A Collection of Chirurgical Tracts
William Beckett




William Beckett

A Collection of Chirurgical Tracts




To the Honourable


Sir Hans Sloane, Bart


PRESIDENT OF THE Royal Society, and M. D

Sir,

IT is with the greatest Satisfaction that I now lay before you the Performance of those Commands, with which you were pleased to honour me, of collecting the Chirurgical Pieces which were singly published by Mr Beckett in his Life time.

This Gentleman might be said to have been begotten in his Profession, as being the Son of Mr Isaac Beckett, Surgeon of Abington in Berkshire, where he was born in the Year 1684.

He received his Education under Mr Pledwell, then Master of the excellent Free Grammar-School belonging to that Town, served four Years of his Apprenticeship with his Father, and the three last with Mr Joseph Bateman, of St Thomas’s Hospital in Southwark.

Mr Beckett died, Sir, at his Sister’s House in Abington, November the 25th 1738, in the 54th Year of his Age, and lies interred in St Hellen’s Church there.

Of this his Native Place, he drew up a Brief Account of it’s History and Antiquities.[1 - See Mr Ashmole’s Antiquities of Berkshire, 3 Vols. 8vo. p. 111 of Vol. 1st.]

A faithful Account of his Writings is prefixed to this Volume; your Generous Patronage of which, he would himself have looked upon as the greatest Honour and Friendship that could be conferred on his Labours, and for which, I most humbly request your Acceptance of the Grateful Acknowledgments of,

Sir,



    Your Obedient,
    And Obliged,
    Humble Servant,
    E. C.

June 29,

1740.




AN ACCOUNT OF THE WRITINGS OF WILLIAM BECKETT, Surgeon, and F. R. S. VIZ,


IN the Year 1709, He Published, I. Chirurgical Remarks, Occasioned by the Death of a Child, whose Case was printed in that Year by Daniel Turner, Surgeon. To these Remarks Mr Beckett subjoined, An Account of a Wound of the Brain by a Bullet; with Reflections thereon. And at the End of this Tract, Mr Beckett gave an Advertisement that He had almost ready for the Press, Annotations and Practical Observations on the Learned and Ingenious Monsieur Gendron’s Enquiries into the Nature, Knowledge and Cure of Cancers.

II. In the Year 1711, He published New Discoveries relating to the Cure of Cancers. Wherein the painful Methods of cutting them off, and consuming them by Caustics are rejected, and that of dissolving the Cancerous Substance is recommended; with various Instances of his Success in this Practice on Persons reputed incurable. Also a Solution of Four curious Problems concerning Cancers, viz. I. Whether the Cancerous Juice is corrosive or not. II. Whether Cancers are contagious or not. III. Whether if the extirpating a Cancerous Breast happens to be successful, it ought to be looked upon as a Consequence of performing the Operation better than our Predecessors. IV. Whether a Salivation will Cure a Cancer.

This Treatise came to a Second Edition the following Year 1712: To which, besides some Corrections, Mr Beckett added Two other Problems with their Solutions, viz. V. Whether Cancers are curable by Caustics. VI. Whether Cancers are curable by Internal Medicines. In this Piece all that he promised relating to Gendron is inserted. And to the present Third Edition He subjoined, by way of Postscript, a very valuable Receipt for the Cure of Cancers, which he informs us was communicated to him by his late eminent Brother Surgeon Mr Dobyns of Snow-Hill. He had it from Mr Pain a Gentleman of Northamptonshire, in whose Family it had been, in the highest Esteem, for above 200 Years. Mr Beckett likewise adds, that he transcribed it from the Original Manuscript.

At the End of the Second Edition of his Treatise on Cancers, Mr Beckett gave an Advertisement that “He was then preparing for the Press, Chirurgical Collections, which would consist of His own Observation of uncommon Cases, also, the most curious things relating to Surgery, taken from the Performances of the German Eruditi, in their Acta Lipsiæ, the Miscellanea Curiosa, Philosophical Transactions. Memoirs for the Curious, Voyages, Travels, Natural Histories of Counties, and many other things that would afford useful Observations. In this Collection was to be a great number of Figures of Cases, Instruments, Machines, &c. all curiously engraven on Copper Plates. This Undertaking was wholly designed for the Improvement of the Art of Surgery; and the Introduction to it was to give an Account of our famous English Writers in Physic and Surgery, for many hundred Years past.”

The great and deserved Practice which attended Mr Beckett’s New Method of curing Cancers, obliged him to postpone the Publication of his Chirurgical Collections, as above recited; and which, upon a mature Deliberation, he changed into a much more extensive and useful Design; and, by Mr Innys at the West-End of St Paul’s, and Mr Hooke in Fleet-street, Booksellers, He published Proposals for printing by Subscription in 2 Volumes 4to, An Account of the Lives, Characters, and Writings, both Manuscript and Printed, of the most eminent British Authors in Physic, Surgery, Anatomy, Pharmacy, Botany and Chemistry, from the Conquest to the Year 1721. To which was to be added, A large Collection of Records, principally taken from the Tower, containing Grants of particular Favours and Privileges to the most noted Physicians and Surgeons by the Kings of this Realm for many hundred Years; whereby, besides other curious Affairs not to be met with elsewhere, the Time in which they lived was to be ascertained, as to several of them, has hitherto remained absolutely undetermined. The whole faithfully collected and reduced to the most exact Order of Time.

This Work was proposed at the Price of one Guinea in Sheets.

Between the Years 1717 and 1720, Mr Beckett published in the Philosophical Transactions, Three Letters concerning the History of the Antiquity of the Venereal Disease. I. To Dr Douglass. II. To Dr Wagstaffe. III. To Dr Halley. Proving That Disease to have been known and cured in England long before the Discovery of the West-Indies.

Of these Pieces Dr Astruc, a French Physician, full of the Vanity peculiar to his Countrymen, seems doubtful as to their Proof, because he had never seen the Manuscripts, nor rare printed Authorities, cited by Mr Beckett; and treating of Dr Turner’s Syphilis, speaks slightly of that Gentleman, because he is of the same Opinion with Mr Beckett.

From the Publication of a small Pamphlet consisting but of 24 Pages, 8vo, Intituled, “A Letter from a Gentleman at Rome, to his Friend in London, giving an Account of some very surprizing Cures in the King’s-Evil by the Touch, (of the Chevalier De St George) lately effected in the Neighbourhood of that City, 1721. Wherein is contained the compleatest History of this miraculous Power, formerly practiced by the Kings of England, ever yet made public; the Certainty of which is confirmed by the most eminent Writers of this Nation, both Catholics and Protestants, as, Malmsbury, Alured, Brompton, Polydore Virgil, Harpsfield, &c. and Drs Tooker, Heylin, Mr Collier, Mr Echard, &c. Translated out of the Italian.” And the following Motto prefixed by the Catholic Translator, viz.

King Edward the Confessor, was the first that cured this Distemper, and from him it has descended as an Hereditary Miracle upon All his Successors. To dispute the Matter of Fact, is to go to the Excess of Scepticism, to deny our Senses, and to be incredulous even to Ridiculousness. See Collier’s Ecclesiast. History Vol. I.

Mr Beckett took an immediate Occasion to explode all these Legendary Assertions, and fully proved the Truth of Mr Collier’s positive ipse dixit to lye on the other side of the Question, in two Letters which he Published, I. To Dr Steigerthal, intituled “A Free and Impartial Enquiry into the Antiquity and Efficacy of Touching for the King’s-Evil.” II. To Sir Hans Sloane in “order to a compleat Confutation of that supposed supernatural Power descending from Edward the Confessor to the succeeding Kings of England. Also, A Dissertation concerning the ancient Method made use of, for the curing Diseases by Charms, Amulets, &c.” To which is added, A Collection of Records.

When in the Year 1722, it was feared that we should be visited with the Plague in England, after it had raged so violently at Marseilles in France; Dr Mead published his Preservative against Pestilential Distempers. And, among several other New Pieces written, and Old ones revived upon this Occasion, Mr Beckett voluntarily lent his helping Hand for the good of his Country, by giving his Judgment, and Publishing (Anonymously) A Collection of Pieces Written during the Plagues, which happened in the two last Centuries.

Mr Beckett’s Chirurgical Observations, made at St Thomas’s Hospital Southwark; Published last Summer, were prepared for the Press by Himself, and Inscribed to Sir Hans Sloane and the Royal Society.


