CHAP. I. A Wound of the Brain Cured.

IN an Engagement with the Hollanders, in which our Ship was boarded by four of their capital Men of War, we were re­duced to our close Fight, our Forecastle and Steeridge doors be­ing made fast, one of our Men was so unfortunate, as to be left out upon the Deck, who calling for quarter, one of the assailants, with a large Cutlace, struck him [Page 3]into the Head, from whence with two endeavours he could hardly pluck it forth; the wounded par­ty lay on the Deck as dead, but the Fight being over, and our Ship taken, he crawled down into the hold, where several with large lacerated Wounds, others with compound Fractures, and some requiring amputation, seemed fit­ter for speedy attendance, lea­ving him to be the last drest, as supposing it only a simple Incisi­on; but looking well upon the Wound, which was in length a­bout five inches, and full of a white matter, which spued out, I could not conceive digestion could be so soon procured, viz. in the space of two hours; I therefore concluded it to be the [Page 4]substance of the Brain, and so it proved; for with my Spatula I re­moved from the surface of the Wound about a spoonful of the Cerebrum, the hair being removed from the sides of the Wound: it was drest with a Stegnotick Me­dicine, for it bled largely, ta­king care withal, to defend the edges of the Cranium with dry lint, for fear the access of such ear­thy Medicines that are Stegnotick, should fowl them, which I would have all Surgeons take notice of in all parts, where Bones lye bare, and is occasion to apply re­stringents, that they cover the boney parts with lint, as I said before, the better to secure them from the injury of the restrin­gents, the not taking care of [Page 5]which is the cause, that many times the Patient is longer delay­ed in his Cure than reasonable, and to wait the Exfoliation of Bones, fowled by such Terrene Medicines. He had ill symptoms, as delirium and dotage, which lat­ter hath not yet left him, if living; he lost eight ounces of Blood next day out of the right Arm, and cupping Glasses were applied to his Neck, and Shoulders; a fo­mentation always made use of at dressings, and to the wound ap­plied Thereb. lot. Tinct. Traumatic. cum Syr. de Ros. Siccis; so in six weeks time the Wound was cu­red, convenient bandage being fitly applied, and greatly condu­cing to the Cure. I saw this per­son several times, and several years [Page 6]after in Southwarke, and observed in him a very great depravation, and but little right use of his sences. I have the more freely set down this Cure, to encourage other Sur­geons, that they should not de­spair of dressing any Man, though never so dangerously wounded, but use his best endeavour and means, leaving the success to God, who often gives a miracu­lous blessing, even when our greatest reasons fail us. If any one doubteth the possibilty of a Cure of this nature, let him con­sult the Learned Sir Charles Scar­borow, who can inform him of a Captain in the King's Army, that received a wound on the occiput, carrying a large part away, and cerebellum with it, and yet was be­yond [Page 7]expectation recovered.

CHAP. II. A small wound of the Head by a blow with its symptoms.

A Gentleman of the Guard, in the Night, received a terri­ble blow on the Head, depri­ving him of his Speech and Sences at the same minute; the next day coming to him, I found a very small wound on the left Bregma, he had bled but little at the wound; wherefore I took away nine ounces of Blood out of the left Arm, and applied cupping Glasses to the Scapula and Spine on each side. I should have told [Page 8]you, he had also lost the use of his right Arm, by the same Pa­ralysis of his Head and Tongue: the second day I dilated the wound a fingers length, the fifth day I made a large triangular inci­sion, leaving the Skull bare for the applying a Trefine, which I did on the seventh day, although no­thing appeared on the Skull of fracture, or sedes; before the se­venth day he fell into dangerous Convulsions, and frequent Lypothy­mies, for remedy whereof were administred Cardiac, and Antiepilep­tick Juleps, &c. too long to be here inserted, as also a Cephalick Plaister to the Head, after the application of the Trefine: through the perforated part of the Skull, came forth a large quantity of [Page 9]black grumous Blood, which by pressing upon the Meninges and Brain, and sending forth putrid steams, had been the occasion of these ill symptoms, which said grumous clots came forth for se­veral days together at dressing, and the Meninge black and dis­coloured, to which I applied Therebin. lot. cum Tinct. Trauma. & melle Ros. and always a hot Fire­shovel held over the Head, to cor­rect the coldness of the Air, and hot Stupes to the Head, dry lint to the Cranium, and to the edges of the wound a digestive of The­reb. vitell. ou. & mel. Ros. cum ol. Rosar. every day, or other day, was a Glyster administred: So with these dressings he every day grew better, and in a short time [Page 10]recovered the use of his Tongue and Arm, which before had been lost by his Palsie, and Convulsions mentioned.

CHAP. III. A wound of the Head, with the Frac­ture of the Collar-bone, dislocati­on of the Shoulder, compound Frac­ture of the Leg, and general con­tusion of the Body.

IN the Year 78. when I was Surgeon to the Honourable Sir Tho. Allen, then Admiral in the Royal James, one of our Men fell down from the Foreyard upon a piece of Ordnance on the Fore­castle, a large piece of the Scalp [Page 11]from the hinder part of the Head being cut clearly off by the breech of the Gun; with a Frac­ture of the left Clavicle, Dislo­cation of the Shoulder, and a com­pound Fracture of the Leg on the same side, such as we call Fracture ascialis, the bones of the Leg coming through his stockins. I first drest the wound of his Head, least the Skull being bare the Air might prejudice it, then reduced the Dislocation of the Shoulder, next the Clavicle, and after­wards the Leg and placed it on a pillow in a box, or case with hinges, to turn down, to come at and dress the wounded places, which I had at convenient interstices left open for that pur­pose; I bled him largely, and kept [Page 12]him to a spare dyet, giving him inwardly some Irish-slate in Spruce-beer, and Sperma-ceti in Balsam. Lutatelli (not of the commonpre­paration) the wound of the Head from the edges incarned, and grew up in a short time, without any exfoliation of the Skull, by care­fully preserving it from the Air, whereas perhaps some might with their Desquamatory powders, needlesly applied, made foul, and cast off some part of the Occiput. The chiefest concern and greatest trouble was the Leg; both fociles being by the heigth and vehe­mence of the fall shatter'd, and dasht in pieces, and ac­commodated with short rowlers for convenience of loosing to dress it, and afterwards bound up [Page 13]the fractured parts wounded; for there is no room for long row­lers: in seven weeks he was so well as to go abroad with Crutch­es, as the Admiral himself can testifie.

