THE Great Advantage OF THE USE of the BARK IN MORTIFICATIONS.
With several ADDITIONS.
By JOHN RUSHWORTH, Surgeon.
LONDON: Printed for LAWTON GILLIVER at Homer's Head against St. Dunstan's Church, in Fleet-street, 1732.
TO THE MASTERS or GOVERNORS OF THE Mystery and Commonalty of BARBERS and CHIRURGEONS of London.
NOT doubting but you will be very ready to join in any Thing that may be of Use to Mankind; and I having practised Surgery many Years, and also been acquainted with the Practice of many of the most [Page 2]eminent of our Profession, who honestly and successfully practised it: Yet, being of Opinion, that Surgery might still be very much improved, by publishing such Cases as deserve it; and thinking you the most proper Persons to encourage it; therefore am desirous, and should be glad, you would appoint some of your Members to receive, and fairly and favourably examine and consider such Cases as shall be offered to them by long experienced Practitioners, and give your Approbation of such as deserve to be made publick. This, I conceive, would very much contribute to the Reputation of Surgery, and be of great Advantage to Patients. [Page 3]And, to shew how sincere I am in what I propose, I here offer to your serious Consideration a Case I formerly communicated to some Physicians and Surgeons, and Sir Hans Sloan desiring me, I, in the Year 1721, left the following Account in his Hands.
IN the Year 1715, I was sent for to a Man who had a Mortification on the Foot, from an internal Cause, the Fever very high, attended with the irregular Pulse that is usual in the Case; I made deep Incisions into the Part mortified to the Bone, and scarified all round as far as there was any Inflamation, and used the common Applications; [Page 4]upon which the Fever abated, the Pulse became not only calm, but also regular, and in a few Days I had a Digestion at the Edges: I was obliged to leave it to the Care of an Apothecary: But in a short Time I was sent for again, the Fever being returned, and the Part mortified higher, I used the same Method as before, with the same Success; but all the former Symptoms returned the third Time; but upon repeating the same Method again, ceased: I thought it to no Purpose to take off the Leg, having too often found Returns after it, the Fault being in the Blood and Juices. But Providence now first directed me to order the [Page 5]Bark in this Case, whilst there was a Remission of the Fever; it answered beyond what I expected; the Fever no more returned; the Leg was taken off, and I saw the Person well and lusty many Years afterwards; and I have since several times had the Experience of the good Effects of it in the like Case, which has been no small Satisfaction to me.
I think it as much my Duty to make a publick Acknowledgement of an Error of my Judgment for very many Years, because (others also of greater Eminency giving the same Judgment) I do verily believe it has been the Occasion of several [Page 6]unfortunate Women, not only to continue in a deplorable State, but also often to have a miserable Exit, which by my too late Practice, attended with Success, I have now Reason to believe, might have been prevented, if their Breasts had been taken off in Time. This I think is worthy to be compassionately considered by all Surgeons, least the too long Omission of it, may some Time become an Uneasiness to them, as it now is to me, when I reflect of it. I hope none can put that Construction upon this, as if I expected, that in all Degrees of Cancers, taking off the Tumor, would be effectual; for some are of that Malignancy, even to [Page 7]so poisonous a Nature, which, if blended with the Blood and Juices, nothing will answer; but I would not have any too much discouraged by the ill Aspect of them; for two I had Success in, appear'd as ill and threatning as most I have seen; and therefore I would not have taken them off, if the Patients had not earnestly desired it. I think fit to intimate, that the fewer Medicines have been taken, whilst the Tumor remains on, the better; for any Thing that causes the least Fermentation of the Humours, does the more contaminate, and spoil the Blood and Juices.
If you should think fit to encourage any Thing of this Nature, [Page 8]in the Way I propose, or any Way you shall think more proper; I have several Observations to offer to you, which I hope may be of Use:
From a Brother that heartily wishes Prosperity to your Society, and is
POSTSCRIPT.
