THE Frenche Chirurgerye, or all the manualle operations of Chirurgerye, vvith divers, & sundrye Figures, and amongst the rest, certayne nuefovvnde Instrumentes, verye necessarye to all the opera­tiones of Chirur­gerye.

Through Iaqves Gvillemeau, of Orleans or­dinarye Chirurgiane to the Kinge, and sworen in the Citye of Paris.

And novv truelye translated out of Dutch into Englishe by A.M.

IMPRINTED At Dort by Isaac Canin. M.D.xcvij.

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TO THE MOST HIGH, MIGHTIE, ROY­alle, and Victoriouse Princesse, the most Christiane, and Virtuose defendresse, of the sincere, & true Christiane Religione LADYE ELISABETH By the grace of God, Queene of Englande, Fraunce, and Irelande. &c.

MOst graciouse Queene, your Royalle Mtye. is not ignorante (I truste) of the greate services, vvhich throughe, the handes, of experte Chyrur­gians, operatinge on Mans bodye, are offerede as svveete smellinge sacrifices, vp into the nostrells, of the omnipotēt, & Longevalle Emperioure of the Caelesti­alle influences. VVherof also all renoumnede, & providente Caesaristes, ha­ve dilligentlye providede, and furnishede themselves, vvhen as they are vvounded, by theire me­anes, and ayde (next vnto God) to be curede, and have of ther health restauratione. I coulde not therfore (beinge also incitatede, and councelede thervnto by divers and sundrye of my frendes, & vvellvvillers) omitt this boocke, composede by the most experte, and verye learnede Chyrurgi­ane Mr. Iaques Guillemeau, addictede Chyrurgian to the Kinge of Fraunce, of the vvhich (vvith­out doubte) the French natione, doe reape greate service, and commoditye therof, and therfore I have for the service and vtility of your Renoumnede Maiestyes subiectes, & poeple, and also to the commoditye of our contrye (beinge vnitede in the bonde of amitye together) vvith all expe­ditione possible for me causede it to be translatede both into Englishe, and Lovvdutch because that all yonger, and iunior Chyrurgians, might heerin behould, and vievve, (as in a resplendente Lookinge-glasse) the most parte, and principalle Instrumentes of Chyrurgerye also vvith a verye excellente methode, and doctrine, for all the especialle operations, vvhich a Chyrurgiane (or any other man beinge in necessitye) other by lande, or by vvater, might have any vse for. And seing that there is noe King, nor Prince on earth, vvhich vvith such fervent desire, and fidelitye ende­voureth by all meanes possible, to maytayne, and protecte, the health and vvealth, both of bodye and soule of theire subiectes, and poeple, as your (most Illustriouse Mtye.) doth for your peculiare inhabitantes, beinge of God thervnto constitutede, and ordaynede. The excellence of this booc­ke, hath therfore, incitatede, & as it vveare cōpellede me to vse this audacitye (in signe of gratitu­de, for soe manye, & innumerable benefites, vvhich next after God, of your Royall Mtye. through your continualle ayde, & opitulatione vve reape) humblelye to presente, and dedicate this verye necessarye boocke, vnto your most Magnificente Mtye. firmelye trustinge, & assuredlye hopinge, that your renoumnede Mtyes. subiectes, not onlye vvithin, but also farre vvithout your Mtyes. Re­almes, & dominiones, shall heerebye be greatlye aydede, and therof also reape greate commodi­tye. I have effected this vvorcke, partelye to demonstrate the sincere love, & affectione vvher­vvith (throughe the good acqvayntance of your Mtyes. Gentlemen, Capitaynes, and valiant Sovl­diours, vvhich your most Royal Mtye. hath vouchsafede so manye years to sende vs) I affect your Mtye. as also to cause all men together vvith me gratefullye to acknovvledge, the ineffable mercye of God, vvhich hath imbuede, and adorned your renoumnede Mtye. vvith so manye noble, vvor­thye, and excellent virtues, and verye miraculouslye hath defendede, and protected, your Grace, agaynst all the slye, and vvylye practises of your Maiestyes enimies, by this meanes to continue, and by your handes to protecte, not onlye your dominion, and other nations, your neightvours and vnitede subiectes (amongst the vvhich vve account our selves, most bounden to your Mtye.). But also heerby to cause the florishinge of all spirituall, & corporalle artes in the middest of your Realme, and Kingdome. Amongst vvhich, the Arte, and Science of Chyrurgery is esteemede, & accoumptede (as the first, and most vvorthieste, and necessarye parte of Physicke) vvherof I heere present your Mtye. one of the most exquisite, and perpolite boockes touchinge, and concerninge the same. Most humblye in treatinge your Mtye. that it vvoulde vouchsafe your Highnes not to miscontrue this my temeritye, but take, and construe my audacitye, vvhich I have in this my de­dicatione vsed, to noe other end, then that vvith all my harte, and minde I endevoure to gratifye [Page] your most renoumnede Mtye. & be at the commaunde according to my bounden dutye) of your most Royall Mtyes. subiectes, as much as is possible for me. Thus fearinge least I might be some interruptione, & hinderance vnto your Highnes, I heervvith, commit your Royall Mtye. into the divine protectione, and handes of the omnipotent Kinge, and Father of Heaven, vvhom inces­santlye I pray, to give ominouse, & fortunate event to your divine attemptes, to the furtherance of his holye vvorde, and reformede church, beinge congregatede together vnder the shaddovve of your Highnes vvinges.