CHAP. IV. A wound on the Head, &c. in a Venereal Person.

A Person (whose name I wil­lingly conceal) in a ren­counter received a large wound on the Head, two on the Arm, and one on the Breast, who applied himself to me for Cure; he had at the same time an Ulcer on his right Leg, a little above the Mal­leolus [Page 14]externus of an ill Figure, to which Ulcer and Wounds, al­though I made use of the most fit (to my apprehension) and methodical Remedies, yet for ma­ny days I could procure no better from neither, than an ugly Ichor or Sanies, or sometimes a green­ish sordid matter; considering with my self, that this could not be barely and solely the product of the parts affected, I asked him, if he had lately, or sometimes before received a misfortune by some one of the Virtuosa's of this Town? He told me, He had, and that he had been in an ill case, but had been under a Surgeons Hands of good note, and that he believed himself to have been well. I told him, it seemed to me [Page 15]that his Scavenger had not taken away all his soil, but had left an Egg still in the nest, and that he could not be perfectly cured bare­ly by Surgery, without referring to some internal Medicines, which might have regard to his former mishap, whereunto he consented; so putting him upon a course of antivenereal Pills, and diet Drink, in three days time there was lau­dable digestion, and in a short time his Ulcer and Wounds were perfectly healed, yet after they were well, I kept him to this course for three weeks longer, be­lieving it more safe in such cases, rather to over than underdo. I was the more willing to express this case, because sometimes an ingenious Surgeon may lye under [Page 16]an Error, to the great detriment, and utter ruine perhaps of his Pa­tient, if he direct his Eye no far­ther, than only to the superficies of the part affected.

CHAP. V. Mania.

BEING Surgeon of the Na­val Hospital, when His Ma­jesties Fleet was at Shotland, there was put on board us, by advise of the Surgeon General, from one of the Frigots, in order to his Cure (if possible) a distracted Person, most violent­ly raving, and the maddest I ever yet beheld, breaking what [Page 17]ever cords he was tyed with. I that Afternoon had him by force of Men held down, and gave him a Glyster, which wrought well; the next Morning I bled him in the Arm, kept him to a cooling spared yet, bled him next day in the forehead, and imposed cupping Glasses with Scarifications to the Neck and Shoulders; but all to no purpose, for he remained as mad still as before; wherefore I appli­ed a Caustick on the Crown of his Head, and made a large Es­char, that being done, and for three days time there being no amendment, I was not willing to tarry for the casting off the Eschar by digestion, which would have protracted time, but with my in­cision Knife I cut out the whole [Page 18]Eschar round to the Cranium, lea­ving it bare, and about midnight it was told me, the Madman had re­covered his senses, and desired to speak with me; when I came to him, I so found it; for he gave me thanks, and exprest himself very joyfully, saying, he was perfect­ly well, and so remained from that time forward. I was unwil­ling to send him aboard again over-soon, but let the edges fill up, and kept it as a Fontinel with a large Pea in it for a month, afterwards took out the Pea and healed it, and sent him to his own Ship again; who near a twelve-month after found me out in London, and returned me a thousand thanks for my great care of him.

CHAP. VI. Wounds of the Head with ill symptoms.

A Young Carpenter being at work upon Bow-Church, be­fore the structure of the Steeple, fell from the top thereof, and was taken up dead; but after a small time perceiving life in him, I bled him, so he was carried home, and remained speechless for seven days, having also by the same ac­cident lost the use of his right Arm: I applied cupping Glasses to his Neck, Scapulaes and Spine, he had three or four wounds on his Head (for he fell amongst ragged Stones) which to sight seemed in­considerable, he took every other day a Glyster, and a very spa­ring [Page 20]dyet (as in such cases requi­site) I drest his wounds with a Cephalick Balsam; he took often of an Antiepileptick Julep. But obser­ving he often laid his left Hand on his right Temple, for there was also a small wound, I dilated the same largely toward the Eye­brow, observing the rectitude of Fibres (which always is to be. heeded, where incisions are to be made, unless an extraordinary oc­casion hinder) from thence I took several small pieces of the Cra­nium, which were divided from the whole, and some of them pricking against the edge of the temporal Muscle, upon the ta­king out of which, he recovered both the use of his Speech and Arm. I should have told you [Page 21]likewise, that he sometimes was troubled with a Spasmus Cynicus on the right side, by reason I suppose of those pungent Ossi­cles; the dilated wound I drest with a Digestive at first, cramming in dorsils of dry lint on the bare Skull, afterwards with a Trau­matick tincture, and Syr. de Ros. siccis; so in five weeks or there­about, he perfectly recovered.

CHAP. VII. A wound in the Liver.

A Person raging with Wine, as well as with love of his dear Mistress, of whose enjoyment he despaired, leaving his company, went forth of the room, and with a Knife stabb'd himself in the upper part of the right Hy­pochondrium, wounding also the Liver, from whence flowed a large and violent stream of Blood; to divert which I took a good quan­tity of Blood from the left Arm; I gave also some aq. Styptica Vitrioli in aq. Plantaginis; I kept him to refrigerating Juleps, wherein was a competent quantity of Sal. pru­nellae, [Page 23]also to laxative Glysters; and although he complained much of a very great pain in his right Hypogastrium, which I feared might arise from extravasated Blood, fal­ling from the wound, and there subsiding, yet by the use of fo­mentations and Glysters, he be­came well, and was in fourteen days recovered.

