Book 11

Wounds made by gunshot, fiery engines, and all sorts of weapons

First written in French in 1545, with updates as late as 1585. English translation published in 1643.

Table of Contents

Preface

Publishing this book

Silvius, the King’s professor of medicine, requested me to publish my opinions concerning gunshot wounds so the damaging opinion that they are poisoned will be taken out of men’s minds. I agreed, but first insisted on having drawings done of the instruments used for extracting bullets and other strange bodies. It took about 9 years to publish the first book in 1545, which was very well received. I amended and republished it in 1552 and 1564, since I had participated in many wars and besieged cities as a surgeon, and observed many things under five kings whom I served with diligence.

 

I also hope to sway your opinion on the use of guns because our society fails to see how serious of a problem they have become, so I begin this book speaking to the origin of guns and the great harm they cause mankind.

 

But more importantly, I explain why we must condemn the method of curing these wounds prescribed by John deVigo, where he cauterizes them because he thought they were poisonous. I prove that the correct method of curing is performed by suppuratives, medicine that brings out pus, and that it is so beneficial and gentle, while the treatment prescribed by Vigo is full of error and cruelty. 

 

I dedicate the second argument to the King, teaching again that the wounds are void of poison, and their malignity depends upon the fault of the air, divine justice, and ill humors in the bodies of the patients.

 

Origin & Harm of Guns

A German monk accidentally invented the gun when a spark fell into a bowl of powder and exploded. He stood amazed at the novelty and strangeness of the event, then experimented by putting the powder in a small iron barrel. He showed his invention to the Venetians, who then used it in a war against the Genoveses in 1380.

 

I admire the cleverness of our predecessors, who named the various guns and cannons after the swiftest birds of prey, hateful, and harmful creatures like serpents and snakes, so we know from hearing them named that they were made for no other purpose but the speedy and cruel slaughter of men, and we should detest and abhor them as wicked enemies of our lives.

The smaller versions of these beasts are even more dangerous because they come into our everyday lives to seize upon anyone when they aren’t even thinking about war, and can’t escape. I’m talking about pistols and hand-guns, which you can secretly carry in your pocket and suddenly take out to oppress those who had thought they were safe. Fowling pieces, muskets and culverines, which you can’t fire as easily, are somewhere in the middle between cannons and pistols. They are so heavy and short that they must be held against the chest. This middle sort of engine we call in Latin by a general name “sclopus”, in imitation of the sound. The Italians call it “sclopo”. The French call it Arquebus.


From the same wretched shop of cruelty are mines, countermines, pots of fire, trains, fiery arrows, lances, crossbows, barrells, balls of fire, burning faggots, grenades, and all fiery engines and inventions which are stuffed with suet for fire and shot by the defendants upon the bodies of the assailants, which easily catch fire. It’s a most miserable and wicked invention when a thousand men can be heedlessly blown up by a mine with the force of gunpowder. These fiery engines shoot the strongest soldiers, who then die with a raging fire spreading cruelly over their bodies and bowels, burning them in their armor with no water powerful enough to quench it.

flintlock gun

Thunder and Lighting vs Cannons

Nothing in the world is more fearful than thunder and lightning, yet the harmfulness of thunder is nothing to the cruelty of these infernal engines, which is becoming even more common than thunder. Man alone of all creatures is not always killed by thunder, but these fire-spitting engines do not spare man any more than they do other creatures. In fact, the very target is man, whose preservation was created by God.

 

There are many remedies against thunder. For example, the charms that the ancient Romans used to drive thunder away, or escaping to a cave that’s at least 5 feet below ground. Thunder nor lightning touches the Bay tree, making it a sign of victory both in ancient and modern times. Tiberius Caesar greatly feared thunder, so he always wore a Laurel wreath around his neck when the air was troubled, which is reported to be immune to thunder. Some say he also made tents of seal skin, because it doesn’t strike seals (nor the eagle). However, charms, the victorious Bay, the seal, the eagle nor anything at all is immune to the violence of these fiery engines. Not even a wall 10 feet thick can protect you.

Cannons are so much more violent than thunder, as we know because thunder can be driven away by ringing bells, playing trumpets, tinkling brass kettles, and even shooting guns. The clouds, by whose collision causes the thunder, become dispersed by this violent agitation of the air and driven to more remote parts of the skies. But the fury of cannons, once provoked, stops for nothing, nor is appeased by any remedy.

As there are certain seasons of the year, so also there are certain regions of the earth where thunder is seldom or never heard. Thunderstorms are rare in Winter and Summer. In Winter, the dense air is thick with a coat of clouds, and the cold frosty wind extinguishes any fiery vapors it receives, which keeps Scythia and the cold countries around it free from thunder. On the contrary, too much heat preserves Egypt. Hot and dry winds condense into very thin, subtle and weak clouds. 

 

Thunder and lightning commonly gives only one blow, and that usually only strikes one man out of many. But one great cannon shot may wound and kill a hundred men. Thunder, as a natural thing, falls by chance: one strike upon a high oak, another upon the top of a mountain, and one on some lofty tower, but seldom upon a man. But this hellish engine tempered by the malice and guidance of man, assails men only, and takes him for its only mark, and directs its bullets against him. Furthermore, thunder acts as a messenger to foretell the storm at hand by making its loud blasts; but, and this is the chief insult, this infernal engine roars as it strikes, and strikes as it roars, sending at one and the same time the deadly bullet into the breast, and the horrible noise into the ear. We should all curse the creators of these evil engines while giving high praise to those who endeavor to dissuade Kings from their use and treat the wounds made by them. 

 

They say that discharging a cannon is exactly like thunder and lightning, which the clouds cast upon the earth. I am not ignorant that lightning, generated from large and vicious winds, breaks the cloud in which it’s encompassed, and doesn’t so much as fall upon the earth, but strikes it with fire. Seneca writes that there are three kinds of lightning:

  1. One of them penetrates objects it touches. 
  2. The other dissipates the objects, because it has a more dense and forcible matter, like whirlwinds have. 
  3. The third burns what it touches, leaving behind the impression of the burning.

Lightning has a pestilent and stinking nature that sends forth loathsome fire with such an odious smell that even wild beasts can’t endure it and leave their dens. In the history of Olau Magnus, he writes that in some places after lightning, a whole plain is covered  with brimstone, but it’s extinguished, unprofitable and useless. Despite this, we must not conclude that the bullets carry poison and fire with them into the wounds. 

 

For though there are many similarities between lightning and cannons, they have no similarities in matter – only in their effects, in that they both shake and break apart the bodies which withstand them. Lightning and thunder do it by means of fire, and oftentimes of a stone generated in them which is termed a thunderbolt. But a bullet is carried by the force of the air, more violently driving and forcing it forwards.

According to Pliny, there are some lightnings which consist of a dry matter that shatter all that withstands them without burning. Others have a more humid nature and blacken things they touch, also without burning. Lastly, others have a subtle matter, whose nature must be divine because they will melt gold and silver without harming the purse that holds it; a sword, without hurting its scabbard, or tthe head of a lance, without burning the wood. Lightnings which break apart, melt and dissipate are similar to guns and cannons, but not those which carry with them fire and flame.

In proof of this, there comes to mind the history of a certain soldier, out of whose thigh I extracted a bullet wrapped in the cloth of his breeches, which had no sign of tearing or burning. I have seen many who weren’t even touched, but nevertheless fell down as if dead due to the report and wind of a cannon bullet sliding close by their ears, so that their members became livid and black. They eventually died of gangrene. 

 

These are like the effects of lightning which we mentioned, and yet they bear no sign nor mark of poison. From whence I dare now boldly conclude, that wounds made by gunshot are neither poisoned, nor burnt, universal and deadly to so many worthy personages and valiant men. What then may have been the cause thereof, if not combustion nor poison? This must we therefore now insist upon and somewhat hardily explain.

Are Gunshot Wounds Poisoned?

In 1536, King Francis I of France sent a powerful army beyond the Alps to relieve Turin, a city in Northern Italy, with food and other supplies and to recover the cities of that province. At 26, I was a surgeon in that army. In this conflict there were many wounded on both sides with all sorts of weapons, but mostly with bullets.

The truce of Nice, 1538, between Francis I and Charles V, and mediated by Pope Paul III. Painting by Taddeo Zuccari.

I wasn’t very experienced in surgery, nor was I accustomed to dressing gunshot wounds. I read in John de Vigo that gunshot wounds were poisoned due to the gunpowder. The cure was to cauterize them with scalding hot oil of Elders with a little treacle mixed in. But I hesitated on this method because I knew that caustics caused excessive pain. I checked with the other surgeons if they had any other treatments for these wounds, but they all used the method Vigo prescribes. They filled the gunshot wounds as full as they could with tents and wads of cotton dipped in this scalding oil, so I did the same.

AMBROISE PARE caring for wounded soldiers in Piedmont, Italy, during the Italian War of 1536. Illustration from a painting by Edouard Hamman, c1850. Source

One day, I ran out of the oil. There were still a few patients left to be dressed, so I made an ointment with egg yolk, rose oil, and turpentine. I was so troubled that the dressing was unfit that I feared they would die overnight. I could not sleep at all. I rose early in the morning to visit them, and couldn’t believe what I saw. The ones who were treated with my ointment were free from terrible pain, well-rested, and their wounds were not inflamed or swollen. On the contrary, the ones who were burnt with the scalding oil were feverish, tormented with excruciating pain, and the areas all around their wounds were swollen. I swore that no one should use scalding oil for these wounds ever again.

Oil of Whelps

 

In 1538, in Turin, there was a surgeon far more famous than all the rest in skillfully curing gunshot wounds. I labored for two years hoping he would teach me how he made his personal balsame which was responsible for his success. Finally, I told him I was returning to Paris and that it would not hinder nor discredit him to teach me his  recipe since I’ll be so far away. He immediately told me to bring two puppies, 1 pound of earthworms, 2 pounds of oil of Lilies, six ounces of Venice Turpentine, and one ounce of alcohol. 

 

Right in front of me, he boiled the puppies alive in the oil of Lilies until the flesh came off the bones. He killed the earthworms by washing them in white wine, then added them to the boiled puppies. He reduced the concoction to a more dry mixture. Then he strained it through a towel without pressing it much, added the turpentine, then the alcohol. Calling God to witness, he swore this was the recipe for his balsame that cured gunshot wounds. He uses nothing but this recipe, and he puts it into wounds barely warm. It helps assuage pain and brings out pus. He sent me away rewarded with this most precious gift, requesting me to keep it a great secret and not reveal it to anyone. I published it in my first book in 1545 and now almost every surgeon uses it with good success. 

 

Ingredients:

2 puppies

1 pound earthworms

2 pounds oil of lilies 

6 ounces Venice Turpentine

1 ounce alcohol

White wine, as needed

 

  1. Wash the earthworms in white wine. 
  2. Boil the puppies in Oil of Lilies until flesh comes off the bone
  3. Add earthworms and reduce to a more dry mixture
  4. Strain through a towel 
  5. Add turpentine, then alcohol

Proving Gunpowder is not poisonous

 

The Prince of the Rock and many other noblemen asked me why men die from gunshot wounds that don’t look very serious and were treated by expert surgeons, if it’s not due to poison. 