IT is to me a very melancholy Consideration, that in a Nation so happy in its Laws and Government, there should be so little Care taken to prevent the great Misfortunes that are very often brought upon the miserable Subjects, by suffering those to practice Surgery (the ancientest and certainest Part of Physick) with Impunity, that are so very ill qualified for it. Tho' [Page 10]I hope as far as your Power extends, this Mischief is in a great Measure prevented. But for the Sake of the Country-People, so numerous and necessary a Part of our Fellow-Subjects; it is certainly the Duty of all those that are sensible of it, to use their best Endeavours to get it put upon a better Regulation.
And if you can propose a Method to do it, if your Charter gave you Power sufficient, you can never have a more favourable Opportunity to obtain the Enlargement of it for so good a Use; their present Majesties having always shewn a humane Tenderness and Compassion for all their Subjects.
And if any new Law should be wanting to compleat so necessary a Work; it is not to be doubted, but that a Parliament that has made so great Improvements in the Law, for the Preservation of the Estates and Rights of the Subjects; will also, if it be properly laid before them, take the same Care for the Preservation of the Lives, Limbs, &c. of the People, in which a particular Provision may be made for the Advantage of the Poor of the Parishes, by erecting an Infirmary in the Center of every County, to receive such Poor as have Occasion for the Assistance of a good Surgeon; and for want of it, in some Cases, become Cripples, [Page 12]and in others, lie long in a languid and miserable Condition, to the great Expence of the Parishes.
The following is a Letter from the Master of the Surgeons Company.
WHEN your printed Letter directed to the Governors of our Company was read in February last, before a Court of Assistants, our Clerk was then order'd to return you our Thanks for the Same, and to desire you to send us such other curious Cases, as you were then pleased to promise, and at the same time to second your Intention for the [Page 13]Advancement of Surgery, 'twas order'd, to print four times a Year, the Court of Assistants Order, which you have or will read from Time to Time, in several of the publick Papers, to encourage every Surgeon to follow your laudable Example; all these Cases, together with such as will be found in the Sea-Surgeons Journals, being entered in a Book, will from Time to Time be perused by the Court of Examiners, and printed at the Company's Expence, as the Gentlemen who send them shall approve: I wish your other Proposal in the printed Letter, for establishing an Hospital or Infirmary in the several Counties, could take effect, but at present I cannot find out [Page 14]any Parliament-Men that will undertake so beneficial an Undertaking. I am now to acknowledge yours of the 17th Instant, and to acquaint you, that from your Example I have given the Bark in all Mortifications with such Success as has encouraged the Gentlemen you mention to administer it. I have now under my Care a Gentleman of 78, who owes his Life to that Medicine; his Case was at first a Gangreen after a Phlegmon; the usual Means seem'd to have removed the Danger, but the Fever continuing without Remission or Intermission, a Sphacelus soon appeared, which nothing did stop the Progress of till the Bark was used, and in Twenty four [Page 15]Hours and less, the Separation began, with a laudable Pus. The same thing happen'd to a Jew whose Sphacelus had got ground for three Weeks in spight of all Means, where several Surgeons were concerned some Years ago, and to another Patient of mine, I have now used it in seven Cases, the Circumstances in each being different, and yet in all the Bark has taken Effect: Even within these few Days to Mr. Delenor, who kept the Bagnio in St. James's Street, in whom a Mortification happened, after several punctures in Dropsical Legs, the Bark stopt the Progress in less than twenty four Hours, and the Sluffs began to separate, but the Patient having a Jaundice, and spent [Page 16]with Evacuations, it revived and came into the other Leg, of which tho' he died, yet the Power of the Bark was so plain, that from this and the other Cases, I think it evident that we may be as sure of getting the Better of, or at least of stopping a Mortification, from any internal Cause, by the Bark, as conquering an Ague thereby.