CHAP. VIII. A wound in the Belly.

A Soldier, being returned from Flanders, upon some disgust he had received from his Mother, with a large Flemish knife stabb'd himself about two inches above, and on one side of the Navel, through the right Muscle and Peritonaeum into the Abdomen; from out the wound hung forth a large piece of the Omentum, which had so done for four hours, for so long after it was that I saw him: it be­ing Winter time, the Air having seiz'd it, and being discoloured, I made ligature upon it, and cut [Page 25]off the discolour'd part near the the tying, and having fomented it with warm Brandy, I put in the Omentum again, leaving the thread hanging forth to the wound; I used a Digestive for three or four days, afterwards a Balsam, whose basis was Turpentine; so without any supervening symptom he be­came well in less than a fort­night.

CHAP. IX. Two penetrating Fistulaes in ano, &c. cured.

AN Apothecary of this Town had for many months try­ed practice upon a Gentleman for the cure of a Fistula, not at all knowing what he was about, having used, as the Patient after­wards informed me, at least forty different sorts of Medicines, as Waters, Oyntments, &c. a suf­ficient argument of his unsteady ignorance. Once or twice, by Mercurial means (against his will as he profest) raised a Salivation on him, had sometimes with [Page 27]his Knife made incisions, and suf­ficiently teaz'd him, at length told him, he had done with him, for he was cured and well; but the Gentleman being alarm'd by some pain he felt there, was ad­vised by a friend of his to shew it to me; upon sight whereof I put my Probe into the Orifice, being about two Inches from the Anus, and past it in length five Inches, viz. two from the Orifice to the Anus, and three Inches from the edge of the Sphincter up into the Sinus, it had made in the intestinum rectum; so having satisfied the Gentleman of the ill condition he was in, and be­stowed on this Amphibious Apo­thecary his malediction, he be­came my Patient from that time, [Page 28]till he recovered. But by the way, it is a common thing for Apothecaries to practise Surgery, but with what success, let them and their Patients boast, as in the case above, and these two follow­ing may appear. A Neighbour of mine in the Old-Baily, consul­ting with a learned Apothecary, he advised her to an Issue, which he would make, and accordingly did; and having made it upon the Gasterocnemius, it caused such a Pha­gedaenic Ulcer, as eat away above half the calf of her Leg, whom I afterwards cured, not without much trouble. The ill Medicines he had applied, having left a stain upon the part, not suddainly to be washt off, according to that of the Poet, [Page 29]

The other case is, a Phleboto­mist Apothecary much exercised in bleeding, (not for want of ig­norance in them who permit him, any more than in himself) let Blood one of his Neighbours Daughters, and in the carreer of his Lancet, made a large wound in the Tendon of the Biceps; be­ing call'd to take care of it, I saw the Arm very much tumefyed, full of pain, and a large quanti­ty of Gleet from the wounded Tendon; the tumor of the Arm I appeased, with Anodyne Cata­plasmes, and drest the Tendon with [Page 30]a There bin thinate Medicine, which after some time became well. I could add many more of these, and other like cases, wherein Apothecaries, by enterfering in our Profession, have gotten to themselves no great reputation; for if a young Apothecary (for the old ones have more pru­dence) get acquainted with some Surgeons Apprentice, who is but an Embrio in his Profession, he shall from him be furnished with such pretty knacks in that Pra­ctice, that he need not doubt to proclaim himself a Chiron, as in Physick he doth an Aesculapius; but I hope these brief Memoires will dehort them from it in the future. But to return to my Pa­tient, whose Postern calls out for [Page 31]help; for upon a second inspecti­on, I found two Sinus's from with­in the outward Orifice, which ran one to the right, the other to the left hand; these having laid open, I yet found another small outlet, within an inch of the anus, that in three or four days, be­ing made wider, by the use of Sponge tents, I incided: in the mean time I confined him to a diet of Sarsa and China, with some vul­nerary Herbs, sometimes gently purging him with an Infusion of Senna and Salt of Tartar, with Syr. Ros. Soiut. or Manna, and twice a Week fifteen or twenty grains of Calomel. with res Gialap. or as much of another Mercurial pre­paration of my own, excellent in Ulcers or Fistulaes, by which [Page 32]means this almost incredible quantity of Gleet was exhaust­ed and dried up: it being most true, that Siccum est sano proximum. the dressings for the Fistulous parts incised, was a Balsam of Sulphur, joined sometimes with a Traumatick tincture: what in­cisions soever I made, I always let them bleed freely, to dis­charge the great hardness round the Anus; to discuss which, did not a little help a fomentation applied Night and Morning be­fore dressing. The Incisions intra anum I made with my Cannula Scis­sor upon the Scoop. Thus in the space of ten Weeks he became absolutely well, and so remaineth.

CHAP. X. A Fistula in Ano.

ANother being a very fat Man, having ridden some hun­dreds of miles, from a tumor of an external Hemorroid Aposte­mating, incurr'd into a Fistula, which searching with my Probe I felt it come through its upper Orifice into the intestinum rectum, about two inches above the Anus. Having an ill habit of Body I durst not presently attempt the Chirurgical part of his cure, till I had given him a preparatory Apozeme, and with an Hydrotick Medicine purged four or five times, the better to empty and carry off that load of humors, I [Page 34]might otherwise expect to fall up­on the part; then with my leaden Probe Idrew a waxen silk through, daily tying it straighter, till at length it cut its way through; which being done, and the part so incised, by use of a drying Bal­sam, in a short time was perfect­ly cured; a drying dyet-drink, which he at that time took, help­ing very much to effect it.