We must dispel the opinion that wounds made by gunshot have poison, and we must teach that there is no poisonous substance in gunpowder. To accomplish this, we will examine the composition of the powder and each of the ingredients of which this composition consists, what essence they have, what strength and properties, and lastly what effects they may produce. By knowing this, the whole nature of it will be made apparent.

 

Ingredients of gunpowder:
1. Charcoals of sallow, willow, or hemp stalks
2. Sulphur or brimstone
3. Salt peter
4. sometimes a little aqua vita

You will find that each of these is void of poison. 

Charcoal has nothing but dryness and a certain subtlety of substance so it catches fire suddenly, like tinder.

Sulphur, or brimstone, is hot and dry, but not to the highest degree. It is an oily and viscous substance, so it does not as easily catch fire as the coal, though it retains it longer once kindled, and isn’t so easily extinguished. Dioscorides prescribes a drink of brimstone supped out of a raw egg to cure asthma, coughs, and yellow jaundice. And Galen applied it externally to venomous bites, scabs, teeters, and leprosy. 


Salt peter is used as salt on food.

 

For the aqua vita, it is of so tenuous a substance that it presently vanishes into air, and also very many drink it, and it is without any harm used for rubbing on the exterior parts of the body. 


When German horsemen are wounded with shot, they cheerfully drink half an ounce of gunpowder dissolved in wine; believing it will prevent malign symptoms that usually occur with gunshot wounds. Whether they are right or wrong I do not judge. French soldiers do the same thing, just to show they are courageous. Many others scatter it upon ulcers to dry them out, with much success. None of these people suffer from their uses of gunpowder.

Now as to those who think that the poisonous quality of wounds made by gunshot springs not from the powder, but from the bullet mixed with poison, or which has been tempered or steeped in some poisonous liquor: the fire is abundantly powerful to dissipate all the strength of the poison, if any should be poured upon or added to the bullet.

The Siege of Rouen 1562

Written in an earlier edition:
People on both sides accused the other side of poisoning their bullets because the gunshot wounds were particularly difficult to cure. Among physicians (according to Hippocrates), all diseases are termed pestilent if they kill many people. Wounds made by gunshot may be called pestilent when they are more difficult to cure than others, not because they partake of any poisonous quality, but by a common cause, such as the ill complexions of the patients, the infection in the air, and the corruption of meats and drinks. By these causes, wounds acquire a wicked nature and become less yielding to medicines. Now that we have put to rest the false idea that bullets are poisoned, let us now overthrow the idea that gunshot wounds are poisoned due to combustion.

Written in a later edition:

I have formerly declared the malignity of the wounds occasioned by the air in the siege of Rouen, which spared no one, not even princes, who had all things which were requisite for their health. Which made me, skilled by experience, to use Unguentum Aegyptiacum and similar medicines instead of suppuratives all that season, so I could withstand the putrefaction and gangrene which commonly assailed them. If the various motion of the stars can send a plague into the air, why then may it not by depravation of their qualities infect, and as by poisoning corrupt both wounds and wounded bodies obnoxious to their changes and that of the air? We learned long since by experience that all pain, but principally wounds, grow worse in rainy and moist season, especially because in that southern constitution, the air is filled with thick and foggy vapors, which cause the humors to flood the body, which then fall upon the affected parts and increase pain. 

But, says our adversary, in the battle of Dreux and at S. Dennis, which were fought in winter, a great number of men wounded by gunshot died. I confess that is true, but I deny that it was occasioned by applying suppuratives or corrosives, but rather by the vehemence and size of their wounds and the spoil the bullet made in their members. But above all, because of the cold. Cold is most harmful to wounds and ulcers. It hardens the skin and causes gangrene. If this gentleman had been with me in the siege of Metz, he would have seen the legs of many soldiers rotting and presently taken with a gangrene to have fallen away, due to the extremity of cold. If he will not believe me, let him make trial himself and go in winter to the Chappell at Mount Senis, one of the alpine hills, where the bodies of such as were frozen to death in passing that way are buried, and he shall learn and feel how true I speak.

Can The Bullets Be Poisoned?

A few months ago I visited a patient with some other learned physicians and skilled surgeons. They began to argue that gunshot wounds might be poisoned, not due to the gunpowder, but by the bullet which could be transfused with poison.

 

Their first reason was that lead is easily melted and can soak in any liquors you please. But this conclusion is weak, for in all mixtures made there are two things to consider: 

  1. The matter and form of the thing which enters the mixture, for example liquid, soft or friable
  2. Whether it can be divided into small particles so it may be evenly mixed

 

For their form, there ought to be a certain affinity. You may perceive this by water and oil – although they are both liquid, and both can be mixed with other things, yet you cannot mix them together. Gold and silver are so agreeable with lead, that as often as they are molten, lead is mixed with them. But brass shuns lead as much as gold, and silver shuns tin and white lead. Therefore brass and lead being melted cannot be mixed together, though contained under the same genus, and common nature of metals, how then can it be mixed with another thing distinct in the whole kind, much more in species, and form, for example, poison? 

 

Their second reason is this: they say iron, which is more dense and solid, may receive some poisonous substance and quality, like arrows dipped in poison, therefore lead is just as capable of being dipped in poison. I answer that the surface of iron may be poisoned, but not the inner part. Here the question is of union, not of anointing.

 

The third reason is thus: although lead purges itself from the dregs, that’s not to say it won’t mix in some strange liquor. Steel, being the most solid iron, comes to the temperature which hardens it by quenching it in liquors contrary to it. I answer that although steel hardens by the quenching of it, none of the juices or liquors wherewith it’s quenched becomes part of the steel. If that were necessary, it might be better and more easily performed when the metal is first cast, than when it’s beaten into plates or bars. 

 

That same answer shall serve to confute their fourth reason: they say that bullets may be made so poisonous by the commixture of the juices of muncks-hood, oleander, crow-foot, and other things which in their whole substance are contrary to ours, that the wound which is made with them can’t but be poisoned. 

 

But on the contrary affirm that mixture is only of these things, which may not only be put, but also stick thereto, and be mutually united; but how can water, or any other liquid juice so much as only stick to lead, as that which is a solid body, it is so far from being united therewith? You may give more certain judgment hereof by experience, than by reason; wherefore let melted lead be put into the aforesaid juices then when the lead is cold, weigh each of them and you’ll find that both of them retain the same weight they formerly had. Which is a most certain argument that neither the lead has mixed or united itself with the juices, nor the juices lost any part of their substance.

 

Their fifth reason is thus: a bullet shot out of a gun against some hard stone grows not so hot, but that you may presently without any harm take it up in your hand. Therefore it’s false, that the poison united with the bullet can be dissipated by the fire and flash of gunpowder. The answer to this objection is easy. For when we say that although the bullet may be infected by poison mixed with lead, yet all the force of the poison would be dissipated by the fire, we would have you thus understand, that we don’t mean this of that fire which is made by the powder at the discharging of the piece, but of that by force whereof the molten head is mixed and conjoined with the poisonous juice, so to make one of many. For this fire exercising its force upon the poisonous juices hindered by the intercourse of no Medium and that for some space of time and not for an instant it may, if not consume, yet much weaken their strength.

 

If anyone is not satisfied by these reasons, let him read Mattbiolus. There are, he says, some of these latter times wholly ignorant of things, who if we may say the truth, have been so madly foolish, that they said it was fit to put anti-venom and mithidate and similar antidotes amongst gold and silver that was melted to make cups, that so receiving the antidotes they might resist poison. But how absurd and ridiculous their opinion is, let them judge who have but a little knowledge in natural things, but chiefly in metals.

 

These are my reasons that confirm me in my ancient and former opinion that wounds made by gunshot don’t partake of any poisonous quality.

 

Are Gunshot Wounds Caustic?


​For the bullets, I affirm that they cannot create so much heat as to become caustic. If you shoot a bullet against a hard stone, you may pick it up without burning your hand, even though it would have gotten even hotter by striking the stone. For the combustions caused by gunpowder, I observed no remedy which might make their cure different from other combustions. To this purpose, I relate this story:

The Greasy Scullion vs The Guard: Two burns

 

One of the Marshall of Montejan’s kitchen boys accidentally fell into a caldron of oil that was almost boiling hot. When I was called to treat him, I went to the apothecary to fetch cooling medicines commonly used for burns. There happened to be an old country woman there, who overheard that I desired medicines for a burn. She persuaded me to lay a raw onion, beaten with a little salt, on the dressing, to hinder the breaking out of blisters, as she had found by frequent experience. I decided to test her medicine upon this greasy scullion. The next day I found that where I had placed the onions on his body, he was free of blisters. But the other parts which had not been touched by onions were all blistered. 

Later, a guard under the German of Montejan had his flask full of gunpowder catch fire, causing his hands and face to be grievously burnt. I used the beaten onions again, just on the middle of his face. To the rest of the burns, I laid medicines usually applied. At the second dressing, I observed the part dressed with the onions quite free from blisters and flayed skin, whereas the other part was troubled with both. Therefore, I give credit to the onions. 

Heat of Bullets


I can barely comprehend how bullets, which are commonly made of lead, are thought to attain so much heat that they would melt when shot from a musket, and yet they are so far from melting, that they will pierce through armor and a whole body and remain whole. Besides, if you shoot them against a stone wall, you can pick them up in your hand without any harm, and also without any manifest sense of heat, although their heat was rather increased when striking upon the stone, if they had any heat to begin with.

Furthermore, a bullet shot into a barrel of gunpowder should set it all on fire, if the bullet was hot by being shot, but it is not so. For if at any time the powder catches fire by such an accident, we must not imagine that it is done by the bullet bringing fire with it, but by the striking and collision thereof against some iron or stone, whence sparks of fire proceeding as from a flint, the powder is fired in a moment. The same goes for thatched houses, for they are not set alight by the bullet which is shot, but rather by linen rags, brown paper, or the like, which rogues and wicked persons fasten to their bullets. There is another thing which more confirms me further of this opinion, which is, take a bullet of wax, and keep it from the fire, for otherwise it would melt, and shoot it against an inch board. It will go through it! So you must understand that bullets cannot become so hot by shooting, nor burn like a cautery. Yes, the orifices (some may say) of such wounds are always black. This indeed is true, but it is not from the effect of heat brought thither by the bullet, but the force of the blow.

The blow is exceedingly great both because the bullet is round and because it enters the body with incredible violence. The wounded men will tell you that it felt as if a great tree, or thing of similar weight, fell upon the affected area, causing the native heat and spirits to dissipate, resulting in a gangrene. But for all these reasons as to how we know the powder is not poisonous, nor the bullet burns, there are many who insist upon philosophical arguments to raise new stirs. 

Unseasonable Air

 

In the parts of the body where the bullet meets with bones and nervous particles, it tears everything it touches into small pieces, not only where it touches, but further also, through the violence of the blow. It causes many grievous symptoms, often impossible to cure, especially in bodies filled with ill humors, or in an ill constitution of the air, such as in hot, moist and foggy weather, when it is likely to cause rot, or in the cold season, when flesh is killed from freezing. It’s difficult to treat gunshot wounds for these reasons – not because the wound is poisoned nor because of the combustion made by gunpowder. It’s due to the foulness of the patient’s body and the unseasonableness of the air.

