THE Great Advantage OF THE USE of the BARK IN MORTIFICATIONS.
With ſeveral ADDITIONS.
By JOHN RUSHWORTH, Surgeon.
LONDON: Printed for LAWTON GILLIVER at Ho⯑mer's Head againſt St. Dunſtan's Church, in Fleet-ſtreet, 1732.
TO THE MASTERS or GOVERNORS OF THE Myſtery and Commonalty of BARBERS and CHIRUR⯑GEONS 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 pra⯑ctiſed Surgery many Years, and alſo been acquainted with the Practice of many of the moſt [2]eminent of our Profeſſion, who honeſtly and ſucceſsfully practi⯑ſed it: Yet, being of Opinion, that Surgery might ſtill be ve⯑ry much improved, by publiſh⯑ing ſuch Caſes as deſerve it; and thinking you the moſt pro⯑per Perſons to encourage it; therefore am deſirous, and ſhould be glad, you would appoint ſome of your Members to re⯑ceive, and fairly and favourably examine and conſider ſuch Ca⯑ſes as ſhall be offered to them by long experienced Practitio⯑ners, and give your Approba⯑tion 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 Pa⯑tients. [3]And, to ſhew how ſin⯑cere I am in what I propoſe, I here offer to your ſerious Con⯑ſideration a Caſe I formerly communicated to ſome Phyſi⯑cians and Surgeons, and Sir Hans Sloan deſiring me, I, in the Year 1721, left the following Ac⯑count 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 Inci⯑ſions into the Part mortified to the Bone, and ſcarified all round as far as there was any Inflama⯑tion, and uſed the common Ap⯑plications; [4]upon which the Fe⯑ver abated, the Pulſe became not only calm, but alſo regu⯑lar, 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 [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 Satis⯑faction to me.
I think it as much my Du⯑ty to make a publick Acknow⯑ledgement of an Error of my Judgment for very many Years, becauſe (others alſo of greater Eminency giving the ſame Judg⯑ment) I do verily believe it has been the Occaſion of ſeveral [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 pre⯑vented, 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 Un⯑eaſineſs to them, as it now is to me, when I reflect of it. I hope none can put that Con⯑ſtruction upon this, as if I ex⯑pected, that in all Degrees of Cancers, taking off the Tumor, would be effectual; for ſome are of that Malignancy, even to [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 Aſ⯑pect 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 en⯑courage any Thing of this Na⯑ture, [8]in the Way I propoſe, or any Way you ſhall think more proper; I have ſeveral Obſerva⯑tions to offer to you, which I hope may be of Uſe:
From a Brother that heartily wiſhes Proſperity to your Socie⯑ty, and is
POSTSCRIPT.
[9]IT is to me a very melancho⯑ly 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 miſera⯑ble Subjects, by ſuffering thoſe to practice Surgery (the ancient⯑eſt and certaineſt Part of Phy⯑ſick) with Impunity, that are ſo very ill qualified for it. Tho' [10]I hope as far as your Power ex⯑tends, 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 Regula⯑tion.
And if you can propoſe a Method to do it, if your Char⯑ter gave you Power ſufficient, you can never have a more fa⯑vourable 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 Sub⯑jects.
[11]And if any new Law ſhould be wanting to compleat ſo ne⯑ceſſary a Work; it is not to be doubted, but that a Parlia⯑ment 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 ere⯑cting an Infirmary in the Cen⯑ter of every County, to receive ſuch Poor as have Occaſion for the Aſſiſtance of a good Sur⯑geon; and for want of it, in ſome Caſes, become Cripples, [12]and in others, lie long in a lan⯑guid and miſerable Condition, to the great Expence of the Pariſhes.
The following is a Letter from the Maſter of the Surgeons Com⯑pany.
WHEN your printed Let⯑ter directed to the Go⯑vernors 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 [13]Advancement of Surgery, 'twas order'd, to print four times a Year, the Court of Aſſiſtants Or⯑der, which you have or will read from Time to Time, in ſeveral of the publick Papers, to encou⯑rage every Surgeon to follow your laudable Example; all theſe Ca⯑ſes, together with ſuch as will be found in the Sea-Surgeons Journals, being entered in a Book, will from Time to Time be peru⯑ſed 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 print⯑ed Letter, for eſtabliſhing an Hoſpital or Infirmary in the ſe⯑veral Counties, could take effect, but at preſent I cannot find out [14]any Parliament-Men that will undertake ſo beneficial an Under⯑taking. I am now to acknow⯑ledge 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 un⯑der 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 Remiſ⯑ſion or Intermiſſion, a Sphacelus ſoon appeared, which nothing did ſtop the Progreſs of till the Bark was uſed, and in Twenty four [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 be⯑gan to ſeparate, but the Patient having a Jaundice, and ſpent [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 Morti⯑fication, 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 them⯑ſelves of it; of late we recom⯑mend them to the Drinking about two Quarts a Day of the Wa⯑ter at the Dog and Duck in St. George's Fields, Southwark, which I can aver, ſtops the Pro⯑greſs of, and likely will get the [17]Better of that Noli me tangere. I am with all Eſteem, Sir,
To Claud. Amyand, Eſq; Ser⯑jeant 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 [19]not taken, to get Surgery not to be ſuffered to be practiſed by any, but thoſe that are regularly brought up and ſufficiently exa⯑min'd, the Country People will be the more impoſed upon by Quacks being made (if poſſible) more bold and impudent, by put⯑ting 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 re⯑gard to it, by ſeriouſly conſider⯑ing it, in order to prevent ſo [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 ma⯑ny ill Symptoms, which daily increaſed, though he had a very good Phyſician (Dr. Freeman) who made uſe of all proper in⯑ternal Means, but they not an⯑ſwering 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 ma⯑king [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 Re⯑putation, 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 diſ⯑charged vaſt Quantities of the [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 demon⯑ſtrations 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 [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 Seſ⯑ſions of Parliament; for I am [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 deſ⯑pair; and I flatter my ſelf that you will excuſe the length of this from,
The following was inſerted in the Norhampton Mercury, De⯑cember 20, 1731.