TO Sir HANS SLOANE

Honoured Sir,

THE last Paper Mr Beckett ever wrote, was an Address to you for a private Favour; in which he says, he likewise had reason to believe that Dr Mead would be his Friend. He therein acquainted you that he had, “contracted such a Cold by sitting to write, with his Neck against a North-Window, as he feared would be his Death; and if so, adds he, it may be said I dye a Martyr to the Improvement of the History of Physic and Surgery.” Thus concluded his Paper which he did not live to sign; it was found among his Collections relating to the Lives of the British Physicians, Surgeons, &c. He had copied fair, for the Press, the greatest part of his Papers; and tho’ it was an unfinished Work, yet from his Character, and the great Pains he had taken, I knew it would be very acceptable to the Public. Accordingly I put it to the Press, and intended to have published it in two Volumes in Octavo. Young Dr B * * * *, was recommended to me as a proper Editor: I sent for him and shewed him the Papers; but soon found, that he was much too young both in Character and Ability for such an Undertaking. I printed one Sheet, in Octavo, (of which there were but two Copies taken off) upon this, Dr Milward informed me, that he had been for some Years compiling An Universal History of Physic. He expressed his Desire of purchasing Mr Beckett’s Papers, and being fully convinced, from his Learning and Candour, that he would do Justice to the Author’s Memory, I readily let him have them. And Sir, that you, might in some measure be apprized of Mr Beckett’s Plan, I have to this Volume prefixed his Introduction to the Work.



    I Remain,
    Honoured Sir,
    Your Most Obliged,
    And Obedient,
    Humble Servant,
    E. Curll.


INTRODUCTION TO THE HISTORY OF Physic and Surgery


Concerning the Antient State of Learning, and the Antiquity of the Practice of Physic and Surgery

BRITAIN has been very happy in furnishing the World, in very early Times, with a great Number of famous and learned Men. Of the first Sort were the Druydæ, who, it is said, had their Original and Name from Druys Sarronius the fourth King of the Celts, who died Anno Mundi 2069. Next the Bardi, who celebrated the illustrious Deeds of famous Men, who had their Name from Bardus Druydus the fifth King of the Celts. Cæsar assures us, (and a noble Testimony it is) that the Learning of the Druydi, was first invented in Britain, and from thence transferred to France; and that, in his Time, those of France came over hither to be instructed. A celebrated German Writer, as quoted by Mr Ashmole in the Prolegomena to his Theat. Chem. says, that when the World was troubled with Pannonic Invasions, England flourished in the Knowledge of all good Arts, and was able to send her learned Men into other Countries to propagate Learning: And instances in Boniface, a Devonshire Man, and Willeboard, a Northern Man, which were sent into Germany for those Purposes. Mr John Leland, a famous Antiquary, in the Reign of King Henry VII, who was excellently well acquainted with our British Authors, assures us, upon his own Knowledge, that we have had a great Number of excellent Wits and learned Writers, who, besides their great Proficiency in Languages, were well acquainted with the Liberal Sciences. And Bishop Nicholson, in his Historical Library says, I think we may without Vanity affirm, that hardly any Kingdom in the World has out-done England, either in the Number or Goodness of her Authors; and that even in the darkest Ages our Lamps shone always as bright as any of our Neighbourhood. When School-Divinity was in Fashion, we had our Doctores Subtiles, Irrefragabiles, &c. But as the History of the Learning of this Nation in general is not my present Design, I shall confine myself more particularly to what relates to Physic and Surgery. An Historical Account of the Antiquity and Progress of which Faculties, with the successive Improvements they have received, has not hitherto been attempted by any Hand. And indeed the Difficulty which must attend an Undertaking of this Nature, must be very great, by reason of the little Knowledge we are able to get, in this Kind, from those Manuscripts which yet remain among us. The ancient Britains, who went without Cloaths, may be very well presumed to live without Physic; but external Accidents they must be liable to, as well in their Wars as from other Causes; and History informs us, they had Methods of Cure for such Misfortunes. The Saxons, while they possessed England, had their Leeches, a sort of Surgeons, but very little skilled in Methodical Practice. But under the Normans that Science began to be much more improved. About this Time the Monks and Fryars, and others in Religious Orders, out of a pretended Charity to their suffering Fellow-Creatures, intruded themselves into the Practice of Physic and Surgery, and continued it many Years, notwithstanding the Decree of the Council of Tours in 1163, where Pope Alexander III. presided; which forbids any Religious Persons going out of their Cloisters, to hear the Lectures in Law or Physic; and that it is absolutely forbidden, that any Sub-Deacon, Deacon, or Priest, exercise any Part of Surgery in which actual Cauteries or Incisions are required. Most of the Physicians who practised in England about this Time, were likewise well skilled in the Mathematics and other Parts of Philosophy; but the Surgeons of those Times were so much addicted to Astrology, as make some Parts of their Writings very obscure. After this both Physic and Surgery began to flourish much more, by the public Encouragement given very early by many of our Kings to several of the Practitioners in both Faculties, as will appear by the List of our Kings Physicians and Surgeons, to be inserted in it’s proper Place. Hector Boëtius informs us, that Josina, King of Scotland, who lived above a hundred Years before our Saviour, well understood the Nature of Scotch Plants, and their Use in Physic and Chirurgery; and John Bale, afterwards Bishop of Ossory in Ireland, assures us, he wrote a Book, de Herbarum Viribus. Buchanan relates, the Scotch Nobility were anciently very expert in Chirurgery, and it is particularly remarked of James IV, King of Scotland, Quod vulnera scientissime tractaret. It is said, that when Scribonius Largus attended the Emperor Claudius in his Expedition to Britany, he wrote a British Herbal, or Description of divers Plants in this Island. And our most learned and famous King Alfred, is said to have written a Book upon Aristotle de Plantis. Cinfrid, a famous Physician, is mentioned by that early Writer Venerable Bede, in his Histor. Ecclesiasticar. page 307, 308. And Ernulphus, another eminent Physician, in the Time of Nigellus, the second Bishop of Ely, is likewise recorded in the Anglia Sacra, Vol. I. p. 625. Many more Particulars might, in all Probability, have been met with relating to my present Design, had not one very great Misfortune attended the Suppression of the Abbies, which was the Destruction of a prodigious Number of Manuscripts. John Bale, before-mentioned, though an utter Enemy to Popery and Monastic Institution, remonstrates against this Piece of Barbarity, in pretty strong Terms, to King Edward VI. Covetousness, says he, was at that Time so busy about private Commodity, that public Wealth was not any where regarded. A Number of them, which purchased those superstitious Mansions, reserved of those Library-Books, some to serve their Jacks, some to scour their Candlestics, and some to rub their Boots, and some they sold to the Grocers and Soap-sellers, and some they sent over Sea to the Book-binders, not in small Numbers, but at Times whole Ships full. Yea, the Universities of this Realm, are not all clear in this detestable Fact: But cursed is the Belly which seeketh to be fed with so ungodly Gains, and so deeply shameth his natural Country. I know, says he, a Merchantman (which shall at this time be nameless) that bought the Contents of two noble Libraries for forty Shillings Price; a Shame it is to be spoken. This Stuff hath he occupied instead of gray Paper, by the Space of more than these ten Years, and yet he has Store enough for these ten Years to come. A prodigious Example is this, and to be abhorred of all Men, which love their Nation as they should do. Yea, what may bring our Nation to more Shame and Rebuke, than to have it noised abroad, that we are Despisers of Learning? I judge this to be true, and utter it with Heaviness, that neither the Britons, under the Romans and Saxons, nor yet the English People under the Danes and Normans, had ever such Damage of their learned Monuments, as we have seen in our Time. Our Posterity may well curse this wicked Fact of our Age, this unseasonable Spoil of England’s most noble Antiquities. Bale’s Declaration upon Leland’s Journal, published 1549. And Dr Thomas Fuller, in his Church History, speaking of the same Thing, tells us, Divinity was prophaned, Mathematics suffered for Correspondence with evil Spirits, Physic was maimed, and a Riot committed on the Law itself. However, notwithstanding this Devastation which was then made among our Manuscripts, our Colleges, and some of our Libraries, will furnish us with a great Number relating to almost all Parts of Learning: Some of which, more especially the most ancient ones, I shall here first give a Catalogue of, and then some more modern ones, confining myself to those which more especially relate to Physic and Chirurgery. And, first, we have in the Norfolk Library, belonging to the Royal Society,

Libellus de Arte Medicinali in Lingua Pictica conscriptus. And in Cottonian Library,

Præcepta nonnulla Medicinalia; partim & Divina ad dierum rationem Saxonice. Galbe. A. 2. 3. 1.

Exorcismi quidam & Medicinalia; partim Latine partim Saxonice. Galbe. A. 2.

Medicinalia quædam Saxonice & Latine Vitel. B. 3. 4.

Herbarium, Latine & Hibernice ordine Alphabetico. Vitel. F. 14. 34.

Tractatulus de Morbis, Latine & Hibernice mutilis initio & fine.

Astronomica quædam & Medica Literis Saxonicis Membr. in Corpus Christi Coll. in Oxon.

S. Dustan de Lapide Philosophorum. In the same College.

Tractatus Botanicus in Lingua Cambro-Britannica. In Jesus Coll. Oxon.

Medicinales Quæstiones Magistri Henrici de Wynton super Isagogen Joannitii. In New College Library in Oxon.

Liber Phlebotomiæ. By the same Author, in the same Library.