For proof, I will tell you what I observed in a Scottish nobleman, the Earl of Gordon, Lord of Achindon, whom I cured at the appointment of the Queen mother. He was shot through both his thighs with a pistol, the bone not hurt nor touched, and on the 32nd day after the wound he was perfectly healed. Neither fever nor any other symptom came upon the wound. If you doubt, there are worthy witnesses, all of whom wondered how this gentleman was healed so quickly without acrid medicine applied.

Amongst things necessary for life, there is none that causes greater changes in us than the air; which is continually drawn into the bowels appointed by nature. And whether we sleep, wake, or whatever else we do, we continually draw it in and breathe it out. 

Through which occasion Hippocrates calls it divine, for that breathing through this mundane orb, it embraces, nourishes, defends and keeps peace all things contained in it, friendly conspiring with the stars from whom a divine virtue is infused within. The air, diversely changed and affected by the stars, does in like manner produce various changes in the lower mundane bodies. And hence it is that philosophers and physicians do so seriously with us to behold and consider the culture and habit of places, and constitution of the air, when they treat disease.

Ball-Bellows of Germany

The ball-bellows from Germany are brass, hollow, round, and have a very small hole in them where water is put in and put to the fire. The water is rarefied into air and sends forth wind with a great noise as they grow thoroughly hot. You may see the same with chestnuts which, when cast whole and undivided into a fire, fly apart with a great crack when the water and inner humidity was turned into wind by the force of the fire and forcibly broke its passage forth. The wind raised from the water by rarefaction requires a larger place than the narrow skin of the chestnut wherein it was formerly kept. Likewise, a bullet is shot from a gun because the air forces its passage out of the barrel, where the bullet lies in its way. The bullet then drives the air ahead of it with such violence that men are often sooner touched by that than by the bullet, and die by having their bones shattered and broken without any hurt on the flesh, just like a lightning strike. We also find the same in mines – when the powder is fired, it removes and shakes even mountains of earth.

Paris Explosion

In 1562, a small quantity of gunpowder caught on fire by accident in the arsenal of Paris and caused such a tempest that the whole city shook and it overturned many of the neighboring houses, shook the tiles off the roofs and broke the windows of the houses farther away. Like a storm of lightning, it laid many here and there for dead. Some lost their sight, others their hearing, and others had their limbs torn asunder as if they had been rent with wild horses. And all this was done only by agitation of the air which the gunpowder turned. Just as winds pent up in a hollow place of the earth which lack vents – in seeking passage forth, they vehemently shake the sides of the earth, and raging with a great noise about the cavities, they make all the surfaces tremble, so that by the various agitation one while up, another down, it overturns or carries it to another place. Megara and Aegina, ancient and famous cities of Greece, were swallowed up and overturned by an earthquake.

The Seasons

The great power and dominion of the air is very apparent, as you may gather by the four seasons of the year; for in summer the air being hot and dry, heats and dries out our bodies; but in winter it produces in us the effects of winters qualities, that is of cold and moisture; yet by such order and providence of nature, that although according to the varieties of seasons our bodies may be variously altered, yet shall they receive no detriment thereby, if so be that the seasons retain their seasonableness; from whence if they happen to digress, they raise and stir up great perturbations both in our bodies and minds; whose malice we can scarce shun, because they encompass us on every hand, and by the law of nature enter together with the air into the secret cabinets of our bodies both by occult and manifest passages. For who is he, that does not by experience find both for the commodity and discommodity of his health, the various effects of winds (what the air is mixed with) according as they blow from this or that region, or quarter of the world. Wherefore seeing that the south wind is hot and moist; the north wind cold and dry; the east wind clear and fresh; the west wind cloudy; it is no doubt but that the air which we draw in by inspiration carries together into the bowels the qualities of that wind which is then prevalent.

The Winds

Hippocrates  wrote that different winds bring different diseases. Northern winds strengthen our bodies and makes them active and daring by invigorating the native heat. Southern winds moisten our bodies, making us heavy-headed, dull of hearing, dizzy, and less agile. The inhabitants of Narbonne, a seaside town in Southern France, finds this to their great harm, when they are otherwise ranked among the most active people in France. 

By Hippocrates degree, droughts are healthier and less deadly than rains. Too much humidity is the mother of putrefaction, as you can see from the countries which are blown upon by a wind from sea. Butchered flesh putrefies in the space of an hour, and ulcers that heal quickly and easily in other parts of the country become stubborn and difficult to cure. Therefore, when the seasons of the year successively are agreeable to their nature, and when each season is seasonable, then either we are not sick at all, or assuredly with less danger. So on the contrary, the perfect constitution and health of our bodies becomes worse and decays when the seasons of the year are depraved and perverted in time and temper.

The Last Few Years


Now seeing that these many years the four seasons of the year have lacked their seasonableness, the summer lacking his usual heat, and the winter its cold, and all things by moisture and the dominion of the southern winds have been humid and languid, I think there is none so ignorant in natural philosophy and astrology who will not think that the causes of the malignity and contumacy of those diseases which have so long afflicted all France are not to be attributed to the air and heavens. For otherwise why else have so many pestilent and contagious diseases tyrannized so many people of every age, sex and condition? Why else do so many people have colds, coughs, heaviness of the head, lung disease, tumors, small pox, measles, and itches not responding to diet and remedies prescribed by medicine? Why else do we have so many venomous creatures like toads, grasshoppers, caterpillars, spiders, wasps, hornets, beetles, snails, vipers, snakes, lizards, scorpions, and newts, unless from excessive putrefaction which the humidity of the air, our native heat being liquid and dull, has caused in us, and the whole kingdom of France? Hence also proceeds the infirmity of our native heat, and the corruption of the blood and humor of which we consist, which the rainy southwind has caused with its sultry heat.

Why else in these last years have I drawn little blood which hasn’t presently shown the corruption of its substance by the black or greenish color as I have diligently observed in all such as I have bled, by the direction of physicians either for prevention of future or cure of present diseases? The fleshy substance of our bodies could not but be faulty both in temper and consistency, seeing that the blood from which it is generated had drawn the seeds of corruption from the defiled air. Because of this, the wounds which happened with loss of substance, could be scarcely healed or united, because of the depraved nature of the blood. The wounds and ulcers of those who are troubled with the dropsy, whose blood is more cold or wholly watery; so of leprous persons, whose blood is corrupt and lastly of all such as have their bodies full with ill juice will not easily be cured. Yes, assuredly, if the very part which is hurt swerves from its native temper, the wound will not easily be cured.

Therefore seeing all these things, both the putrefaction of the air and depraved humors of the body, and also the distemper of the affected parts conspired together to the destruction of the wounded, what marvel was it, if in these late civil wars, the wounds which were for their quantity small, for the condition of the wounded parts but little have caused so many and grievous accidents and lastly death itself? Especially seeing that the air which encompasses us is tainted with putrefaction and corrupts and defiles the wounds by inspiration and expiration, the body and humors being already disposed, or inclined to rot.

 

Once, there came such a stink (a sure sign of rot) from these wounds that even when they were dressed, anyone standing nearby could hardly endure it. Noblemen as well as common soldiers would suffer this rotten smell. The corruption was so bad that if they went undressed for one day, which sometimes happened amongst such a multitude of wounded persons, the next day the wound would be full of worms. In addition – and this shows it was due to rotten humors – many had abscesses in parts opposite to their wounds. For example, an abscess in the left knee, when the right shoulder was wounded, or an abscess in the left arm, when the right leg was hurt. This was the case for the King of Navarre, the Duke of Nevers, the Lord Rendan and many others. For all men had such an abundance of vicious humors, that if it wasn’t expelled through the abscesses, it traveled to other parts of the body. 

In dissected dead bodies, we observed that the spleen, liver, lungs, and other organs in the abdomen were full of pus. The patients continually suffered from fevers because of this moisture being sent from the organs to the heart. They suffered because the liver and veins were so polluted with pus that good blood couldn’t be generated, so they lacked proper nourishment. And when the brain was affected by these excess fluids, the patients had ravings and convulsions.

Divine Justice

If a remedy is unsuccessful in terrible wounds, the surgeon cannot be blamed because it is a crime to fight against God and the air, in which the hidden whips of divine justice lie hidden. When we follow the commands of the great Hippocrates, and we have not only obliged, but added other medicines as well, and we still fail to cure them because of these rots, gangrenes and dead flesh that come about from the corrupt air, at some point there is just nothing more we can do but remove ourselves.



I. The Variety of Gunshot Wounds

All wounds made in man’s body by gunshot, whether simple or compound, are accompanied with bruising, tearing, illness and swelling. All these happen in either the noble or ignoble parts, the fleshy, nervous or bony, and sometimes tearing asunder the larger vessels, but sometimes without harming them. These wounds are either superficial, or pierce deep and pass through the body.
Consider the variety of the bullets themselves. Some bullets are bigger, some smaller, some in between. They are usually made of lead, yet sometimes they’re made of steel, iron, brass, or tin. Rarely, they are made of silver, and even more rare are bullets made of gold. Almost all of them are round. The surgeon must make his diagnosis about what to do and what medicines to apply. The first care must be that he does not mistake these horrid symptoms to arise from combustion or poison. Rather, he should judge they proceed from the vehemence of the contusion, tearing and fracture caused by the bullet’s violent entry into the nervous and bony bodies. When the bullet only strikes upon the fleshy parts, the wound will be cured as easily as any other wound that occurred from a bruising and round weapon. 

II. Signs a Wound is Made by Gunshot

Wounds made by gunshot are known by their shape (usually round), by their color (after the original color decays it leaves behind a livid, greenish, violet or other color), by the feeling or sense of the stroke (when in the very instant of the receiving thereof, he feels a heavy sense as if some great stone, or piece of timber, or some such other weighty thing had fallen upon it), by the small quantity of blood which issues out of it (when the parts are bruised, a little while after the impact, they swell up so much that they will scarcely admit a tent), by heat (which happens either by the violence of the motion or the vehement impulsion of the air), or the attrition of the bruised flesh and nerves.

You may also guess that the wound is made by gunshot if the bones are broken and the bone splinters are pricking the neighboring bodies, causing inflammation. The reason the bullet makes such a big bruise is that it enters the body with its round and spherical body, which cannot penetrate but with mighty force. So the wound looks black, and the adjacent parts purple. Hence also proceeds many grievous symptoms, such as pain, inflammation, abscess, convulsion, frenzy, palsy, gangrene, and dying flesh, until at last death ensues. The wounds often cast forth virulent and stinking filth due to the great bruising and the tearing of the neighboring particles. A great abundance of humors flow from the whole body and fall down upon the affected parts of which the native heat, being diminished, forsakes and presently an unnatural heat seizes upon it. Hither also tend a universal or particular repletion of ill humors, chiefly if the wounds possess the nervous parts of the joints. Verily neither a stag with his horn, nor a flint out of a sling can give so great a blow, or make so large a wound, as a leaden or iron bullet shot out of a gun, as that which going with mighty violence, pierces the body like a thunderbolt.

