WOUNDS OF THE BRAIN Proved CURABLE, Not only by the Opinion and Experience of many (the best) Authors, but the remarkable History of a Child four Years old cured of two very large Depressions, with the loss of a great part of the Skull, a Portion of the BRAIN also issuing, through a penetrating Wound of the Dura and Pia Mater. Published for the Encouragement of Young Surgeons, and Vindication of the Author, JAMES YONGE. Haec dixi ut contradicerem Opiniosis, qui non credunt cerebrum posse sanari,— juia ego cognosco, & Cerebrum sanari, & alias medullas. Jac. de Carpio, Tract. de Fr. Cranii. LONDON, Printed by J. M. for Henry Faithorn and John Kersey, at the Rose in St Paul's Churchyard 1682. Non audita loquor, narranti credite, vidi His Oculis, tetigi non dubitante manu. Accr erat Juvenis, medio cui Vulnus adactum Est Capiti; Cerebri pars quoque caesa fuit, Ille tamen vivit. Si credas Arte Melampi Id factum, peccas; hic Medicina silet. Monstra sed in Morbis Arabum Flos ille Sophorum Quod fieri dixit, re patet apse palám. G. F. Hildan. obs. m. Chir. 13. To the HONOURABLE Sir HUGH PIPER Kt, Lieutenant Governor of His Majesty's Royal Citadel at Plymouth. SIR, BEfore I enter the Lists with my Adversary, and engage in a public Vindication of myself and Fraternity, I presume to put myself under Your Patronage and Protection; For the World will have good reason to conclude my Complaint true, and my Cause just, when I dare take sanctuary under Your Name, who (besides Your impartial knowledge of us both) are in such (other) circumstances as render the right or wrong of our pretences easily discernible to You, and who have long since been well assured of the truths here related, and (by an unquestionable hand) the falsehood of those reflections my Antagonist hath made thereon. These considerations encouraged my presumption, and is all the Apology I can make for it. I know there needeth none, for the smartness wherewith I have treated my Opponent, to a Person that understands so well as You the justice of such resentments, and hath with more bravery vindicated his honour by his Sword, than ever any Writer did an Hypothesis by that sharper Weapon his Pen. Nor shall I, according to custom in applications of this nature, seem to bribe and bias Your Favour, by soothing Flourishes, and complementing Harangues, though Your constant and unblemished Loyalty, Your great Age and Courage, with the wonderful Briskness and Vivacity that accompany them; be Subjects so manifestly large and rare for Encomium and Celebration, that I might without flattery praise and admire: Yet because severe Men and Censurers will say, It looks more like the mercenary Addresses of Plays and Poems, than Seriousness and that Integrity with which I profess to appeal, and defend myself and my Cause, and is an Entertainment which few good men receive with delight; I shall decline it. But thus much I dare affirm, That how short soever I may come of obtaining satisfaction by this method of vindicating myself, and confuting my malicious Opposer; I am sure of gaining one Point of my design (for which I thank Him) that is, to let the whole World know that I am, SIR, Your Obliged, Humble Servant, JAMES YONGE. Plim. April 26th 1682. THE PREFACE. I HAD not ushered this small Tract into the World, with the formality of a Preface, had it not been extremely necessary to give my Reader an account of the occasion inducing me to publish this Case, and the provocations I had to handle my Opponent so roughly. About two years since I had the good fortune to be a successful Chirurgeon to the Child, whose Case is contained in the following Narrative: But I had scarce wiped my Instruments, and put up my Plaister-Box, before a Physician of this Town, sneakingly and maliciously endeavoured to stifle the reputation Dr. Spenser and myself got by that Cure, insinuating that it was impossible to be performed, because Wounds of the Brain were absolutely mortal. We endeavoured to rescue and secure our credits from so spiteful a calumny, by producing the Parent, the Apothecary, and others who handled and saw what came out through the Wound of the meanings. But that not satisfying, we sought Compurgators in our Books, where we found more than we expected, and produced their suffrages, to the number of no less than fifty. This was so unanswerable a Proof, and clear eviction, that my Enemy retreated and became silent. Had he so continued, this Story had remained a Secret to the World: But he, impatient and dissatisfied with people's believing so many men and Books, against his single and groundless opinion; very lately took occasion (unprovoked by any man) in company of divers Gentlemen, in a public place, to renew his reflections on us, repeating with the utmost advantage his great malice and little wit could afford, those objections we had so long ago baffled and confuted; and, not content to bond his scurrility there, he proceeded to vilify all the Surgeons in this place, calling us, A Company of Ignoramus's, fit for nothing but to cut Corns. Judge, if these repeated provocations and affronts were not enough to raise resentments in any man that had but common sense, or regard of his credit, and tenderness for his good name: I accordingly took a speedy opportunity to confront him, offered to produce Authorities against his Objections, and to vindicate our own affirmation. He himself nominated time and place for the deciding the Question; but as ungenerously (absenting) declined the Test, as he rudely gave the occasion. I resolved therefore, since he would not abide a private trial, to refer my Cause to the World, and by a public Vindication stop his mouth for ever. Having thus signified the occasion and provocation to this Effort, I hope the sharpness wherewith I have treated him will not be thought rude, nor those little heats and excursions in the Epilogue, causeless. Had he stuck to his first reflection, (though that wanted not its Dirt) and acted like a Disputant only, I had behaved my self accordingly, and continued to oppose him with as soft words and hard arguments as I could. But when he forsook the Scholar, and took up the part of a Railer, when he became reproachful and contumelious; I resolved to deal with him according to his demerit. I am not insensible how little esteem this contentious way of Writing hath in the World, and that a superfoetation of Controversies hath surfeited even a wrangling Age: But certainly for a man to be called Fool and Knave unjustly, to be disparaged in his reputation and way of living, belied and reproached in his Practice, on which the life and happiness of himself and Family depends, and this by a series of words and actions some years long, is such an intolerable indignity and barbarous affront, as will excuse and justify the sharpest resentment: To suffer such abuses tamely, is to betray and expose a man's self to the lash of every injurious Calumniator, and encourage ill-minded men to trample on and abuse us. Wherefore, let Controversy and recrimination be ever so immodish, I shall not be thereby deterred from acting once more out of fashion. If my Adversary perform his threatening promise, and answer me publicly, I will rejoin, and that with so little favour to him, that in comparison with it, the smartest I have here said will appear very inferior. But I know my Cause to be impregnable against the strongest attacks he can make; and how otherwise inconvenient (to say no worse) it's for him to attempt what he hath menaced. An Alphabetical Catalogue of the Authors quoted to prove, Wounds of the BRAIN not absolutely mortal. ACademia Curiosa Germ. Alexander Benedictus, Alexander Read, Amatus Lusitanus, Ambros. Pareus, Andreas Laurentius, Bartapalea, Bernardus Gordonus, Cabriolus, Caspar Bauhinus, Cornelius Celsus, Cornelius Gemma, Christopherus à Vega, Danielus Senertus, Desiderius Jacotius, Felix Wurtz, Franciscus Arceus, Franciscus Sanchez, Franciscus Valeriolus, Gabrielus Fallopius, Galenus, Georgius Horstius, Glandorp, Guido Cauliacus, G. Fabricius Hildanus, Henricus Petreus, H. Fab. ab Aquapendente, Hilkiah Crook, Horatus Augenius, Jacobus de Carpio, Jann Van Beverwik, James Cook, Jaques Guilleameu, Joannes And▪ à Cruse, John Banister, John Brown, Joannes Bilgerus, Joannes Fernelius, John Goulart, Joannes Heurnius, Joannes Langius, Joannes Rhodius, Joannes Scultetus, Joannes Skenckius, Joannes Tagaultius, Joannes Veslingius, Leonardus Fuchsius, Marcellus Donatus, Musa Brasavolus, Nicolas Nicolaus Flor▪ Paul Barbet, Peter Borellas, P. J. Fabrus, Petter Forestus, Phil. Jacobus Sanchz, P. J. Lotichius, Peter de Marchetis, Peter Pigreus, Sergeant Wiseman, Simon Aloysius, Symphor, Campegius, Theodoricus, Thomas Bartholine, Volcher Coitarus, Zacutus Lusitanus. ERRATA. PAge 11. line 20. read ℥ viij. p. 19 l. 19 r. Rad. Poeoniae, p. 27. l. 12. r. Cephalick Julep, p. 46. l. 12. r. all else, p. 49. l. 18. r. Objection. THE HISTORY OF A Wound in a Child's Brain, cured, although some part thereof issued forth, together with a large piece of the Skull; with Remarks thereon. ON Saturday the 28. of February 1679. I was called to Swilly, a House above a Mile distant from Plymouth, where Mr. John Stone was retired with his Family, to secure them from the small Pox, at that time