IN search of Things, laudable and praise­worthy, Ambition is a Vertue. Prior to other Men, those of our Profession are required to pursue their Progressive Improvement in this Case; but we must climb the Hill; Vertue sits o' Top. Care is painful; the Charge of Men, and Women's Lives, and Limbs revolves [Page 2]the Surgeon's Breast. To retain his Tranquility he is to proceed in his Business, according to the re­ceived Maxims, and approved Me­thod of the best Practitioners. Learning gives Tranquility of Mind; it points the Road to Re­putation and Riches.

IT is a Maxim among Infidels to speak well of all Men as far as Vertue will permit; Slander is base, and does recriminate. It is far from me to derogate from the Masters of your Hospital, ^* but who among such Folks imparts his Knowledge, and if they do, ought not young Men to proceed in their Research: Reputation lost, is hardly retrieva­ble; we are not to risk this rashly: On the other Hand, the World is apt to form a great Idea of a Sur­geon of an enterprizing Genius; they presume that his Knowledge [Page 3]is well founded; so they may, be­ing attended with Success. Te­merity puts a Man off his Guard; this is subject to great Danger.

THE Reduction of Fractures, and Dislocations is a great and necessary Article in a Surgeon's Business; to decline this, is inconsistent with his Character, see himself postponed to a country Fellow, in all other res­pects inferior to him. Granting that many of those People set Bones at random, you will not easily be believed in saying so, even when they miscarry. There is Reason to retort, that good Surgeons fail in this Case, tho' Men are required to speak Truth, it would be a Hardship on Surgeons to tell all which they know, or believe: they would confess that sometimes the Swelling confounds them in distinguishing the Species of Frac­tures, [Page 4]particularly Luxations. This Reflection ought to put young Sur­geons under an indispensible Ob­ligation to distinguish the great Variety also of Sub Luxations, and be familiarly conversant with the [...]her Rules of Art, to arm against C [...] [...]ngencies. When you have [...]n instructed in the Osteology, the Myology, and the Angiology, the History of the Bones, the Mus­cles, and the Blood-Vessels, you will cut without Danger, by the Dis [...] and Re-place of the Head of the Bone, see how and where the Muscles and Ligaments are banded, and relaxed; then from the in­tense Pain, the privation of Mo­tion, and the Position, judge where the Distortion is made, notwith­standing the Swelling. This Rule will direct you in adjusting the Ex­tension, and in moderating the Vi­olence.

WHEN the Femur, the Thigh, is dislocated backward; I mean when the Head of the Bone is un­der the Gluti, or Fleshchi, the three Extensor Muscles of the Fe­mur, all Authors, as well as other Surgeons, agree, few contradict, that the Reduction is impractible, by Reason that the Head of the Bone cannot be removed; especially in that the Ligament, Tarsor, being broke, the Bone will not keep in it's Place: I will demonstrate how this Luxati­on may be reduced, and by what Means the Ligament restored.

RULES will be given respect­ing Fractures, particularly the Ob­lique, and Transverse-Fracture of the Femur, the Thigh bone, which cannot be felt, by Reason afore­said.

EXCELLENT Directions Will be given to keep the Com­pound-Fracture free from Pain, and without the exfoliating the Bone, cure the Wound with Facili­ty, and Promptitude. In depart­ing from these Rules the menacing Accidents rising high, the Life of the Diseased is cast away, or hangs in doubt.

YOU will be apprized of an Er­ror in a reputed great Author: ^* this for many Years has been a stum­bling Block to his Practising-Suc­cessors, and sometimes fatal to the Subject, if he escaped with his Life, he underwent a long Weakness, and not seldom a Deformity in his Limb. I am acquainted with a Gentleman, a shameful Example of this Error in two great Surgeons in Concert, one of them a Grandee of the first [Page 7]Class; the Afflicted deplores the Remembrance of his Sorrow, and the Loss of the Use of his Elbow; these in a great Measure might have been prevented, with no danger of his Life, or Lameness, little Pain, loss of Time, or Expence compara­tive.