Tractatus de effectibus quatuor Qualitatum, secundum magistrum Ursonem. In New College Library.

Practica Chirurgiæ. Tho. Sculling, continens quatuor partes. In New College Library.

Guilielmi Scoti Medici Watlingtoniensis celeberrimi Liber de differenciis Urinarum.

Joannis Ketham Chirurgia parva.

De Virtutibus Herbarum & notabila Chirurgica.

Liber rerum Medicinalium quondam spectans ad Pharmacopolam Edw. IV. Regis Angliæ in quo continentur Medicamina quam plurima pro Rege & Magnatibus præparata. In Mr Hen. Worsley’s Library.

William de Pine, his Chyrurgery.

Receipts and Observations for curing Emrods, Fistula’s, Leprosy, Aches in the Joints, Tetters, Worms, Cramps, and Noli me tangere, in a very ancient Hand. By Robert Williams of Cockwood.

A Treatise containing the whole Rules of Physic and Surgery, M. S. Vetus. Formerly in Dr Tyson’s Library.

Medicines of Master Willeam du Jordyne, given to King Henry, Regent and Heuter of the Reume of Fraunce. In Mr Thoresby’s Library.

A approbat Treite for the Pestilence, studied by the grettest Doctours of Fysick amongs Thuniversitie of Cristen Nations yn the Time of St Tho. of Canterburie. In the same Library.

A Book of Surgery, wrote in the Year 1392. Divided into three Parts. The first of Anatomy. The second of Wounds, Imposthumes, Dislocations, and Fractures of Bones. The third, the Antidotary of Surgery. Formerly in Dr Tyson’s Library.

Friar Theodore Chalk’s Chirurgical Receipts, on Vellum. Dedicated to Archbishop Valentine.

Here beginnen gud Medicenes for all Yevels yat any man may have yat gud Leches have drawn out of ye Bokes yet Galien Aschipeus Ypocras hadden. For yai were the best Leches yat were in ye World. On Vellum, in my Possession.

I proceed now to give an Account of some of our early Writers, besides those already mentioned. And first of Maugantius, who was by Birth a Briton, a famous Physician and Mathematician; who, says Leland, for his eminent Learning, was made President of a noble College (in those Days) of two hundred Philosophers; which Geofrey of Monmouth extols to the Skies, under the Name of Legionum Urbs; which Bale supposes to be Chester, excelling all other British Cities, at that Time, in Wealth and Roman Structures. This Place being most pleasantly situated, Astrologers, and other Artists, settled in it to observe the Motions of the Stars, and undertook to forewarn Mankind from the Comets, and certain Indications of the Planets, what should come to pass. Hence Maugantius, said to be superior to all others in this Art, being questioned by King Vortiger, whose chief Physician he was, about the prodigious Conception of Ambrose Merlin, after a Recital of various Philosophical Reasons, did, at length, it seems, give him Satisfaction therein. This Person, who was the most renowned Scholar of his Country, and who is said to have composed several Books, flourished in the Year of Christ 470, when King Vortiger was much distressed by the invading Anglo-Saxons. I have before observed, that there were several Dignitaries of the Papal Communion as well as those of inferior Orders, besides the Monks, who very early took upon them to practise Physic; and that they were absolutely forbid to exercise that Profession, by the Roman Assembly, in 1139. Of this Sort was Frabricius, or Faricius, as he is sometimes written, who practised Physic not long before this Time. He was the eighteenth Abbot of the Monastery of Abington in Berkshire; to whose Care Godfrey de Vere committed himself, to be cured of a grievous Disease he then laboured under; and, as an Acknowledgment for the Care the Abbot had taken of him, he bequeathed to the Abbey before-mentioned, the Church belonging to his Estate, in the Village of Kensington, near London, with 240 Acres of Land, &c. which was confirmed by the King; a Copy of which Grant will be given in the Antiquities of that Town, and the History of it’s Abbey. This Abbot departed this Life the VIIth of the Calends of March, Anno 1117. Soon after him flourished Athelardus, a Monk of Bath, who was so diligent in searching out the Mysteries and Causes of Natural Things, that he deserves to be equalled with some of the ancient Philosophers. Having a very promising Genius, while very young, and continuing, as he grew up, to improve his Parts, and fit himself for great Affairs, he left his native Soil, and, with much Alacrity, went to visit foreign Parts. In his Travels through Egypt and Arabia, having found many Things he sought after, he came Home again with good Fruit of his Labours and Improvement of his Learning. He was, without Dispute, in Philosophy, Astronomy, Physic, Mathematics, and Rhetoric, no ordinary Proficient. Some of his Works he Dedicated to Richard, Bishop of Bayeux: In the first Work he treats of the Principles, Qualities, and Effects of Natural Things, against the vain Opinions of the old Philosophers. In the Preface it appears, he wrote in the Year 1130, under the Reign of Henry I. I might here enlarge upon the great Fame and Merits of John Giles, a Native of St Albans, who made such Progress in the Study of Physic, that he was made Professor of that Faculty at Paris and Montpelier, and Physician to Philip, King of France. After his Return to his own Country, he was, according to Matthew Paris, consulted by Robert Grosthead, the learned Bishop of Lincoln, in his last Illness; of which he died in 1253. He has written, De re Medica, and de Prognosticis, and some other Things. He flourished about the Year 1230, in the Reign of King Henry III. Hugh de Eversham, deserves in this Place to be remembred, who was a Man of great Learning, a Physician by Profession, and perhaps the best of his Age. He was well known in many Countries, being a great Frequenter of the Universities. With the severer Studies of his Art, he mingled the pleasant Science of the Mathematics, and particularly Geometry and Astronomy. This made him known to many in France and Italy, and among the rest, to Pope Martin IV, who invited him, by Letters, to come to him, and solve some Questions in Physic, which were then newly started: Accordingly he went without Delay, and performed what was required readily and learnedly. He published Super Opere Febrium Isaac. Medicinales Canones. Problemata quædam, and some other Things. He flourished the Year 1281; when he was created Cardinal Presbyter of St Laurence, by the said Pope Martin, in the Reign of Edward I. He is said to have died by Poison at Rome, Anno 1287; although Cicæonius, to palliate this Matter, says he died of the Plague.




Chirurgical Remarks ON A Wound of the Head RECEIVED



By a Child from the Blow of a Cat-Stick in throwing at a Cock on Shrove Tuesday, 1709


Addressed to Mr WILLIAM COWPER, Surgeon

SIR,

I do not question but you have had the Curiosity to read over a very remarkable Case in Surgery, not only upon Account of the Recommendation the Name of the Author[2 - This Case was published by Mr Daniel Turner, Surgeon.] gives it, but partly because I know you have been for a long time of opinion, That this Age wou’d distinguish it self by the Advances that Medicine has, and will receive; I need not observe, to a Man of your Capacity, how just, according to my Opinion, our Author has been in relating all the Particulars of the Case he gives us the History of: Nor need I intimate to you how peculiarly the Prescriptions were adapted to the several alterations that were observable in that little Patient: I will only take the freedom to make some Remarks on a considerable Circumstance, which perhaps we shall find obstructed so methodical a Procedure, in order for a Cure.

Our Author is of opinion, That his Death was owing to the effused Blood from some Vessel upon the Pia Mater, which had been ruptured by the Concussion or Shock of the said Vessel, from the Force of the Blow; which Blood pent in (for want of a Discharge) had formed an Abscess, thereby deluging the Surface of the Brain with Matter: And this, tho’ continually draining off thro’ the Orifice in the upper Membrane, yet some part thereof lying beyond the Elastic Power of the said Membrane to raise up, and out of the Reach of Medicine to deterge and mundifie, was at length imbibed by the Vessels, where missing the Salutary Crisis, sometimes observed in the Empieme and Pleuritic Cases, it was conveyed by the Circulation to the Heart, and at length, we are to suppose, somehow effected the Nervous System, bringing on the fatal Spasm.

Thus you see, Sir, how plain and consequential the Account of the Child’s Death is; but even here, I hope, I shall do no Injustice to the Author, if I inform you, I cannot perswade my self that the Matter was imbibed by the Vessels, purely because some part thereof lay beyond the Elastic Power of the Dura Mater to raise up, and out of the Reach of Medicine to deterge and mundifie, as our Author’s Words are; but that it is reasonable to believe, that some part of it was reassumed by the Vessels, when it could no longer discharge it self as before; for if you will give your self the trouble of looking back to the 32d Page, you will find, that no sooner was the Orifice choaked up by a caked Matter, but the mischievous Effects of the Suppression of the Discharge soon began to discover themselves by the Rigours the Child was attended with; and we find our Author soon after fearful of such a thing.