raging in Town: He had a Daughter, almost six Years old, and a Son that was then four Years, and two Months, a sanguine fair Child, but somewhat sickly. These two endeavouring to get into a Field, where they espied a Maid milking of Kine, pulled at the Gate thereof, which she had shut; they unhappily tugged at a part of it which was heaviest, and lose, and by their little strength, made the defective hinges give way, so that the Gate fell upon them; the Girl escaped without hurt, but the Boy unluckily falling, had his head crushed between the heavy end of the Gate, (so heavy, that a man could scarce lift it) and a small stone, that stood above the level of the ground: this stone bore against the left Bregma somewhat above the Ear; opposite to which on the other side, about the same distance from that Ear, a pin of Wood an inch square, that stood out half an inch from the Gate, and served to fasten an obliqne piece to the bars; being forced by the weight of the Gate, made a small wound, but a very great depression; it bled much, the Child cried a little, did not faint, nor convulse, only vomited two or three times. This Accident happened some hours before I came to the House, in all which time, nothing had been applied to, or removed from the Head; I presently laid it bare, and upon examination by my fingers, found where this little wound was, and that the Skull under it was largely depressed; I cut and shaved away the hair from about it, in doing which, I used warm Sack diluted with water, and glowing coals, (not charcoal, it being hurtful to the head, and suffocating) to prevent ill impressions from the air, at this time cold and raw. That being done, I entered my Probe at the wound, and found the scalp separate from the skull a great way, and that there was a very large depression of the latter; I therefore resolved without delay to dilate it, and free the Dura Mater from any shivers or splinters of the bone, that might prick or offend it. Mr. Knotsford the Apothecary, was just then (unknown to me) come into the chamber, and stood behind me, when withdrawing my Probe, some of the Brain came out upon it; I rubbed it on my hand, and bruised it with my finger, and found it to be Brain. Before I would proceed to incision, I entered my Probe again with the eye forward, and endeavoured to get out what I could at once (the instrument being both times without the skull only) it brought forth as much as two Pea's, Mr. knotsford presently apprehended it, and whispered to me that it was Brain; I than put it from my Instrument on his hand, and proceeded to dilate the wound by an incision knife; after doing it, several parcels of Brain appeared among the blood, I cleaned it off, and finding the depression to be but of one piece, and that none of it, or aught else offended the Dura Mater, I dressed it up with Dossils', dipped in Mel Rosatum, and Spirit of Wine made warm, and covered all with a plegent of linimentum Arcei. This great mischief, I found, was done by the Pin of the Gate, a Figure of which I have here inserted, that every Reader may be able to understand this part of the Story. The place where the Pin was, is marked + disagram of a gate This Wound, thus dressed up, I examined the rest of the Head, and found on the other Bregma, an Ecchymosis; and under it another depression. I shaved off the Hair from thence also, and with the same Razor excised a piece of the Scalp, as big as a Shilling, which laid bare the depression and fracture, which was such as I could not then elevate. I filled this wound with Dossils' of dry Lint, covered with a plegent of Arceus lineament, over all laid a Plaster, rolled up the head, and laid the Child (who endured all with incredible courage) to Bed, his head bolstered as high as he could well lie. Having dispatched a Messenger to Plymouth for necessaries, I examined that part of the Brain which I had taken out; the Father, Mr. Knotsford, and others, saw it, and were assured that it was such; no man of brains can imagine what else it could be. I than gave the Father a dreadful Prognostic, though not of positive death, (as I secretly thought) but the utmost hazard thereof, and desired the assistance of Doctor Spenser. That Evening I gave the Child a Clyster, which having wrought two or three times, I got him to take the following mixture to sweat, and a little draught of a Cephalick Julep upon it, these kept him in a small Diaphoresis all Night, the Julep in little quantities being sometimes repeated to him; they being Diaphoretical and Cephalick, were good for the design I then had, viz. to comfort and relieve the Brain and Head, so egregiously hurted; and to prevent coagulation, or other mischievous effect, of the Contusion. The Clyster. ℞ Decoct. come. pro Clyst. ℥ x. Mel. Anthosat. Ol. Hyperrici c. ana ℥ ij. Succini Chym. Gut. 8. Sal Gemmaeʒsx. M. fiat Clyst. The Sudorific Mixture. ℞ Pulu. ad Casumʒs. Sperm. Ceti gr. 12. Balsam. Peruv. gut. iij. Syr. Betonicae ℥ ss. misce. The Cephalick Julep. ℞ aq. Cerasor. nigr. Flor. Tiliae. Jugland. s. Betonicae ana ℥ iij. Syr. paralyseos Aq. poeoniae comp. ana ℥ ij. Pulu. guttetae Tinct. succini anaʒi. M. The Child sweated very well, and slept quiet most part of the Night, had no more vomitings or convulsions, etc. but was as if he ailed no other than a common slight wound of the head. The sharp Point was depressed so, as the surface of it was contiguous with the inside of the Skull, from whence it was separated, so that it was fallen just the thickness of the Child's cranium; this made us fear it might hurt the Dura Mater, and therefore we resolved (though no symptom argued any such thing) to at tempt the raising of it. I was so close, that we could not enter an Elevatory, and therefore at that time left it, as it was, and dressed it up as the day before; all this while the whole head was guarded with woollen stuphes, wrung out of the following fomentation, made hot. The Fomentation. ℞ Fol. Betonicae m. iij. Verbenae, Centaurii, Hyperici, Paralyseos ana. m. ij. Herb. Salviae, Rorismarini, Lavendulae ana. m. j Praep. & coq. aquaf. q. s f. colatura. Opening the other wound, and taking out the Dossils' that I had laid in the day before, several small portions of the Brain shown themselves among the grumous Blood, and on the dress; but we were not more astonished at that, than when we saw a prodigious piece of the skull, beaten in, and wholly separate from the rest, and (which was a very ill circumstance) the outward table being broken narrower than the innermost, made the deepest piece larger than the hole it had made, so that at that time we could not get it out, and indeed we were not solicitous of it, since it no where hurt the Dura Mater, and for aught we knew, might secure the torn meanings and keep the Brain from spewing out extravagantly. So that having cleared the part of matter, etc. I then only made yesterday incision into a cruciat, by which that whole fracture lay open; we dressed him as before, and rolled up his head upon a Stuphe, dry wrung from the fomentation. A little before, and during this dress, he took of his Cordial, Cephalick Julep, though the Child's courage seemed not to need it. He had no heats upon him, nor made any complaint, but a little of the incision; although he was as perfectly sensible and apprehensive as ever. The same Julep was kept by him, that was first ordered, excepting that instead of Syr. Florum Paralyseos, was mixed Syr. Poeoniae simple. and the addition of Aqua Hirundinis, Rond. ℥ i. The Clyster was repeated every day for some considerable time, as being extremely necessary to divert humours from a too great recourse to the head. His Diet was Water-gruel, with Corinth's, &c. thin Broth of a Chicken, wherewith was boiled Pearl Barley, Hartshorn, Raspt Ivory, Flowers of single Paeony, Sage and Rosemary; he sometimes drank small beer (not bitter) with a Tost rubbed with Nutmeg, but more commonly the following Julep: ℞ Flor. Poeoniae Rorismarini ana P.j. Hordei perlat. Ras. C. Cervi Eboris ana ℥ ss. ℞ Poeoniae M. ʒiij. Visc. Quercin. ʒiss. Tamarindar. ℥ i. coq. aq. Font. lib. iij. ad lib. ij. ℞ Colaturae lib. ij. Syr. Poeoniae ℥ ij. Aq. Poeoniae comp. ℥ j Misce. The second Night the Child slept indifferently well, and continued in good temper and courage; we again opened the left side, and attempted to fasten a Terebra into the depressed Skull, and thereby to raise it: But it seemed so to shake, and yield to the pressure of that Instrument, that we desisted, doubting it might force it wholly in, to which (considering how small the sound part was) we feared it would be very incident. I endeavoured therefore by a Head Saw and a Rasp, to enlarge one of the Seams, that we might enter an Elevatory; but when we had done so, we could not raise it, without hazard of forcing down the sound part of the Skull, or breaking in pieces the depressed, the one was so thin and weak, and the other so tied down, to its depression. Considering therefore that we had made breathing enough, that there was no ill symptom, and that when any occurred we should have time enough to use force; we resolved to let it remain, and, strewing Cephalick Powder on it, with dry Plegents of Lint, dressed it up as before, and betook ourselves to the other more