Your Mtyes most humble, & vvellvvillinge subiecte, vvho in signe of gratitude addicteth himselfe vvholye to the service of your Highnes and your subiectes. Maximiliane Bouman Chirur­gian at Dort.

TO THE KING

MAn beinge allianced, both with Heaven, and earthe, is throughe his corporall necessityes constrayned, to conterate, and spende the best time of his Life, in Sleepe, & repose: notvvithstanding being resuscitated, & erected out of a profounde, & deepe somniation, through the best parte of himselfe, vvhich is his Soule, he pursueth, only and favoureth verye soberlye, the most vile and abiecte thinges, the concupiscence, and apetite vvherof, he communicateth, and participate the, vvith brute, and irrationalle beastes. For man is not only this maske or vizard, and this figurated and articulated Massa in certayne members, vvhich vvith our eyes vve discover and behoulde, & vvith our fingers vve may touche and sensiblye feele: but is rather, the virtue, and internalle for me, vvhich effectuateth life in him, vigor, agilitye, and temperature, the same beinge as it vveare, a radiant beame a little sparckle, and parcell, of the Divinitye, transmitted, and descended out of the most gloriouse Empire of Heaven, to effectuate, and bringe to passe in this vvretched vvorl­de, in our bodye, a shorte, and breefe ligatione: For vvho is there vvhich doubteth, that the Soule, remembringe, and callinge to minde her first originalle, vvoulde not addresse, and endevou­re her selfe to lerne, yea and if it vveare possible to relerne, all those thinges, vvhich be honora­ble vnto her Creator, & might also be profitable to all other creatures? & for this cause it is, vvhye vve have not our countenances declined tovvardes the earth as the brute beastes, but have them elevated tovvardes Heaven, because through such contemplacione, and by readinge of the true booke of lyfe, vve might dravve therout, and practice on the ordre, and imitate, the constance vvhich the caelestiall corps, doe observe, and one their perpetualle, and profitable agitatione therof. Let vs therfore consider on the Sunne, vvhich is as it vveare a Prince, and moderatoure of all other caelestiall constellations: vvhat doth shee othervvyse effect through her environing roun­de of the earth, then light vs, calefye, and vvarme vs, vivisye, & administre lyfe vnto vs? but vvhat commoditye, and profite is it vnto vs to searche the sunne on highe have vve not the earth it sel­fe vvhich vvith our feete vve inculcate, and treade one, and accuse the same to be brute, & insensible, doth shee refuse, to receave, and conceave, and agayne continuallye, and vvithout cessation superfluouslye procreate, and liberally imparte vnto vs, all that vvhich is necessary, vnto our ve­sture aliment, and nourture? It vveare also indeede great shame, perfidiousnes, and execrable di­sloyaltye, and treason for vs, vvhom God hath adorned vvith so livelye, vigorouse, and fruictfull a spirite, that as all thinges vvhich are inanimate, doc travayle, and laboure for our proffite, vve shoulde shevve our selves stupidouse, and involuntary to helpe the one the other in all thinges possible and advaunce them: for as the vvise, and sage men heertofore have sayed, that even as all the mundayne, and terrestrialle thinges, are created for man, and his vse, in like sorte also are men created for God, and the one man for the other. This consideratiō most illustriouse, & migh­tye Kinge, hath vrged, and impelled me, after that I next vnto your maiestye, have discharged my duty, and function, vvhich I vvas ovvinge vnto your Highnes, and that especiallye in curinge of my Lorde, the Earle, of Montpensier and my Lordes