III. How these wounds must be treated at the first dressing

The wound must immediately be enlarged, unless the condition of the part resists that, so there may be free passage forth for the matter and things contained within, such as pieces of their clothes, bombast, linen, paper, pieces of mail or armor, bullets, hail-shot, splinters of bones, bruised flesh, etc, all which must be plucked forth with as much celerity and gentleness as may be. Just after receiving the wound, the pain and inflammation are not as bad as they will be a short time later.


This is the principal thing in performance of this work: that you place the patient in the exact posture as he was in at the receiving of the wound, for otherwise the various motion and turning of the muscles will hinder the passage forth of the contained matter. Search for the matter with your fingers, so you may the more certainly and exactly perceive them. If the bullet is somewhat deep inside, then search for it with a round and blunt probe, lest you put the patient to pain, but it’s unlikely you’ll find the bullet this way.


As it happened to the marshall of Brissac, in the siege of Parpignan, who was wounded in his right shoulder with a bullet, which the surgeons thought entered his body. But I told the patient to stand exactly the same way as he did when he received the wound, and I found at length the place where the bullet lay, by gently pressing with my fingers the parts near the wound, and the rest which I suspected, as also by the swelling, hardness, pain and blackness of the part, which was in the lower part of the shoulder near unto the eight or ninth spondill of the back. Because the bullet was taken out by making an incision in that place, the wound was quickly healed and the gentleman recovered. Believe the judgment of your fingers over that of your probe.

IV. A description of instruments to extract bullets and other strange bodies

The size and shape of instruments for extracting bullets and other matter are varied according to the occasion. Some are toothed, others smooth, others of another shape and size, and many of all sorts which the surgeon must have at the ready, that he may fit them to the bodies and wounds, and not the wounds and bodies to his instruments.

The straight cranes-bill, being serrated, is good for pulling out hail-shot, pieces of armor, splinters of bones, and such things that lie deeper within.

A. The trunk

B. The rod (or string) which opens and shuts the joint

C. The joint

 

Another catch-bullet called a Lizard-nose, made for extracting bullets which are somewhat flattened from striking bone.

Lizard-nose

Parrots-beak

The Parrots-beak is made for extracting pieces of mail thrust into the flesh or bones.

A. The screw pin

B. The hollowed part which receives the round part noted with C

C. Which is opened and shut by the screw

D. Falls or stays, which governs the running branch

Swans-bill

The swans bill opens with a screw: you may dilate the wound and put in a straight crane-bill as pincers to pluck forth strange bodies.

 

If the strange bodies, especially bullets and hailshot, are not too deep in the wound, they may be taken out with your lavatory, or these gimblets. These gimblets are screwed into their pipes, or cane, and enter with their screwed points into the bullets, if they are of lead or tin, and of no harder metal; and so being fastened in them, bring them out with them.

Gimblet with its pipe, or cane.

Besides the swan-bill which we mentioned, there are also other instruments suitable to dilate and open the wounds, called dilaters, who help hold the wound open so the hidden bodies may be seen; when you press together the two ends of this instrument, the other two ends open and dilate themselves. You may also use them in dilating many other parts of the body, such as the nostrils and anus.

Dilaters.

 

The following instruments are called seton needles, or probes, whose use is to draw through a flamula to keep the wound open, so you may more easily take out any strange matter. We use the same needles to determine the deepness of wounds and find bullets. They don’t cause too much pain because they have smooth and round ends. Likewise, all probes we use to search for bullets must have somewhat large, smooth, and round ends. Seeing that the verges of the wound meet together presently after the hurt, if the probes are too small or slender, they will stick in the inequality of the flesh, nor will they be able to find the bullet. But if they’re sharp and pointed, they will renew the pain by pricking the flesh they melt withall, and so hinder your intention of finding the bullet. You must be furnished with several different lengths of these instruments to accommodate the various thicknesses of the wounded body parts, for you can’t use a short one for a thigh wound.

Probes for putting flammulas through a wound

V. The first dressing after the strange bodies are extracted from the wound

After the strange matter is plucked out of the wound, the main objective is to heal the bruise and amend the distemper of the air. If the air is hot and moist, which makes the wound likely to rot, give medicines taken inwardly, applied outwardly, and injected into the wound.
Things to be ingested are diet and pharmacy, which I leave to the judgment of educated physicians.
For topical medicines, depending on the present constitution of the air, the condition of the wounded part, or from some other cause there be danger of a gangrene, use suppuratives, as typical for bruises. For this, use the Puppy Oil and an ointment. You must avoid suppuratives if the wounded part is of a nervous nature. All nervous parts require dryer medicines, so for wounds of the joints and nervous parts you shall use venice turpentine instead of oil.
Laurentius Jobertus, the King’s physician and secretary at the University of Mompelier, wrote about wounds made by gunshot, forbidding the use of escharotics, both actual and potential, because they induce pain, inflammation, a fever, gangrene, and other deadly symptoms. In addition, an eschar will hinder pus, which is to be desired in these kinds of wounds, sever the bruised flesh from the healthy flesh, lest it also rots by contagion, which easily happens when a scab is drawn as a bar over it, because then the excrementitious humor remains longer in the wound, and the putrid vapors are hindered from draining, so they grow  and spread over the whole body. And that’s why when you suspect rot, first use this following ointment:

Powdered Red Alum ointment

Rx. pulver. alumin. rocha, viridisaris, vitrioli romani, mellis rosat, an.ij aceti boni quantum sufficit, bulliant omnia simul secundum artem, & fiat medicamentum ad formam mellis

 

Rx. powdered red aluminum, verdigris, roman vitriol, honey of roses, 2 drachms (¼ ounce), sufficient amount of vinegar, boil it all together, give the medicine in the form of honey.

 

This will thin the humors due to the heat and subtlety of the substance, and also calls forth the native heat drawn in and dissipated by the violent and forcible entrance of the bullet into the body. It also corrects the venomous contagion of the toxic humor. 

 

Dissolve this medicine in vinegar or aqua vita, and put it into the wound using tents or pledgets. The tents used at the first dressing must be somewhat long and thick so that they dilate the wound, making space for applying other remedies. Otherwise, you may make an injection with a syringe, so that it may penetrate more powerfully. But this described Egyptiacum shall be tempered according to the condition of the affected parts, for the nervous parts will be offended with it as being too acrid, but it may be qualified by a mixture of turpentine oil and St. John’s wort. We may well be without this Egyptiacum when there is no pestilent constitution of the air, as was seen in the last civil wars. After using the Egyptiacum, procure the falling away of scabs using emollients and softeners. Use this following oil, somewhat hot: 

Kitten Oil

Rx. Olei violati lib. iiij. in quibus coquantur catells duo nuper nati, usque ad dissolutionem of sium, addendo vermium terrestrium, ut decet preparatorum, pound . J. coqnantur simul lento igne, deinde fiat expressio ad usum, addendo terebinth, venet, ℥ iij, aqua vita. 1oz.

 

Rx: put two newly born kittens in 4 pounds of boiling oil until they dissolve. Add earthworms as befits the preparations, 1 pound. boil together over a slow fire, adding turpentine, venet, 3oz. alcohol, 1oz.

 

This oil has a wonderful force to assuage pain, to bring the wound to suppuration and cause the falling away of the eschar. This ensuing oil is made more easily:

 

 Rx. olei feminis lini & lilior. an. ℥iij. unguent, basilic. Lique fiant simul & fiat medicamentum; 

 

Rx: oil for women, flax and lily. 3 ounces. An ointment, basil. Let them be made into a liquid at the same time, and let them be a medicine

 

Put a sufficient quantity into the wound; applied hot, this will assuage pain, to soften and humect the orifice of the wound, and help suppuration, which is the true manner of curing these kind of wounds, according to the rule of Hippocrates, which wishes every contused wound to be presently brought to suppuration, for so it will be less subject to a phlegm; and besides, all the rest and bruised flesh must putrify, dissolve and turn to quitture, so that new and good flesh may be generated instead.

Laurentius Jobertus much commends this following medicine, of whose efficacy, as yet, I have made no trial:

 

Powdered Mercury Remedy

 

Rx. pulver, mercur, bis calcinati, ℥j, adipis porcirecentis, vel butyrirecentis, ℥viij. camphora in aqua vita dissolute, ʒij. misce omnia simul, addende tantillum olci litiorum, ant lini. 

 

Rx powdered mercury, twice calcined, 1oz. pork fat or butter, 8oz, camphor dissolved in water, 2 drachms. Mix everything together, adding a little bit of olive oil.

 

This kind of remedy is very commendable. Mixing the powder of mercury with a thick and moist matter turns bruised flesh into pus without causing great pain. For the camphor, whether it’s hot or cold, much conduces to that purpose, because of the subtlety of the parts of which it consists. Made in this way, the medicine will enter into the affected bodies more easily, and camphor resists putrefaction. 

 

Some drop alcohol mixed with calcined vitriol into the wound. This kind of remedy doesn’t cause pus, but resists putrefaction, so use it when the weather is hot, moist and foggy. When the wound is fresh, it will be burnt by the flame of the powder; in which case use remedies for burns as well as remedies for contusions. 

 

For the parts next to the wound, do not, except at the first dressing, apply refrigerating and astringent things, but rather emollient and pus-inducing. Those things which have a refrigerating faculty weaken the part and hinder suppuration. Astringents constipate the skin, which is why putride vapors are shut up and hindered from airing out, so a gangrene and mortification easily seizes upon the part. If the contusion is large, the part must be much scarified so the contused and stagnant blood, which is subject to putrefaction, may be evacuated. 

 

For the parts which are somewhat distant from the wound, apply refrigerating and strengthening medicines so their humors don’t fall down and settle into the bruise, such as: 

 

Refrigerating and Strengthening Medicine:

 

Rx. Pul boli, armen, sanguin dracon. myrrha. an ℥j succi solan. sempervivi, portulac. An ℥iB, album iiij. ovorum. oxyrhodin, quantum sufficit, fiat linimentum, ut decet

 

Rx: powdered bolus armen, Dragon’s Blood, myrrh, one ounce fruit juice, house-leek, purslane, half-ounce, white, 4, egg, oxyrhodin, as much as will suffice, let it be made into a thin ointment as it should be.

 

You may use this until the suspected symptom is past fear. Neither must you have less care of binding up and rolling the part, than of your medicines; for it does not a little conduce to the cure, to bind it so fitly up as it may be without pain. The wound at the beginning of the cure must only be dressed once in 24 hours, that is, until the wound come to suppuration; but when the quitture begins to flow from it, and consequently the pain and fever are increased, it shall be dressed twice a day, or every twelve hours. And when the quitture flows more abundantly than usual, so the collection thereof is very troublesome to the patient, it will be requisite to dress it every 8 hours, or thrice a day. Now when this abundant efflux is somewhat flaked, and begins to decrease, it will suffice to dress it twice a day. When the ulcer is filled with flesh and consequently casts forth but little matter, it will serve to dress it once a day, as you did at first.

VI. How you shall order it at the second dressing.

Only put some of the oils formerly described, and egg yolk, and saffron, into the wound on the second dressing and thereafter. Do that until the wound comes to pus. Note that these kinds of wounds take longer to pus than other wounds made by any other sort of weapon. It’s because of the bullet as well as the air which is carried with it, much bruising of the flesh, dissipation of the native heat, and the spirits of the part are exhausted. Such things hinder digestion and often cause the matter to stink, as also many other pernicious symptoms. Yet most usually pus within three or four days, depending on the patient’s complexion and temperament of their bodies and the condition of the ambient air in heat and cold. 