dangerous part of our work. Upon opening of which, we saw again some little owzing of the Brain among the matter; but not so very distinct as before: we now resolved to extract the piece of Skull. After some little time I did it, by turning it so that the narrowest part of it might come to the broadest of the Gap, when holding it fast with a Crow's Bill, it easily came forth. It was dreadful to behold what a breach it left, as may be imagined by the following Figure, which is exactly its shape and bigness. diagram of the piece of skull A is the part that was undermost, next towards the ear. B is a rima or fracture of the outward Table only, the inward remaining whole, but on the depression bend, and yielded so, that the Angle of that part, marked A (the edge whereof was very keen, by the obliqne transient division thereof) ran through the meanings, into the Brain. This we concluded from the place where the wound was made, and the length of it, both corresponding with the situation, of that part of the depressed Skull, and the length of that end of it, which bent at that crack, like a half broken Stick. C is the end towards the Lambdoidal suture. D that towards the Coronal. E the upper part towards the Sagittal. The wound on the Membranes we saw plainly, with some effusion of the Brain; but it happened (though in the inferior, and consequently most disadvantageous place, because more apt to shed Brain) that it was below the edge of the sound Skull, so that it became succoured thereby, and (the Child being young, the Membranes more soft, and apt to consoliclate) coalesced the sooner, for after four days we saw no Brain. We made our dress this time after this manner. We had a good Guard of hot Stuphes, to defend from the Air, and having cleansed out the part, and smoothed the uneven edge of the Skull, we dipped a Synclon (that is a piece of fine Cloth, bigger than the extracted Skull, having a thread fastened to the middle to draw it forth by) into a mixture of warm Spirit of Wine, Honey of Roses, and Balsam of Peru, and with a Probe thrust the edge of it between the Skull and Dura Mater. Upon it was strewed Cephalick Powder, covered with dry Lint. Then I snipt off the lips of the Cruciat, and, laying on a plegent, armed with Arceus' Lineament, rolled him up. This day we ordered Tinctura Ambrae Griseae to be given in his Cordial, six or eight drops at a time, as there appeared need. The Cephalick Cordial he took at pleasure. And here I cannot forbear to celebrate the admirable, and as it were prudent, courage of this little Gentleman, more especially remarkable in three things; First, That he was very quiet and steady, scarce wincing at whatever was done; and this from a sense of its being beneficial and inevitable: as appears by the second, That when one of the Bystanders (whilst I cut him) observing him mute, feared him to be in a swound, and peeping into his face, asked him how he did, he briskly replied, Pretty well; and, as if he had apprehended the cause of her enquiry, added, They don't hurt me. Thirdly, That once, on a more painful and tedious dress than ordinary, he prevented himself from crying by biting a Linen Cloth hard in his teeth, and pulling it with both hands; A cunning way to ease himself, and be silent! Next Day, being the 4th from his hurt, we found he had had a good Night, and was courageous to a Miracle; I shaved the whole head, anointed it with a Cephalick, Balsamous Lineament, and laid on a Plaster of equal parts, Opodeldoch, and Empl. de Betonica, then dressed the wounds as before, and covered them with Plasters made of equal parts of Diapalma and de Detonica; some Vulneraries were added to the common Julep, and the Flowers of Betony, Rosemary, Sage, and Paeony, seethed in his Broths and Grewel, by which they were not only made Cephalick, and good for the part offended, but balsamous, and a remedy for the wounds, and other effects of the contusion. Each dressing we did also anoint the Neck all round, the Temples, behind the Ears, and on the Backbone, with the following Lineament, (the same wherewith we had anointed the Head before the Plaster was laid on) the design being to comfort, strengthen and heal those parts. ℞ Ol. Catellorum, Hirundinis, Castorei, ana ℥ ss. Nucis M. per Inf. ʒij. Succini rect. ℈ j Balsam. Peruviani ʒj misce. The Child continued in great heart and courage, under the use of these means, for many days, no remarkable symptom or alteration occurring, save that the wound became more tender. After a few Days, when we saw the continuance of that Balsamous Dress, to the crassa meninx, had united the wound there, we used instead of it, what might be more digestive, ℞ Lineament. Arcei, Ol. Rosarum ana ℥ ss. Terebinthinae ʒij. Balls. Peruviani ʒj. misce. The Syndon being dipped in some of this, made warm, produced good digestion in a short time, but the Skull scaled very slowly, a thing not unusual, and without cause in Children, whose Bones being soft and moist, are therefore tedious in exfoliation; we used nothing at first to induce it, but this Cephalick Powder, ℞ Rad. Aristoloch. R. Iridis Florent. Dictamni, Rorismarini sic. Sarcocollae, Myrrhae, Olibani, ana ʒj, fiat pulv. subtilis. and towards the end to have it more drying, to suppress or prevent fungus, and quicken desquamation, added the Bark of Guaiacum in Powder to it. In all that time the Powder by exsiccating the moisture that causeth fungus, kept any from arising, a thing so usual and vexatious in Children, that scarce a small wound in their heads can be cured without it. To be short, the Dura Mater united in four or five days, the unition was confirmed, so as we used digesives after five more, digestion was procured in a Week after. And in about six Weeks from the first dress, the Skull scaled, the Flesh grew up from the Dura Mater, and under the scale of the Skull, and became level with the Skin; it would sometimes be exuberant, and soft or spongy, before it could be cicatrized, a gentle touch of Roman Vitriol, and sometimes strewing prepared Lapis Calaminaris thereon, shrank it up, and cicatrized the left wound in seven Weeks; but the right remained three months. For it was not only difficult to make a final desiccation thereof, because of the moisture gleeting from within the Cranium, but necessary to delay it, that the matter might discharge itself, as it gradually decreased. In performing this last part, I used a very desiccative Sparadrap-Plaster, (that is, made by dipping in it when relented) which being laid double served not only as a desiccative and a defender from confluxion, by its gentle adstringency, but by its stubbornness and strength defended the part from hurt by blows, falling, and such other accidents as Children are liable to. During the Cure, besides the frequent use of Clysters, we purged him four times, beginning after five Weeks; at which time we made him a Cephalick Electuary to take twice, or oftener in a day, the quantity of a Nutmeg. About the time of exfoliation, he began to be vexed with a Cough and Catarrh, for it he was purged twice, had some pectoral things, etc. which removed that accident: and in the conclusion we ordered ten or twelve drops of Elixir Proprietatis Paracelsi, to be some mornings given, in what Vehicle was most acceptable to him. This is truly and bonâ fide an account of the whole process in this Cure, which while I was writing I resolved to make as particular in the manner of the operations, and matter of the curatory method, as I could, having always thought it a great defect in many Relators of Observations, that they have not given a Diary of their principal applications, successes, variety of symptoms, etc. most seeming rather to report that they cured such a Disease or accident, than how they did it. And that my Reader or Adversary may not surmise or object, That at the distance of time, and intermixture of other avocations, some circumstances may be less certain to me, it being improbable I should remember so particularly as I seem to relate; I do assure them (and will at any time demonstrate it) that I keep a Diary of all accidents occurring in my Profession and Practice, though very much inferior and less considerable than those I have here recounted; from whence I supplied the defects of my memory in drawing up this History. And as a proof à posteriori, of the firmness of his head since we left him, it's well known he hath recovered once of a malignant Fever, and another time of the Measles; in the former he did indeed complain much of his head paining him; but that I imagine to be nothing, or little more than he would have done, had that accident never betided him: At this day is he alive, brisk and sound, hath no obvious fign of any infirmity but a wan face, and that not considerable, resulting rather from his constitution than sickness, being no other than he had before he was hurt. Thus have I finished the History of fact and success: I must beg my Readers permission to make a few Remarks thereon; they are such as I hope may compensate for the time and trouble of a perusal. First, therefore, we will look back and consider the greatness and plurality of the wounds and fractures, the loss of so large a piece of the Skull, the wounds of the Dura and Pia Mater, and of