of Buhy, & of Montigny, to peruse, & revo­lve certayne rescriptiones, and memorialles, vvhich I had compiled, and collected together, vvhē I served the disceased Kinge, as vvell touchinge the manuall operations, as also the comparisone, and conference of the aunciente instruments of Chyrurgerye, vvith the nue inventede, because through the discourse & rehearsall of the same, and by the discriptione and defiguratione of the foresayed instrumentes, to demonstrate, vvhat commodity vve might hope, and reape out of the one more then out of the other: All vvhich, havinge accordinge to mye possibillirye, & as much as this pitifull time vvoulde permit & allovve of finished, I have embouldened myselfe, to con­secrate, and dedicate the same vnto your most renoumned Maiestye: vvhom supliantlye & vvith all humillity I desire, requeste, and intreate, benignly to receave it, as a gifte, or present, vvhich is not disagreeing vnto the present time, nether vvill be discommodiouse to your highnes. For be­cause this Kingdome of Fraunce, is blinded vvith rage, & error, through the fatalle censure of the most fearfull God, doth ruinate it selfe, into his ovvne spoyle, of vvhat arte I pray (seinge that all other artes doe decrease, vnder this fear of vvarres) might it rather implore cōfort & secourse, thē of Physicke or Chyrurgerye? And vvhat is more Royalle, & more magnificall heer on earth, yea and more divine, then to recreate the afflicted, to relevate, & consorte the depressed, & humbled, and to restore health to all men, vvithout vvhich all dulcor, & pleasantnes of our life is nothinge els then amaritude, and Gaule? VVherfore most magnificent, and renoumned Kinge, permit [...] praye and humblye intreate your highnes, that vnder your Heroicall name, this Pamphlet may [Page] be published, because throughe the same, as alsoe throughe youre most illustriouse actes, of the vvhich the posteritye, perpetuallye shall not be silent, may be revealed, and knovvne, hovv fayn your Highnes savve this poore Kingedome of Fraunce florishe agayne: vvhich novv seemeth to respire, and in shorte time exsperateth to have an ominouse and happye end of her miseries, and calamityes, through the prudence vvhervvith your Maiesticall valoure, and vigilant valiaunce is accompaniede, and associated. From Paris, the 15. of Septembre, 1594.

Youre most humble, and most obe­dient subiecte, and servitoure GVILLEMEAV.

The Epistle to the benevolent Reader.

THere is a common saying, & is novv taken for a common proverbe: that all thin­ges have theire time, theire place, and theire sayson: by vvhich occasion divers, & sundry interprises, vvhich indeede of themselves are goode, doe leese their grace, and decorum, onlye because in theire condecent time they vveare not practised, & put in vre. But it is not soe vvith the vtilitye, vvhich the common vvealth ex­pecteth, throughe our industrye, principallye, & especiallye, through the studyes of good artes: such fruictes are never importune, nether at anye time out of season, nether ab­ortive: but are at all times very vvellcome, & profitable, on vvhat time soever, on vvhat manner, or of vvhome they might be brought: In vvhich facte, the maxime, or proverbe may very truely be spoken of Maximo Fabio, vvhoe sayede, that all intentions, vvhich to the publiqve profite of the commonevvealthe vveare assayede, & intēded is allvvayes vvell hopede of, to have a good e­vente, & is esteemede to be a happye intente, or praemeditatione: And contrarily those are estee­mede infeliciouse, & vnfortunate, & are of a funestalle, and sorrovvfull event, vvhich are inten­dede, and attendede, vnto the dammage of the commone vvealthe.