By this we may see how circumspect we ought always to be, lest we interrupt the Design of Nature when she is about to expel any morbifick Matter, the ill Effects that attend it oftentimes discovering themselves after different Manners; We look upon a continued Discharge of Matter to be, as it were, a natural Evacuation, and that it’s immediate Stoppage, without other Means, being made use of to divert and evacuate it, to be succeeded by a greater Fulness and Distention of all the Vessels, as is observable upon the Suppression of the Menses, Hemorrhoides, or insensible Transpiration, there is this Difference to be observed that the ill Accidents that attend the Stoppage of the Discharge of Matter are not so much owing to the Distention and Plenitude of the Vessels, but according to the ill Quality of it, ’tis disposed to render the Patient feverish more or less, which is generally ushered in by Rigours, and sometimes succeeded by Spasmodic Contractions.

For a further Illustration of this, we will take the liberty to relate the Case of a Man of about Forty Years of Age, who was for a considerable time incommoded in his Business, by reason of a violent Contusion he had received on the Upper-part of his Left Arm, a little below the Shoulder: After some time it was succeeded by an Apostemation, upon the opening of which I was informed, a considerable Quantity of Matter discharged, which was not of any ill Colour or Smell, the Matter continuing to make its Exit the same way for several Weeks, at length formed a Sinus, which might be easily traced to the Upper and Fore-part of the Os Humeri. The external Orifice of this was endeavoured to be dilated, but it not only put the Patient to a great deal of Pain, but pent in the Matter, and caused the contiguous Parts to tumifie very much. About this time the Axillary Glands began to swell and pain him, and by their Pressure on the Limphaticks the whole Arm became Oedematous; soon after some part of the Matter made it’s way out under the Arm, upon which it almost ceased to flow from the Sinus on the upper-part of it. In short, upon this the Patient found himself very much indisposed, he lost his Appetite, was attended with Shiverings, became feverish, and at length died violently convulsed.

On Dissection we found the Surface of the Lungs to be interspersed with blackish Specks, the left Lobe adhered to the Pleura, and the Pericordium contained a much greater Quantity of Liquor than usual, though its Colour was natural. The Right Auricle and Ventricle of the Heart were very much distended, and the Diameter of the Arteria Pulmonaris considerably enlarged: on the Division of the Integuments of the Abdomen, a very large Quantity of yellowish fœtid Matter discharged it self, which was somewhat viscid; we found that the Intestines floated in this, for the Abdomen was full of it. In the lower-part of the Concave Side of the Liver there was a very large Abscess discovered, which contained a Fluid of the same Colour and Consistence with that which we took notice of before. There was an Orifice in the lower part of the Abscess capable of admitting the End of one’s Finger; by which, without doubt, Matter discharged it self into the Abdomen. The Spleen was of a very odd Figure: On it’s convex Side there were a Multitude of Streaks, that proceeded from all Parts of it, and centered in one Point, which proceeded only from the Disposition of the Fibres of it’s internal Membrane. It was almost full of Blood, which in the middle was corrupted, and stank abominably. After it was cleared from the contiguous Parts to which it adhered, and taken out of the Body, it weighed four Pounds and a half.

There might have been something more observable upon the Dissection of this Body, but the short time that was allotted for it did not give us an Opportunity of making that strict Enquiry as seemed to be necessary. Blancard. in his Anat. Pract. Rationalis, p. 252. has much such an Observation as this which we have related. See likewise Schenckius, Lib. 3. Obs 26. But I do not doubt, Sir, but you have made some curious Remarks on Cases of this Nature, tho’ I am pretty positive you will agree with me in this, That the immediate Cause of the Death of the Person we have been speaking of, was the giving a sudden Check to the Discharge of the Matter. It was the Work of Nature in this Case (and what she was endeavouring to perform) to disburden herself of those disproportionate and offensive Particles, which by their Continuance in the Body would but have occasioned an irregular Motion of the Fluids, and consequently a Discomposure of it’s whole Frame: For the animal Body being nothing else but a Congeries of Canals, filled with different Liquors, it must necessarily suffer very much, and it’s Actions be irregular, if any Heterogeneous Particles become incorporated therewith. We must here allow, that in Discharges of Matter of a long Continuance, sometimes the Diameters of the Fibres and Vessels may be so much enlarged, that the nutritious Juices may be thrown out with the other, and so occasion a general Emaciation: But this may be easily rectified at the Beginning, without Detriment to the Patient, by making use of some spirituous and moderately astringent Remedies, to recover the natural Tone of the too lax Fibres and Vessels, and give the Matter a proper Consistence. It is to be observed in such Cases as these are, that the Part from whence the Matter discharges, if it be the Leg or Thigh, first loses it’s former Fulness and Dimensions, tho’ soon after there appears an Emaciation of the whole Body. Such an Abscess as we discovered in the Liver of the Person before mentioned, we are inclined to believe might have been found in the Child, had the Abdomen been dissected; for several Authors have assured us, it has frequently been observed to be the Consequent of Fractures of the Skull, tho’ I am apt to believe it never happens, but when the Matter has received a Check in it’s Discharge.

I shall now take the Liberty to observe, that the imprudent Application of Repellents to some Tumours, and inconsiderate Healing of old Ulcers, with the unhappy Method of Procedure, in order to the Cure of some Diseases, very often discover themselves, by their being succeeded by very ill Effects. Non tamen in omnibus Huxionibus repellentia adhibere licet, (says Sennertus) Partibus ignobilibus, præcipue iis, ad quas natura interdum humores protrudere solet, ut sunt Glandulæ post aures, & in collo, sub axillis, in inguinibus adhibenda non sunt, ne humor ex iis repulsus ad partes principes & nobiles feratur.

The same Author informs us in his Paralipom.ad lib. 5. Pract. Med. of a Boy, fourteen Years of Age, that died upon the Accession of an Epileptic Fit, which was caused by the striking in of the Scab by the imprudent Use of Liniments. And Baglivi allows, that the irregular Cure of the same Disease may be succeeded by a Spitting of Blood, an Apoplexy, Dropsy, lingering Fevers, &c. The Healing of old Ulcers, without having a Respect to those Circumstances that ought to precede such an Undertaking, generally lays the Foundation for a Train of mischievous Accidents; for the Patient soon begins to be sensible of an Unactiveness of the whole Body, is sleepy, has a weak Digestion, Head-ach, and is feverish, which is attended with very profuse Night-Sweats; and these we have several times observed to be the Forerunners of the Patient’s Death, though sometimes all these ill Accidents may be prevented by an Imposthumation in some part of the Body or other.

Now to account for such remarkable Alterations, in such Subjects, we are obliged to take notice, that here is the Suppression of the Evacuation of a Humour, that had been constantly discharged for a long time; and this, we have before observed, will cause a greater Fulness and Distention of all the Vessels. Now the Quantity of the Blood being very much encreased by the Addition of this viscid Juice, the Celerity of its Motion must be considerably abated, upon which Account it will enlarge the Diameters of the Vessels, by relaxing their Coats, and pass with so great a Difficulty through the Capillary Vessels, that if it arrive at any Part where the Fibres have lost their due Tensity and Spring, it is disposed to stagnate, and produce an Imposthumation. If this does not happen, as the Motion of the Blood continues to be very languid, the Quantity of Spirits filtrated in the Brain will be less upon two Accounts: First, Because as the Blood moves more slowly, all the Parts of the Body through which it circulates, will receive a much less Quantity of it in a given Time, than they must have done, had it moved with a greater Celerity. Secondly, The Viscidity of the Blood, together with it’s Motion diminished will lessen the Quantity of Spirits, according to the 20th and 22d of Dr Wainright’s Propositions of Animal Secretion.

Now this being so, it is no wonder to observe such an Inactivity of the Parts, Sleepiness, weak Digestion, &c. to attend a Person under such Circumstances: For the Quantity of Spirits being so much diminished, the Parts can never be sufficiently influenced by them to perform their respective Functions with that Force as usual. To this we may add, that they are in a great measure deprived of their Power and Spring, and Sensation in general is not near so strong and lively. From hence it is evident, that when Nature has found a Passage whereby she may disburden herself of any excrementitious Humours, we ought for a considerable time to give proper Internals, and make use of some other Method, as by Issues, or such like, whereby we may divert the Course of the Matter, which, if I may so say, has been so long together determined to pass the same way. Beside this Advantage which will accrue by that Method, there may be near the same Quantity of Humours evacuated; and so those unhappy Accidents, will be prevented, and the Ulcer cured.

I am perswaded, that it is not without a great deal of Difficulty that we can sometimes divert the Tendency of Humours to a Part; and I can bring several Instances of Sores that have been healed, where the suppressed Matter has discovered it self, by an Aposthume near the Place where the Sore was, a short time after it had been healed.

Fælix Wurtz, who was a very judicious Surgeon, informs us, That it sometimes happens, that in a little time after a Patient has been cured of a Wound of the Head, he feels violent Pains there, which indicates that Matter is collected in the Part. He adds, That many die of it, by reason the Cause is not understood by some Surgeons. This Remark proves, that the Wounds were not kept open long enough, or else that the Surgeon acted imprudently in not making use of proper Means to divert the Tendency of the Humours to that Part; not but it will abundantly more easily happen to those Parts that are depending, and where the Weight of the viscid Fluid will incline it to settle.