the Brain, together with the loss of part of it; the coldness of the Season (a most injurious time for such an accident) the hereditary infirmness and age of the Patient, and confess it's not usual to have such an accumulation of very ill accidents and circumstances, to be not only accompanied with such slight symptoms, but recovered so fortunately. This is a suggestion which I make not vaingloriously, but to document and encourage young Practitioners, that they be resolute, not despairing of success in cases that seem the most difficult. To give a favourable Prognostic where there is apparent danger, is rashness, and frequently discredits the Artist. I would not put courage into his tongue by this Inference, but hope and vigorous vigilance into his heart and hand; and how terrible and discouraging soever the Case be, to proceed strenuously, as if there were the greatest probability of success. No mischief (only a little disappointment) can be the worst effect of a courageous endeavour; but many and great evils have been the result of despair, and great and stupendous the success and benefit that have attended a courageous and resolute Undertaker. Despair! the great Enemy to all Achievements, and remora to improvement of all good things; Courage! the great Discoverer and Columbus of Art, a temper to which the most noble acquisitions, not in War only, but in useful knowledge, are owing. Neglect is the consequence of despair, for men do but by halves what they think is impossible to be finished; whence they too truly verify their own Prognostic: G. Fallop. cap. 45. lib. expos. Hip. de Vulner. Sennertus' p.m. lib. 1. part. 1. c. 23. whereas hope and courage, with a diligent use of proper remedies might have saved the Patient. Hildanus Obs. cent. 1. obs. 13. Exempl. 4. cent. 4. obs. 2. And this I find to be the advice many Authors infer from the Cure of wounds in the Brain.— Itaque nunquam derelinquatis aegros, semper sprerate salutem. Nothing hath been more the Parent of despair, or benumbed men's courage and endeavours, so much as the Maxims and Prognostics of former, especially the first Writers, if such as are delivered down to us with great Name and Character; for than they seem confirmed by universal consent and constant Tradition. Macrobius, Langius and others speak idolatrously of Hypocrates; and a more modern Physician little less, calling his Aphorisms and Predictions, Heurnius Com. in Aphor. Hippocrat. Books full of Divine Oracles. Indeed among all the first Physicians, Hypocrates and Galen are of the biggest Name, and most continued and deserved repute; the former so happy to escape the censure, and have the praise of him that ranted all that were before this Age, Helmont. and spared very few in it: and yet it cannot be denied that some of his Aphorisms are not only contradicted by daily experience, but confessed fallible by his many Expositors and Commentators, although such as extravagantly admired him. I will instance but in two or three, on one of which I shall remark at large, as being that which seemeth to have been the Parent of this Principle I am labouring to destroy. Indeed the high veneration I have for so great a name as his, to whom the Art of healing is so much a Debtor, renders it uneasy to me to object against any thing he hath delivered, Sed magis amica veritas. Sect. 5. Aphor. 31. Mulier utero gerens, sanguine misso ex vena, abortet— Sect. 6. Aphor. 58. Si omentum excidat, necessario putrescit. Sect. 6. Aphor. 18. He that would see more of these let him read Sanctus Sanctorius, Methodi vitandorum errorum omnium qui in arte medica contingunt; especially lib. 1. cap. 31. Vesica descissa, aut cerebro, aut cord, aut septo transverso, aut aliquo ex tenuioribus intestinis, aut ventriculo, aut jecore, lethale est. Divers have been the ways his many Commentators have taken to expound this Aphorism, and interpret the word lethale: By it some would have us understand he meant that they are for the most part deadly; others that there is danger of death; and some, that he means only large or very deep wounds of those pares, vide the Comments of Galen, Jacotius, Brasavolus, Chr. à Vega, Fallopius, Forestus, Heurnius, Fuchsius, etc. I shall note in general only, That there are numerous instances against each part of this Aphorism, produced by these Commentators, by Tagaultius, the Germane Vertuosis, etc. and betake myself to that especially therein which seems to authorise the Objections of my Adversary against what I have here delivered; which is, That Wounds of the Brain are absolutely mortal and incurable: An opinion that so far obtained among even the remotest Successors of Hypocrates, as to make some of them write after his Copy, as J. de Vigo, Mr. Woodall, P. Lowe, Paracelsus, and Jaques Guilliameau, (though the last, after he had so prognosticated, (without reserve) in his Chapter of Wounds of the head, concludes his Apology, at the latter end of his whole Work, with a prodigious Story of one cured by himself) and others I fear, to rely thereon so far, as to despond, and become negligent, and consequently suffer to be lost the life of that Patient, who by a man of other persuasions might have been preserved. Such is the mischief of implicit credence, and receiving for Oracles the Dixits of men, who (we all confess) died before the most considerable and advantageous things in Anatomy, Medicine and Chirurgery were born. The folly and vanity of so doing in this Particular will be abundandy manifest, when I come to reckon the Authors and Observations that are opposite to it. But before I proceed to that, I must make a necessary Note or two more, for the benefit of my young Brother, and observe to him the great advantage of sufficient breathing in fractures of the Skull, or hurt of the parts within it; for to no other but such a liberal and copious vent, for the discharge of matter, etc. can be attributed the wonderful lenity or remissness of symptoms in this Child: It's usual for want of it to have vehement accidents, Sopor, Vomitings, Convulsions, Fevers, intolerable headache, hemorrhages at the Nose, Eyes, Ears, etc. and all to vanish upon discharge given by a Trepan. By this Observation more particularly I have seen the falsehood or mistake of that Objection which H. Rhoonbuyse, Observe. Med. Chir. part. 2. Obs. 1. and Monsieur de Foy urge against the use of a Trepan, viz. That the Dura Mater adheres firmly to the inside of the Cranium, and that it cannot be separated therefrom without laceration; nay it sticks, saith Monsieur de Foy, so fast as Paper pasted to a Board. And hence they take occasion to render not only Trepanning and all Perforations impertinent and useless, but make an absurdity of what's a most common Observation, viz. (which I just now noted) that large breathing or discharge prevents the severe symptoms of Convulsions, Vomiting, Sopor, etc. by venting off the matter: For if the Dura Mater so closely and firmly adhere to the Skull, and therefore trepanning be dangerous and useless; upon the same reason and principle must all discharges be of no benefit, yea they are impossible; so that they deny not only what is commonly inferred, That the discharge prevents the deadly symptoms; but tacitly disown the possibility of any such efflux: since it the Dura Mater and the Skull be so united, there can be no room for matter there to lodge. But forasmuch it's frequently seen that large quantities of blood and matter ure to gleet out of cracks and perforations of the Skull; we may conclude them mistaken till they tell us from whence that should come, and where it lay, except there be a space between the Dura Mater and Cranium. I have, upon opening the Skull of one dead by a fall or blow, seen almost all the Dura Mater covered with coagulate blood, and in some places near half an inch thick; but more remarkably doth the History of this Child confute the pretended observation of these two men (although they say Silvius de Boe and Blasius were Eye-witnesses) for here was many days a sensible evacuation from under the Skull, of much matter, at first serous, and sanguinary, but afterward concocted and laudable. If it be alleged, that this was matter descending from the wound of the Calvaria, it doth not answer me; for come it whence it will, it supposeth that there was room to contain it under the Skull, and consequently that there was no such adhesion as they pretend. If it be further urged, That upon such accidents as fractures of the Skull, Concussions of the Brain, etc. the extravasate blood, separates the Dura Mater, as Serum doth the Cuticula in application of Cantharideses, or scalding; then their inference against Trepanning is out of doors, and it remains as safe and needful as, if their exploration had never been made. I must profess that I never found any truth in their discovery by divers dissections, trepanning, etc. nor in this Child, but that the large piece of Skull I extracted had not the least adhesion to the Dura Mater; certainly had it been so common, or, as they say, constant an Observation, it's probable in one so young, where parts are usually less distinct, and separation imperfect, it must have been found. The Summary of all that hath been said in the Remarks on this Case are reducible