CHAP. XI. An Abscess on the Os Sacrum.

ANother Gentleman having lain ill of a Fever for a long time, the Disease at length terminated into an Abscess near the lower part of the Os Sacrum; be­ing sent for, which was two or three months after the breaking thereof, I perceived a small Ori­fice, out of which issued a thin matter dayly in a large quantity, and extreamly fetid; after three or four days time I past my Probe in at the Orifice (which at first I could not by reason of its smal­ness) down toward the Anus, a­bove four inches in depth, and after some time, with my large [Page 36]Probe Scissors, I dilated as far as their length would permit, and so filling it with Dorsils of dry lint (for it bled not much) I so left it till next dressing, which was with a digestive, be­ing for some weeks time con­tinued. From the part affected a great quantity of matter daily flowed, with an excessive ster­corary odour, which gave me occasion for a while to fear, there might be some small perfo­ration into the Intestinum rectum, which might be the reason of this ill smell: However by the use of Fomentations and Injections, in which were some Vulneraries in a Decoction of Aqua calcis, adding some Traumatick tincture and honey of Roses, the stench daily [Page 37]diminished. I continued still to dress twice a day; the Medicine with which I drest the part, was a Balsam of Sulphur with Trau­matick tincture, by the use of which Medicine and Injection, and using now and then a little lift with a Mercurial Bolus, the parts were corroborated, the mat­ter lost its ill smell, became well digested, and in quantity daily decreased, till at length having shortned my Dressings, the Party became well. Note. He still con­tinued his Diet-drink, which re­duced his Cachochymick Body to a better habit, I advised him to make use of little pieces of Sponge dipt in an Emplastick matter, which I prepared for him, for purpose to keep it open as a [Page 38]Fontanel, which he did for ma­ny Months; but not long after his Cure, by some disorder, he fell into a most violent Feaver, from whence he was recovered by a large torrent of humours, finding vent at the Orifice so kept open; which extreamly running, in about a Fortnights time made a total discharge of the Morbifick matter, and he became well, and about half a year after, unwilling for the troubles sake to wear it open as a Fontanel, closed it up, and hath remained well for above a year.

CHAP. XII. A penetrating Wound in the Thorax.

AVintner bringing in a Recko­ning, and giving some un­pleasing Language to his Guests, one of them with his Rapier ran him into the right side, about an Inch below the Axilla or Arm-pit; he bled not much at the Wound; wherefore I took away about fourteen Ounces of Blood; two days after the Wound received, the Party wounding sent three eminent Surgeons to take a view of him, believing him not so wounded as reported; I desired one of them that he would please [Page 40]to take the Candle in his hand, and hold it near the Wound, which he did: Whereupon I ad­vised the Patient to shut his Mouth, and hold his Breath, and immediately the included Air be­ing forcibly expell'd, blew the Candle out. I made use of short Tents dipt in Balsamum Lucatelli; kept him to a thin Diet, refrigera­ting Juleps and Glysters every day, or at least every other day; and if he slept not well, in his composing draught, I gave him sometimes fifteen or more drops of Liquid Laudanum; so his Feaver going off, and finding no occasion to keep it longer open, I took out my Tent, and in ten days he recovered, not leaving behind me that ill acci­dent, which I remember a Surgeon [Page 41]once did, who by keeping open a penetrating Wound of the breast too long with Tents, procured a Callosity round the edges of the Wound, leaving behind him a Fistula uncured.

CHAP. XIII. A Wound in the Breast.

ACountry Gentleman being in London, and going in the dusk of the Evening home to his Lodging, was met by a Bully of the Town; who because he im­mediately gave him not the Wall, drew upon him, and ran him through the Pectoral Muscle into the Thorax; there was a consi­derable flux of Blood at the Wound, as also out of the Mouth, as often as he spit or cough'd; from whence we may believe the Lungs to have received prejudice; I nevertheless took away ten or twelve Ounces of Blood, used to the Wound for four or five days [Page 43]after the first dressing, Tents arm­ed with a digestive, keeping him to a Pectoral and Traumatick De­coction, and a very low Diet; but finding that little matter pro­ceeded from the Wound, and that his Cough (which at first was troublefome) went off, I left out my Tent, and only applied a Pledget on the part spread with Lucatellus's Balsam; so in three days more it was healed, and he went down to his Affairs into the Country.

CHAP. XIV. A Mortification on the Arm.

AYoung Woman upon a dis­order in Diet, fell into a most desperate Feaver, she having an Issue in her Arm, was over hard bound, the slackning and dressing of which, being for three or four days neglected, there hap­ned a large tumour of the Arm and Hand; when I came I found the Arm discoloured, and a large Mortification upon it, from the Shoulder to the Elbow quite round, part of the Mortification reaching to the Clavicle and Breast: with my head Razor I made many and deep Incisions, which she felt not, unless upon [Page 45]the edges of the sound parts, which I spared not to cut to cause the sooner separation. I drest her twice a day with Stupps wrung out of a strong Lixivium, and ap­plied scalding hot. The applica­tion to the incised parts, was E­gyptiacum and Spirit of Wine, as hot as with Dorsils, and pledgets dipt, could be applied, and over all a Cataplasme of Mithridate, or sometimes Venice Treacle round the Arm. In the mean while there was no neglect of fit Alexipharmacaes, and cordial Ju­leps; so a stop being put to the progress of the Mortification, and the Feaver abated, I began to make use of Digestives, by which means, and by cutting off daily large quantities of the mortified [Page 46]cadaverous and stinking sloughs, the subjacent parts daily appear­ed more florid: after gently mundifying, for a long time I made use of the best Incarnatives, by which means there was a gra­dual reparation almost of that vast loss of substance she sustain­ed. In the mean time I laid open by incision several Fistulous Si­nus's, the virulent and corro­sive matter had made upon the Breast, Shoulder and Scapula, which I afterwards cured, and she in the space of ten weeks re­covered, and hath the use of her Arm almost as well as ever.