WHereas in a Poſtſcript to a Letter to the Surgeons Company (Oct. 18, 1731.) men⯑tion is made of the erecting of an Infirmary in the Center of every County, for the Reception of ſuch Poor as ſhall have Oc⯑caſion for the Aſſiſtance of a good Surgeon, and for want of it, in ſome Caſes, become Crip⯑ples, and in others, lie long in a languid and miſerable Condi⯑tion, to the no ſmall Expence of the Pariſhes: This Deſign the Propoſer thinks himſelf par⯑ticularly obliged (and by Judg⯑ment and Inclination is led) to [26]promote to the utmoſt of his Power; but knowing his own Inſufficiency (upon ſeveral Ac⯑counts) to do any Thing conſi⯑derable towards it, therefore does humbly offer it to the Conſi⯑deration of the Gentlemen of England, and hopes that thoſe who think it may prove a good Charity, will afford their Aſ⯑ſiſtance for bring it to Perfe⯑ction. The Propoſer forbears to offer any Method for the re⯑gulating 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 pub⯑lick, [27]the following Advertiſe⯑ment was put into the Gazette, Nov. 20, 1731. viz.
‘"John Ruſhworth of North⯑hampton, Surgeon, having ſent a Propoſal to the Surgeons Com⯑pany of London, for the Im⯑provement 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 Conſi⯑deration of the Gentlemen of England, conceiving it would be a great and as extenſive a Charity as any that has been [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 pro⯑per Time they ſhall think fit to appoint, for the taking it into Conſideration; and if they ap⯑prove [29]of it, he doubts not but they may put it upon ſuch a Foundation, as may be an Ex⯑ample to other Counties.
Tho' I am ſenſible I may be cenſured for this, yet if the gi⯑ving this Hint does in the leaſt contribute to the bringing to Perfection what I do ſo much de⯑ſire, I ſhall value that more than any other Conſideration.
Inſtead of an Encomium up⯑on 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 Phyſi⯑cian; When thou makeſt a feaſt, call the poor, the maimed, the lame, the blind; and thou ſhalt be bleſſed, for they cannot recompence thee; [30]for thou ſhalt be recompenſed at the reſurrection of the juſt. And if an Infirmary can be made ca⯑pable to receive the Incurables al⯑ſo, 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 Compa⯑ny, the following Letter is in⯑ſerted.
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. [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 pro⯑bability he would not hold out 24 Hours longer: Then Mr. Dic⯑kins propos'd the Bark, not upon his own Experience, but upon your Authority, and Mr. Serjeant Amyand (who had alſo made ſe⯑veral [32]ſucceſsful Experiments with it) which was with ſome Diffi⯑culty 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 In⯑termitting Fevers) is of too much Conſequence, not to be commu⯑nicated to the Fraternity; there⯑fore 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 Mortifica⯑tions, than you gave in your printed Letter to our Company, [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 Fa⯑vour 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 de⯑ſire the Gentlemen of England, to conſider what I before propo⯑ſed, (in an Advertiſement in the Gazette, Nov. 20, 1731.) for erecting an Infirmary in every [34]County; for I ſhall be very ſorry if I muſt own, (excepting Lon⯑don) in this Kingdom there does not appear, that generous Re⯑gard 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 [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 Mortifica⯑tions from all internal Cauſes, for in ſome it is not proper, as Sur⯑geons 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 con⯑clude with heartily wiſhing, that we may endeavour to prove our ſelves Chriſtians, by being kind⯑ly [36]affectioned one towards an⯑other, and alſo publick Spirit⯑ed; not ſeeking meerly our own Things, but every one alſo the Things of others, i. e. The Com⯑mon 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 Wa⯑ters; (it has given me great Sa⯑tisfaction, 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 no⯑tice, [37]That as the Juice of deli⯑cious Fruit, plays upon the Or⯑gans of Taſt, ſo doth the right Healing Waters upon the Ulcers: at firſt touch, it ſeems to tear the Fleſh off deeper, but im⯑mediately changes the beginning of deep Pain into a deeper Plea⯑ſure; and after many Aſſaults and quick Slidings, the Rugoſi⯑ties 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 [38]and Cancers by outward Appli⯑cation, may be too buſily corro⯑ſive 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 con⯑ſiderably wonderful; it is ſome⯑what 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 lea⯑ding [39]the People to Superſtition thereby, has been a great Means to bring them out of Credit, by which many miſerable Peo⯑ple 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 conſi⯑deration, by comparing ſome of the Waters, of the old Holy-wells, with thoſe at the Dog and Duck; and alſo that they may with di⯑ligent 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.
Appendix A 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.
- Citation Suggestion for this Object
- TextGrid Repository (2020). TEI. 5643 The great advantage of the use of the bark in mortifications With several additions By John Rushworth surgeon. University of Oxford Text Archive. . https://hdl.handle.net/21.T11991/0000-001A-5E36-F