Then add detersives little by little, adding to the former medicine some turpentine washed in rose, barley, or some other similar water, which may wash away the biting thereof. If the encompassing air is very cold, you may add some aqua vita. By Galen’s prescript, use hot medicines in winter, and less hot in summer. Then use detersives such as:

3 Recipes for Detersives

1

Rx. aqua decoctionis hordei quantum sufficit, succi plantaginis, appij, agrimon. Centaurei minoris an ℥j, bulliant omnia simul; in fine decoctionis adde terebinthina veneta ℥iij. mellis rosat. ℥ij. Farin hordei, ʒiij. croci ℈j. 

 

Ingredients

Barley-water, as much as sufficient

juice of plantain, appij (2 app.)

common agrimony

gentiana centaurium, 1oz. 

Boil it all together and add:

Venice turpentine, 3oz, 

honey of roses, 3oz. 

Barley meal, 3 drachms. 

Saffron, One scruple.

 

Boil the barley-water, plantain juice, agrimony, and centaurium together. Then add the turpentine, rose honey, barley meal, and saffron. Mix it all together to make a smooth mundificative.

 

Or 

2

Rx. succi clymeni, plantag. absinth. appij, an. ℥ij. tereb. venet. ℥4. syrup. absinthe. & mellis ros. an. ℥ij bulliant omnia secundum artem, postea colentur, in colatura adde pulver. aloes, mastiches, Ireos Florent. far. hord. an.ʒj. fiat Mundificatiuum ad usum dictum. 

 

Ingredients

juice of clymeni, 

plantain, 

absynth. appij an. 2oz. 

Venice Turpentine. 4 ounces. 

Syrup absinthe 

honey of roses. 2oz. 

powdered aloe, 

resin of the Lentiscus, 

ireos florent. 

Barley meal One drachm. 

 

Boil the clymeni juice, plantain, absinthe, turpentine, syrup absinthe, and rose honey together. Strain. Add powdered aloe, resin of the lentiscus, oreos florent, and barley meal. Let it be made for use.

 

Or else

3

Rx. terebinth. venet. lotae in aq. ros. ℥v. olei ros. ℥j. mellis ros. ℥ij. myrrha, aloes, mastich. aristoloch. rotunde, an. ʒiß. far. bord, ʒiij. misce.

 

Ingredients

Venice turpentine, 

lime in rose water? 5oz. 

Oil of roses, 1oz. 

Honey of roses, 2oz. 

Myrrh, 

aloe, 

resin of Lentiscus, 

Moschatellina, half a drachm,

barley-meal 3 drachms. 

 

Mix ingredients together to make a mundificative, which you may put into the wound with tents, but such as are neither too long, nor thick, lest they hinder the evacuation of pus and vapors, whence the wounded part will be troubled with erosion, pain, defluxion, inflammation, abscess, putrefaction, all which severally of themselves, as also by infecting the noble parts, are troublesome both to the part affected, and to the whole body. 

 

Only put small, smooth tents into the wound, lest you block the passing forth of the matter or cause pain by pressing on the wound. 

 

Since tents are used both to keep a wound open until all the strange bodies are taken out as well as to carry medicines into it, they are anointed even to the bottom of the wound. If the wound is too sinuous and deep for the medicine to be carried to it by those means, you must do your business by injections made of the following decoction:

 

Barley-water recipe

Rx. aq. hord. lib. 4. agrimon. centaur. minor. pimpinelle, absinth. plantag. an.M.ß.rad.aristoloch.rotund.ʒß. fiat decoctio ad lib. J. in colatura expressa dissolve aloes hepatica ʒiij. mellis ros. 3ij. bulliant modicum.

 

Ingredients:

Barley-water 4 pounds

Common agrimony, 

salad burnet, 

absinthe, 

plantain, half a handful, 

moschatellina, half a drachm, 

aloes hepatica 3 drachms, 

honey of roses 2 ounces, 

 

Make a one pound decoction of the barley-water, agrimony, salad burnet, absinthe, plantain, and moschatellina. Strain. Then dissolve aloes, rose honey into it. Boil moderately.

 

Inject some of this decoction 3-4 times into the wound, as often as you dress the patient, and if this isn’t sufficient to cleanse the filth and flush the spongious, putrid, and dead flesh, dissolve therein as much Egyptiacum as is fit for the present necessity, usually an ounce of Egyptiacum dissolved in a pint of the decoction. 

 

Egyptiacum powerfully consumes the proud flesh which lies in the capacity of the wound; it only works upon such kind of flesh. I have also tried powdered mercury and burnt alome mixed equally together, and found them very powerful, almost like sublimate or arsenic, but these cause less pain. I wonder at the large size of the scab which arises by the aspersio of these powders. Many practitioners would have a great quantity of the injection to be left in the cavities of sinuous ulcers or wound, which I could never allow. 

 

The contained humor causes an unnatural tension in these parts, and taints them with superfluous moisture, hindering the regeneration of flesh; because every ulcer requires to be dried, in Hippocrates opinion. Many also mistakenly use too many tents, because when they are changed every hour, they touch the sides of the wound, cause pain, and causing the ulcers to cast forth an abundance of matter. They should be dressed with hollow tents like those for wounds of the chest. Press a linen bolster to the bottom of the wound as well, so the parts themselves may be mutually condensed by that pressure and the quitture thrust forth. It will neither be amiss to let this bolster have a large hole fitted to the orifice of the wound and end of the hollow tent and pipe, so you may apply a sponge to receive the pus, for the matter will be more speedily evacuated and spent, especially if it is bound up with an expulsive ligature, beginning at the bottom of the ulcer, and wrapping it up to the top. 

 

All the bolsters and rollers which are applied to these kinds of wounds shall be dipped in oxycrate, or red wine, to strengthen the part and hinder defluxion. Take special care not to bind the wound too hard, for that will cause pain and hinder the passage forth of the putrid vapors and excrements which the contused flesh casts forth. A tight binding will also create an atrophia or lack of nourishment because the alimentary juices will be blocked from entering.

VII. How to remove strange bodies left in at the first dressing

It often happens that splinters of bones, broken and shattered asunder by the violence of the shot, cannot be pulled out at the first dressing, for they either do not yield or cannot be found. This is an approved medicine to draw forth that which is left behind:

2 Recipes

1

Rx. radic. Ireos Florent. panac. & cappar. an. ʒiij.aristoloch.rotund.mannae,thuris. an. ʒj.in pollinem redacta incorporentur cum melle rosar. & terebinth.venet.an.3ij. 

 

Ingredients:

root of Ireos Florentina, 

panac & cappar, 3 drachms, 

Moschatellina, 

bark of the Elathera of Catesby; one drachm, 

the reduced pollen should be incorporated with 

rose-honey and 

Venice turpentine, 2 drachms.

 

Mix the root, panac & cappar, moschatellina and bark together, then add rose honey and turpentine.

 

Or

 

2

Rx. resin.pini sicca 3iij. pumicis combust & extincti in vino albo, radic. Ireos, aristolochia, an. ʒB. Thuris ʒj squama aris, ʒij. In pollinum redigantur, incorporentur cum melle rosato, fiat medicamentum.

 

Ingredients

Resin of dry pines, 3 drachms

pumice 

white wine

Root of ireos, 

aristolochia, half a drachm. 

Musk-wood, one drachm. 

Dried scales, 2 drachms. 

rose honey

 

Burn the resin of dry pines with pumice. Extinguish with white wine. Add root of ireos, aristolochia, musk-wood, dried scales and reduce to a pollen. Add rose honey to complete the medicine.

VIII. Indications to be observed in these kinds of wounds.

After you have cleansed and purged the ulcer and removed all strange bodies, nature endeavors to regenerate and cicatrize flesh, but it must be helped with remedies both ingested and applied topically. Galen says that you must observe the context of the wound to understand the indications, or signs, you see. Notice how it began, how it progressed, its current state, and its decline. Each of these four stages require certain remedies. Also note the temperament of the patient – no surgeon doubts that some medicines are fit for choleric, others for phlegmatic bodies. 

 

Note the patient’s age and diet as well. Do not prescribe a slender diet to one who is accustomed to constantly feeding, nor a large diet to someone who is accustomed to eating only once or twice a day. Furthermore, consider the culture: a diet consisting only of boiled bread is more fit for Italians than for French men. When prescribing the diet, the patient’s vocations and daily exercises must be taken into consideration as well. Things that befit husbandmen and laborers, whose flesh is dense and skin hardened by much labor, are different than things fit for idle and delicate persons. 

 

But above all else, have diligent regard of the signs of the strength of the patient; for if nothing else, we must presently succor the fainting or decaying strength, in case it is necessary to cut off a member that is rotten, the operation must be deferred if the strength of the patient be so dejected that he cannot have it performed without manifest danger of his life. 

 

You may draw indications from the encompassing air, including the season of the year, region, the state of the air and soil, and the particular condition of the present and lately by past time. Hence it is we read in Guy de Chauliac that wounds of the head are cured with far more difficulty in Paris than in Avignon, yet the wounds of the legs are cured with more trouble in Avignon than Paris. The air is cold and moist at Paris, which is hurtful to the brain and head, but the heat of the ambient air at Avignon attenuates and dissolves the humors, making them flow from above down. But anyone who has contradicting experience to this might say that wounds of the head are more frequently deadly in hot countries. Let him understand that this must not be attributed to the manifest and natural heat of the air, but to a certain malign and poisonous humor, or vapor, dispersed through the air and raised out of the seas, as you may easily observe in those places of France and Italy which border upon the mediterranean sea. 

 

Note also the peculiar temper of the wounded parts: the muscular parts must be dressed in one way and the bony parts in another. The different sense of the parts requires different remedies; do not apply acrid medicines to the nerves and tendons like you do to the ligaments, which are destitute of sense. Similarly, for the function of the parts necessary for the preserving life, for example, wounds of the brain, divert the whole manner of the cure. Neither that without good cause, for oft times from the condition of the parts, we may certainly pronounce the whole success of the disease, for wounds which penetrate into the ventricles of the brain, into the heart, the large vessels, the chest, the nervous part of the midriff, the liver, ventricle, small guts, bladder, if somewhat large are deadly; as also these which light upon a joint in a body replete with ill humors, as we have formerly noted. 

 

Neither must you neglect that indication which is drawn from the situation of the part, and the commerce it has with the adjacent parts, or from the figure thereof; seeing that Galen himself would not neglect it. We must consider whether there is a complication of the diseases, because if there is one and it’s a simple indication of just one and that simple disease, then the indication must be various of a compound and complicate disease. But there is observed to be a triple composition, or complication of affects besides nature; for either a disease is compounded with a disease, as a wound, or a phlegmon with a fracture of a bone; or a disease with a cause as an ulcer with a defluxion or a disease with a symptom as a wound with pain or bleeding. It sometimes comes to pass that these three, the disease cause and symptom concur in one case or effect. In artificially handling of which we must follow Galen’s counsel, who wishes in complicated and compounded affects, that we resist the more urgent, then let us withstand the cause of the disease and lastly that affect without which the rest cannot be cured.


