 _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 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 {177}
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 _Panacaea_ 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
{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 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.
_Of the proper Composition of the _Mercurial Panacaea_._
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 {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 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
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 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.
* * * * *
{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 asswag'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 Mass, and put into it white Amber and Gum _Elemi_, a
sufficient quantity 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.
If the Bone be put out of its place by a coagulated sort of Matter like
Mortar or Plaister, Resolutives and Attenuants are to be us'd, such as the
volatile Spirit of Tartar prepar'd with the Lees of Wine, volatile Spirit
of Tartar destill'd with Nitre in a Retort with a long Neck, or Spirit of
Tartar prepar'd by Fermentation with Tartar, and its proper _Alkali_: This
last is the best of all, and the use thereof ought to be continu'd. The
volatile Salt of Human Bones is also very efficacious; but it is necessary
to begin first with the taking of Laxative and Sudorifick Medicines,
appropriated according to the respective Circumstances. The Spirit of
Earth-Worms may be also apply'd outwardly, which is made by Fermentation,
and may be often laid on the Part either alone, or with the Spirit of _Sal
Ammoniack_.
If a dislocated Bone be not set in good time, a _Coagulum_ or kind of
curdled Substance is form'd in the Cavity, which hinders the reducing of it
to its place; but this _Coagulum_ may be dissolv'd with the following
Medicament, before you attempt to set the Bone. Take one {187} part of the
destill'd Oil of Human Bones, two parts of foetid Oil of Tartar; mingle the
whole, and add quick Lime to be destill'd in a Retort: Let the Parts be
fomented with this Oil.
If the Dislocation happen'd by the Relaxation of the Ligaments, recourse
may be had to universal Sudorificks taken inwardly; as also to such
Medicines as are full of an unctuous and volatile Salt, particularly
Aromatick Oils, and Spirit of _Sal Ammoniack_. In the mean while
Aromaticks, Resolutives, and moderate Astringents may be apply'd outwardly.
* * * * *
CHAP. II.
_Of the Fractures of Bones._
_What is the Fracture of a Bone?_
It is the Division of the Continuity of its Parts.
_After how many different manners may a Bone be broken?_
Three several ways, _viz._ cross-wise, side-wise, in its length, and
perhaps in Shatters or Splinters.
_By what means may a Bone be fractured?_
It may happen to be done by three sorts of Instruments, _viz._ such as are
fit for bruising, cutting, or wresting; that is to say, a Bone may be
divided in the Continuity of its proper Parts, by Contusion, Incision, or
Contorsion.
_How is the Fracture of a Bone discover'd?_ {188}
Divers ways, _viz._ by the ill Disposition of the Part, which becomes
shorter; by its want of Motion; by its flexibility or pliantness elsewhere
than in its Articulations; by the unevenness that may be perceiv'd in its
Continuity; by the cracking which is heard; sometimes also by the shooting
forth of one of its ends thro' the Flesh which it hath open'd; and lastly
by a Comparison made thereof with the sound Part on the other side, as that
of the Right Arm with the Left.
_What kind of Fracture is most difficult to be discern'd?_
It is that which happens in the length of the Bone, commonly call'd a Cleft
or Fissure, which gives occasion to very great Symptoms when it is unknown:
But it may be found out by the Pain and Swelling felt at the bottom of the
Cleft in touching it; besides the Conjectures which may be made from the
Relation of the Person who hath had a Fall, and might have heard the
cracking of the Bone.
_What sort of Fracture is most difficult to be cur'd?_
The shattering or splitting of a Bone in Pieces, by reason of the great
Number of Splints which daily cause new Pains and Suppurations.
_What is a simple and what is a complicated Fracture?_
The simple Fracture is that whereby the Bone is broken, without any other
Accident; and the complicated Fracture is that which is follow'd by some
Accident; as that in which there is a splitting of the Bone in pieces, or
{189} where the Bone is broken in two several places, or else when the
Fracture is accompany'd with a Luxation, a Wound, an Inflammation, or other
Circumstances of the like Nature.
_Are old Men or Children most subject to these Fractures of the Bones?_
Old Men, because their Bones are drier; whereas those of Infants are almost
Cartilaginous, and yield or give way to the violence offer'd to 'em; from
whence proceed the sinkings and hollowness that happen in their Skulls,
especially in the Mould of their Heads, or elsewhere; for which a Remedy is
found out by the means of Plaisters, Splints, and Bandages, fitted to the
shape of the Parts. It is also on the same Account that Bones are more
easily broken in the Winter than in the Summer.
_In what Parts are the Fractures of Bones most dangerous?_
They are those that happen in the Skull and Joints; in the former by reason
of the Brain; and in the latter in regard of the Nervous Parts.