VVherfore I neede not doubte, of that vvhich I praetende to mayntayne, and publishe into light, shall of any one vvhatsoever, be taken in badde parte, because I have conceavede, and pub­lishede the same in time of iarres, and vvarres: For vvhat time might I have elected more conve­nient, & propre, & more profitable to meditate one this Chyrurgerye, vvhich compraehendeth her operatione, & propre Instrumentes, then at this time, Fraunce beinge in all qvarters, & in al partes, armed, & in vveapons? & animated agaynst her ovvne entralles, & vve having our ovvne mindes exvlcerated as it vveare, and hardened the one agaynst the other, by vvhich occasione vve to our greate greefe, and sorrovve, must behoulde, at all houres, so manye poore vvounded, & mutilatede persons, their corps beinge vvoūded throughe the rage, and malevolence of their foes, on the vvhich vve are constrayned to imploy our handes, & instrumentes to reduce agayne the same to theire former, and accustomed health agayn? Or vvhat might they othervvyse hope, and expecte of me, then that vvhich is accordinge, and agreinge vnto my vocatione, & callinge▪ For as the Poëte sayeth▪

The Neptunist of windes, of stormes, and of tempest
Discoursinnge on the shoare, to his mates can talke best;
The Cerialist, of Oxen, Horse, and Plowes
The cruell Martialist, of wounds, and of his blowes.

Therfore havinge seene, and also vvith my ovvne handes practized the space of tvventye yeares the operation of Chyrurgerye, in most of the famouse, & renoumned Cityes, of Fraunce, & the Lovve Countryes, as vvell one greate, as smalle persons, and that vvith such diligence, and methode, that I couplinge, and comparinge, the vse of the aunciente Chyrurgians, vvith the pra­ctice of the moderne, and latter Chyrurgians, I then endevoured my selfe, as much as the disease, & the Patient also vvould permit me, to temperate, the rigoure, and severitye of the first Opera­tours, or Chyrurgians, throughe the supple, and gentle or svveete dexteritye of those vvhich fol­lovved, to assimilate thē the one vvith the other, supplyinge in the counterchang, of that vvhich vvas vvantinge in the one, through the dexteritye, and industriouse curiositye of the other, re­ducinge the same vnto the best forme of beinge, & alsoe the vvritinges, or scriptions, of the most expertest Chyrurgiās, of this presēt time, vvith the vvritinges & iudgemēt of the vvhole, through the controulinge of the vvritinges of the one & of the other: So that I have intended to make a collection: in forme of a Manuall for my selfe, to opitulate, & addresse my memorye, in time of neede, and promptly to effectuate, any manualle, and not vulgare operatione: but the liberalitye throughe the vvhich I am so voluntarye, to communicate the same vnto certayne of my goode frendes, vvhoe are studiouse, & desiruose of Chyrurgerye, hath precipitated me into this present prodigalitye, of the vvhich I suddaynlye retired & drevve my selfe backvvarde, blushing & as it vveare ashamed, cōsidering the meānes therof, as being vnvvorthy to come into light (although notvvithstandinge everye one hath a vayne imaginatione, & affectione, vnto the same vvhich is proceded from him) so that I omit the hardines vvhich I might have had, to publishe the same vnto the printe, I coulde verye difficultly contayne my desirouse, & covetuouse handes, of that vvhich I vvith greate laboure, dilligence, and throughe longe experience had collected toge­ther, to have in one momēt abolished the same, if I had not purposed to reserve the same for my ovvne particulare, and peculiare cōmodity. But my foresayed frēdes debellating agaynst my ti­morous & fearfull defensions, through certayn experiēce of time passed: to vvitt, that my booke of the diseases of the eyes, after certayne dayes he vvas cōmited to the presse, vvas vnto all Ch [...] ­rurgians [Page] verye necessarye, & profitable: and that my first, & seconde Tables of Anatomye, had ad­ministred vnto all men such greate service, and promptitude of the Anatomy, and cognisance of the partes of mans bodye: They have in the end resolved me of my doubtfull feare of prodigality, addinge also therbye that this feare of prodigalitye, coulde be dammageable vnto noe man then vnto me, and that it coulde make noe breach into my credite at all.