I knew a lusty Fellow, about twenty five Years of Age, that had an Ulcer on the internal Ancle of his left Leg near twelve Years: It had been cured three or four times, but he always found himself very much indisposed after it, till it broke out again, and the Matter had a free Discharge: At length, upon his coming from Sea, it was healed again, upon which he was seized with a violent Pain in his Head, Loss of Appetite, which the next Day was succeeded by a violent Fever and Looseness. His Physician ordered, among other Things, a large Blister-Plaister, to be applyed to the Leg on which the Ulcer had been. The Patient recovered; but what was very observable, was, that the Sore the Blister-Plaister had made terminated in an ugly Ulcer, which would not heal, though various Applications were made use of. If Nature had been in this Case compelled, as it were, and forced to a Compliance in the healing of this Ulcer, it is probable the Matter would have been thrown upon another Part, and so occasioned a Disease there.

By this we may see how cautious we ought to be not to proceed in a Method contrary to the Dictates of Nature; for if we do, we consequently disturb her regular Motions, upon which she oftentimes commences a new Work, which, if it does not tend to the Subversion of the whole Oeconomy, there ensues a Permutation of the Disease, by the Translation of the Matter from one Part to another.

It would be impossible to recount all the obscure Motions Nature makes use of to accomplish such Ends: We will only mention some where the Disease has been perfectly changed from what it was before by such Methods. Mear gives us an Instance of a Dropsie of the Breast, which succeeded an ill-cured Hydrocele. Hildanus observes, that an inveterate Ulcer of the left Leg being unhappily healed up, the Patient died of a Pleurisy some Months after.

To this I may add an Observation of a Man that had an old Ulcer on each Leg, which being attempted to be cured, as the Matter gradually lessened, he was deprived of his Sight. There was no Alteration to be observed in the Eyes of this Person, but only a Dilatation of the Pupils, as is generally observed in a Gutta Serena, which was judged to be his Case. In short, upon the running of the Sores, though he had been perfectly blind, he effectually recovered his Sight again.

I will not tire you, Sir, with the Recital of any more Cases of this Nature. What has been hitherto said, I hope is sufficient to incline you to believe, that the immediate Cause of the Death of the Child I spoke of in the former part of the Letter was the Suppression of the Matter, which had continued to discharge in such large Quantities so long together. And that such a sudden Stoppage of a Discharge of Matter may procure a Patient’s Death, though the Symptoms that proceed may be different. I have likewise shewn the Difficulty there is in Diverting the Tendency of the Matter to a Part, and mentioned how one Disease is sometimes converted into another: But of what Use these Remarks may be I leave you to judge. To me it seems reasonable enough to suppose, that as a regular Method of Practice is not the Effect of a Man’s Sagacity, but the Product of repeated Experiences, every thing that occurs may tend, by a proper Application, to the Illustration of the Art. What else has made some Men so famous for their Prognosticks? Had not our great Master Hippocrates a Respect to the Suppression of the Discharge of Matter from Ulcers, when he expressed himself thus, Ulcus lividum & siccum, aut cum virore pallidum lethale est? And this we have known to be true in several Cases.

Well then, does not this sufficiently prove, that where we have Cause to fear a Suppression of the Discharge, we ought to remove any Impediment that may embarass Nature in her Work, and advise a proper Method to promote the precipitating the morbific Matter? For so shall we, by joining our Forces with those of Nature, still keep her in due Course; and that when she is grown languid, and departing from her former Measures.

You must excuse me, if I digress a little to take notice of an Observation that some Authors have made, viz. That from a dangerous Fracture of the Skull, after Death the Liver has been often found impostumated. They have been likewise very sollicitous to know which way the Matter could be conveyed to so remote a Viscus; but it would be needless for me to offer what has been said in this Case, because it seems to be evident enough, that a Part of it is reassumed by the Vessels; which, with that should have been discharged from the Mass of Blood, is by the Circulation deposited in that Part. But here we may start a considerable Problem, which is, How comes it to pass that the Morbific Matter if it’s Discharge is suppressed, is thrown upon the Liver rather than any other Part? In order to the Solution of this, we ought to consider, That the Spleen is subservient to the Liver in performing its Office, by giving the Blood a Check in it’s Progress, whereby it’s Velocity is lessened; otherwise so thick a Juice as the Bile could not be separated from it. Now the Motion of the Blood being rendered abundantly slower in this Part, it is no wonder that the Morbific Particles separate themselves from it, while the Filtration is carrying on, and by their Assemblage form an Abscess in the Part.

You may perhaps expect, Sir, that I should make an Apology to excuse the Length of my Letter; but I assure you, the Pleasure I have taken in writing it would oblige me to make it of a larger Extent, if I did not find I should be forced to take notice of some things, which may perhaps have a Place elsewhere. I have only this to add, that if through the little time I have taken to write it in, I have in any part omitted to pay that Respect as is due to you, I shall very readily ask your Pardon. In the mean time I must own my self to be,



    Your very much obliged Servant,
    Wm. Beckett.

Southwark,

Aug. 22, 1709.


OF A Wound of the Brain By a BULLET


To the Same

IF you remember, Sir, in the History of the Child’s Case, which I have before mentioned, it was observed, that notwithstanding the violent Pressure upon the Brain, by the depressed Pieces of the fractured Skull; yet the little Patient laboured under no worse Symptom, than a Head-ach, and was in a Condition to walk about the Chamber. This was really very remarkable; but if you will be pleased to give your self the Trouble of reading the following Account, I do not question but you will meet with something much more surprizing.

On November the 4th, 1707, it happened, that during an Engagement between a small English Vessel and a French Privateer, near Margate, one of our Men was unfortunately wounded by a Bullet, which past through the middle of the Os Frontis. The Surgeon aboard the Ship immediately enlarged the Wound, by making an Incision through the Integuments, but could not discover the Bullet; whereupon he dressed him up, and the same Day being set ashore, he was dispatched for London. On Thursday the 6th Day of the same Month, he arrived, having walked much the greater part of the way in that time, which is about 66 Miles; the same Day his Surgeon endeavoured to extract some Pieces of the Bone, which discovered themselves through that Aperture which was made by the Bullet, but without Success; for they consisted chiefly of the internal Table, which were much larger than the Hole in the external: Upon this the Wound was immediately drest up, and a second Attempt was made a Day or two after; but it proved as successless as the former. In the mean time, the Patient continued to be very hearty and well, and seemed to be no more indisposed than if he had only received a slight Wound of the Head. The opening the Skull with the Trepan was proposed, and which would probably have been put in Practice in a Day or two’s time: But on the Sabbath-Day Morning following, after he had rested well all Night, he was seized with such violent convulsive Motions as were very surprizing; during which he expired. The Body being laid on a Table to be dissected, all it’s Parts appeared so prodigiously inflated, that the Person, when a live, being one of the largest Stature, it seemed perfectly monstrous. A Puncture being made in any Part through the Integuments, there was nothing discharged but a subtile Matter or Air; immediately after which the Part subsided, though before on a Compressure of the Fingers it would receive such an Impression as is observed in Oedematous Tumours; but it would suddenly return to it’s former State. The Surface of several of the Parts appeared livid and vesicated. The Skull being opened, the Bullet dropped out of the Brain, all the Fore-part of which was corrupted, and abounded with a thick yellowish Juice, of a very offensive Smell; there were two or three very large Pieces of the inner Table of the Skull, with some smaller that were found among the lacerated Membranes, and lodged in the corrupted Brain.

This Case is so particular, that it may not be amiss if we make some Reflections on it.

We are very well assured, Sir, that it has been a Matter of very great Surprize to several ingenious Men, to consider how the various Operations of the Body have continued to be performed, when those Parts which were so absolutely necessary to the Well-being of the Animal, have been naturally or accidentally disordered to such a degree, as to suffer a perfect Confusion of their Parts: And of this we find Variety of Instances in those Authors, who have very obligingly applied themselves to relate the Histories of deceased morbid Bodies. But that the Brain it self, which is the very Source and Principle of all Animal Functions, should, after it has undergone such a Violation as we have observed, continue several Days without incommoding the Person in the least respect, is really very remarkable; for if we do but consider what an absolute Necessity there is for a constant Supply of Animal Spirits, to empower the Parts to perform their mechanical Actions, and at the same time reflect on the Disorder and Corruption of that Part, whose Office it was to secrete a sufficient Quantity of those Spirits, we might very reasonably expect a considerable Alteration in the whole Body. One might very well think, that from the Deficiency of Spirits that would ensue, the Parts could no longer continue to perform their Actions, but must gradually lose their Power and Spring, and at length become in a manner destitute of Motion: For we can scarce perswade our selves, that Nature in this Case is so provident as to suffer the Cerebellum and Medulla Spinalis to filtrate the Spirits in a greater Quantity, that they might supply the Exigencies of the Body.