His counsel must be observed, for in this composure of affects which distracts the charlatan; but on the contrary the rational physician has a way prescribed in a few and these excellent words, which if he follows in his order of cure, he can scarcely miss to heal the patient. Symptoms truly as they are symptoms yield no indication of curing neither change the order of the cure, for when the disease is healed, the symptom vanishes, as that which follows the disease, as a shadow follows the body. But symptoms do oftentimes so urge and press, that perverting the whole order of the cure, we are forced to resist them in the first place as those which would otherwise increase the disease. Now all the formerly mentioned indications may be drawn to two heads; the first is to restore the part to its native temper; the other is that the blood offend neither in quantity or quality, for when those two are present, there is nothing which may hinder the repletion, nor union of wounds or ulcers.

IX. What remains for the surgeon to do in these kinds of wounds.

The surgeon must first of all assuage pain, hinder defluxions, and prescribe a diet forbidding the use of hot and acrid things and wine. At first, let his diet be slender so the course of the humors will divert from the affected part towards the stomach, since an empty stomach draws humors to it.

 

Sex is very wicked because it inflames the spirits and humors far beyond other motions, carrying the humors, waxing hot, to the wounded and overheated part in large amounts. 

 

The bleeding must not be staunched immediately upon the receiving of the wound, because the more plentiful outflow of blood from the wounded part frees it from danger of inflammation and swelling. If the wound doesn’t bleed sufficiently at first, open a vein the next day and take blood according to the strength of the patient; for there usually flows no great store of blood from wounds of this nature; because the greatness of the contusion and vehemency of the moved air, forces the spirits in, as also I have observed in those who have one of their limbs taken away with a cannonball. For in the time when the wound is received, there flows no great quantity of blood, although there be large veins and arteries torn asunder thereby. But on the 4th, 5th, 6th, or some more days after, the blood flows in greater abundance, and with more violence, the native heat and spirits returning into the part. 

 

The belly must have such a quality that he may have at the least one stool a day, either by nature or art. If by art, then with an enema rather than purging medicines taken by the mouth, because the agitation of humors, chiefly in the first days of the disease, is to be suspected, lest we increase the defluxion falling down upon the wounded part. Yet Galen writes that both the evacuations are here necessary, that is, blood-letting and purging, though the patient is neither plethoric nor full of ill humors. But the care hereof must be committed to the judgment of the learned physician. 

 

Pain if joined with inflammation shall be mitigated by anointing the parts near unto the wound with unguent nutritum, composed with the juice of plantain, house-leek, nightshade, etc. Unguentum diacalcitheos described by Galen dissolved with vinegar, oil of poppies and roses is of no less efficacy; nor unguent, de bolo nor many other things of the same faculty, though properly no anodynes, as those which are not hot and moist in the first degree, but rather cold, but yet not so as to have any narcotic faculty. Now these forementioned things assuage pain for that they correct the hot distemper, and stay the acrid and choleric defluxions, whose violence is more than cold. After the use of repercussives, it will be good to apply this following cataplasm. 

Recipe

 

Rx. Mica panis infuse in lacte vaccino ꝉꝧ.j.ẞ. bulliant parum addendo olei violacei & rosar. an. ℥iij. vitellos ovoram nu. iiij. pulver. rosar. rub flor. chamem. & meliloti, an ℥ij farin. fabar. & hordei, an ℥j. misce , fiat cataplasma secundum artem

 

Ingredients

½ pound bread crumbs infused in milk

3oz Oil of violets and roses

4 Fetal calves

2oz Powdered rose….chamomile, honeydew

1oz Barley meal

 

Boil the bread crumbs in milk then add the oil of violets and roses. Add the fetal calves, powdered rose, and barley. Mix. Make a poultice according to art.

 

You may also easily make a medicine of bread crumbs boiled in oxycrate and oil of roses. The cure of tumors, if any associate the wound, may be found in their proper place. Nature’s motion, whether to suppuration, or any such thing, must still be observed, and helped by the physician and surgeon, as the ministers or servants thereof.

X. Bullets which remain in the body for a long time after the wound is healed up.

Leaden bullets lie in some parts of the body somewhiles seven, eight, or more years, so that they neither hinder the agglutination of the wound, neither do any other symptom, happen thereupon, as I have many times observed; until at length by the strength of nature forcing them, and their proper weightiness bearing them down, they show themselves in some lower part, by their swelling or bunching forth, and so must be taken forth by the hand of the surgeon. For they say lead has a certain sympathy and familiarity with man’s body, chiefly the fleshy parts. Wherefore it neither rots itself, nor causes the flesh to rot, besides it has an excellent faculty in cicatrizing old ulcers. 

But bullets of stone, iron and of any other metal are of another nature for they can’t remain any long time in the body without hurt; for iron will grow rusty, and so corrode the neighboring bodies and bring other maligne symptoms. Yet a lead bullet can’t remain any long time in nervous parts without danger.

XI. How to correct the constitution of the air, so that the noble parts may be strengthened and the whole body besides.

There are times when even small wounds made by gunshot prove deadly, not by their own fault but by the fault of the air. The surgeon must correct the air with all diligence and reduce it to a certain quality to strengthen the head and the whole body, which may be performed by the following medicines which are to be taken inwardly and applied outwardly:

9 Recipes

 

Rx. Diarhodon abhatis, aromaticum rosatum, treasantalon, biamoschum, or laetificans galeni, etc.

Astringent powder, rose oil, [unknowns], etc.

taken 3 hours before meat in the morning

 

Apply some such epitheme as here described to the heart and liver:

 

Rx. aqua rosar. ℥iiij, aquabuglossae, aceti boni, an.℥ij. coriandri praparati ℥ẞ. caryophill. Cortic. Citri an ʒj. Sant. rub. ʒẞ. Coralli utriusqne ʒẞ. camphora ℈j. croci ℈ẞ. pulver. diarhod. Abbat. ʒij theriace & mithridaty an ℥ẞ. Pul. flo. Chamem & melil. an. ʒiij. misce, fiat epithema. 

Ingredients:

4oz rose water

2oz aquabuglossae, good vinegar, 

½oz prepared coriander 

1 drachm caryophill. Cortic citric 

½ drachm Sant. rub. 

½ drachm coralli utriusqne 

1 scruple Camphor 

½ scruple Saffron

2 drachms Powdered diarhodon abhatis 

½ oz Theriace & mithridaty 

3 drachms Powdered …flower of chamomile? And honey


Mix all together and dip a scarlet cloth in it, and apply it, warm.

Frequently put odorifferous and refrigerating things to the patient’s nose to strengthen the animal faculty, as:

 

Rx. aqua rosar & aceti boni. an. ℥iij. caryophyllorum, nucis moschat, cinamomi conquassatorum & Theriacae Galeni, an. ʒj. 

Ingredients:

3oz rose water and vinegar,

1 drachm clove, nutmeg, crushed cinnamon & Galen’s anti-venom


Dip a linen rag in this and every now and then put it to the patient’s nose. 

He shall also carry this pomander with him and smell it often: 

Rx. ros. rub. violar. an. ʒiij. baccarum myrti, juniperi, santal. rub. an. ʒijẞ. styracis calamit. ʒij. aq. rosarum, quantum satis est:lique fiat simulcum cerae alba quod sufficit, fiat ceratum ad comprehendendos supradictos pulvers cum pirisillo? calido, & ducutur in pomum.

Ingredients:

3 drachms red roses violar

1 drachm boiled juniper berries and red saunders

2 drechms dry storax

Rose water, as needed

Liquid white wax

Powdered parsley

Or

Rx. rad. Ireos Florent. majoran. calam. aromat. ladani, benzoini, rad. cyperi, caryophll. an. ʒij. Moschi, gra.4. Fiat pulvis cum gummi tragacanth.quod sufficit. 

Ingredients:

Orris root

….

Make a powder…sufficient amount

Or else

Rx. ladani puri ℥i. Benzoini ℥ẞ, styracis calamit. ʒvj. ireos Flor. ℥ẞ caryophylli ʒiij. majoran. ros. rub. calami aromat. an. ʒẞ, in pollinem redigantur omnia, & bulliant cum aqua ros. quantum sufficit; colentur, colata liquesiant cum justa cerae albae quantitate, styracis liquide, ℥j, fiat ad modum cerati, & cum pistillo fiat pomum, addita moschi ʒj.

1oz Pure laudanum (a sweet, purple-brown rosin)

½ oz Benzoin (a sweet, brown rosin)

6 drachms Storax

½ oz Iris

3 drachms Cloves

1oz Liquid storax

1 drachm Musk

 

[translation coming]

You may also corroborate the animal faculty by application of frontals, induce sleep, and ease the pain of the head, with: 

Rx. aq. ros ℥ij. olei ros. & papav.an.℥iẞ. aceti boni, ℥j. trochis. de camphora, ʒẞ. fiat frontale.

2oz rose-water

½ of 1 oz rose oil and opium

1oz Good Vinegar

½ drachm Camphor

 

Make as a frontale

Linen rags dipped in it may be applied to the temples of the forehead, and often renewed; otherwise by their heat, dryness, and hardness, they will cause wakefulness instead of sleep. Neither must you in the meantime bind the head too hard, lest by intercepting and hindering the pulsation of the temporal artery, you increase the pain of the head. You shall make a fire in the patient’s chamber of oderiferous woods, such as juniper, bay-tree, the prunings or cuttings of vines, rosemary, and orris roots. For the same purpose, you may sprinkle the floor with sweet water, if the patient is able to undergo such cost. As: 

Rx. majorane, menthae, radic. cyperi, calami aromat. salvia, lavendula, fanicul. thymi, stachad. flor. chamem. melilot. saturciae, baccarum lanti, & juniperi, an. M. iij. pulv. caryophyll. nucis Moschat. an ℥j. aqua rosar. & vitae, an. lib. ij. vini albi boni & odorifici. Tb. x. bulliant omnia in balneo Maria ad usum dictum.

Marjorum

Mint

Root of cyperi

Lavender

Thyme

Chamomile honey

Juniper

You may also make perfumes to burn in his chamber, as thus:

Rx: carbonis salicis ℥viij. ladani puri ℥ij. thuris masculi, ligni & baccarum juniperi, an. ℥j. Xyloaloes, benjoini, styracis calamit. an. ℥ẞ. Nucis moschatae, santal. citrin. an. ʒiij. caryophill, styracis liquid, an. Ʒij. zedoariae, calaemi aromat. an. ʒj. gummi tragacanth. aqua rosar. soluti, quod fit satis

[translation coming soon]

Make hereof perfumes in what fashion you please. For the rottenness and corruption of bones we will treat thereof hereafter in its due place.

 

XII. Case Studies.

1. Count of Mansfelt

The famous and most valiant Count of Mansfelt, coming to the aid of the French king, was in a conflict at the Battle of Moncontour when he received a great wound at the joint of the left arm from a pistol bullet. The bones shattered and broke in so many pieces it was as though his arm was laid upon an anvil and struck with a hammer. Hence proceeded cruel and tormenting pain, inflammation, fever, edema, and flatulent tumor of the whole arm, even to the ends of the fingers and a certain inclination to gangrene: which to resist, Nicolas Lambert and Richard Hubert, The King’s surgeons, had made many and deep scarifications. But when I came to visit and dress him, by the King’s appointment, and had observed the great stench and putrefaction, I wished that they would use lotions of Egyptiacum made somewhat stronger than ordinary and dissolved in vinegar and alcohol, and do other things more largely spoken of in the book on Gangrene. 