Throughe these foresayed remonstrations being convicted, & persvaded, vnder the pretexte of greate furtherance, vvhich yonger Chyrurgians might heerby reape, and not beinge possible for me anye longer to resiste, the importunitye of certayne sproutes, & beginners of Chyrurge­rye, vvho vveare of opinione, that this present peece of vvorcke, vvith all the deformityes therof, might be profitable for them, and beinge certifiede, that if by anye means they coulde attayne them into theire handes, they vvoulde commit the same to the printe even such as it vveare. So that I am constrayned to imploy my selfe certayne hovvres of the day, in correcting of the same and a little more imbellishe, and adorne, the same, vvith 4 portrayctures of mans bodye because the same entringe into the vvorlde, might be effected vvith more favoure, & credite, vvherof the tvvo first, doe demonstrate all externall partes, as vvell anteriorlye, as posteriorlye, & in the other tvvo, all the superficiall Vaynes, are evidently layed opē vnto vs, vvhich as little rivers doe runne throughe the face & throughe all other externall partes of the bodye extende themselves as vvell behinde as before, because the same beinge of the yong Chyrurgians noted, they vvith lesse daū ­ger might open anye of them.

Farther I have enriched this vvorcke, vvith divers defigurations of Instruments, not of all Instrumentes, but of those onlye, vvhich I esteemed to be most necessarye: For even as the sage, prudent, and vvyse Nature, hath instituted such an ordre, to mans body, that shee vvith fevv par­tes, can accomplishe, manye great and excellent actions, In like sorte must the Chyrurgiane, an imitatoure, and administre of Nature, endevoure, and constraygne himselfe, vvith fevv Instru­mentes to execute, and effecte, manye, & greate Operations. And to speake the playne truth all this greate companye and treasure house of Engines, Molitiones, and of other Chyrurgicall In­strumentes, are more for curiousity, & oftentatione, then for anye necessitye, and vse. I am also verye certayne of that vvhich our Hippocrates sayeth, to vvit, that vve ought not to constraygne, or restraygne, the libertye of our corps, and the Operations, vnto the penurye, and deficience of In­strumentes: but much more amplifie, and enrich the same, vnto the commoditye of the bodye, and ease of the Operations: but I vvoulde rather exoptate, and desire, that this vanitye, & super­stitiouse bravadinge of Instrumentes, vveare ruled vvith more religiouse mediocritye.

Also I have made, a greate & ample Table, or Index, in the end of the Boock, vvherin through Alphabeticall ordre I have illustrated, the most notablest, & difficultest thinges, vvhich in the in­qvisitione might be an impediment, vnto the vnexperte in the arte of Chyrurgerye, in seekinge of their farther commoditye. And if so be any man obiecte vnto me, that this my discourse, is onlye compilede together of certayne rapsodyes of the antiqve Chyrurgians: I vvillingely heere confes, & acknovvledge, that in this Treatise, ther is verye little, or nothing at all of myne ovvne Inventione: For I am not the man vvhich liveth by an other mans mutuated supellectilles and I rather publiqvely confes, that I have collected all this out of auncient Chyrurgians, being greate shame for me to be repraehended, and surprised, of a secrete thefte. For vvhat noveltyes are vnder the Sunne? as the vvyse man sayeth: And as the Comicus sayeth, vvhat shoulde vve novv adayes say, vvhich hath not before bin spoken? But I may at all times vvith veritye say, that I am not entred into this matter to sovve, and feminate the same in an infertille grovvnde: For I have added thervnto greate amendmente, and have eradicated, & vveeded out all spinosities, & thistles, vvherof they vveare replenished vvith greate difficultyes, seqvestringe on the one syde malevolēt herbes, vvhich choacked the good fruictes of the truth, composinge all thinges in good ordre, to adde thervnto cleernes, and facilitye: throughe the vvhich excellent, moderne, & aunciente Aucthors may be vnderstoode of those, vvhich can attayn to the klovvledge of noe strange langvages. Ne­ther have such Personages, out of vvhich I have taken anye of their operationes, observed in all their treatises one ordre, perfectlye, and one manner of operatione, but one divers places, and in divers Bookes they have discribed them: vvherfore they are not to be reprehended, vvho vvith a conseqvence, have redacted them together, because they might the easyer be compraehended, and vnderstoode. And althoughe those vvhich heeretofore have vvritten of Instrumētes have cō ­tentede themselves only vvithe the representation, of the simple Figures: In have heer endevou­red to present dimensions, and proportiones, theire longitude, and crassitude, and so naturallye, that nether the Chyrurgiane, nor the Smithe vvhich vve cause to compose the same might have anye occasione of hesitatione, or doubte, nether fall into anye erroure, of theire commensurati­one appropriatinge vnto everye one of them his name in Greecke, Latin, & Frenche, & reporte also his ovvne opportunitye, and vsage therof.