There still remains some considerable Phænomena to be accounted for, as the convulsive Motions, the prodigious Inflation of the Body, &c. As to the former, it may be perhaps accountable from the violent Conflict we may imagine to have happened on the mutual Engagement of the Juice that was found so plentiful in the corrupted Brain, and that which had undergone no Alteration from it’s original Purity. Add to this, that the Animal Spirits in the Nerves receiving some ill Impressions by the Accession of some of those impure Particles, could no longer sally out upon the Command of the Will to any particular Part, but must consequently so irritate the Nerves, as to cause their Extremities to contract themselves; upon which Account the Blood becomes imprisoned in the muscular Fibres, which abridging their Length by enlarging their Diameters, the Parts must necessarily suffer involuntary Contractions: At the same time those minute Capillary Extremities, which terminated in the Miliary Glands, were probably so contracted, or crispt up, as perfectly to close the Orifices of the excretory Ducts of those Glands, which are the only sudatory Pores: By this means all that vast Quantity of Matter which is usually discharged by insensible Transpiration, became imprisoned underneath the Integuments of the Body, and so distended all its Parts to such a prodigious Degree, as was observed. This Constipation of the excretory Ducts, and crisping up of the Extremities of the Nerves, might likewise have a considerable Effect on the small Branches of the Arteries and Veins which accompanied them; for by this means the Blood they contained might be obliged to stagnate in the Glands, which must occasion an Enlargement of the Diameters of those minute Vessels; and so the livid Colour which was extended on several Parts might be probably procured: Besides this, the Blood being in such a comprest State, some of its more fluid Parts might be exprest from it, which lodging underneath the Cuticula, might make the Parts appear to be vesicated; there is nothing more certain, than that Animal Bodies perspire after Death; or that the perspirable Matter continues to pass off as long as the Body retains any Warmth. This is confirmed by an Experiment of Sir Thomas Browne, in his Pseudodoxica Epidemica, where he tells us, That “upon exactly weighing and strangling a Chicken in the Scales, upon an immediate Ponderation he could discover no sensible Difference in Weight; but suffering it to lie 8 or 10 Hours, till it grew perfectly cold, it weighed most sensibly lighter. The like, says our Author, we attempted and verified in Mice, and performed their Trials in Scales that would turn upon the 8th or 10th part of a Grain.”



    I am, Sir,
     Yours, &c.
    W. B.




NEW DISCOVERIES CONCERNING CANCERS



ADDRESSED TO Charles Bernard, Esq; Serjeant-Surgeon, AND Surgeon in Ordinary, to Her Majesty Queen ANNE