to these five Consectaries, First, That improbable and discouraging accidents have been cured, and that therefore we never ought to despair or esteem any thing absolutely mortal; Secondly, That we may be deceived by relying on the Axioms, Aphorisms and Prognostics of the Ancients, though of the most constant and universal reception; Thirdly, That wounds of the Brain in particular, are curable, Fourthly, That ample vent through the Skull in fractures thereof prevents the direful symptoms, and the want of it, occasions them; and lastly, That the Dura Mater doth not always adhere to the Skull, but trepanning is safe and necessary, and, Monsieur de Foy and Rhoonhuyse in an error. My next Work is to produce my Vouchers, the Authors that affirm wounds of the Brain curable. Some from their opinion, confirmed by History; but most of them from their experience: the number of the Evidencesare sixty four, that of the Experiments a hundred. I hope it will not seem superfluous and redundant to produce so many, since in matters of great dispute, and where an Adversary is very cofident, it's not only usual, but a great credit to the Cause to have a multitude of Witnesses. It's no less necessary to produce all those, and more, if I had them, to show the wonderful ignorance of my Adversary, in not knowing any of them; or his wickedness in dissembling that knowledge (so common and familiar to men of reading, in his Profession) and that only because he might have the better pretence and colour to abuse. A COLLECTION OF THE Opinions of sundry good Authors concerning Wounds of the Brain, wherein no less than sixty affirm them curable, and confirm it by above an hundred Observations. GAlen in Comment. ad Aphor. 18. lib. 6. Hippocratis— Cerebrum vulneratum, saepius sanatum vidimus, & semel, & bis in Smyrna joniae, vivente adhuc Praeeeptore Pelope, & erat Vulnus satis effatu dignum— Idem, de usu partium, cap. 10. lib. 8.— Admirabile spectaculum, atque incredibile, quod Smyrnae in jonia accidit, aliquando sumus conspicati, Adolescentulum Vulnere in alterum anteriorum Ventriculorum accepto, superstitem fuisse Dei (ut plerisque videbatur) voluntate. Nicolas Nicolaus Flor. Serm. 7. Tract. 4. cap. 91. writing of one wounded in the head by a Sword, saith, Profundato vulnere, usque ad substantiam Cerebri, super verticem in anteriore parte Frontis, usque ad medium Capitis, qui sequenti die post vulnerationem, incurrit paralysim universalem,— rectus evasit. Jacobus Carpus Tract. de fract. Cranii— Vidi ad hunc usque diem, sex homines, à quibus notabilis quantitas medullae cerebri exivit, & sanati sunt,— & habui fideles & peritos physicos in societate, à quibus in prima vet secunda visitatione aegro, extraxi à labiis vulnerum magnam cerebri partem, quae ex se exierat cranium; he proceeds to give very particular accounts of each, and brings Persons of great Name, one of them being Nephew of the Cardinal of Histrigon: Et ad istum habui multos Nobilissimos Testes. M. Brasavolus Comment. ad Aphor. 18. lib. 6. Hippoc. Nos in Cerebro vulner at is mira vidimus: in uno, qui Magnificis Valengis inserviebat, tanta substantiae cerebri quantitas exivit, quantum est parvum galliae ovum, tamen evasit:— Alium vidimus ex Corsica mili●em, cui sere dimidium Capitis, cum sua cerebri portione, ablatum est, qui convaluit. N. Massa Tom. 2. Lib. 1. Epist. 11.— Ego testor Deum, & quamplurimi homines qui adhuc vivunt, testes sunt, me plurimos vulneratos in capite, cum incisione ossis panniculorum & insignis cerebri substantiae, sanasse art & remediis medicinalibus— laceratio in substantia cerebri, cum deperditione non modicae cerebri quantitatis. Inter quos vivit adhuc Clar. P. Raymundus, Vir Nobilis Venetus— who, he saith, was wounded in the backpart of his head with a Sword, whereby the meanings and substance of the Brain were hurt; the wound being two fingers long, and as deep as three fingers are thick.— Sanitati restitutus est. Testes sunt imprimis non pauci hujus Civitatis Medici, ac etiam tota & Nobilium, & Civium Multitudo. Sanitati etiam mea opera restitutus est Marcus Goro, who was wounded on the Crown by a Halberd, which drove several pieces of the Skull through the Meninge into the Brain. We lay dead till he drew them out, and then like one newly awake cried out, Ad Dei laudem, sum sanus; for witnesses hereof, he brings the like persons as in the Case before: Medicorum omnium, Nobilium Senatorum. Alphonsus quoque Bononiensis, qui percussus fuit cum ense, in part sinistra capitis, inter suturam sagittalem & mendosam, cum incisione non solum ossis & Membranarum, sed etiam insignis quantitatis substantiae Cerebri: etenim vulnus erat ad longitudinem unius digiti cum dimidio, ita ut manifestissime substantia cerebri incisa inspiciebatur, & digito tangebatur; cui supervenerunt accidentia omnia mala mortem & interitum attestantia,— Qui tandem Domino auxiliante evasit.— He also cured Theod. Bua a Greek, who not only lost his left hand, but received four great wounds on his head with a Sword; they were horrible to see, the Brain was considerably wounded, and terrible accidents followed, which he removed, and cured the Patient, non sine maximo stupore totius Civitatis. He also cured a young man whose Brain was wounded by a Blow, made with a Staff by a strong man. He cured a Servant of D. Pasch. Myshochiae, whose Brain was wounded between the Coronal Suture and the Forehead,— Possem quamplurimos alios mirabiles casus cum incisione, & laceratione substantiae cerebri sanatos enumerare,— dicant antiqui & moderni Medici, quicquid sibi placuerit. Christopherus à Vega Comment. ad Aphor. 18. lib. 6. Hippoc.— Multa vidimus sanata, quae ad cerebri substantiam perveniebant, & amissa cerebri ipsius portione. Fr. Arceus lib. 1. cap. 6. de Cur. Vuln.— Nos Dei auxilio, multos è maximis & gravissimis vulneribus liberatos testari possumus; inter quos bactenus novem jam sunt, quibus non exigua cerebri pars perierat.— One wounded by a Sword, whence issued as much Brain as three Wheat-Corns; secondly, A Boy of ten years old, wounded in the forehead by a Mule, the edge of whose Iron-Shoe stuck in the Bone, and lost as much Brain as the quantity of a Lentil; the fourth, A man who had the hair, flesh and skull beaten through the Meninge into the Brain, by a blunt Dart [Telo obtuso;] a fifth, Servant to the Marquis de Falcis, wounded after the same manner, by a blow of a Candlestick; a sixth wounded by the fall of a Stone, a Cubit long and broad, weighing twenty four pounds, on the Sagittal Suture. Corn. Gemma lib. 1. cap. 6. Cosm. Sic in vulneribus Cerebri, fragmento Calvarivae ad mollem usque Meningem, per duram prorsus adacto, nonnulloque ipsius substantiae apparente effluvio, nuper è populo quidam, Nobis manum admoventibus est restitutus. J. Andr. à Cruse lib. 1. tr. 2. cap. 14. Chirurgiae— Hoc anno— ac alibi dum juniores essemus, vulnera Meningarum & cerebri sanavimus, & sanata vidimus, nec sumus decepti,— he than names many Witnesses— Et paulo post Feltriae nos fuimus in curatione cujusdam Adolescentulae, quae cum à cuspide falcis, vulnus cum cerebri laesione passa fuerit, ex quo terebrata Calvaria, notabilis portio ipsius cerebri exivisse competum est, transacto quarto mense sanitati fuit restituta— Horatius Augenius Tom. 1. lib. 9 Epist. 2. Vidimus nos aliquando totam substantiam cerebri vulneratam, ventriculos dissectos, aliquam etiam portionem cerebri, cum vulnere jam primum illato, foras profluxisse; hominem tamen vulneratum, sanitati fuisse restitutum. Bartapalea de fract. Cranii cap. 5. Et semel habui unum, Rusticum, cui erat remota pars medullar is cerebri, qui est sanatus. Theodoricus lib. 2. cap. 2. Chirurgiae.— Quia multos fractis ambabus membranis, & aliquos à quibus non parva quantitas medullae exivit, perfectè sanari vidimus.— Scivi hominem, cui una Cellularum tota evacuata fuit, & tandem repleta carne loco cerebri, per Dom. H. sanatus est.— Volcherus Coiter. lib. obs. Chir. & Anatom. tells us of one be cured in the house of Caesar Malvaticus a Noble Man in Bononia, wounded by a Sword. Vulnus verò ab osse Bregmatis sinistri lateris, paulo post aures incipit, & transversim per musculum temporalem, qui totus transcissus fuit, ad oculi canthum majorem sese extendebat, atque in cerebri profundum ad ejusdem lateris ventriculum fere penetravit,— horrible symptoms followed, much Brain came out,— postquam curatus fuit. The same Author in the same place relates at large the Story of a Soldier, who by the splitting of a Gun received a wound— inter supercilia pefregit, & ad dimidii digiti longitudinem, in cerebrum oblique dextrorsum ingressum est. Some other pieces wounded him on the eye, and several other places; so as he seemed dead: a Barber dressed it at first, very ill; when by Command from the Duke of Bavaria our Author was called, many very horrid symptoms attended, and yet— ac tandem 13 post inflictum vulnus mense, valetudinem pristinam recuperavit. Guido Cauliacus, The same qoutation I find in the Scholia Obs. 2. l. 6. P. Forest. Obs. Chirurg. A. Parcus l. 10. c. 22. as quoted by Desid. Jacotius Comment. ad Aphor. 15. lib. 1. sect. 3 coac. Hippoc. and Tagaultius, Inst. Chir. lib. 2. c. 3. se quendam vidisse affirmat, cui ex vulnere parte capitis postica accepto, parva quaedam portico substantiae cerebri exierat.