BY the Indication of the Pulse, and of the Urine, you may betimes animate your Digestive, then by change of Dressing turn gradu­ally the redundant Discharge to In­carn the Wound, and generate, and confirm the Callous: This Practice must needs be just, seeing that by certain Tokens in the Matter or Discharge, this is known to be the Chyle, and indeed the native Balm of the Blood which cures all Wounds. In this Case, Old People seldom recover their Strength; the Spirit and Balsam of the Blood is [Page 8]evaporated: This is become Cadave­rous.

IF I do not take upon me to determine the controverted Hypo­theses in Theory, it is not improba­ble but in this I shall make a plea­sing Advance.

IN this Sentiment you will find yourself in Condition to distin­guish Books; was I to speak my Opinion of them, I must own that there are not many worth reading. It is not hard to comprize in a Sheet or two of Paper, what is ma­terial in some of the best of them, particularly those of the Practice of Surgery.

WITH a copious, and beauti­ful Variety of Topics, you shall have the Occasional Method of In­ternal Prescription, to digest [Page 9]Wounds of the Brain, and Wounds of the Viscera. Of all other, Gunshot Wounds in the Joints are formidable to Nature. Application of actua­ting, fortifying, and resolutive Me­decines of various Kinds not ge­nerally known are to be made ac­cording to the Exigency of the Wound: the Surgeon is to steer his Course, as it were, between Cha­rybdis and Scylla, a Rock, and a Sand, as they term it. Without adding Fewel to the burning Fe­ver, he is to cherish the Genus Ner­vosam; from thence the interes­sing Soul sends continually Suc­cours of Animal Spirits in Aid of Nature in the unequal War with her united cruel Enemies Pain, Fever, Thirst, Burning, Watching, Delirium. In Failure of these Spi­rits to rarify, and animate the con­densing Blood, to digest the Wound, alleviate the Pain, and support or [Page 10]strengthen the Heart, labouring under the redoubling Pulse, the mortal Symptoms prevailing; the noble Organs ceasing to perform their Vital and Animal Functions, the Soul deprived of her Power, is forced to depart.

YOU should learn to despamate, secern, and transfer the dangerous Rellux of purulent Matter oppres­sing the Blood, and Animal Spirits with Restlessness, Fever, Delirium, the Hickok, Lethargy, Apoplexy, Convulsions, &c. the Harbinger of Death.

UPON a sudden Suppression of Sweat sometimes this becomes a Hetorene Humour, and with pun­gent Pain vellicats the Intestines, the Missentory, the Pleura, the Mediastinum, the Pericranium, and other Parts greatly subject to [Page 11]Resentment. Of all Cases this em­barasses the Surgeon; Secretion be­ing the Work of Nature he cannot appoint the Time, nor till this is accomplished hardly obtain a Res­pite, or Cessation of the Violence: This seems to have been the late Case of a great King which for what we could perceive his Physicians and Surgeons knew, yet like a Starrost with his Hand on his Sabre in Se­nate, they were for defending their Argument in the Antichamber.

Laudanum is our great Anodyne, this we are forbid; it restrains the Transfusion of the Animal Spirits on which depends the Function and Formality of the Parts, also the Energy of the secerning Blood. A continued Use of this Medicine may render the Disease incurable, or of a long Duration. Purging and Bleeding interrupt Nature: She has chose to deliver herself by [Page 12]the denographical, or culicular Glands, and will not be controuled. Perspirating, Alexipharmic, and Volatile Medicines are of a little Effect till towards the Crisis; Na­ture alone maintains the Conflict; Hence it happens that sometimes she does not overcome till from a Vernal Solstice chiefly, the Blood has received an Accession of Warmth to ferment, and discharge in the Surface.