_What Course is to be taken by a Surgeon who is sent for to cure a
Fracture?_
He ought to do three things, that is to say, at first he must incessantly
endeavour to reduce it, to the end that Nature may re-unite the Parts with
greater Facility, and that its Extremities may be brought together again
with less trouble, before a Swelling, Inflammation, or Gangrene happen in
the Part. Afterward he is to use means to retain the Parts in their proper
Figure, and {190} natural Situation, and to prevent all sorts of Accidents.
_How is the setting of a broken Bone to be perform'd?_
When the Fracture is Cross-wise, it must be reduc'd by Extension and
contra-Extension; and when it is in length, the Coaptation or bringing
together again of the Sides, is only necessary.
_What is to be done in a Fracture complicated with a Wound?_
The Operator must first reduce it, and then administer the other Helps, as
in a simple Fracture.
_How may it be known that the reducing of the Fracture is well perform'd?_
When the Pain ceaseth; when the Part hath resum'd its natural Shape; when
no Unevenness is any longer perceiv'd therein; and when it is conformable
to the sound Part on the other side.
_What are the Signs which shew that the Splints remain in the Fracture
after it hath been reduc'd?_
They are the secret and continual Workings of the Fibres, or twitchings,
that are felt by Intervals in the Part, with great Pains, which are the
Indications of an Abcess arising therein; and when a Wound is join'd to the
Fracture, the Lips of it are puff'd up, and become more soft and pale, the
purulent Matter abounding also more than ordinary.
_When the Splints appear, must they be drawn out by force?_ {191}
By no means; for great care ought to be taken to avoid all manner of
violent Operations; it being requisite to wait for their going out with the
purulent Matter; or at most to facilitate their Passage by the use of
Injections of the Tincture of Myrrh and Aloes; by the application of
_Emplastrum Andreae Crucii_, and by the help of the _Forceps_.
_How is a simple Fracture to be dress'd, after it hath been reduc'd?_
The Parts are to be strengthen'd and consolidated with Liniments of _Oleum
Lumbricorum_, or of Oil of St. _John_'s-Wort mingled with Wine, Brandy, or
_Aqua-Vitae;_ with Fomentations of Red Roses, Rosemary, and St.
_John_'s-Wort boil'd in Wine; and with _Emplastrum contra Rupturam_, or _de
Betonica_, carefully wrapping up the broken Member, but after such a manner
that the two Extremities may not cross one another; and that a small Space
may remain open between both. Afterward the Splints and Bands are to be
apply'd, taking care to avoid binding 'em too hard, and to take 'em off
every three Days, in order to refit 'em, to abate troublesome Itchings, and
to give Air to the Part; by these means preventing the Gangrene, which
might happen by the Suffocation of the natural Heat. If the Thighs or Legs
are broken, Scarves are to be us'd to support and stay 'em in the Bed.
_What space of time may there be allow'd for curing the Fracture of a
Bone?_
The Cure will take up more or less time, according to the variety of the
Parts, or the different thickness of the Bones: Thus to form {192} the
_Callus_ of the broken Jaw-Bone, twenty Days may well be allotted; for that
of the Clavicle, or that of the Shoulder-Bone, twenty four; for that of the
Bones of the Elbow, thirty; for that of the Arm-Bone, forty; for that of
the Wrist-Bone, and those of the Fingers, twenty; for that of the Ribs,
twenty; for that of the Thigh-Bone, fifty; for that of the Leg-Bone, forty;
for that of the Bones of the _Tarsus_ and Toes, twenty.
_What ought to be done in particular to promote the formation of the
_Callus_?_
The fractur'd Part must be rubb'd with _Oleum Lumbricorum_ and Spirit of
Wine heated and mingled together: The Decoctions of Agrimony, Sayine, and
Saxifrage are also to be us'd, and the _Lapis Osteocolla_ is a Specifick:
It is usually given in great Comphrey-Water, or in a Decoction of
Perewinkle made with Wine, and is often re-iterated.
* * * * *
CHAP. III.
_Of the particular Fractures of the Skull._
_What is a Fracture of the_ Cranium _or Skull?_
It is a Wound of the Head complicated with a Fracture of the Skull-Bone.
_After how many manners may the Skull be fractur'd?_ {193}
Three several ways, _viz._ by Contusion, by Incision, and by Puncture.
_What is the most dangerous of these Fractures?_
It is that which happens by Contusion; because the Concussion and Commotion
is greater.
_Do all the Fractures of the Skull require the use of the Trepan?_
No, the Fractures must be deep which stand in need of the help of such an
Instrument; for those that are superficial may be cur'd by a simple
Exfoliation.
_What is that deep Fracture, wherein the use of the Trepan is absolutely
necessary?_
It is that which is made in the two Tables of the Skull, penetrating to the
_Meninges_ of the Brain; upon which at that time the Blood is diffus'd, and
must be taken away by the Operation of the Trepan.
_How may it be discover'd that the two Tables of the Skull are broken?_
By the Eyes, and by Ratiocination.
_Are not the Eyes sufficient alone, and are they not more certain than
Ratiocination?_