[Page]name in Greecke, Latin, and Frenche, and reporte also his ovvne opportunitye, & vsage therof▪

I knovve right vvell, that in this vvorcke ther vvilbe some operations of Chyrurgerye vvan­tinge, and that it is not vvholye perfect: But I assure my selfe, that everye man of a good spirite, & iudgement, vvill acknovvledge, that I of purpose have omitted the same, and that especiallye be­cause certayne operations, therof are not novv a dayes in vse, & practise: as is the manner of insci­sione of the skinne of the Heade, vvhich the Greeckes call Pericuphismos: Also the extirpatione of vvoemens brestes vvhich hange toe long: of the Cauterizinge of the Liver, and of the Mil [...]e: of the extractiō of a stone out of the blather, because I my selfe am not therin instructed: Al vvhich operations, I permit to practise the right vvorshipfull Monsr. Collo Chyrurgiane at Paris, a perso­nage so rare therin that all Fraunce hath not his like, vvith all dexterity to effectuate such an ope­ratione: In like sorte also Mr. Pineau, also Chyrurgiane at Paris, vvhich is the resplendente starre of Light vnto all the Anatomistes of these times. Nether doe I doubte, that he vvhich dilligently searcheth this vvorcke, that he shall finde anye diffaulte therin: for I doubte vvhether that anye curiouse poeple shoulde accomplishe, the same, seinge the Aucthor himselfe coulde not suffici­entlye accomplishe the same: But I hope, to receave of the benevolent Reader, some excuse, he notinge, and consideringe, that such operatiōs vvhich are verye titillouse can not at one time be begunne, and also at the same time finished, and that it is sufficiente, vvith greate difficulty right­lye to imprinte the same. VVherfore if this enterprise seeme alienate, and strange vnto any bo­dye, and they mocked thervvith, I certifye vnto them, that I envye noe man, vvhich can meliori­ze the same: And as touchinge those vvhich seeme not to be in the vvorlde for anye other vse, then to censure, & repraehende others vvithout vvillinge yea and being able to effectuate ought thēselves, let them iovise, & ioy themselves, of their privileadge, as long as pleaseth them, vvher­vvith I doe not much molest my selfe. Othervvyse, I have vvritten only for the iunior, & yonger Chyrurgians, and not for those, vvhich are vvholye and completlye edoctrinized, and search for nothinge els then for a perfection of all thinges: I have not exalted my harte so hight, as those se­vere censurers vvoulde require, and I suffise my selfe vvith my accustomed manner, & vvith the behouldinge of the commoditye of the Frenche iunioritye, of that vvhich my small vvitte, could set forthe: I onlye desire this one thinge of them, that they vvoulde vouchsafe to meliorize the same, as I certaynlye knovve they vvell can, and doe not retayne their ovvne commodity therof. And it vvilbe a greate ioy, and peasure vnto me that therin they surpasse me: & I shall very vvell knovve to applye the same to my profite, and commoditye, vvhich they throughe theire great la­bour, and industrye, have brought forth, nether vvill I conceale that vvhich of them I shall have learned.