CHAP. XV. A Leg Amputated.

A Neighbours Son about nine years of age, by reason of a wrench, had a painful tumour of the Ancle, and afterwards of the whole Foot, without alterati­on of colour. For remedy of which, use had been made for many Months of several Surge­ons one after another, and some pretending Bone-setters, in hopes to have a Cure; but all in vain, the tumour and pain daily increa­sing, and becoming almost in­sufferable: at length his Parents desired me to visit him, which I did; they asked my opinion concerning his Cure. When I had [Page 48]considered the violence of his pain, the tumour of the lower part of his Leg and Foot, his lost appetite, want of rest, and his being emaciated, I informed them that I did believe, that his Cure was impossible, and that there was but one way left to save his life, which was, to take off his Leg without much further delay; for that it had been kept on too long already, which news was unwelcome to them, they tel­ling me, that such eminent Surge­ons as they had applied them­selves to, and had had the ma­nagement of it all along, could not be so ignorant or deceitful, as thus to abuse them, and leave them in the lurch, and they hoped I was much mistaken in [Page 49]my Prognosticks. But I still per­sisting, in what I had asserted, left them to their future consideration, and further advice; whereupon they applied themselves to the Surgeons of the Hospital, the result of whose advice was, that my opinion was to be agreed with; whereupon two days af­ter by their consent and desire, I amputated him below the Knee, Mr. Pierce and Mr. Johnson being Wardens, then present. So soon as I had drest his stump, rouled him up, and placed him in Bed, I took the Leg, and made incision according to the length of the Tibia, laying it bare, where I shewed them a hole quite through both sides of it, as if made by an Augre, and through which I could [Page 50]put my little Finger; so power­fully penetrating and corrosive are acid humours, that they can with their pungent Particles thus terebrate the Bony parts. There being a very great Atrophy of the Thigh and Knee (which yet re­mains, though nine years since ta­ken off) the adjacent parts having received an ill taint from the sub­jacent putrid humours, it was a long time, before I could raise flesh enough to cover the ends of the Bones; but what is most remarkable, such was the indu­stry of Nature, who is never idle, but always endeavouring to pro­gender, though impeded by imper­fect and defective principles, that some time after there grew out of the end of the stump from the [Page 51]remaining part of the Tibia (as it were) another little Tibia, near an Inch in length, and about the bigness of a Tobacco-pipe, hol­low, and covered round about with a Cartilaginous substance, which I cut off with a pair of cut­ting Nippers close to the stump end, and which several times since hath flown out the breadth of a Twopence, for as I said above, the Leg was kept on too long. The Excoriation was easily Ci­catrized with aq. calcis. This caution therefore may be of use to Surgeons, that although it is not good to be over-hasty to dis­member, without sound and ur­gent reasons; yet on the other hand, it is as dangerous to be di­latory, in keeping on a defective [Page 52]Member, until it hath made a vi­cious communication to the o­ther parts, to the depraving their Natural tone and temper.

So I shall conclude this, begin­ning with another not much un­like.

CHAP. XVI. A Thigh Amputated.

A Lawyers Son in Fetter-lane, about the age of the pre­ceding, and much about the same time, having eleven Fistu­laes in his Leg, and Thigh; for about a Twelve-month, had been under the hands of se­veral Surgeons; who at length despairing of his cure, left him off. The Boy calling to mind, that some four years before, I had cured him of two Ulcers in his Leg (for this accident was since, and hapned by a Contusion from a Cart-wheel, hurting his Thigh and Leg, from whence after­wards [Page 54]Apostemations, and Fistu­laes were produced) desired his Father to send to me, telling him withall, he was confident I could cure him. At his request to go along with him to see his Son, I accordingly went; but found him so discarned, that he was almost a Skeleton, having for twelve weeks been detained by a Diarrhaea. From his Ulcers, and Fistulaes flowed a silthy mat­ter, stinking beyond all compari­son, his Heel stuck to his But­tock, and his Knee disjoynted; for the head of the Tibia met not with the Os Femoris (which over­hung it) by above an Inch, the Ligaments being all eaten asun­der, by the matter there contain­ed. I told his Father, I had con­sidered, [Page 55]the circumstances he lay under, were so severe, that I thought, there was no likelyhood of his recovery, nor possibility of Cure; to which the Boy very heartily replied, he knew he should be well, if I would cut off his Thigh; and that if I would lend him a Knife, he would cut it off himself; whereat his Father weeping, he bid him not be troubled, telling him, that if he died, there would be an end of his charges, but if he out-liv'd it, he would make him amends. I proposed to his Father, to bring the Wardens with me next day, to take a view of him; who when they came, and saw the mi­serable condition he was in, knew not what to think of it: But ta­king [Page 56]notice of the Boys undaunt­ed confidence in me, by their perswasions, I was encouraged to dismember him, leaving the success to God, thinking it better rather to try a doubtful remedy, than to leave him (as others had done before) to perish without any. It being concluded, on the next day after his Mother should be brought to bed (for she was almost ready to lye down, and feared to have it done, till that was over) it should be attempted; so on the Morning after she was delivered, I came, and Amputated him near the upper part of his Thigh, above his uppermost Fi­stula; he not so much at the use of Knife or Saw, as once crying, or making any complaint, until [Page 57]the application of hot Cauteries, which I was forced to make use of, by reason of the largeness of the Vessels, from whence other­wise I might have expected in a few minutes his whole Mass of Blood, and Life to have been ex­hausted. It was on a Munday morning I took it off; and on the Thursday following, when I came to dress him, I found him very lively, his stump very fair, being indifferently well digested, and in six Weeks time perfectly healed; afterward he grew ve­ry plump and carnous, and so remaineth. Next I will set down another case of an Arm ill handled, and too long kept on, which is as followeth.