SIR,

I LOOK upon it as a peculiar Happiness, to live in an Age when Men of our Profession consider, that as the Art is capable of receiving daily Improvements; useful Discoveries, confirmed by Experiments, ought to receive the joint Concurrence of their good Wishes; notwithstanding, they may contradict an Opinion that has been almost universally received. These we shall always find, are the Gentlemen who in opposition to those Bigots whose Tempers discover them to be the Votaries of a few opinionative Men, endeavour to guide their Judgments by Reason, backed with judicious Observations, and whatever Arguments are produced, will never go about to controul Matters of Fact. It is a grand Truth that Necessity gave Being to Physick and Surgery, and Experience is the only Way to bring them to Perfection; but it is much to be lamented by them that are Well-Wishers to those Arts that the Persons which are perhaps capable of advancing them most, devote themselves so much to speculative Fictions (the Effects of teeming Brains) that some have pretended with a magisterial Air to dictate, even to Experience itself. In such a Case it would be needless to go about to offer Arguments sufficient to disengage their Inclinations, Time only must discover to them their Error, when it makes them sensible they have, to no Purpose, persisted in the Pursuit of frivolous Niceties; for in reality, the Benefit of Mankind in general is deduced from Practical Truths. The Thoughts of this are sufficient to inspire every generous Soul with an ardent Desire of discovering something that may be of so universal an Advantage: As for my own Part, I was not animated to concern my self in the Undertaking I have engaged in, by a Prospect of gaining that Honour that is often liberally bestowed on those that mint new Hypotheses, or make new Discoveries; my only Design was to inform my self, whether some of those Diseases, which are generally reputed incureable, are not actually in themselves curable, and by this means to wipe off a Reproach which has been cast on Nature, when in reality it proceeds only from our own Weakness, and the Infirmity of our Art. A diligent Application to those Distempers which baffle us most, has been frequently recommended by very reputable Authors, and some of those who have obliged us with the Histories of Diseased Persons, have very often mentioned considerable Cures, which have been happily performed after the Patients have been looked upon by some as incurable. Hippocrates tells us, Lib. 2 Aph. 52. Si Medico secundum rectam Rationem Facienti, Curatio non statim succedat, non est tamen mutanda Methodus, quamdiu id restat quod à Principio visum est. I am fully persuaded that most Practitioners in Surgery have at some Time or other, by an industrious Application, been successfull where Art could not warrant a Cure. As to the Disease I propose to make the chief Subject of this Letter, tho’ it be generally branded with the Character of Incurable, I must freely own I never could discover any thing essential to it in general that should make it so; it is true, there are many Diseases that are not to be cured, where certain Circumstances are conjoined, which very much contribute to the Misfortune; tho’ Others of the same Class exempt from those Adherents may, perhaps, be happily enough cured; Thus for Instance. In Cancers we have but little Reason to expect a Cure in a Person that is old, if the Cancer has been of many Years standing, and is firmly fixed to the Ribs; but if the Patient be not so far advanced in Years as to be uncapable of receiving the Benefit of Nature by the regular Discharge of the Menses and the Cancer be loose; notwithstanding, it be Ulcerated, over-spread with fungous Flesh, discharge a filthy Matter, and smell very offensively; we do upon Experience affirm that such a Patient may be cured. We must own we cannot be of the Opinion of the Paracelsians, who affirm there is no Disease but what is curable in any Patient, for the Reason we have given; nor can we with the Galenists, agree that the Gout, Dead-palsie, Stone, Cancer, &c. are Diseases absolutely incurable; because Experience discovers the contrary. We find that Mr Boyle is of the same Opinion, and thinks it were no ill Piece of Service to Mankind, if a severe Collection were made of the Cures of such Persons as have been judged irrecoverable by the Doctors; that Men might no longer excuse their own Ignorance by the Impotency of Nature, and bare the World in Hand, as if the Art of Physick and their Skill, were of the same Extent. There seems to be one very effectual Way to rescue the medicinal Art from the Aspersions of some bold Persons; and that is that of a certain Number of regular Practitioners in Physick and Surgery, each of them should apply himself to the Study of one particular Disease: By this means we should soon find they would be capable of surmounting those Difficulties that have all along baffled the most Judicious of the general Practicers. How odd, and disagreeable this Opinion may seem to some Men I know not; but I assure you, Sir, I find it of a very ancient Date; for Herodotus, a Greek Historian informs us, that before his Time, the Physicians in Egypt used to apply themselves to the Study and Advancement of one Disease in particular. Baricellus, and Lionardo di Capoa, observe the same likewise, in Relation to the Practice of Physick in that Country. Baglivi, in the Scheme he lays down for erecting of Colleges for the Improvement of Physick, tells us, that every Fellow of his Literate Society must have one Disease allotted him for the Task of his whole Life; and which elsewhere he says is not sufficient for the illustrating the Province of one Disease; but that we lie under a Necessity of taking in Materials from all Hands. But there is no Man that we know of, has spoke more agreeably of this Matter than Dr Harris, in his Pharmacologia Anti-Empirica, he owns that he took more than ordinary Pains in one particular Disease, and assures us he verily believes if learned Men, after a compleat Acquisition of the universal Method of Physick, and a necessary Search into the Nature and Cures of those manifold Infirmities and Diseases, which, with a kind of infinite Variety, do afflict Mankind, would, with their utmost Vigour and Resolution, prosecute the Knowledge of some one Disease eminently above others; they would, most certainly, find a particular Providence attending and assisting them in so good and honest a Design. He adds, a few Pages farther, that wherever a Man’s Thoughts are intent and fixed, wherever his Genius does naturally incline, and all his Aims and Application do continually tend, whether it be to pertinent or insignificant Matters; whether it be to useful, or else meerly curious Things; if he has but tolerable Parts, and Education corresponding, he can hardly ever miss; it is hardly possible he should miss the becoming Eminent, and in great Measure perfect, (I mean perfect (says he) according to the Modulum of Human Capacity) in that one Point. But there is one Thing to be recommended to the Consideration of the Person, who takes upon him the Enquiry into the Nature of one particular Disease, which perhaps he might be very liable to err in, if not cautioned against; and that is, that he be not too bold and rash in his Attempts; for, as Galen says, The Physician’s Art is not like that of an Artificer, who may make what Experiments he pleases, to satisfy his Curiosity; because if he spoils the Materials he works on, no Body is endangered by the Miscarriage: In Corpore autem humane (adds he) ea tentare quæ non sunt Experientium comprobata Periculo non vacat, cum temerariæ Experientiæ Finis sit totius Animantis internecio. I believe we shall find that one of the grand Reasons, why Persons, generally speaking, have been so negligent in making any Attempts on Cancers, has been the seeming Discouragement they have all along met with from Authors. The Caution Hypocrates has given us in his Thirty eighth Aphor. Sect. 6. has scarce been omitted by any one considerable Person that has wrote of this Subject, tho’ perhaps the Sentence has often had an Exposition put upon it, contrary to the Author’s Meaning; but of this, more in it’s proper Place. I proceed now to give an Idea of Cancers in the Breast from an external Cause; and this I shall do without concerning my self with the Opinion of the Ancients; for since we have been so happy as to live in an Age which will be remarkable for the many surprising Discoveries which have been made in Anatomy: We should be reckoned unworthy the Advantages we enjoy, if we did not study to apply them to the Benefit of Mankind in general. The more inquisitive and learned Part of the World, are at this time very well assured that the Animal Body is an exquisitely framed Machine, and that it’s Composure is little else than a Compages of branching and winding Canals, which are kept to a moderate Degree of Extention, by Fluids of different Natures; and that the Motions of these were first determined by the divine Architect: Thus in a natural State, the whole Fabrick is governed by certain Laws impressed on the Fluids; and we often find the unhappy Consequences of the Discomposure of a Part, to discover themselves first by an Interruption of the Motion of the animal Juices. Thus in a Cancer of the Breast which proceeds from a Blow or Bruise (as upon strict Enquiry we have found they most commonly do) is it not probable that by such means a Confusion of the true Order of the little Glandulous Grains and their excretory Ducts may happen? and at the same time an extravasated Lympha may lodge in such a spungy Texture, which in time becoming viscid, will coalesce with the Glandular Substance, and form a Mass considerably compact? Now this being so, it is reasonable to believe that as the Lymphatic Juice continues its Motion till it arrives at the indurated Part, its Passage must be embarrassed there; upon which, it will soon be qualified for an Union with the remaining Part of the glandulous Substance of the Breast; and so the whole be perfectly changed from what it was before. This Hypothesis is in a great Measure grounded on Experiments; for if we express a Juice from some of the Cancerous Mass, and hold some of it in a Spoon over a Fire, there immediately flys off a small Vapour, and the Remainder hardens not unlike the white of an Egg boiled; this shows it to have the Properties of the Lympha; for the Chymical Analysis of that Liquor assures us it is a Composition of a great deal of fixt Sulphur, a little Volatile, some Phlegm, and much Volatile Alkalie; to which some add a little Earth: Now while the Volatile Alkalie keeps the Sulphur dissolved, the Lympha remains in a State of Fluidity; but when, by making the same Experiment, the Volatile Alkalie is evaporated, the Remainder hardens, and forms a pretty compact, whitish Substance. From hence the judicious SURGEON may easily deduce the Reason why these Sort of Tumours can never be brought to Suppuration. We shall not be so particular as to mention those Cancers which proceed from internal Causes, nor several other things which relate to the former; for what we have here said, we look upon to be commonly the Method of the Formation of them; and as such, we did endeavour to calculate Remedies that should peculiarly operate on the Mass, so as to dis-unite the firm Cohæsion of its Parts, and dispose them to separate and come away, without any great Inconvenience to the Patient; which is what we would recommend with all the Earnestness imaginable to those that are desirous of discovering a Method of curing Cancers. We were before sensible that it was possible for one Body to operate on another determinate Body, without being able to have any such Effect on innumerable Others; as Quicksilver will desolve Gold, Aqua-fortis Iron, Vinegar the Shell of an Egg, Oyl common Sulphur, &c. which will not have any such Effect on several other Bodies; for there is nothing more certain than that the Operations of Dissolvents are so determined by the various Texture of the Bodies on which they are employed, that a Liquor that is capable to corrode a more hard and solid Body, may be unable to disunite the Parts of one more soft and thin, if of a Texture indisposed to admit the small Parts of the Menstruum. It may be expected I should say something in relation to that which is generally looked upon to be the grand Cause of the Incurableness of Cancers, I mean the acid Humour in the Blood. But if those Gentlemen who are fond of entertaining this Opinion, do but consider that Cancers are often formed in a perfect State of Health; and that during the Time the Cancerous Substance dissolves, and comes away according to our Method, the Sides will run a digested Matter, and heal by the Application of dry Lint only; they will be of my Opinion, that neither the Atrabile of the Ancients, the corrosive Alkalious Salt of the Chymists, nor the predominant Acid of the Rest of the Moderns, are capable of procuring those Alterations that Cancers are sometimes attended with. If we trace the Writings of our Predecessors to their earliest Date, we shall find that many of them have made Mention of the Roots of the Cancer, which they took to be the large blew Veins that are often extended on its Surface; and the entire Removal of these they thought to be absolutely necessary, or the Patient could not be cured: But I believe there is no Body at this Time that considers the Mechanism of the Parts in such a Condition, but will agree they are the necessary Consequents of it, and that their Absence, or Presence is of no Importance; that the Cancer is sometimes attended with Adherents, or Appendices, which may very well resemble Roots, we are assured; but these generally lay deep, and not easily discovered; the most considerable One that ever we saw was very near Five Inches long, and of an unequal Bigness, some Part of it did not exceed the Largeness of a Goose’s Quill, but some others were near as big as the Top of the Thumb, which resembled so many Knots in it, it divided in the Middle, and continued separated about an Inch and a Half, and then re-united, it was of a more tender Substance than the Body of the Cancerous Mass, but of the same Colour, and was probably the Juice that was last applied to the Cancer, which assumed a Form agreeable to the Cavities it lodged it self in. Such Adherents as these are, I am more inclined to believe, are the Cause of the unsuccessful Attempts on Cancers, than any Acid in the Blood; for I am of opinion there are few Persons unacquainted with Medicines that are capable of correcting its Acidity when it happens; and had the Cure of Cancers depended on that, I am positive they would not at this Time have had such ill Character. We have before shewed that Cancers have generally their Rise from a Blow or Bruise, and that when the Body is in an healthful Condition, and the Blood and Lympha temperate and sweet: Now if there always is an Acidity of the Blood when Persons are afflicted with Cancers, the Cancers must sometimes cause it, and not the Acid in the Blood the Cancers, as is the Opinion of most of the Moderns. What has been hitherto said, is sufficient to prove that if Men will be always so sluggish as to acquiesce in the Dictates and Dogmatical Positions of their Predecessors, and not exert their Faculties in endeavouring to undeceive themselves; we must no longer expect our Art will receive any Advancements, but as Slaves to their Opinions content our selves with what we know already. Were not Parisani, Riolan the Son, and Plempius, so much in the Interest of the Ancients, that when our Country-man, the assiduous Harvey, had discovered the Circulation of the Blood, they not only opposed his plain Demonstrations, but engaged in vigorous Disputes against him, tho’ at the last they were obliged shamefully to recant their Follies. Celsus tells us, Vix ulla perpetua Præcepta Ars Medicinalis recipit; scarce any of the Precepts of the Medicinal Art are perpetual. And shall we engage then in the List with a few opinionative Men, that ground their Course of Practice on those Methods only, in which they have been brought up, and implicitly assent to the Conjectures of others. No certainly, this would be to strangle Truth, and extinguish the Vigour of our Wits with precarious Authorities. Consonant to this, Dr Paxton, in his lately published Treatise, tells us, Thus Men, out of a trifling Distrust of their own Parts, will not use them; or out of Laziness of Temper, will not employ them, chusing rather to be wise or learned, by being adorned with Others Whimsies, than undergo any Labour, Fatigue, or Trouble of being really so. I believe there are some Men that would rather contradict their Senses than deny the Authority of a darling Opinion: Of this, we have a sufficient Proof in an Instance, related by an Italian Author before-mentioned. He tells us, That a certain Publick Reader long Time versed and grown Old in the Books of Aristotle being one Day present at a Dissection, and clearly seeing that the Vena Cava takes its Rise from the Liver, confessed with Astonishment what his Senses discovered to him, but that he ought not therefore, by crediting his Senses, to contradict his Master, who constantly affirms all the Veins in Man’s Body to have their Original from the Heart; because, said he, it is much more easy for our Senses to be sometimes deceived, than the Great and Sovereign Aristotle. I here seriously confess, I have as much Veneration for Antiquity as any Person whatsoever; but it would be ridiculous, if, as One says, we should so far forego our own Judgments as always to follow the Foot-steps of Others, and to be certain of nothing our selves: For this would be to see with others Eyes, to hear with others Ears, and to understand with other Men’s Intellects; so that whenever we make Quotations from the Ancients to strengthen our Opinions, we ought to do it judiciously, and fully consider, whether their Notions of Things are consonant to the Experience of these Times. To prove to you, Sir, that I have not proceeded to apply my self to the Cure of so formidable a Disease, without a Precedent, I shall instance to you that Fuschius, a learned Italian Surgeon, had such a wonderful Reputation for it formerly, that some Authors say he was distinguished by a particular Title, which discovered his Success. His Method I have made use of, and tho’ by passing thro’ several Hands (the Author being mentioned by few) it has been stampt with wonderful Encomiums, I have not hitherto found it deserves it, notwithstanding I did not omit the most minute Circumstance in preparing the Medicine, or prosecuting the Directions; but in its proper Place, I shall take particular Notice of this, and several other Remedies, that have been recommended by some Authors, as substantial and extremely useful; for if in One or Two Instances they have been crowned with Success, by Degrees they are handed down as infallible in all Diseases of the like Form. To the former Account I may add, that Monsieur Alliot, Physician to the Duke of Lorrain, has applied himself to the Cure of this Disease very successfully, as a Schedule he published at Paris some Years ago informs us; we are likewise assured by Mr Boyle that Dr Haberfield, one of the Principal Physicians of Bohemia, has had extraordinary Success in the Cure of Cancers; and the Sieur Gendron, Doctor of Physick in the University of Montpelier, has done extreamly well on that Head; the latter of these Gentlemen I cannot mention, without making an Apology for not Publishing our Annotations on his Enquiries relating to Cancers which was promised at the latter End of our Chirurgical Remarks, Printed above a Year ago; but I assure you, Sir, I was more inclined for some Reasons to offer what is therein contained, with several Observations made with the greatest Exactness, and to which, perhaps I may have an Opportunity of making several Additions, in a particular Treatise, so that the whole may conspire to finish a compleat Account of this Disease. I had at first a Design of enlarging considerably on this Subject in this Letter by adding various Things, but considering they might better find a Place in what I just now mentioned, and that you did not desire an exact History of the Disease, I resolved to omit them. I shall now proceed to give you some Instances of the Success of our Method, as being what you are most solicitous of, the Cases I shall relate shall be each of them different from the other, for I know you do not approve of that pompous Method of some Persons, that enumerate abundance of Instances of Cures when perhaps there is no great Difference in the Cases or the Method of treating them.