SOME Years ago I tended a Gen­tleman who upon drinking cold Water when hot, and Sweating was seized with a violent Pain in the nervous Tunicle of his Bowels. After a tedious Indisposition a large Abscess was formed in his Groin. Tho' I opened the Swelling as soon as it fluctuated: The Blood and Spirits were so tainted, and charged with this foreign Humour, [Page 13]that he had an accelerated, a low, and an irregular Pulse; was delirious, had cold clam Sweatings, an Hic­kok, a Diarrhea and a Gangarene round the Border of the Wound; also an advanced Mortification on the Inside of That Knee. In five or six Days the Wound discharged so many Quarts of a lixive, ganger Lymph: When the Mortification was stopt and a Separation made one might turn his Hand in the Wound quite to the Peritoneum in sight. Now the mortal Symptoms began to remit: In less than five Weeks the Wound was sicatrized. You will agree that the Cure depend­ed on proper Internals; had there been a Defect in the Dressings he must have perished, so he would had I fatigued him with Pain.

BETWEEN two and three Years ago, one Mrs Gyles, had for [Page 14]Year before, a continual Diarrhea, or Lienterria; the Chyle, or Nou­rishment, ran off, the greatest Part of it before it entered the Lacteals. In the Spring of the Year a large, cold, white, fluctuating Swelling grew on her right Hypondria be­low the Ribs. From the begin­ning she had an aching Pain shoot­ing deep into the Liver; the Seat or Source of her Indisposition; a suppressed Sweat transferred. A considerable Surgeon in Town told her to be well advised in whom she trusted, and that he did not o­pen the Swelling too soon. In a­bout a Week I stopt the Loosness: In eight, or nine Days more the Swelling became warm, and red­dish, but frightfully increased in Bigness: I told her now was the Time; she yielding, I opened the Swelling with a Lancet; there was a Bason of a Quart and half a Pint of [Page 15]formed Matter catcht; here and there streaked with Blood, toward the End. She, and others who saw the shifted Cloths and Bedding did believe that in 48 Hours the Wound did run a Gallon, and in four Nights two Quarts more; in all Six Quarts. The Return of the Diarrhea was what I apprehended most: This happened the first Night attended with cold, clam Sweating, a trembling Pulse, and Fainting; so again the second Night; and were as often taken off. In few Days more she mended daily, and in three Weeks was quite well: Then she grew Fat, Healthful, and Strong. She is lately married to James Taylor, a White-smith in Hatfield-street.

IN five Weeks I cured a Gentle­woman of a large Mortification in her Loins extending on the Os [Page 16]Sacrum, and the Coxis, to affect the Sphinctures of the Anus, and the Bladder, cut off the Course of the Spirits, that she rendered her Ex­crements involuntary. In the be­ginning she had a Fever of the Spi­rits, a Delirium, cold Sweatings, and a Syncopa.

THESE Cures well understood, and the Medicines given will, with Variations, be a Precedent in many Grand Cases; nor are the Internal Things mentioned in any Book on such Occasions; yet which no Phy­cisian, or Surgeon, speaking with­out Prejudice, can disavow: They will, and must needs own that if any one ever was, these People, all of them by Medicine, were brought back from the Gates of the Grave.

WHAT deserves Remark; there was no Ruburb, or Astringent, no [Page 17]Opiate, or Theriaca given in the Diarrhea, the Cortex suspends, or restrains Secretion; so does Lau­danum: This shuts the Avenues of the Nerves, binding, or cente­ring the Animal Spirits, it leavens the Blood, and opposes Digestion and Re-union. I shall occasionally speak farther of these Medicines, and how they may be given safely; here they would have been mortal by Reason of the Nervous Fever.