CHAP. XVII. An Arm Amputated.

AN Hostler belonging to an Inn in Holbourn, received a blow on his Elbow from a Horses head, which for several Months gave him some pain, tho' not so much, but that he could follow his occasions; at length the tumour and pain increasing, he applied himself to a Surgeon of his acquaintance, one G.R. who kept him so long in hand, that for want of timely laying it open, the matter discharged its self, through several perforations it had made; into which per­forations [Page 59]he daily injected such large quantities of Vitriolate, and sometimes Mercurial Waters, that fouled both the Ancon or Ole­cranon, and lower head of the Adjutory, there being a large tu­mour of the lower part of the Arm, the upper part being quite extenuated. Having sent for me (for he had discharged his other Surgeon) and taking notice of the extream tumour, fetid smell, and colour of the Arm (for it was Livid) I told him I did be­lieve the Bones were so foul, and the Arm so putrid, that he must of necessity lose his Arm, to save his life; and that if he would per­mit me, to make Incision, which should not hurt him, he should find my words to be true; so [Page 60]with my head Razour, I laid it open about four Inches in length (the parts being insensible) and with my Finger pull'd out a great piece of the Adjutory, being loose and carious, like a rotten Cork. When he perceived the danger he was in, he told me he was very willing to submit to the loss of his Arm, rather than of his Life. I applied a Stupe wrung out of hot Brandy round about the Arm, and so left him till the next day. In the mean while I informed the Wardens of his condition, and of the neces­sity of taking off his Arm; on the next Morning they there met me, where having all things in readiness, I Amputated him; and afterwards laying the Arm open, [Page 61]I found the lower part of the Adjutory, for about three Inches in length foul quite through, so were also the upper parts of the Ulna, and Radius carious about the same length. About three days after his Surgeon hearing, that he had been dismembred, came to see him; I understanding that it was he, bid the Nurse let him in, whilst I stept behind the Bed (unseen) so coming to the Pa­tient, he told him, he had done villainously by him, and that he desired not to see him; T'other re­plied, he wondred any one should be so base and foolish to take off his Arm, when he would take his Oath, he could have cured it, in a week or ten days at farthest. Whereupon I came from behind [Page 62]the Bed, and told him he was as impudent as ignorant, to affirm such impossibilities, and that I had the Wardens to justify me in what I had done; asking him withal, what Medicines he had made use of, to occasion this mis­chief? he reply'd, he knew what he did, as well as any Man in Eng­land, and needed not be taught by any one; for he had used Injecti­ons with Vitriol and Plantane Water, and sometimes ☿ Subli­mate and Plantane Water, as good as ever was used. I told him, those good Medicines were the cause of the loss of this poor Mans Arm, whereupon he went down Stairs railing at me, and very much displeased. He being so emaciated, it was somewhat long [Page 63]e're I could procure flesh enough, to cover the end of the stump. the keeping the Arm on so long had rendred him Hectick; for not long after the stump was Ci­catrized, he took leave of this World.

CHAP. XVIII. A Womans Throat cut.

A Young Woman who had been at a Meeting-house, where the Bonerges had shut Heaven Gates, and threatned Hell to all, who were not on his side of the way; in a great discontent went home, and fell into such despair, that being me­lancholy by her self in her Cham­ber, with a Knife cut her Throat; the Wound was near six Inches in length and uneven. When the thing was done, being sent for, I was not in the way, but came about an hour or more after, [Page 65]where I found another Surgeon had been before me; I was very unwilling to meddle with it, but the Party her self making signs to me, that she would have me look on it, her friends and neigh­bours perswading me to it; I went about it, and perceived a large quantity of Tow sprinkled with some Astringent Powder cramm'd into the Wound, which I took out. The Wound look'd very dreadful, having clean­sed it, I saw the Larynx was notcht in two or three places; for as she afterwards told me, she had made two or three cuts at it: Having brought the Lips of the Wound together with five stitches, and drest it with an Ag­glutinative Balsam; she spoke [Page 66]not for three days, but on the fourth, askt me if I thought she could live; I told her there was no fear of her death, if she would be but governed, for she was in a Feaver; wherefore I at first bled her, and kept her low, taking care she had every other day a Glyster; the Wound healed as well as one could wish, and in less than three Weeks she reco­vered.

CHAP. XIX. A Wound in the Belly.

A Shoomakers Wife, her Hus­band not presently grant­ing her unreasonable demand, took one of his sharpest Knives wherewith he used to work, and stabb'd her self obliquely into the Epigastrium: the Wound was small, (and so was the Knife, which I saw was Bloody about two Inch­es or more) and it bled but little; wherefore I took Blood from her to prevent inward bleeding which I feared; I drest the Wound with a short Tent with a Digestive. There hapned after 2. days a large [Page 68]tumour round about the wound­ed place, of which she complain­ed very much, and proved to be only from wind; for upon the use of warm Fomentations, it was wholly discuss'd, and she in se­ven or eight days became well.

CHAP. XX. A mortification of both Feet.

