Memorable medical histories.

Following text is from: The workes of that famous chirurgion Ambrose Parey [Ambroise Paré] translated out of Latine and compared with the French. by Th: Johnson

Ambroise Paré.

CHAP. XII. Certain memorable Histories.

Peter Ernst I von Mansfeld-Vorderort

Here I think good for the benefit of young practitioners, to illustrate by examples the formerly prescribed methods of curing wounds made by gunshot. The famous and most valiant Count of Mansfeld, Governor of the Duchy of Luxembourg, Knight of the order of Burgundy, coming to the aid of the French King, was at the battle of Moncontour, where in the conflict, he received so great a wound at the joint of the left arm with a pistol bullet, that the bones were shivered and broken in so many pieces, as if they had bin laid upon an anvil and struck with a hammer: hence proceeded many malign symptoms, as cruel and tormenting pain, inflammation, a fever, an edematous and flatulent tumor of the whole arm even to the fingers end, and a certain inclination to a gangrene which to resist, Nicolas Lambert, & Richard Hubert the Kings surgeons, had made many and deep scarifications. But when I came to visit and dress him, by the Kings appointment, and had observed the great stench, and putrefaction, I wished that they would use lotions of Aegyptiacum made somewhat stronger than ordinary, and dissolved in vinegar and aqua vitae, and do other things more largely spoken of in the chapter of gangrene. For the patient had also a diarrhea or flux, whereby he evacuated the purulent, and stinking filth which flowed from his wound. Which how it might come to pass we will show at large when we come to treat of the suppression of the urine. For this seemed very absurd to many, because that if this purulent humor flowed out of the arm into the belly, it must needs flow back into the veins, be mixed with the blood, and by its pernicious and contagious pas∣sage through the heart and liver, cause exceeding ill symptoms, and lastly death. Indeed he often swooned by the ascent of the filthy vapors raised from the ulcers to the noble parts; which to resist, I wished him to take a spoonful of aqua vitae with some treacle dissolved therein. I endeavored to repress the edematous and flatulent tumor possessing all the arm with stoups dipped in oxycrate [mixture of water and vinegar], to which was put a little salt and aqua vitae; these stoups I stayed and held to the part with double clothes, sowed as straight as I could. Such a compression held the broken bones in their places, pressed their Sanies [a thin mixture of pus and blood serum discharged from a wound] from the ulcers, and forced back the humors flowing to the part into the center of the body. If at any time I omitted this compression, the tumor was so increased, that I was in a great deal of fear, least the native heat of the part should be suffocated. Neither could I otherwise bind up the arm by reason of the excessive pain which molested the patient upon the least stirring of the arm. There were also many abscesses about his elbow and over all his arm besides. For the letting forth of whose matter I was forced, to make new incisions; which he endured very stoutly. At length I cured him with using a vulnerary potion [drug or plant used to heal wounds], and by cleansing the ulcers, and correcting the putrefaction with Aegyptiacum dissolved in wine or honey of roses, and so poured into the ulcers, and repressing the growth of proud flesh, with the powder of burnt Alome [alym], drying it after the detersion [the act of cleaning a wound] with liniments. Now this I can truly affirm and profess, that during the time of the cure, I took out above threescore splinters of bones, and those necessarily, amongst which there was one of the length of ones finger yet by Gods assistance at length he became sound in all things, but that he could not put forth, or draw in his arm.

Charles Philippe de Croÿ

Not long after by the Kings command I went to see Charles Philip of Croy, Lord of Auret, the Duke of Aschos brother, not far from Mounis a City of Henalt [Havré Castle]. He kept his bed seven months by reason of a wound made by a bullet the space of three fingers above his knee. When I came to him, he was afflicted with these symptoms, intolerable pain, a continual fever, cold sweats, watchings, excoriation of the hips by reason of his long lying upon them, his appetite dejected with much thirst. He oft sunk down as if he had the falling sickness, had a desire to vomit, and a continual trembling or shaking so that he could not put one hand to his mouth without the assistance of the other: he swooned frequently by reason of the vapors ascending to the noble parts. For the thighbone was broken long ways and sideways with many splinters of bones, whereof some were plucked out and others remained sticking fast in. He besides also had an ulcer in his groin which reached to the midst of his thigh, and many other sinuous ulcers about his knee. All the muscles of his thigh and leg were swollen with a phlegmatic, cold and flatulent humor, so that almost all the native heat of those parts seemed extinct. All which things being considered, I had scarcely any hope to recover him, so that I repented my coming thither. Yet at length putting some confidence in his strength, and prime of youth, I began to have better hopes. 