IN case of a Collection in the Mediastinum, De Verney says we may trepan the Sternum. He was Professor of Anatomy in the Roy­al Garden at Paris, and probably the greatest that ever lived, taken throughout. He Illustrated his De­monstrations of all Parts of the Body with his comparative Anatomy of Horses, Calves, Dogs, Cats, Fowl, Fish, Frogs, Eggs; including his [Page 18]public Lectures, and Course of Operations. His Course of Anato­my lasted from the Beginning of September till the end of March, all the Week (Sundays, and Holidays excepted) from Morning till Night, an Hour at Noon allowed. He was Forty Years Royal-Professor; had read all valuable Books; was thought to be one of the greatest Orators in France. Being of easy Access his Scholars had a fair Op­portunity of Improvement. His Papers would have made a Volume little less than a Church-Bible; but they never were published. Few can judge of the Loss, yet this may easily be perceived in the Defects, and Impertinencies in Mens Dis­course and Writings on this Sub­ject, some who hold their Heads high.

YOU shall see the several In­tentions practised to restrain the Affluence of Suppuration, which procrastinates, and defeats the Cure of Wounds, and renders Ulcers sinous, callous, and fistulous, then by exalting, and displaying, reba­ting, and correcting the Blood, ren­der this subservant to your Purpose.

YOU will be entertained with an Essay on the Hernia of the Parts, will learn to disengage the Intes­tine Ilion strangled in the tendous Perforation of the great Oblique, the external Muscle of the Abdo­men; and how to prevent the Return of the Ilion into the Inguin, or Groin. Such is the Force of a few ex­ternal Medicines, that they effect the Cure of the Rupture in People ad­vanced in Years, if I do not say without help of a Truss, this I have done, upon considering [Page 20]them well, and how they are adapted to several Pur­poses co-operating, you will per­ceive that they bear the greatest Congruity to Reason, and Proba­bility of Success; should they fail, or fall short in what is promised, others are appointed to sustain the Effort, strike off the Symptoms as they arrive. In fine, you shall have a System of Prescriptions to tra­verse the Train of Appearances, and anticipate the dangerous Ope­ration of the Bubonocele or stran­gled Rupture even when the ver­micular, the peristaltic, or natu­ral Motion of the Intestines is in­verted, and they vomit their Ex­crements as in the Micere, or Ili­ac Passion.

ASK at Mr Baker a Cooper in Nottingham-street: I cured his Wife of a strangling of the Bowels [Page 21]attended with violent Pain and Sickness, when without Passage downwards, she for Eight Days vo­mited every thing that she took.

WHEN on this Occasion, and probably in this Manner, you have had the good Fortune to redeem, or ransom Men from Death; you should fence them with Strength, brace the unbended Muscles, and the expanded Tendons, restore the Resort of the relaxed Ring, to with­stand the Protrusion of the Intes­tine, and of the Epiploon into the Ain, or Inguin, and the Scro­tum, the Seat of the Bubonocele, and of the Complete Hernia.

I have a Sheet of Paper wrote throughout on the Cause and Cure of the Rupture.

FROM the long and often­times repeated Experience which I have had of my Method of Cure of the Rupture, I will, and do en­gage to take only Twenty Shillings for Things, nor will I ask more if I do not cure the Diseased abso­lutely, if through Neglect, or o­therwise they do not profane the Use of my Medicines. I will, put them to no Pain, Trouble, or In­conveniency farther than to wear a Cotton-Truss 10 or 12 Days till my Medicines do take Place.

YOU will take Notice that this Promise is to be understood with some Exceptions, or Restrictions, respecting great Age and Weak­ness.

MR Mitchell, Colourman over-against Haberdashers Hospital in Hoxton; had his eldest Son born [Page 23]with a Complete Rupture. I cured him at Ten Years old.

A Scholar at the Latin Boarding School at Edmonton was lately cu­red by me of a complete Rupture on both Sides the Intestine, or Bowel, quite down in the Scrotum. Send to Mr Harrow Master of the Boarding School.

YOU shall learn to supercede successfully the Stitch, or Suture of the Tendon, cure the Wound, and recover the Use of the Part soo­ner, and with far less Pain, than by the Operation.