 

The patient had also a Diarrhaa or fluxe, 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 passage through the heart and liver, cause exceeding ill symptoms, and lastly death. 

 

Indeed, he often fainted by the ascent of the filthy vapors raised from the ulcers to the head, which to resist, I wished him to take a spoonful of alcohol with some anti-venom dissolved therein. I endeavored to repress the edematous and flatulent tumor possessing all the arm with stupes dipped in oxycrate, to which was put a little salt and alcohol, these stupes I stayed and held to the part with double clothes, sewn as straight as I could. Such a compression held the broken bones in their places, pressed their sanies 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, lest 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, and by cleaning the ulcers and correcting the putrifaction 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, drying it after the detersion with liniments. Now this I can truly affirm and profess that during the time of the cure, I took out over threescore splinters of bones and those necessarily amongst which there was one of the length of one’s finger; yet by God’s assistance, at length he became sound in all things, except that he could not bend his arm.

2. Charles Philip of Croy

By the King’s command I went to see Charles Philip of Croy. He had been in bed for seven months due to a wound made by a bullet above his knee. When I came to him, he was afflicted with intolerable pain, a continual fever, cold sweats, insomnia, excoriation of the hips by reason of lying in bed so long, no appetite, and much thirst. He often sunk down as if he had the falling sickness, had a desire to vomit, and a continual trembling so that he could not put one hand to his mouth without the assistance of the other. He frequently fainted due to the vapors of the wound. The thigh bone was broken long ways and sideways with many splinters of bones; some were plucked out and others remained in. He also had an ulcer in his groin which reached to the middle of his thigh, and many other sinuous ulcers around 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 these things being considered, I had scarce any hope to recover him, and I regretted coming there. 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 made two incisions, to let forth the matter which was lying about the bone. This had happy success and drew out a great quantity of matter. Then with a syringe, I injected Aegyptiacum dissolved in wine, and a little aqua vita into these incisions, to restrain and amend the putrefaction, repress the spongy, loose and soft flesh, resolve the edematous 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 scarcely 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 lie made of oak ashes, adding thereto as much salt and vinegar as I judged requisite. Now we used them long and often, so to waste the humor more by drying up and breathing through the passages of the skin, more thereof than fell into the part. For this same purpose, we ordained that he should use massage with hot linen cloths, and that these should be made from above downwards, from below upwards, and so on every side, and somewhat long withall. 

 

A short massage draws more humor into the part than it can resolve. I recommended that every other day they lay hot bricks heated in the fire around his leg, thigh, and sole of his foot and quench them somewhat by sprinkling them with wine and vinegar and a small amount of alcohol. This moist heat caused a lot of watery moisture  to sweat out of the wound, the tumor shrank, and the native heat was restored gradually. 

 

Then shoupes dipped in lye made of oak ashes, wherein sage, rosemary, lavender, salt and cloves were boiled, some alcohol added, were applied thereto, but the rollers were so gently and artificially wrapped about, that he did easily endure them without any pain, and that with such happy success, that if they were omitted but for one day, the tumor became really large. But thick linen bolsters were laid upon the lower cavities of the ulcers that so the sanies or filth might be more easily pressed forth. But I had always a special care that the orifices of the ulcers should be kept open with hollow tents or pipes put therein and sometimes this following cataplasm was applied to resolve the tumor:

Recipe

Rx. far. hord. fabar. & orobi, an 6oz, mellis com. & tereb. an. 2oz. flo.chamam. melil. & ros. rub. an. ½ oz. powdered root of ireos, Flor., cyper. Mast. an. 3 drachms. Oxymel. simp. Quantum sufficit; fiat cataplasma ad formam pultis satis liquide.

 

Ingredients:

6oz barley meal and orobi

2oz honey com and turpentine

½ oz chamomile honey and rose 

3 drachms powdered root of ireos…

oxymel . simp, as needed

 

Mix all together in the form of a liquid poultice?

 

And Emplastrum de vigo without mercury was applied thereto whereby the pain was much assuaged and the tumor shrank yet were they not applied before the parts were thoroughly heated by the fomentation, massage, and evaporations; for otherwise this emplaster could never have been activated because of the excessive coldness of the affected parts. Neither did we omit catagmatic powders, fit for the taking and drawing forth of broken bones. He used vulnerary potion for 15 days. 

 

In addition to the particular massages of the affected parts, I appointed other  general massages of the whole body, which became very lean, for by these, blood together with the spirit was drawn to the parts, and the acrid, and fuliginous vapors were breathed forth. 

 

To conclude, his fever 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, but to more fully give examples of surgery.

XIII. A Retort.

I recently read a book written by a certain physician who endeavors to disprove what I have written regarding wounds made by gunshot. Assuredly if there were no other harm but the loss of my credit, I would willingly hold my peace, and stop his mouth with modest silence. But seeing that the safety of so many men lies upon the judgment of this point, I must refute this error so it doesn’t add to the great destruction of mankind.

 

He says the use of suppurative medicines have killed many who have been only lightly wounded with gunshot, and acrid medicines, such as Aegyptiacum, have killed more. Nor should we follow Hippocrates in how to cure these wounds because it’s a new kind of wound and requires a new kind of remedy, not ancient medicine. The temper of the air should not indicate a change of medicine, and thunder and lightning shouldn’t be compared to guns and cannons so much.  These are the chief arguments of his book, which because they dissent from the truth and these things I have formerly delivered, I have decided to confute. 

Gunshot Wounds ARE Contusions!

First, seeing lead bullets which are usually shot out of guns are round, obtuse and heavy, they can’t wound the body without contusion. No contusion can be cured without suppuration, not only according to the opinion of Hippocrates but also of Galen and all others who have written of medicine. 

Don’t Question the Ancients!

Neither must we invent new remedies for these new kinds of wounds for the laws of the sacred and divine art of medicine. These are established with immutable necessity which time, age, nor tyranny can pervert. 

 

Joubert and Botallus, great physicians to kings and princes, would not dare to depart from the rule of Hippocrates. They not only do and follow in curing and doing the works of medicine, but much and highly commend, confirm and propround to be diligently observed by all, in their books which they have published concerning the cure of these kinds of wounds. And yet these physicians are daily conversants in armies and kings houses and have healed and cured daily as many wounded by gunshot as this physician, our Antagonist, has seen in all his life. 

 

Not only do these men whom I have named cure these wounds, but almost all that dress such kinds of wounds do the like, and as far as anyone can tell, they apply suppuratives. And I wonder if he has not observed how his neighbor Doublet the charlatan cures desperate wounds of this nature, with no other than a suppurative medicine composed of lard, egg yolk, turpentine, and a little saffron.

[mentions oil of whelps again and that everyone is using it now]

My Medicine Is Not Poisonous

But in condemning Aegyptiacum, I think he has no partaker, seeing there has not yet been found a medicine more speedy and powerful to stop putrefaction from beginning or correcting it once present. These wounds often degenerate into virulent, eating, spreading, and maligne ulcers which cast forth a stinking and carion-like filth, so the part gangrenates unless you treat them with Aegyptiacum and other acrid medicines. But this unguent is poisonous, he says, and therefore has been the death of many who have been wounded by gunshot. Certainly if anyone diligently inquires into the composition of this ointment and considers the nature of every ingredient within, he shall understand that this kind of unguent is so far from poisonous but on the contrary it directly opposes and resists all poisons and putrefaction which appear in a fleshy part.

Seasonableness DOES Matter

It is most false from the doctrine of Hippocrates to affirm that the seasons of the year swerving from the law of nature and the air, not truly the simple and elementary, but that which is defiled and polluted by the various mixture of putrid and pestilent vapors either raised from the earth or sent from above make not wounds more malignant and hard to cure at some times more than other times. For the air is either very hot or cold, drawn into the body by inspiration or transpiration, and generates a condition in us like its qualities. Therefore why wouldn’t the air, when defiled with the putrid vapors of bodies lying unburied after great battles, or shipwrecks of great armados, infest our bodies and wounds with those same qualities? 

 

In 1562, when the civil wars concerning religion first began in France, many slain bodies were cast into a well some hundred cubits deep. Such a stinking and pestilent vapor arose from there some two months later that many thousand people died all over the province as if the plague had been among them. The pernicious contagion spread twenty miles in compass, which none ought to think strange, especially seeing the putrid exhalations by the force of the winds may be driven and carried into regions far and wide, like the seeds of the pestilence. Whence proceeds a deadly corruption of the spirits, humors and wounds, not to be attributed to the proper malignity or perverse cure of wounds, but to be the fault of the air. 

 

Frances Daleschampe, in his French surgery, agrees that defiled air hinders the healing of ulcers. He learned from his master Hippocrates that the mutations of times chiefly bring diseases, and he read in Guy de Chauliac that this was the chief reason that wounds of the head at Paris and of the legs at Avignon were more difficult to treat. 

 

Lastly, even barbers and those with the least skill in surgery know that wounds easily turn into a gangrene in hot and moist weather. That’s why when the wind is southerly, the butchers will kill no more flesh than to serve them for one day.

Cannons ARE Like Thunder and Lightning!

He mocks me for comparing thunder and lightning with the discharging pieces of ordinance. First he can’t but deny that they are similar in effect. It’s certain that the flame arising from gunpowder set on fire resembles lightning, and you see it before you hear the crack. I judge that the eye almost perceives its object; while the ear can’t but in some certain space of time and by distinct gradations. But the rumbling noise is the same in both, and certainly the report of great ordinance may be heard sometimes at forty miles distance, while they make any great battery in the besieging of cities. 

Besides also iron bullets cast forth with incredible celerity by the feared gunpowder, throw down all things with a horrid force, and that more speedily and violently by how much they resist the more powerful by their hardness. They report that lightning melts the gold but not the purse, and how many men, by only the violence of the air agitated and vehemently moved by shooting a piece of ordinance just like being touched with lightning, have died in a moment, their bones being shattered and broken, with no sign of injury appearing on the skin. 

The smell of gunpowder when it is fired is hurtful, fiery, and sulfurous, just like that which exhales or comes from bodies killed with lightning. Men do not only shun this smell, but also wild beasts leave their dens if touched with lightning. The cruelty of cannons destroy buildings just as badly, and slaughter men and beast, equally as lightning, as we have formerly shown by examples not only horrid to see, but to hear reported, as of mines, the arsenal of Paris, and the city of Malignes. This may seem sufficient to demonstrate that thunder and lightning have a great similitude with the shooting of cannons, which notwithstanding I would not have alike in all things. For they neither agree in substance, nor matter, but only in the manner of violently breaking apart its targets.

Adversary’s Cures

Let us now examine how my adversary would cure gunshot wounds. He would have suppuratives used and applied, but not hot and moist or of an emplastick consistency, but hot and dry. He says it is not the same as in abscesses, where the physician intends nothing but suppuration, but because a contusion is present with the wound, this requires to be ripened with suppuratives but the wound to be dried.