Therefore with his good liking, first of all I make two incisions, so to let forth the matter, which lying about the bone did humect the substance of the muscles. This had happy success, and drew out a great quantity of matter then I with a syringe injected much Aegyptiacum dissolved in wine, and a little aqua vitae into these incisions, so to restrain and amend the purification, repress the spongy, loose and soft flesh, resolve the oedematous and flatulent tumor, assuage the pain, and stir up and strengthen the native heat almost oppressed by the abundance of excrementitious humors, so that it could scarsely assimilate any nourishment and adjoin it to the parts. Then I fomented the affected part with sage, rosemary, thyme, lavender, chamomile and melilot flowers and red rose leaves boiled in white wine, and lye made of oak ashes, adding thereto as much salt and vinegar as I judged requisite. This fomentation did attenuate and draw forth the morbific humour. Now we used them long and often, so to waste the humour more by drying up and breathing thorough the passages of the skin, more thereof than fell into the part. For this same purpose, we ordained that he should use frictions with hot linen clothes, and that these should be made from above downwards, from below upwards, and so on every side, and somewhat long with all. For a short friction drawes more humour into the part than it can resolve I wished that each other day they should lay bricks heated hot in the fire about his leg, thigh, and sole of his foot but they were to besomewhat quenched, and sprinkeld with wine and vineger, with a small quantity of aqua vitae. Much waterish moisture by this moist heat, did sweat out of these parts, the tumour was lessened, and the native heat by little and little restored. Then shoupes [rose] dipped in lye made of oak ashes, wherein sage, rosemary, lavender, salt, and cloves, were boyled, some aqua vitae added, were applied there to; but the rowlers were so gently, and artificially wrapped about, that he did easily endure them without any paine, and that with such happy success, that if they were omitted but for one day, the tumor became very great. But thick linnen boulsters were laid upon the lower cavities of the ulcers that so the sanies or filth might be more easily pressed forth. But I had alwayes a special care that the orifices of the ulcers should be kept open with hollow tents or pipes put therein and sometimes this following cataplasme [poultice] was applyed to resolve the tumor. 

℞. Far. hord. fabar. & orobi, an ℥vj. mellis com. & tereb. an. ℥ij. flo. chamam. melil. & ros. rub.an. ℥ss. pulv. rad. Ireos, Flor. cyper. Mast. an. ʒiij. oxymel. simp. quantum sufficit; fiat cataplasma ad formam pultis satis liquidae. And Emplastrum de Vigo. 

Without mercury was applied thereto, whereby the pain was much assuaged, and the tumor lessened yet were they not applyed before the parts were throughly heated by the fomentation, frictions, and evaporations for other ways this emplaster could never have been activated, by reason of the excessive coldness of the affected parts. Neither did we omit catagmatic powders [In pre-modern medicine, the term catagmatic generally referred to any treatment purported to heal bone fractures, by promoting the formation of a callus] fit for the taking, and drawing forth of broken bones. He used a vulnerary potion for 15, days. Also besides the particular frictions of the affected parts, I appointed other general frictions of the whole body, which was become very leane for by these, blood together with the spirit was drawn to the parts, and the acrid, and fuliginous vapours were breathed forth.

To conclude, his feaver and pains being assuaged, his appetite restored, by feeding plentifully upon good meats according to his strength, he in a short time became more lusty and lastly by the singular mercy of God, recovered his health perfectly, but that he could not very well bend his knee. I thought good to recite these things, not to glory or brag of the happy successe of those patients, which have recovered by my meanes, and the favour of God but that thus I may more fully and perfectly by familiar examples instruct young practitioners in the operations of surgery.