As to the Cure of Cancers by Amputation, there are but few Surgeons here that flatter themselves of it; of late we recommend them to the Drinking about two Quarts a Day of the Water at the Dog and Duck in St. George's Fields, Southwark, which I can aver, stops the Progress of, and likely will get the [Page 17]Better of that Noli me tangere. I am with all Esteem, Sir,
To Claud. Amyand, Esq; Serjeant Surgeon to His Majesty, and Master of the Surgeons Company.
I Heartily thank you for the Favour of yours, for until now, I had reason to believe, that our Company slighted my Letter, for your Clerk never wrote any thing to me about it, nor did I hear any thing of it before your kind Letter informed me, for no publick Papers that come into these Parts (that I ever saw) mention any thing of the good Method, the Company has taken. But if at the same time, care be [Page 19]not taken, to get Surgery not to be suffered to be practised by any, but those that are regularly brought up and sufficiently examin'd, the Country People will be the more imposed upon by Quacks being made (if possible) more bold and impudent, by putting into their Hands what they are not capable of making a good Use of, and Surgeons of Value (who have the Misfortune to live in the Country) will be much injured by it, which I should be very sorry any ways to contribute to. This can't appear so plainly to you, as to those that live in the Country, but I doubt not but your Goodness will have regard to it, by seriously considering it, in order to prevent so [Page 20]ill a Consequence. I hope I shall not tire your Patience, by giving you an account of a Case of a Patient of mine this Spring, who was far gone in a Dropsy and Asthma, attended with very many ill Symptoms, which daily increased, though he had a very good Physician (Dr. Freeman) who made use of all proper internal Means, but they not answering I was consulted; his Legs and Thighs were grown to a very great Bulk, and did appear to me (and also to the Doctor) as if they would soon mortify; I told the Doctor I had never found that Punctures would be sufficient to relieve in so dangerous a Case, but I was of Opinion that nothing but making [Page 21]many large Incisions into the Legs could be of Use, tho' I was unwilling to begin such a Work; but in a few Days we plainly saw that he could not continue long, if not soon reliev'd; the Doctor encouraging me, I was resolved to venture my Reputation, rather than the Patient should be lost, tho' I knew the censorious Age, did not spare to reflect on Surgeons, when they used any new Method without Success; but I can with Pleasure tell you, that the Patient was soon reliev'd by it, and by often using Fomentations, and as often changing the Cataplasms, I not only preserv'd the Tone of the Parts, but also constantly discharged vast Quantities of the [Page 22]watry Humour for more than two Months, until it was all carried off, from all Parts of the Body; and the Legs have recovered their true Tone, and are as small as they were before he was ill, and do not so much as swell at Night, tho' he daily goes about his Business performing it with chearfulness, and is better in every respect than he has been for many Years.
I am very glad to hear, that you have had so many demonstrations of the good Effect of the Bark, tho' certainly a great deal ought to be imputed to your good and proper directing of it: I beg leave just to mention, that leaving off the Bark too soon, a Patient of mine had a Return [Page 23]of the Mortification, in about five Days time, but scarifying and repeating it, I presently had the good Effect of it again, and she is now perfectly recover'd; and tho' she had a very ill Habit of Body before, is now better than she has been for several Years, and her Looks shew it to all that knew her before, tho' she is fifty Years of Age.
I rejoice to hear of any thing that gives Relief in Cancers; but if the Tumor be not perfectly reduced by it, I fear no Cure will continue, unless the Tumor be first removed; but I shall wave this, until I have the Happiness to see you, which I hope to do at the beginning of the next Sessions of Parliament; for I am [Page 24]very desirous to gain the Point of having Infirmaries, and tho' my Interest be but small, yet join'd with yours and others that I hope we shall meet with, I do not despair; and I flatter my self that you will excuse the length of this from,
The following was inserted in the Norhampton Mercury, December 20, 1731.