And although it be the opinion of the Sages that vve ought not to lightly, thereveale secretes, of Physicke, vnto the common, & vulgare poeple treating of such matters, in theire maternall, & motherlye langvage, because it might be esteemed of little vvorth, & be of all men little accoun­ted of: And although I coulde easily, have vttered, and expressed my intente, in latine, yet I rather published the same in our French language: And that first of all, because all annciente Learned men, vvhether they be Greeckes, Arabers, or Latinistes, have vvritten al theire doctrine, and experience in the maternall language. The primates, and princes of Physicke, Hippo­pocrates, and his faythfull, and fidele interpreter, & commitatoure Galen, Paulus Aegineta & Oribasius doe vvitnes of the same. Avicenna, and Averroes, have also done the same, vvritinge in the Ara­biane Langvage. Celsus and Plinius, the firste and they vvhich have only vvritten in Latine, have alsoe done theire endevoure, and have also disired to imbellishe, and eternize, theire Latine lan­gvage, & contrye, through the termes, and theoremes of Physicke. Farthermore also, by hovv much the more a thinge is more commone soe much the more is it better, and by so much the more may this science of all men be knovvne, lauded, and extolde. The Physicke of Hippocrates, and of Galen, the Phylosophye, of Plato, and of Aristotle, are they therfore obscured or lesse estee­med of, because they vveare vvrittene of the Auncientes in Latine, and Arabicke langvage? And those vvhich of our time, have vvritten, in French Dutch & Italiane, as manye renoumnede mē have done, vvhoe in all sortes have indevoured, to doe some service to the common vvealthe, hade they heere in committede anye thinge vvorthye of repraehension? they vvhich vvrite in vn­knovvne langvages, besydes that they are profitable vnto straungers, and to theire onre native soyle discommodiouse, are assimilated and resembled vnto farmers, vvhich vvould rather till, an other mans feelde, then theire ovvne propre grovvnd, to the greate dishonoure, shame, & detri­mente, of theire countrye, and inhabitantes.

VVherfor I most humblely intreate, and obsecrate all men, to receave gratefully, & thanck fullye this my laboure, and divine desire, vvhich I have to see the iunior Chyrurgians, vvith all their mindes industriously labourīg to follovv & imitate me: & if so be it pleased & that any mo­re learned mā thē I am vouchsafede to perlegate vvith pleasure, & imploye a small of their time [Page] in the readinge, of my scriptsons, and vvritinges, I most courtiouslye desire thē, that they vvould more vvith good vvill, then vvith a spirite, vvhich to narrovvlye espyeth, to repraehende the faul­tes, vue & circumsplectlye note the defaultes vvhich might be therin: Least that through to grea­te curiositye, and to seriouse subtilty, that same happen to me, as in times passed, happened to the Philosopher Theodosio, vvho turning over the preceptes of Philosophye vvith his right hande frō his Anditors, they vvho vvith theire lefte hande coulde also reach him, throughe malice, and im­puritye of spirite, turned, & misconstrued the same in badde sorte. VVhich if so by anye meanes I can attayne vnto, and knovve that this my vvorcke, (published throughe the importunitye of the iunioure Chyrurgians) shalbe aggreeable, and acceptable, vnto manye, it vvill then admini­stre courage, vnto me, to pursue, and addresse the remanent of my studyes, vvherin I am entred: that is, to medidate, and to publishe for the yonger Chyrurgians, all those thinges, vvherby Gods honoure might be increased, and be profitable, for the common vvealth.

Candidus imperti meliora, vel vtere nostris:
Carpere vel noli nostra, vel ede tua.
Some men do reade, to reape some good therof,
Others to mocke, and hovvlde therof a soffe,
It is more ease heerin to reprehende,
Then anye thinge therin, for to amende.

To the gentle, & curtiouse Reader.