A Master of a Ship (bound for the West-Indies, where­of a young Man belonging to me was Surgeon) had a Servant, who by extremity of cold Wea­ther, got a Mortification of both his Feet; being desired I went down to Limehouse to see him, and feeling on his Feet, se­veral of his Toes came off in my hand. I made divers deep Incisions on both Feet, till I came to the parts sensible; then with a broad Carpenters Chissel and Mallet, I cut off both Feet near the upper part of the Metatarsus; [Page 70]the ends of the Bones I covered with dry Lint, & to the Mouths of the Vessels I applied Chalcanthum; over all Bole, Whites of Eggs and Oxycrate, and so rould him up; I came every other day to see him for three Weeks, in which time the Bones were covered with flesh; so the Ship being bound to Sea, and he to go in her, I left him to the care of my Man, who gave me account by Letter, that before the Ship went out of the Downs, both his Feet were Cica­trized and well. I have often aboard made use of the Car­penters broad Chissel in Morti­fications of the Hands and Feet, occasioned by Gun-shot Wounds, and therefore borrow room for it in the Armamentarium Chirurgicum.

CHAP. XXI. A Dislocation of the Inner Ancle, with a Lacerated Wound.

ONe belonging to an Inn on Snow-Hill, Aged about threescore and ten, be­ing very corpulent and weighty, by a fall suffered a Dislocation of the Foot, the inner and low­er head of the Tibia (the Liga­ments being by the violence of the fall broken asunder) coming through at the Wound, which was above four Inches in length: I bled him largely, and kept him to an extraordinary spare Diet, to take off his too great Pleni­tude, [Page 72](having also an ill habit of Body) and much ado I had to keep off a Mortification, which twice or thrice had like to have hapened, but that he was rescu­ed from it by Scarifications, a strong Lixivium and Theriacal Ap­plications. The Medicine with which I drest the wounded part was, of Ol. Therebinth. Tinctura Traumat. and Syr. de Ros. Sicc. and in two Months time I healed up the wound; but because the dis­location remained (which could not be remedy'd, the Ligaments which should have kept the head of the Bone in its place, being torn asunder) I made use of an Instrument of Steel, riveted to the Shoe below, and coming up the outside of the Leg, with [Page 73]a Leather Brace at the gartering place, and another below, to Lace on the out-side of the outer Ancle, by which means the head of the Bone was firmly kept in his place, and he went indifferently well, till some years after growing still fat and unweldy, and wanting exercise, he fell into a Dropsie, whereof he died; this being the only cure I ever heard of this nature, I thought good here to insert it.

CHAP. XXII. A large Wound on the Head.

ONe going down a pair of stone steps, it being Win­ter time, and very slippery, had the ill fortune to fall down with his Head upon the edge of one of the steps, whereby he received a Wound from a little above the Eye-brow, fetching a circumfe­rence round the side of the Head, to the hindmost part thereof, in­somuch that the Scalp hung down upon the Neck, the Wound in length being eight Inches. Having taken off the Hair, and cleansed the Wound, I joyned the Lips by [Page 75]six Equi-distant stitches, and left both ends of the Wound open with two short Tents, the bet­ter to make discharge of the great quantity of Sanies, and matter which continually slid down. The application after the two first days being Pledgets dipt in Balsam Lu­catell. with Tinctur. Traumat. ma­king use always of a warm Fo­mentation before dressing, by which means in five Weeks time he was made well.

CHAP. XXIII. Two Wounds of the Head.

ANother being a little Boy, lately received such a Wound by a Cart-wheel going over the side of his Head, tearing away the Scalp, and leaving the Cranium bare in some places; the Wound was about six Inches long, there being another Wound likewise on the other side of the Head about three Inches in length; the Head was very much tumefied, & from the greater Wound came such an excessive quantity of Sanies, that I was compell'd to dress it twice a [Page 77]day. This Wound was handled much after the same manner, as that above mentioned, and in near the same space of time was perfectly cured.

CHAP. XXIV. A Compound Fracture of the Leg.

ONe by a fall from a Scaffold, being about eighteen Foot high, received a Compound Fra­cture of the Leg with 2 Wounds, at the Wound above, came forth a part of the Tibia, at the lower Wound on the out-side a part of the Fibula. I bled him, kept him low, and wrapt the whole Leg in a Sear-cloth, cutting out two pieces, one above, and the other below: for convenience in dressing, I also contrived a Case of Tin to contain the Leg, in which were two little doors [Page 79]to open and shut, for the oppor­tunity of making applications to the wounded parts. The Medicine to the ends of the Bones was of Tinctur. Traumatica, Mel Rosar. and Pulv. Irid. Florentiae; for they had received prejudice from the dirt he fell into. Wherefore it was some­what long before they cast off; however within the space of three Months he became well.

CHAP. XXV. Divers Wounds by small Shot Cured.

BEing in a Merchant-man, we were attact by two Turks-Men of War of good force, and by them at length taken; they did so gaul us with their small Shot, that a Man could scarce appear upon the Deck, where several of our Com­pany received very untoward Wounds, viz. one of our Men hal­ling at a Tackle to run out a Gun, was shot with a Musquet Bullet through both Arms, near the middle and hinder parts of the Brachia, about the beginning of [Page 81]the Brachiaeus externus; I at first drew Flammulaes of Tow through, armed with a digestive, and af­terward I used a short Tent to each of the four Orifices, suffe­ring the Wounds to Incarne in the middle: The flesh being pretty well fill'd up, I at length took out my Tents, using only Pled­gets spread with the same Medi­cine; and lastly with dry Lint Ci­catrized them.

CHAP. XXVI. A Wound by a Musquet Ball.

A Sea-man received a Wound by a Musquet-ball, entring in about the upper Angle of the Sca­pula, which passing through the Trapezius, and under the Levator humeri lodged upon the Cartila­go Thyroeides. Running to me almost strangled, and not able to speak, he made sign of being choakt with his Finger, where­upon feeling the Bullet, I made incision, and taking it out gave it him, scarce willing to stay to be drest, only I clapt into the Wound above the Scapula, a short [Page 83]thick Tent of dry Tow; he went to his quarters again, and behaved himself with a great deal of courage, till the fight was over; the wound made by Inci­sion proved but little trouble­some, for that easily healed; and that on the Shoulder after it came to be well digested (the quanti­ty of matter daily decreasing) short Tents being still applied, in about three Weeks was perfect­ly Cured.