— & tamen is à tali. vulnere convaluit. Er. Valleriolus lib. 4. obs. 10. lib. 5. obs. 9 lib. 6. obs. 4. giveth three Histories of wounds of the Brain that were cured. Cabrolius obs. 16.22. & 24. relates. the Histories of three more cured. Gabr. Fallopius Expos. in lib. Hip. de vuln. c. 45. directeth to a method of curing wounds of the Brain, and concludeth, Ego etiam mirabilia expertus sum: Vidi Zinganum, Januario mense frigidissimo, partisanone percussum, & sectum est dimidium fere caput, & major quantitas Cerebri exiit, quan includi possit in ovo gallinaceo, & sanatus est. Notate tamen, quod vidi multos in quibus egressum est cerebrum, & aliquot remansere stolidi, aliqui supervixere usque ad 120 dies, aliqui sanantur, & integri remanent. The same Author Tom. 2. cap. 4. de Vuln. in genere, disputing against this common acceptation of Hypocrates 's Aphorism, faith, Quinimo & ego ipse praeter alia multa, exemplum habeo de quodam, cui Ferrariae in maximo frigore, ac etiam Pado glaciato resecta fuit quantitas cerebri bri ad instar Ovi Anseris; & tamen sanatus.— Ego probo ex eodem Hippocrate 2. Prorh. ubise interpretatur, dicens, quod partes vulneratae, si inferant mortem, oportet ut sint validissime vulneratae— Peter Forestus obs. med. lib. 9 obs. 35, 36. and in obs. Chir. obs. 2. lib. 6. in the Scholia on those Observations, he discourseth the various interpretations of Hypocrates, Aphor. 18. lib. 6. that it denieth not, but that such wounds may be cured; and himself gives divers instances and authorities to confirm it. Amatus Lusitanus curate. med. obs. 83. cent. 2. saith, he saw a young man at Rome wounded in a Duel— Per frontem ensem immisit, ex quo vulnere illico laesus in terram concidit, & eum humi prostratum— All the Physicians and Surgeons agreed in opinion that he would die.— Tam enim penetrans dirúmque vulnus erat, ut cerebri substantia incisa, perforatáve crederetur— He concludes from the unexpected success, at which all were amazed, that the Sword went between the Ventricles of the Brain, etc. H. Fab. ab Aquapendente lib. de vulner. c. 20. Pia Mater omnino tenuis est, & prorsus cerebro adhaeret, ut vulnerari nequit sine cerebri vulnere; haec vulnera ferè semper sunt lethalia, interdum tamen aeger restituitur,— ac nuper in magno cerebri vulnere felicissimo successu, hoc sum usus: ℞ farinae Milii, etc. Zacutus Lusitanus, Prax. Admir. lib. 1. obs. 5. Decennis Puer percussus est cum ense in part posteriore capitis. Hic passus est vulnus satis magnum, cum incisione ossis Velaminum, & deeper ditione substantiae cerebri, nam haec exivit quantitate nucis juglandis; curatus convaluit citra noxam. See the next Observation in the same Author. Frans. Zanchez, obs. in opera, pat. 375. relates the Story of one, cui per Bregma uncus ad cerebri medullam usque penitus adactus est, hujusque portiuncula foras progrediens exsecta est, convaluit. J. Veslingius, Syntagma Anatom. cap. 14. Sunt qui magnis cerebri vulneribus superstites feliciter discrimen evaserunt; quamvis portio ejus aliqua sublata, aut suborta putredine separata fuerit. Vulnere item coalescente, profundius adacti Globi plumbei retinerentur, stylorúmque fragmenta cerebro, & meningibus infixa multis annis inhaererent. Glandorp obs. 5. in curing a wound of the head, took out as much Brain as would fill an Eggshell. Jaq. Guilleameu, although in his Chirurgical Works he be positive in this Prognostic, That wounds of the Brain are mortal; yet in the end of his Apology, with which he concludes the Book, gives us this Story: At Chartres there was the Chamberlain of my Lord the Earl of Chiverny, called the Peitmontois, who was wounded on his head by a Rapier, whereby the Parietale was clean rescided through, yea and clean through the Dura and Pia Mater also, piercing the depth of ones Finger into the substance of the Brain, whereof in the second dressing there came out as much as the length and bigness of the little Finger. He was completely cured by me, Monsieur Le Febure & Duret, the King's Doctors, and others of the faculty of Paris, expert in Chirurgery, divers Surgeons of the City of Chartres stood by; viz. Monsieur Chereu, Fauven, etc. the Patient retaining no accident or impediment thereof. Ambros. Parey lib. 10. cap. 22. saith, he cured at Turenne a Page of the Marshal Montejan of a fracture, and as much Brain being lost as half an Hazelnut. And in Chapter 19 lib. 25. How many have I seen who— have had a portion of the Brain cut off by a wound of the head; yet have recovered! Peter Pigreus de vuln. c. 9 lib. 4. relates the Cure of a very desperate wound of the Brain. G. Fab. Hildanus obs. Chirurg. cent. 1. obs. 13. Vocatus fuit à quodam Rustico J. H. prove Hattingen, ut ipsius inviserem Sororem, quae vulnus contusum in dextro osse Bregmatis, cum fractura Cranii— portiunculam ad instar Fabae, ex cerebri substantia digitis extraxi,— denuo extrabit portiunculam ipsius cerebri, ad Nucis Avellanae magnitudinem, and more afterwards, and yet— tamen convaluit plenissme— The same Author Exemplum 2. in this Observe. writes of a Maid, that by a blow of a Stone had a fracture of the Skull,— Tribus hebdomadibus fermè quotidie portiones aliquas, ex cerebri substantia abstuli, natura ipsa expellente; ita ut pars illa valde concava conspiceretur.— Sicque pristinam sanitatem, Puella brevi recuperata videbatur. He names many eminent Persons that saw this Cure performed. And in Exempl. 4. he relates the Cure of one that was wounded by a Sword into the Brain, where the quantity of a Nut was lost, and many desperate symptoms followed. In cent. 4. obs. 1, 2, 3. he giveth other instances, disputeth upon the Aphorism of Hypocrates, and enconrageth Surgeons to be courageous, and think nothing impossible to Art. D. Sennertus p. m. lib. 1. part. 1. cap. 23.— Dum haec scribo, offertur mihi & chirurgo, Faber Lignarius curandus, qui in osse sinistro; ad Suturam Coronalem, securis ex alto projectae acie, vulnus pollicis ferè longitudine in cerebrum penetrans, acceperat; ita ut particula cranii effracta, statim eximi posset, & cerebri portio Nucis Juglandis fere magnitudine propenderet: convaluit tamen, cerebri illâ portione extrà propendente sensim abscedente. Et quod mirum est, toto morbi decursu nec de dolore capitis, nec de ullo symptomate conquestus est. A. Laurentius Histor. Anat. Corporis hum. lib. 10. cap. 6. discoursing of the Ventricles of the Brain saith, Et geminy, ne altero eorum affecto, alterius functio animali tam necessaria intercipiatur; laeso enim alterutro, levius conting it perculum, quam si uter que afficiatur: testis est ille Juvenis qui vulnere in dextro sinu accepto, evasit— I find two Anatomists more suggest the same thing, viz. Casp. Bauhinus Anat. lib. 3. cap. 3. Dr. H. Crook Microcosm. lib. 7. cap. 11. J. Cook Mellif. Chir. p. 1. sect. 3. cap. 19 saith, Though wounds of the Brain are accounted deadly, yet experience showeth they are of Curation— One I saw at Worcester after the Battle of Poick; the other I cured at Warwick, of which Mr. W. Thorp had a sight. Jann Van Beverwick, a Dutch Chirurgeon, in his Heel Ronst. part 2. cap. 1. saith he saw two very remarkable wounds of the Brain cured. It's too tedious to transcribe more: I will refer my Reader and my Adversary to those following, which I will only name. Symphorianus Campegius ennarrat. Hist. 25. lib. 4. Desiderius Jacotius Comment. ad Aphor. 18. lib. 6. Hippoc. J. Langius Epist. Med. lib. 1. Ep. 6. Felix Wurts, part. 2. cap. 8. Marcellus Donatus lib. 5. de Hist. Med. Mir. c. 4. P. J. Lotichius lib. 6. c. 8. obs. 2. J. Heurnius Com. ad Aphor. Hip. 18. sect. 6. J. Skenckius obs. med. lib. 1. obs. 40.42. Hen. Petreus tom. 2. disp. harmony. 36. quaest. 10. Dr. Alexander Read, lect. of Wounds the 23. J. Scultetus, Armam. Chir. tab. 32. An anonymous Commentator on Mr. Bannister of Wounds, lib. 2. cap. 1. S. Wiseman, page 401. J. Brown of Wounds, chap. 35. P. Borellus cent. 1. obs. 88 J. Rhodius cent. 1. obst. 32. Leonard Fuchsius comment. ad Aphor. 18. sect. 6. Hippoc. J. Tagaultius Instit. Chirurg. lib. 2. cap. 3. Bern. Gordonus Lilium Med. partic. 1. cap. 26. J. Bilgerus Epist. G. Horstii obs. 14. lib. 2. par. 2. P. J. Fabrus Chirurg. Spagyrica sect. 2. cap. 10. G. Horstius Epist. Med. lib. 2. sect. 8. J. Goulart Mem. and Admire. Histories, page 90. Sim. Aloysius obs. 124. in Ephim. Germ. Vol. 7. Ph. Jac. Sachz. obs. 119. miscel. curios. annus secundus. I might also quote Fernelius lib. 7. cap. 8. de extern. corp. affect. and C. Celsus de re medica lib. 5. cap. 26. Servari non potest cui Basis Cerebri percussa est. And P. Barbet page 172. Wounds of the brain are for the most part deadly; for they seem to pronounce death to wounds of the Brain not absolutely, but on circumstances; and therefore are not for, but against my Adversary: but what is defective in them will be abundantly supplied in those three Stories, with which I will try the faith of my Reader, and conclude. Alexander Benedictus lib. 4. Anatom. c. 24. as quoted by Zac. Lusitanus, (I not having the Original) writes of one, quem vulneratum circa tempora sagittâ, post annum 25. Teli partem sternutatione rejecisse affirmat. Tho. Bartholinus Acta medica pro anno 1676. obs. 55. commends from his own experience an Oil of Amber, made sine Igne, in wounds of the Brain; but in his Acta Medica Ann 73. Hist. 132. saith, Eques quidam Borussus Telum ferreum digitum longum & crassum, 14. annis sine insigni molestia, in cerebro gestâsse narratur.