THE Cure of the painful An­chylose, or White Swelling in the Joint, is a Consideration of no little Import, and known but to a few. You shall see how to give a present Judgment of this, and [Page 24]cure all curable Kinds; this will go far. I have wrought Miracles of this sort, so may you with help of my Thesis on this Subject.

I have an Essay on the Circulati­on of the Blood in the Foetus, and on the Nourishment of the Foetus.

WHAT is alluring to the Ear: You shall hear a Discourse on the Parts of Generation in Women, and on the Law of Formation, the Pre-existence of Lineaments in the Ovum.

I will annex an Essay on the Passions and Affections, accounting for them from the near, and fami­liar Consent of the Various Plexus of Nerves, and the intimate Cor­respondence of the Animal Spirits reciprocating in them.

You shall be convinced of the Certainty of extracting the Stone in the Urethra, without Danger of having the Wound remain Fistu­lous.

To many opposite Digressions on the other great and necessary Heads of Anatomy and Surgery; I will give a Process on the Bron­chocele, the glairous Swelling of the Glands Thyroides, threatning a Suffocation from the Pressure of the Swelling on the flexible Part of the Annular Cartilages of the Aspera Arteria.

ABOUT a Year ago, I opened an Ulcer in the Roof of Captain Hughes's Mouth: I exfoliated, and took out the Bone of the Pallat. Inquire at Mrs Starky's in Dean­street, by Red-Lyon Square. The Captain will show the Bone, and [Page 26]that the Wound stands sound, nor can you perceive any Alteration in his Speech.

THREE Years ago I opened and cured a Scrofolous, or King's Evil Swelling in a Gentlewoman's Neck. Inquire at Mr Kitchen's Ba­ker in Buckle-street, by Red Lyon­street, Goodman Fields.

AN eminent Surgeon in Town will witness, that when with Three Bolusses of fourteen Grains of my Panacea I fluxed a Man Thirty Days; I opened the ulcerated Skin of his Nose. I cauterized the ca­rious Bones several Times: I took out the Bridge, the Ossa Nasalia, both of them, and without sinking the spungy Bone underneath to make a Blemish; I cured him also of an Ulcer in his Throat large e­nough to receive a small Apple; [Page 27]an Exostosis on his Wrist, and one on the second Joint of his great Toe; of all which he held well se­veral Years, till he died of another Distemper. ^* Other Surgeons give 150 Grains of Mercurius Dulcis, or more; consequently my Method of cure of the Venerel Dis­ease is much safer, nor is it less effectual, than a Flux raised by Unc­tion, whereas their Method of Sali­vation comes far short in Certainty.

I saw a great Surgeon in Town give fourteen Grains of Mercurius Dulcis, and seven Grains of Tur­bith Mineral, or yellow Mercury, for one Dose in a Gonorrhaea, a run­ning of the Reins as they call it. He told me that the Brotherhood speak as they please, but this is what they give, and even in greater [Page 28]quantity, whereas I do not exceed ten Grains of my Panacea, and that castrated of its vitriolic cor­rosive Points, in which is the Dan­ger: It is by this Means that so small a Quantity of my Panacea raises a Salivation. It is true that I mix another Powder; but you shall be satisfied that this has no Re­lation to Mercury of any kind; nor is it Subject to ill Consequence.

TURBITH Mineral causes worse Effects: Of this I give none; It weakens, and relaxes the Medul Spinalis, or Back Bone Marrow, the Root of the Nerves of the infe­rior Parts that they cannot receive the Animal Spirits, nor indeed the Impression of the Imagination to push them. Thus defrauded of Spirits, the Stamen of Sense, and Motion, the Muscles of the Loins lose their Action and Strength, more or less.