CHAP. XXVII. A Wound in the Thigh by small Shot.

ANother of our Men at the same time received a small shot in the Thigh, between the Rectus and the Vastus Externus; I could by no means (although I made diligent enquiry) trace or find out the Bul­let, wherefore leaving it behind me, in eighteen days time I cured the wound, and never heard he had the least trouble or inconve­nience from it afterward.

CHAP. XXVIII. Several Wounds by small shot.

ANother time a great many of our Men were wounded by an Ambuscado of the Turks ashore, who unawares surprized them. One received a Wound on the side of the Thorax, the Bullet coming out near the Spine; I could not find it had penetrated the cavity of the Breast, either before or behind; wherefore bending my Probe, I found the shot had glanced upon the Rib, and had gone round it. I kept both wounds open by two short Tents dipt in Digestive, and with good Bandage (being a great cause of Unition) in a short time healed him.

CHAP. XXIX. A Wound by a Musquet shot.

A Second was wounded in the Face with two slugs; one came in at his lower Jaw, beating in three of his Teeth, and a piece of the Mandible: the other having fractured the Os Jugale, came through the Orbit of the Eye, not wounding it, but with the violence of the contusion leaving behind an incurable Amaurosis, or Gutta Se­rena.

CHAP. XXX. A fracture of the Leg by a Musquet-ball.

A Mariner at the same time was shot through the Leg with several shot, fracturing both Foci­les with great laceration of the Muscles & Tendons; divers pieces of Bones also being driven through some that were loose, I took out; the tumour of the Leg increasing, he fell into a Mortification, which proved of difficult cure; however at length by Incisions, the use of hot Lixivial Stupes, & Medicines for­merly exprest, he got off from it; but it was long e're he recovered, the Unition of some, and exfoliati­on of other Bones, also the Confir­mation of the parts debilitated, re­quiring much time.

CHAP. XXXI. Remarks on some Errors in Surgery.

BEing in the Hospital Ship in the year 65. after that great Engagement with the Dutch on the third of June (where his Royal Highness was so signally Victori­ous) from each Man of War were put aboard us their wounded Men; where I observed very great errors committed by some Surgeons, whose fame was greater than their merit; many of the wounded per­sons being brought in so ill a dress, that it is almost a shame to men­tion, viz. from aboard where J. F. was a Surgeon, among others one [Page 89]having a Compound Fracture of the Arm by a great shot, and shatter'd all in pieces from the Elbow to the Wrist, there was only a sheet of brown Paper (with­out any other application) wrapt round it, which I shewed the Sur­geon General, who lookt upon it with admiration: This Person was a Scotchman, and so timerous that I could by no means perswade him to the taking off his Arm, nor yet to be drest; at length it send­ing forth such a cadaverous smell, as was noisome to himself as well as his Neighbours (we having at that time above five hundred wounded Men aboard, near two hundred of them with amputati­ons, the rest with Compound Fra­ctures, and other Wounds by Gun­shot) [Page 90]I at length overcame him by perswasive arguments to save his Life, which by no other means could be effected, but by taking off his Arm, to which he con­sented; accordingly I did it, and he recovered.

CHAP. XXXII. A Leg Amputated.

ANother from aboard a Third Rate Frigate (where T. M. was Surgeon) upon the Recoil of a Gun the Truck ran over his Foot, breaking in pieces all the Bones of the Metatarsus; percei­ving his Foot very much tumefied and discoloured above the Anckle, I made deep Incisions on the Tar­sus, and Metatarsus, which he felt not; I told him there was a ne­cessity to take off his Leg, to which he readily agreed; so he hopp'd on one Leg to a Chest, [Page 92]where sitting I took it off, (he not expressing the least sign of pain or sorrow,) and afterwards when well, was by his Maje­sties favour made Cook of a Se­cond Rate Ship.

CHAP. XXXIII. Remarks on some Errors in Surgery.

AFore mast-man on a Second Rate, (where O. R. was Surgeon, and a Male Practicer) had by a great Shot his Leg dasht in pieces; the Surgeon aforesaid made no other Amputation, than by cutting off the Leg with his Knife, and dividing it from the parts it hung by. I wondred much at the strange sight, when I came to Unrowl him; for there I found the shatter'd parts of the Tibia ly­ing loose, and split up to the Jun­cture, the Gasterocnemii turned back [Page 94]like the flap of a Shoulder of Mut­ton, and with a Rowler bound back above the Hamm; so that I was forced to make a new Am­putation above the Knee.

CHAP. XXXIV.

I Could insert a great deal more Surgery of this kind (for I had too much occasion for such ob­servation) but I will forbear. However before I take leave of this, let me give you a tast of that Famed Surgeon Y. F. from whom after several Fights I re­ceived aboard divers Amputated Persons, who needed no other Certificate for their Pass-port in­to the other World, than his: His custome being after Amputation to apply to the Stumps Mercur. Sublim. by which means was al­ways procured a Mortification, Malignant Feaver and death; [Page 96]which might have been avoided, had he made the happy exchange for Calcined Vitriol; but I will leave him among his dead Pati­ents. And here I protest, I have not made these remarks upon any one out of ill will, but out of meer love to Surgeons, that notice being given them by the Sandy and Rocky errors of others, they may the better, and with more safety steer their course, 'till they arrive to the Haven of fair and re­putable Practice, it being the sa­fest Harbour for their Patients, and most reputable to them­selves.