— Tandem per Fauces suppuratum est. He names the person, all the circumstances, and among them a Copy of Verses in the Church where the Piece of Dart now hangs for a Monument. The Academia Curiosa, Germanica miscel. vol. 3. obs. 278. relates from Martin Schodel, in dissert. de Regno Hungarico, Anno 1629. that one Marcus Buxam a Captain in Battle against the Turks had— Lancea Turcica per oculum dextrum adacta, ut retro per cervicem exiverit mucrone, mortem non intulit, sed diligenter Chirurgorum manibus tractatus, restitutúsque. They add another Story of a Wound of the Brain cured; and give not only the Figure of this; as set up in a Monument in Hungaria, but do very well attest it. P. de Marchetis giveth us five very remarkable Histories of Wounds of the Brain cured: I will not transcribe them at large, but leave you to judge of them by their several Titles, viz. Obs. 1. Vulnus cum fractura cranii, & effluxu particulae cerebri, in seen sexagenario. Obs' 2. Vulnus partis posticae capitis, cum fractura cranii, & cerebri parte corrupta excreta. Obs. 3. Portio cerebri, cum annexa Dura & Pia Membrana, ex cranii fractura educta. Obs. 4. Vulnus mediae partis capitis, ad corpus usque callosum pervadens, cum magna vi sanguinis effrusi, ad Lipothymiam usque feliciter sanatum. Obs. 5. Vulnus magnum, cum paralysi Brachii oppositi, & linguae, sanatum, educto frustulo ossis, cum portione Membranae Piae, & Cerebri. I will conclude all with the words of that excellent Chirurgeon Fab. Hildanus, obs. 13. lib. 1. who having related the Stories of four Wounds of the Brain saith, Exempla haec in gratiam tyronum Chirurgorum recensere placuit, quos adhortor, ne unquam de sanitate, aegri, quantumvis morbus magnus fuerit, ac prima fronte incurabilis videatur, desperent, quemadmodum Chirurgus ille, cujus in proximo praecedente exemplo mentio facta fuit, de salute aegri sui desperabat: posita itaque fiducia in Dei Omnipotentia (facta tamen prius Prognosticatione & protestatione coram consanguineis & adstantibus, de manifesto periculo) curationem aggredi omnémque diligentiam adhibere debet Chirurgus, nec impio illo Dicto, Desperatos non oportet attingere, ab Officio suo avocari. Saepissimè enim in morbis contingunt multa, quae antiquos latuerunt, & quorum ratio nulla reddi potest. THE EPILOGUE To my Learned and Civil ANTAGONIST, Dr W. Durston OF PLYMOUTH. HAving been at the trouble and pains to write an History, and collect so many Quotations to convince You (Worthy Sir) that Wounds of the Brain are curable; I could not part so abruptly, or bid adieu to a Person of Your Merit and Candour, till I had not only expostulated a little with You, but entertained You with one wonderful Story more, which several modern Observators relate, viz. That on dissection, they have found not only Sheep, and Creatures of a mere sensitive, but some of the rational Species, without any Brain at all. Zacut. Lusit. prax. mir. lib. 1. observ. 5. Fr. Jo●. Burii Epist. 1. ad Tho. Bartholin. Theod. Kirking Spic. Anatomic. obs. 46. Nie. Tulpius obs. m. lib 1. obs. 24. Miscel. Curiosa Germ. Vol 2. obs. 36. Tho. Barthol. Acta Med. Anno 71, 72. obs. 131. J. Rhodius cent. 1. obs. 32. pag. 19 They are many that thus say; and indeed they are things that strain a man's faith no less than his reason. I must confess myself so credulous, and apt to believe, that I am almost persuaded, Your death (if Your Skull be penetrable) will furnish the World with an instance more surprising and incredible, viz. a Man above fifty years old no better stocked in the Noddle than those other addleheaded : If the contrary appear, it will certainly be the first evidence You ever yielded of having any. Had You as much as this Child lost, (whole Case your incivility hath extorted from me) You would not have given the lie to the eyes and fingers of a Physian, a Gentleman, an Apothecary, a Chirurgeon, and divers others; and (without the help of a Telescope) pretend to see better at a miles distance, than they at the nearest advantage for prospect. Who but a brainless Physician would oppose his single and ungrounded opinion against the sense and observation of a multitude of the best and most reputable Authors; and not only sneakingly, and in Corners, but publicly aver and hold Guineas, that Wounds of the Brain were incurable; when the contrary is affirmed by so many learned and experienced men, living and dead? What! Have You read nothing but Hippocrates' Aphorisms? Is there not a Galen, nor a Sennertus, a Bartholine, nor a Sckenckius, a Horstius, nor a Bauhine, a Fallopius, nor a Laurentius, a Forestus, nor an Hildanus, a Zacutus, nor a Pareus, in Your Study? Or are they there to be looked upon only? I never thought your Library a Vatican: But I expected it should exceed that which Rablaias' tells us was in Pantagruel's Study, and Samson Carasco, in that of Don Quixot. I have been told indeed by a worthy Person, That You lately in a Bravado boasted You had done with Books, things were common-placed in Your head. I believe there wants not room for them, and that what's there is common enough; for things a degree above it, I find are not in your Index. Honest Doctor, I beg You not to conclude hence that I deny You to be learned: I acknowledge your skill in Grammar, and I have a particular reason for it: But in some matters of Art and learning You must confess yourself ignorant, or a wicked and scandalous Prevaricator; for from those numerous Quotations which I have cited from Authors of the best credit and commonest reading, not only in Chirurgery, but Anatomy, Philosophy and Physic; it's plainly inferrible, that You are the one or the other. The Dilemma (Civil Sir) lieth thus: Either You knew those Authors did contain those affirmations, or You knew it not; if You knew it, the last Point of the Dilemma is in your teeth; if You knew it not, the consequence is most plain and natural, That You are (in some things) ignorant. I have been told, that since You have been convinced by us, You have excused yourself to some by saying You spoke in jest, to others by suggesting You had forgotten those readings. By which excuses You entangle yourself in both these Noozes. For is a man the less wicked not a more knavish Prevaricator, for wounding a man's reputation in jest, and sacrificing the good name and honour, not of a single Artist, but a whole Fraternity, to sport? You know who betrayed with a kiss. The trivialness of the inducement, and lightness of the provocation, aggravates the knavery of the action. What! Cut the throats of men for pastime, and turn Gladiator for a Farthing? To have pretended revenge, advantage or policy, had been equally honest, and more generous. In Italy the Slave's slab for a Ryal (that's but Six Pence) but the Heroes and the Bravoes are those that scorn to undertake it under a hundred, two or three of Crowns. Nor will your forgetfulness excuse your ignorance, except You show also the difference between an ignorant man, and one that neither observes nor remembers what he reads, especially when of so considerable a nature as this, and so frequently mentioned. I perceive by your last excuse, that the Common-Place-Book in your head was but a Vapour, or You lodged it in your Skull incomplete. But let's cease to be Satyrical like Poets, and argue rationally like Physicians, and expostulate the Case a little. Suppose it had never been known de facto that Wounds of the Brain were curable, is that reason enough for a wise and experienced man, one that daily beholdeth the prodigious effects of Art, and the increase of skill, to affirm they never can? How ridiculous is the memory of those that anathematised the Bishop, for affirming that there were Antipodes? And they that put Galileo into the Inquisition, for his new Philosophy, now so much in vogue even among the most learned of the Jesuits themselves? How imprudent is it to bar Posterity by unreasonable anticipations, and hang or damn men for opinions that by to morrow possess our own Brains? I am so far from denying (what seems impossible) that Posterity may familiarly make Voyages to the Moon, that I am almost persuaded with Bishop Wilkins and others, (not less eminent for, their piety than learning) that it will be so. Navigation, to former times, before Ships were invented, must have seemed as absurd and impossible; to have said then that men in great numbers together should travel so many thousand miles on the Ocean, without seeing any Land, till they hit directly to a small Island (suppose it St. Helena) had been laughed at as much as this is by some men now. How many prodigious things are there done in this last Age, that to the former seemed impossible? And how are we puzzled now to recover and believe many things Pancirollus saith were done by the Ancients, and lost to us? Should all be Sceptics, and think nothing possible but what they see, we should neither believe him, nor hope any future improvement by invention. Had our Predecessors, and many Contemporaries, been of that humour, they had sat down in despair, contented with what they knew; many useful