Now to answer this objection, I will refer him to Galen, who will teach him the nature of suppuratives, from whom also he may learn that great regard is to be had for the cause and the cure of compound diseases. I would then willingly learn from him whether he can heal a wound made by gunshot without first bringing the contusion to perfect maturity. If he affirms he can, I will allow myself to be judged by any practitioners he wants. So you may better understand there is nothing better than our oil of whelps to ripen wounds made by gunshot, unless putrifaction, corruption, or a gangrene hinders the remedy. He would pour oxycrate into these wounds to stop their bleeding, and if that doesn’t work, he would apply a medicine consisting of egg white, clay containing iron oxide, oil of roses and salt. But I leave it to other men’s judgment whether these medicines have the power to stop bleeding; certainly they will make it bleed even more. Vinegar is a tenuous and biting substance, there is no doubt that it will cause pain, defluxion and inflammation.

I once used a medicine to stop bleeding for lack of another remedy. I put some vinegar into a wound received by a Moore, an attendant of the Earl of Roissy. An English horseman ran a lance through his arm before Bologne. He came to me again a little later, crying out that his whole arm burned like fire. I gladly dressed him again and put another medicine into his wound, an astringent medicine, but did not pour it inside. 

And then above all other remedies he extols his balm composed of oil of wax and myrrh, beaten together with the white of an egg, which he says is equal to the natural Balm of Peru. He affirms that this has a faculty to consume the excrementitious humidity of wounds, and strengthens the parts so no symptom afterwards troubles them. Yet he says this doesn’t so well heal and agglutinate these wounds, as it does others which are cut. It is quite ridiculous to think that contused wounds can be healed in the same manner as simple wounds, which only require the uniting of the loosed continuity. 

Therefore neither of these balms can be good remedies to heal wounds made by gunshot, because their dryness hinders suppuration, which unless it be procured, the patient cannot heal. Wherefore such things ought not to be put into wounds of this nature before they are ripened, washed and cleansed from their filth. Yet I can barely believe where we shall be able to find out so many chemists which may furnish us with these things sufficiently to dress so many wounded soldiers as usually are in an army, or whence the soldiers shall have sufficient means to bear the charge thereof. Also that which he says is absurd, that these balms must be put into the wounds without tents, and presently forgetting himself, he says, it will not be amiss, if there be a little and slender tent put into the wound, which may only serve to hinder the aggutination thereof. But how can these balsames come to the bottoms of wounds without tents, when it is their chief property to carry medicines even to the inner most parts of wounds, and always keep open a free passage for the evacuation of the quitture? 

 

But it is noteworthy that after he rejected unguentum Aegyptiacum, he nevertheless bids to apply it, from the beginning until the contusion comes to perfect maturation, dissolving it in a decoction of the tops of wormwood, St. John’s wort, the lesser century and plantain, and injecting it into the wound. Besides, a little after he gives another way of using it, which is to boil a quantity of honey of roses in plantain water, carefully skimming it until it’s boiled to the consistency of honey and then add as much Aegyptiacum thereto, so to make an ointment most fit to bring these wounds to suppuration. But I leave it for any skilful surgeon to judge whether such medicines can be suppuratives or whether they’re not detersives. 

 

Last of all he writes that these wounds must only be dressed every four days. And if there be a fracture of the bone joined with the wound, then to move nothing after the first dressing until the eighth day, then presently in another place he says it will be good and expedient to drop 10-12 drops of the formerly described balm into the wound. Verily such a doctrine, which neither agrees with itself nor the truth, can be much use for a young practitioner of surgery who is not yet versed in the art or the operations thereof.

XV. Wounds Made by Arrows

Arrow wounds are different from gunshot wounds in two primary ways:

  1. Arrow wounds don’t make bruises
  2. Arrows are often poisoned. 

Due to these differences, the cures are very different. But the cure of arrow wounds is different in itself because of the various sorts of darts and arrows.

 

The diversities of arrows and darts.

 

Arrows and darts are different amongst themselves both in matter and in form, in number, making, faculty/strength. In matter, for that some of them are wood, some are reeds, some are blunt headed, others have piles or heads of iron, brass, lead, tin, horn, glass, or bone. In figure, for that some are round, cornered, sharp pointed, barbed, some barbs stand to a point, or shafts, or else across, or both ways, but some are broad and cut like a chisel. For their size, some are three foot long, some less. For their number, they differ because some have one head, others have more. But they vary in making, for that some of them have the shaft put into the head, others the head into the shaft, some have their heads nailed to the shaft, others don’t, but have their heads loosely set on, that by gentle plucking the shaft, they leave their heads behind them, whence dangerous wounds proceed. But they differ in force, for that some hurt by their iron only, others by poison. You may see the other various shapes in the following figure. 

 

Figure of many sorts of arrows.

The differences of the wounded parts

The wounded parts are either fleshy or bony, some are near the joints, others seated upon the very joints, some are principal, others serve them, some are external, others internal. Now in wounds where deadly signs appear, it’s fit you give an absolute judgment to that effect; least you make the art to be scandaled by ignorance. But if it an inhuman part, and much digressing from art, to leave the iron in the wound, it’s sometimes difficult to take it out, yet a charitable and skilful work. For it is much better to try a doubtful remedy than none at all. 

Drawing forth arrows.

You must in drawing forth arrows shun incisions and dilacerations of veins and arteries, nerves and tendons. For it is a shameful and bungling part to do more harm with your hand than the iron has done. Now arrows are drawn forth two ways, either by extraction or impulsion. Now you must presently at the first dressing pull forth all strange bodies, which you is done more easily if you put the patient in the same posture as he was when he received the wound, and you must also have all your instruments ready. Especially that which has a slit pipe and toothed without, into which there is put a sharp iron style, like the gimblets we mentioned for removing bullets, but that is has no screw at the end, but is large and thick so to widen the pipe, that so widened it may fill up the hole of the arrows head whereinto the shaft was put, and so bring it out with it, both out of the fleshy as well as the bony parts, if the end of the shaft isn’t broken. That also is a fit instrument for this purpose, which opens the other end toothed on the outside by pressing together the handle. You’ll find the iron or head that lies hidden by these signs, there will be a certain roughness and inequality observable on that part if you feel it up and down with your hand; the flesh there will be bruised, livid or black, and there is heaviness and pain felt by the patient both there and in the wound.

A delineation of instruments for drawing forth the heads of arrows and darts that have been left in the wound without the shaft

The differences of the wounded parts

The wounded parts are either fleshy or bony, some are near the joints, others seated upon the very joints, some are principal, others serve them, some are external, others internal. Now in wounds where deadly signs appear, it’s fit you give an absolute judgment to that effect; least you make the art to be scandaled by ignorance. But if it an inhuman part, and much digressing from art, to leave the iron in the wound, it’s sometimes difficult to take it out, yet a charitable and skilful work. For it is much better to try a doubtful remedy than none at all. 

Drawing forth arrows.

You must in drawing forth arrows shun incisions and dilacerations of veins and arteries, nerves and tendons. For it is a shameful and bungling part to do more harm with your hand than the iron has done. Now arrows are drawn forth two ways, either by extraction or impulsion. Now you must presently at the first dressing pull forth all strange bodies, which you is done more easily if you put the patient in the same posture as he was when he received the wound, and you must also have all your instruments ready. Especially that which has a slit pipe and toothed without, into which there is put a sharp iron style, like the gimblets we mentioned for removing bullets, but that is has no screw at the end, but is large and thick so to widen the pipe, that so widened it may fill up the hole of the arrows head whereinto the shaft was put, and so bring it out with it, both out of the fleshy as well as the bony parts, if the end of the shaft isn’t broken. That also is a fit instrument for this purpose, which opens the other end toothed on the outside by pressing together the handle. You’ll find the iron or head that lies hidden by these signs, there will be a certain roughness and inequality observable on that part if you feel it up and down with your hand; the flesh there will be bruised, livid or black, and there is heaviness and pain felt by the patient both there and in the wound.

A delineation of instruments for drawing forth the heads of arrows and darts that have been left in the wound without the shaft.

But if by chance either arrows, darts or lances, etc are run through and left sticking in any part of the body, as in this figure, then the surgeon should use his cutting mullets to cut off the end of the shaft or staff and then with his other mullets pluck out the head.

How arrows broken in a wound may be drawn forth.

But if it chance that the weapon is so broken in the wound, that it cannot be taken hold on by the formerly mentioned mullets, then must you draw, or pluck it out with your crane, or crows-bill, and other formerly described instruments. But if the shaft is broken near the head, so that you can’t take hold of it with your crane-bill, then draw it forth with your gimblet which we described for drawing out bullets. If such a gimblet can be fastened in bullets, if might be far better to take hold of wood. Buf if the head is barbed, as the English arrows usually are, then if you can, it will be fitting to thrust them through the parts. For if they should be drawn out the same way they went in, there’d be no small danger of tearing the vessels and nerves by these hooked barbs. That’s why it’s better to make a section on the other side where the head entered, and give it passage forth if you can, for so the wound will be more easily cleansed and consolidated. But on the contrary, if the point tend to any bone, or have many muscles or thick flesh against the head thereof, as it happens sometimes in the thighs, legs and arms, then you must not thrust the head through, but rather draw it out the same way it came in, dilating the wound with instruments, and with skill in anatomy avoiding the larger nerves and vessels. So for this purpose put a hollow dilater in the wound, then take hold of both the barbs or wings of the head, then grab hold of the head with the crane-bill and pull all three out together.

 

A dilater hollowed on the inside, with a cranes-bill to take hold of the barbed head.

What to do when an arrow is left fastened in a bone.

But if the weapon is so deep and fastened in a bone that you can’t push it out the other side, nor pull it out the way it came in, you must gently move it up and down. Take special care that you don’t break it, which would leave some fragment in the bone. Take your crows-bill or similar instrument and press to let it bleed a lot, according to the strength of the patient and nature of the wounded part. For thus the part shall be eased of the fullness and illness of humors and reduce inflammation, putrefaction, and other symptoms we commonly fear. If it’s a compound wound, then handle it according to the condition and manner of the complications of the effects. The oil of whelps is very good to assuage pain. To conclude, cure the rest of the symptoms according to the method prescribed in our treatise of wounds in general, and that which we just delivered concerning wounds made by gunshot.

Poisoned wounds.

You can tell if an arrow or dart is poisoned by the property of the pain. If it is great and pricking, as if continually being stung by bees, it usually means the wound is poisoned with a hot poison, as arrows usually are. You can also tell by the condition of the wounded flesh, for it will become pale and livid with some signs of mortification. In essence, there are indications to help you determine whether a wound involves poison. 

After you have plucked out the strange bodies, encompass the wound with many and deep scarifications, apply ventoses with much flame, that so the poison may be more powerfully drawn out, to which purpose the sucking of the wound, performed by one whose mouth has no soreness and is filled with oil – so the poison which he sucks won’t hurt him or adhere to his mouth. Lastly, it must be drawn out by rubefying, vesicatory and caustic medicines, and assailed by ointments, cataplasms, emplasters, and all sorts of local medicines. 

 

End of the Eleventh Book.