The most considerable Case that offered it self during our first Enquiries into the Nature of Cancers, was that of a Woman, who about Four Years before received a Blow on one of her Breasts, upon which it began to swell, grow painful, and after some time became all over livid, and of so prodigious a Bigness and Weight, that she was obliged to keep it suspended by a Napkin round her Neck: But in regard our Method was not put in Practice till by other Applications it was become ulcerated, we shall speak of it as such. The Patient, then, at this time complained of a very violent Pain, which extended it self to the Back and Shoulder, by the Communication of the Nerves (for those of the Breast come from the fifth Pair of the Spine, and from a Plexus about the Clavicels.) To remedy this, she had taken no small Quantity of Hypnotic Medicines, which, without Doubt, destroy the due Texture of the Blood, and so become prejudicial to the Patient, and disadvantagious to the Surgeon that proposes a Cure. But because Persons generally find some Relief by Opiates, as they retard the determined Motion of the Blood, straiten the Nerves, and check the tumultuous and disorderly Influx of the Spirits; so, probably, in these Cases, their Use will be continued. Besides the acute Pain, the Cancer was over-spread with fungous Flesh, its lower Part extreamly hard, knotty, blackish, and its Basis seemed inclinable to fix; the Matter which was discharged was thin, reddish, and stank abominably. This was the Condition of this poor Woman, when we first applied our grand Dissolvent; the Pain she was attended with the first and second Day after was inconsiderable, nor did she complain of more afterwards, than would have been procured by the most mild and easy Remedy the Dispensatory affords. In four Days Time we found a very evident Alteration for the Better; for the Consistence of the Matter was changed, and the Surface of the Cancerous Mass became somewhat soft, we continued the Use of the same Medicine, and in a few Days more some part of the Cancer came away with the dressing. In short, in about six Weeks time, the whole Substance was entirely gone, and nothing remained to be done but to heal the Ulcer, which was effected in about a Fortnight. During the time she was under Cure we gave her a proper internal Medicine, not calculated to destroy the Acidity of the Blood, but to dispose the whole Cancerous Mass, with its Appendices to come away, which might otherwise, as the Seeds of the Disease, cause it to spring again: Thus was this Patient, (after so great a Fatigue she had undergone before she came to me) perfectly cured, and has continued so to this Time, without any manner of Inconvenience as she lately told me, it being a long time since she has been well.

A Gentlewoman near fifty Years of Age, by some Accident received a Blow on her left Breast, which in a few Days was succeeded by a considerable Tumour, whereupon she applyed herself to a Surgeon, who immediately let her Blood, ordered her to take the Lap. Hibern. in Posset-Drink, and embrocated the Breast with Ol. Succini: By the use of these Means the Swelling was much abated, a small Hardness only remaining, which did not exceed a small Wallnut in Bigness; in this State, with very little Pain, she continued above a Year; but being persuaded to apply an Emp. de Ran. cum Mer. to it, it encreased very apparently, was extreamly painful, and in Seven Months time became as big as a large Egg: After this she made use of a Woman who was reputed Famous for these Cases; but by One or Two of her Applications the Tumour became as big again as before: In short it continued to encrease gradually from that time, till the whole Breast, which was of a monstrous Bigness, and which was judged not to weigh less than Eight Pound, in time became entirely Cancerous. It was at this time that I saw it the Skin was very livid, looking sleek and shining, and seemed ready to open, as being scarce capable of longer containing such a prodigious hard Mass as laid concealed under it, and was in all Probability as big as the Breasts of the Ammonian Women, of which Juvenal thus speaks, In Meroe, crasso majorem Infante Mamillam. She had been with various experienced and reputable Surgeons before, among which was One not long ago deceased, who was justly looked upon as an Ornament of his Profession; but not one would willingly attempt a real Cure by cutting it off, or any other Way: They only prescribed some palliating Remedies to remove the Pain and prevent its Breaking. I was animated by my former Successes, and prevailed with my self to undertake it, not thinking I was at all blameable if my Success in so extraordinary an Affair contradicted the Prognosticks of so many worthy Gentlemen; and though it did, I shall at all times think my self obliged to pay a Deference to them. I began the Cure by removing the Integuments from the upper Part of the Cancerous Substance, but did not wait for a Separation of the Slough the Escarotick made for fear of being incommoded in my Procedure by a Fungus; For this Reason I mixed some of our Dissolvent with a digestive Ointment, by which Means I had a Part of the Cancerous Mass came away with it, without any Trouble to my Patient. I continued this Method of Dressing several Days longer, with very little Alteration; but upon a Complaint of a Pain between the Shoulders, I was obliged to change my Medicine, and foment the Cancer with an Infusion of some of those Herbs that contain many Volatile attenuating and active Particles. And here I cannot but remark, by the by, that Applications to the pained Part would have been of no Effect, as I have many times observed, and particularly in a Woman which had a Cancerated Breast, that was violently afflicted with a Pain in her Arm on the same Side, which would not be removed by any of the Applications the Person that had the Care of her made use of the affected Arm. To this I might subjoin a very pertinent Case from Galen; but I fear I shall digress too far. The Pain of my Patient’s Back being removed, I proceeded to apply the Dissolvent, which so softened the Superficies of the Cancerous Mass that in Three or Four Days Time I could take off above a Quarter of a Pound of it with the Edge or Back of my Incision Knife, and my Patient not so much as feel me, this I continued to accustom my self to, because it would have been more tedious to have waited for the coming away of the Cancerous Mass of it self. Sometimes I varied my Applications as I saw Occasion, but, as my Patient confessed, I scarce put her to any more Pain during the Time her Breast was dissolving (abating for the Pain of her Back) than there is in the dressing of an Issue. The prodigious Bigness of the Cancerous Mass made the Cure the more tedious, for it was above Three Months before all of it was entirely dissolved and gone; but this being at length surprisingly and very happily effected the Cancerous Ulcer (the last Part of the Cancer that came away left) was incarned and cicatrized by an Infusion of vulnerary Herbs, to which was added a small Quantity of Tincture of Myrrh: Thus was this Cure entirely compleated and my Success in it confirmed that French Proverb, which says, It is better to be condemned to die by the Doctor, than by the Judge. I did not make use of that internal Medicine I mentioned in the former Case, because here I found no pressing Necessity for the Use of it, but some other proper Physick was taken to dispose the Ulcer to heal, as one would have done in any other Case. Upon the whole of this Cure, I cannot say whether I had more Trouble with the Cancer, or in endeavouring to oblige my Patient to a strict Observance of some of the Non-Naturals she so often erred in. There is nothing can create a greater Trouble to the Surgeon




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notes



1


See Mr Ashmole’s Antiquities of Berkshire, 3 Vols. 8vo. p. 111 of Vol. 1st.




2


This Case was published by Mr Daniel Turner, Surgeon.