OLD Gleets proceed from what the French call a Debility, or Laxness of the Vessels, the Emun­ctory of the Prostates. Purging makes the Case worse: Astringents are dangerous. I stop Gleetings of a long standing by tempering the Heat and Ferment of the Hu­mour, by a Medicine absolutely safe, and pleasant to take.

You will expect that I should give my Opinion of the Seat, or Source of the Gonorrhaea. We are commanded to strive for Truth; this obliges me to speak affirma­tively in Contradiction to a Book on the Hypothesis of the Lacunae, and the Patrons of this Theory. ^*

Monsieur De Verney, the Gentle­man already mentioned, shewed an Ulcer in the Prostates, of a Man who had this Distemper when he [Page 30]died. I heard him also say, that from thence came the Matter or Discharge in this Case.

THE Prostates lie on the de­pending part of the Bladder near the Sphincter, and the Erector Mus­cles of the Penis. The Inflamati­on, and Swelling of the Ulcer, is soon communicated to those Parts through the porous Tunicles of the Bladder, from this it is easy to account for the Heat, the Stoppage, and Strangury of the Urine, also for the Pain and Cordee in the Time of Erection.

WHAT I am going to say will cast the Ballance, and determine the Controversy on my Side, absolute­ly.

IT is manifest that a Discharge of Matter must come from a Wound. [Page 31]Consistent with this Demonstrative Proposition it is found that the Excoriation, or Ulcer of the Pros­tates-Glands is always antecedent to the Gonorrhaea, whereas that of the Lucanae does not happen of some time after, sooner, or later, according to the Heat, and Sharp­ness of the Urine, and of the Run­ning from the Prostates, so the Excoriation or Ulcer of the Lacunae can be only an Effect, or Conse­quence of those Symptoms: I mean that the Heat, and Sharpness of the Urine, and of the vitiated Dis­charge of the Ulcer in the Prostates passing often through the Urethra does chafe, and fret the thin and tender Membrane of the Lacunae, so occasions an Ulcer, or Excoriati­on in this Part.

IN a long and great Discharge the Prostates are found to waste, [Page 32]and in the End to shrink, and shrivel to almost nothing, while the Excoriation of the Lacunae re­mains without Alteration. These Reasons rise to a Demonstration of my Assertion. The Experiment may soon be made in the Hospi­tals.

THE Succus or Juice of the Prostates, is the Vehicle which conveys the Volatile Semen into the Uterus. When this is spent, and the Prostates withered, Men become incapable of Procreation, but fertile Nature recovers some, as by a Miracle.

AS in the Prostates, a long, and great Discharge of Matter or Nutritious Juice from the Lacunae would run sinous the cavernous Body of the Penis, and give as little Trouble to cure it.

WE should find it impractible to restore the Masculine Proportion of the Penis.

BUT these Accidents do not happen; therefore the Seat of the Gonorrhaea, is not in the Lacunae.

I was bred in St Thomas's, Hos­pital, under Mr William Coates­worth: After this I was two Years under the celebrated De Verney at Paris, and in the Hospitals there.

A great Man in Town was my Pupil: Now he is a Physician, he does not scruple to own that he formed himself chiefly on the Ana­tomy, &c. which I taught him. His Father was a Surgeon of good Account; he chose me to educate his Son preferable to any Man in Town; so he used to say. I have bred several other Surgeons: Some [Page 34]of them are much sought to in set­ting Bones.

DR James Keill was a Gentle­man no less valued for his Integri­ty than his Knowledge in Anato­my; I have inserted a Certificate from him.

TAKE down in Writing three or four remarkable cases in Cure in your Hospital according to the Number and order of your Queries, I will Account for the Appearances from the Fabric, the Function, and Situation of the Parts.

HAVE you a mind to hear something previous: Inquire out a Professor of Anatomy. I will meet him at his appointed Time, and Place, to answer and question him on this Subject. If he thinks fit the controverted Points shall be [Page 35]submitted to the Wardens of Surge­ons Hall, or to two other Professors, or Physicians, and a third to ad­judge.