WHereas in a Postscript to a Letter to the Surgeons Company (Oct. 18, 1731.) mention is made of the erecting of an Infirmary in the Center of every County, for the Reception of such Poor as shall have Occasion for the Assistance of a good Surgeon, and for want of it, in some Cases, become Cripples, and in others, lie long in a languid and miserable Condition, to the no small Expence of the Parishes: This Design the Proposer thinks himself particularly obliged (and by Judgment and Inclination is led) to [Page 26]promote to the utmost of his Power; but knowing his own Insufficiency (upon several Accounts) to do any Thing considerable towards it, therefore does humbly offer it to the Consideration of the Gentlemen of England, and hopes that those who think it may prove a good Charity, will afford their Assistance for bring it to Perfection. The Proposer forbears to offer any Method for the regulating of it, because he is in Hopes that those that are better qualified will do it to a greater Advantage; and it will be more regarded, if done by Persons of Character, and not of so low a Station of Life. In order to make this Design the more publick, [Page 27]the following Advertisement was put into the Gazette, Nov. 20, 1731. viz.
‘" John Rushworth of Northhampton, Surgeon, having sent a Proposal to the Surgeons Company of London, for the Improvement of Surgery, in the Postscript to which he proposes the erecting an Infirmary in the Center of every County, for the receiving such Poor as shall want the Assistance of a good Surgeon; but thinking that not sufficient to promote it, he humbly offers it to the Consideration of the Gentlemen of England, conceiving it would be a great and as extensive a Charity as any that has been [Page 28]done since the Reformation, and hopes it may require no great Expence more than the Parishes are already obliged to do for their Poor, and doubts not but what is further wanting will be supplied by charitable disposed Persons, and shall be glad to have an Opportunity to subscribe fifty Pounds towards it in the Country where he lives."’
Therefore he hopes that the Gentlemen of this County will excuse him in humbly desiring them that are for the promoting this Charity, to meet at the County Sessions, or at what proper Time they shall think fit to appoint, for the taking it into Consideration; and if they approve [Page 29]of it, he doubts not but they may put it upon such a Foundation, as may be an Example to other Counties.
Tho' I am sensible I may be censured for this, yet if the giving this Hint does in the least contribute to the bringing to Perfection what I do so much desire, I shall value that more than any other Consideration.
Instead of an Encomium upon that great Christian Duty, CHARITY, to enforce this, I shall only mention the following Words of our Saviour, as wrote by St. Luke, the beloved Physician; When thou makest a feast, call the poor, the maimed, the lame, the blind; and thou shalt be blessed, for they cannot recompence thee; [Page 30]for thou shalt be recompensed at the resurrection of the just. And if an Infirmary can be made capable to receive the Incurables also, it will be making a continual Feast for those poor miserable People.
For the Satisfaction of those that gave themselves the Trouble of reading Rushworth's printed Letter to the Surgeons Company, the following Letter is inserted.
ABout two Months ago, I was sent for to a Gentleman about 50 Years of Age, who had a Mortification on the back of his Foot, from an internal Cause. [Page 31]Upon sight of it, I scarified it and dress'd it up, S. A. and his Physicians ordered him the Conf. Raleigh. Rad. Serpt. Ther. V. &c. of the establish'd Medicines. Next Day Mr. Serjeant Dickins and Mr. Chesselden were consulted, and they confirmed what we had done, and desir'd us to go on, which we did to no manner of Purpose, for eight Days, for the Mortification encreased, and the Fever did not abate, upon which we had another Consulation, in which we agreed, that in all probability he would not hold out 24 Hours longer: Then Mr. Dickins propos'd the Bark, not upon his own Experience, but upon your Authority, and Mr. Serjeant Amyand (who had also made several [Page 32]successful Experiments with it) which was with some Difficulty agreed to. Upon taking the Bark the Fever soon left him, the Mortification stopt, the Wound digested, and the Sloughs cast off, to the great Surprize of every one that ever saw or heard of it. I think this new Use of the Bark (for which we are more oblig'd to you, than to him who first shewed the Use of it in Intermitting Fevers) is of too much Consequence, not to be communicated to the Fraternity; therefore I beg the Favour of you to fend me a farther Account of the send me a farther Account of the Experience you have had of the Use of the Bark in Mortifications, than you gave in your printed Letter to our Company, [Page 33](which Mr. Serjeant Amyand, our present Master, was so kind as to shew me) and it shall be inserted in your own Words and the Favour gratefully acknowledged, by, Sir,
As this gives me Reason to desire the Surgeons Company farther to take my Letter into Consideration; so I take this Opportunity once again, to desire the Gentlemen of England, to consider what I before proposed, (in an Advertisement in the Gazette, Nov. 20, 1731.) for erecting an Infirmary in every [Page 34]County; for I shall be very sorry if I must own, (excepting London) in this Kingdom there does not appear, that generous Regard to the Health, and Life of Man, as in several Foreign Parts; and if their Charitable Care of the poor Sick and Maimed, be an Effect of their Religion. I blush to think, that we (who call our selves the Reform'd) should come so far short of them in this great Christian Duty: And as the Gentlemen of this County, did not think fit to take any Notice of what I proposed to them, I shall be very ready to subscribe fifty Pounds, if an Infirmary be erected in any neighbouring County, that the Poor may not suffer for Want of Advice and [Page 35]Medicines, as the Rich often do, by having too much.