discoveries and noble inventions had still remained in the hands of oblivion. I doubt not, at least I will not deny, that the perpetual Motion, Quadrature of the Circle, Philosopher's Stone, Universal n =" *" See Helmont's account of Butler's Stone. Remedy, the Antichrist; manner of knowing longitude at Sea; so much sought after, and puzzling the minds of many men, together with all the desiderata will be discovered and invented. But we will talk more strictly like Physicians: What is there in the Anatomy of the Brain (especially the Cortical part) as delivered to us by the hands of the accurate and most renowned Willis, Highmore and Malpighius, that can justify your opinion? I believe it might be demonstrated (but it were too tedious, and I have more direct proof) from their several Hypotheses concerning it, that the opinion (not of Hypocrates, for he wanted those complete descriptions and notions concerning it) is absurd and groundless, in such who after those illuminations persist in errors, the defective knowledge of our Forefathers made them seem guilty of. It's pertinacity in You, after all those reasons to the contrary, and being told of so many Authors against You, to continue two years in a mistake. If it were the opinion of Hypocrates, it was but in him an error or defect. Divers of his Commentators make it probable he meant not as You do, that those Wounds were incurable; but that they were for the most part so, or that very great ones were mortal. But should it be allowed according to your apprehension and interpretation, are his Aphorisms infallible? are there not some of them which every days experience confuteth? Est magnopere medicis expendendum, quod in morbis gravissimis sape evadunt, vel imbelles plurimi, etiam omnibus reclamantibus notis, quae juata Hippocratis sacrosancta oracula mortem in limine esse designent, sic in vulneribus cerebri— C. Gemma l. 1. c. 6. Cosmic. I will give You two for a taste, and refer You to Sanctorius for a Bellyful, Method. vi. tanned. error. in med. lib. 1. cap. 31. Sect 5. Aphor. 31. he saith, Mulier utero gerens, sanguine misso ex vena, abortet. Did that ever deter You from bleeding a teeming Woman? Hypocrates fearing the Precept would not be sufficiently obliging, makes it a part of the matriculating Oath, which all his Disciples took, that they should not bleed a gravid Woman. This made Phlebotomy so terrible to big Bellies, that Pleurisies and the severest cases, could scarce obtain the use of a Launcet, let the Age, Constitution, Season and Clime be what it would. Nimium antiquos scrupulosos circa V. S. in gravidis— in Graeca major apprehensio fuit.— but now it's become the common remedy of abortion, frequently done in all times of their breeding, and an opposite Aphorism set up, Primrof. Vulgi errorib. lib. 4. cap. 27.53. Gravidis venae sectione mnon esse noxiam; n =" †" J. Schmidt. obs. 48. Ephim. Germ. vol. 7. Certè ego in praxi mea sine noxâ, tempore ingravidationis omni, urgente necessitate febrile, sanguinem tuto detraxi, non raro iteratis vicibus, non raro in satis bona quantitate, neque unquam aliquam inde percepi noxam— This one Aphorism, saith the Famous Mr. boil, Exper. Philos. par. 2. pag. 5. Edir. 2. hath cost more lives than Draco's Laws, which were written in blood; having for divers Ages prevailed with great numbers of Physicians, to suffer multitudes of their Female Patients to die under their hands, who might probably have been rescued by discreet Phlebotomy, which experience hath assured us hath been sometimes not only safely, but carefully employed, even when the Infant is grown pretty big.— Through this mistake numbers of teeming Women have been suffered to perish, who might probably by a seasonable loss of some of their blood, have prevented that of their lives. So far that honourable Author. Another saith, It hath cost more lives than there are Letters in that Book; and Sanctorius in one Chapter, Ubi supra lib. 15. cap. 11. Ostenditur exemplo localium, quod quaelibet sententia Medicorum sit methodi censura moderanda, as it were cryeth out, Exempla in medicina sunt innumerabilia— Ecce quod medica praecepta, nifi methodo ponderentur, & moderentur, saepe nos fallere possint. The other Aphorism is the 58th of the sixth Section, where he delivereth, Si omentum excidat, necessario putrescit. I need not quote Authors to show the mistake thereof; but with Sanctorius conclude, That all the Sentences of Hypocrates are not of perpetual verity, since Galen himself in his Comment on that Aphorism saith, Si quis vero aliquando vidit omentum, quod parvo tempore extra prodierit, & deinde ad suum locum reductum, non putruerit, perpetuam quidem, non esse probabit Hippocratis enuntiationem. And that the World since he wrote it, hath had a thousand Observations, contrary to that Aphorism, even beyond the enlarged sense that he in the beginning of his Comment thereon would have it understood, we may therefore make the inference of my Author, Plures Aphorismos non esse eternae veritatis, and doubt whether this also may not have tempted our Predecessors immediately to cut off the elapsed part of the Zirbus, without trying whether they could reduce or preserve it; a thing common now, even after it hath been some considerable time in the crude Air. Will You not submit to daily experience, loudly proclaiming the mischief of such Principles, rather than jurare in verba Magistri? Sir Thomas Brown tells us, He knew a Divine in France, a Man of singular Parts, that was so plunged with three Lines of Seneca, that all the Antidotes drawn from Scripture and Philosophy could not expel the poison of his error,— Post mortem nihil est, ipsáque Mors nihil. Mors individua est, noxia Corpori, nec parcens animae— toti morimur, nullaque pars manet Nostri— We find Wounds not only of the Brain, but Stomach, Liver, Guts, Heart, Bladder, etc. cured, maugre the admired Aphorism of Hypocrates that seems to contradict it. And this made good to us in the Observations not of Pliny, Amatus Lusitanus, Baptista Porta, Goulart, or Mandevil; but of Fallopius, Forestus, Skenckius, Hildanus, Zacutus; and a Body of the best Physians in Germany. Shall we not believe them, confirmed by experience, rather than two ambiguous Lines in Hypocrates? Dear Sir, I beg your patience one minute more, while I comfort myself after all your affronts with thinking how general they are. Society, You know, alleviates misery. It's not my particular self alone that You have reproached; all of my way in these Parts are in the same Predicament. But I thank You kindly, You treat us no worse than You do those of the Faculty to which You pretend a more immediate relation. Every Doctor is a Novice, an Ignoramus, and an obscure Fellow, in the presence of such an Apollo as You, like Candles in the Sun. Civil Sir, Be advised and persuaded for the sake of your own credit, and the reputation of your Faculty and mine, to be hereafter more prudent, more civil; forbear to disparage Artists, for thereby You will find (in the end) disreputation to redound, not only to the Profession, but yourself also, who must needs suffer in the general contempt and ruin such vituperations will produce: By your reproaching your Brethren, they are tempted to retaliate and recriminate; and the World, apt to believe both, will make Conclusions very ruinous to all. Utrum horum, etc. If I seem too severe in my reproofs, and guilty of an incivility in treating You, which I have condemned in your demeanour to myself; I hope my Apology will be easy to any man that considers who was the Aggressor; that I have forborn You two years, and that now necessitated to vindicate myself, I have done it fairly and above board. The Law excuseth a man if he kill another in defence of his own life. If your reputation be wounded by this Vindication and Defence of mine, the Law of Reason (they say, Reason is the soul of the Law) will quit me on the same Principle. The Author of the most peaceable and passive Religion in the World, by recommending the Serpent with the Dove, tacitly alloweth us to turn and sting those that tread on us. But however, I shall not be sorry if your reputation escape; my design was to defend my own, not ruin yours; nor only to repartee on You by this Epilogue. It was also to recommend a more prudent Principle to You, and to do You justice; for to You is the World indebted for what benefit or advantage it may obtain by the publication of this Narrative. I am very desirous they should not only pay that thanks that is your due, for so signal a favour; but know also to how honest, how civil and how learned a Gentleman they are beholden, that they may proportion their gratitude to the Degree and Merit of the Person to whom they are redevable. I presume they will be more charitable to us than You were, and (which is all I have to beg of them) infer more justly and ingeniously, That they are no Fools and Ignoramus's that can cure at this rate, nor Knaves that can so well vindicate and justify their actions, and are not ashamed to display them to the whole World. And now, my most worthy Opponent, I have done the Epilogue, not for want of matter, for I have abundance more and better at your service, when your next courtesy shall draw them from the Pen of J. Y. FINIS.