It is necessary that I intimate to all Surgeons, what I have mention'd to our Company (in a Letter the 17th of this Month) that I would not be understood by my printed Letter, as if the Bark would answer in Mortifications from all internal Causes, for in some it is not proper, as Surgeons may easily suggest to themselves.
And that the Aspersion of the Adage of Tres; Duo; may not be cast upon Surgeons, as it is upon the Practicers of the other Branch of Physick: I shall conclude with heartily wishing, that we may endeavour to prove our selves Christians, by being kindly [Page 36]affectioned one towards another, and also publick Spirited; not seeking meerly our own Things, but every one also the Things of others, i. e. The Common Good.
Having within these few Days met with an Account formerly given (by an ingenious Physician in his Time) of great Cures (in Surgery) done by Mineral Waters; (it has given me great Satisfaction, in hopes that the Water at the Dog and Duck in Southwark, mentioned in the Letter of our worthy Master, Mr. Serjeant Amyand, may prove of great Use in Cancers) among many rational Thoughts how this is performed, he takes notice, [Page 37]That as the Juice of delicious Fruit, plays upon the Organs of Tast, so doth the right Healing Waters upon the Ulcers: at first touch, it seems to tear the Flesh off deeper, but immediately changes the beginning of deep Pain into a deeper Pleasure; and after many Assaults and quick Slidings, the Rugosities of the Wounds, or of the Liquor, or of both, are by their dancing Vibrations smooth'd into a delightful Accord; and we may perceive, how some Waters, may by their rolling Particles, be the greatest Probes, and yet the surest Searchers, Cleansers, and Healers. And hence also on the contrary, we may see, how some Waters, which cure Ulcers [Page 38]and Cancers by outward Application, may be too busily corrosive and dangerous, if taken inwardly.
He mentions several of the old Holy-wells, so call'd; one he says he can affirm upon his own knowledge, has done many Cures, upon putrid and faetid Ulcers, which were many Years deplored for incurable, he had seen it tried often, and always to good effect, sometimes considerably wonderful; it is somewhat asperous, but pleasing to malignant Ulcers.
Now I fear the Monks and Priests making an ill Use of these Wells, by pretending they had their sanative Vertues given to them by their Saints, and by leading [Page 39]the People to Superstition thereby, has been a great Means to bring them out of Credit, by which many miserable People may have been deprived of the great Benefit they might have received by them; and therefore it may be necessary at this time to take them again into consideration, by comparing some of the Waters, of the old Holy-wells, with those at the Dog and Duck; and also that they may with diligent and strict Observation (by some neighbouring Surgeon) be tried upon Cancers; that no Care may be wanting to promote so great and good a Work, as the Cure of Cancers.
ERRATA.
PAge 10. line the last, for Sub- read Subjects. p. 26. l. 11. for bring r. bringing, p. 31. l. 4. for Pher r. Ther.