SOmetimes vvith my selfe cōsideringe, & in the ballance of my cogitations vvei­ghinge, hovv perrillous, & daungerouse an attempte it is (most benevolence, be­nigne, & curtiouse Reader) in these times, and ages, I omit ether to vvrite, or di­vulgate anye vvorcke, but to translate it out of one language into an other. Yet I vvoulde not, nor indeede coulde not partely to satisfye the greate importunitye of certayne vvellvvillers of the Englishe natione, and poeple, but especiallye of my reverente master, vvhoe althoughe noe Englishe man, yet I assure thee one vvho throughe certayne acqvayntance of English Captaynes in these Lovvcountryes, doth affect all Englishe men, & vvoulde heerby shevv himselfe gratefull not onlye vnto them, but to the vvhole society of our Maiestyes subiectes, by incitatinge, & as it vveare compellinge me his poore servant heere vnto, obiectinge vnto me my inconstant levitye, vvhoe havinge receavede so manye, & so greate benefites of the poeple, & studentes in Englande vvoulde not imparte this excellente, exquisite, and perpolite peece of vvorcke vnto them, seinge that also the Printer, vvas so vvillinge to inci­tate me heere vnto, heere by alsoe expressinge his affectionated goode vvill both to our most re­noumnede Maiestye (vvhome God longe praeserve) and her subiectes. I standinge in a dumpe, & beinge vvith these obiections mute, Nesciens quid agerem, aut quo me verterem, not knovving vvher to hide my selfe, at the last as one beinge erectede, and suscitatede out of a svvound, I feeblely ma­de this ansvver, that it fitted not nether vvas agreinge to my harshe, rude, and illiterate stile to be­ginne such a peece, of vvorcke, and I being noe Englishe man borne might chaunce (as vvithout doubt I have) to take Sissiphus his laboure on me, in not vvritinge goode Englishe. And vvhich is more, least I shoulde attribute any occasion of offence to my most reverent brother vvho be­inge a Doctour of Physicke, & I but an illiterate, & ignorāt youth applying my minde vnto Chy­rurgerye, might suppose me to be so pratchante, & highminded that I sought to aequall my selfe vvith him vvho through his affectione he beareth to Englande hath also translatede an excellent booke of Physicke. But at the last I being fully resolved of my doubtes, & of thē persuaded, that it vvould of all men be taken, & construede to a goode end, I coulde not any longer resist their im­portunate assaultes on the imbicille vvalles of my ansvvers, but they havinge therin made a bre­ach I vvas constrayned to yeelde my selfe a captive, & acknovvledge them victors in consentinge to their requestes, by takinge this laboure of Atlas on my shoulders. Therfore I vvoulde not vvillingelye, have that this light inconstancye shoulde be obiected agaynste me, for not im­partinge vnto thee (most gentle Reader) these my obliterate lines of this experte, excellente, and perpolite Chyrurgiane Iaqves Gvillaemeau, vvhome for his excellentie of his manuale operations I assure thee such a one hath never in Englishe binne trāslated: Behould novv therfore to shevv my selfe greatefulle for those benefites vvhich vvhilome I have receavede in this florishinge, & blessed countrye of Englande, both in the Vniversitye, and in the other Cityes therof, I heere humblelye praesent vnto thee this my firste attempte, vvho althoughe indeede no Englisheman borne, yet bearinge a true English mans harte vnto our Maiestye endevouringe continuallye to shevv my selfe gratefull vnto her, & her subiectes. And althoughe it be more grosse, & impolite, then decent, & convenient, to ansvver the fine, & scoffing heades, & vvittes of these times vvhoe allmost can doe nothinge els then scoffe, mocke, & floute, at other mens industryes, and labours, yet I pray the (gentle Reader) not to eesteeme them all vayne, indecent, and invtile, for Non cuivis homini contingit adire Corinthum, everye man can not have a nose like a shooing horne, that is eve­rye one hath not such a fertile vvitte as they have for I acknovvledge my selfe to have but a bar­rane, & vnfrictefulle grovvnde & that ther doth nothinge then Filix innascere agris meis, and hovv is it possible then to reape goode Fruictes therof? And knovve (curtiouse Reader that I take it to be a godly thinge to publishe such a peece of vvorcke for the ayde, & succoure of all yonge Chy­rurgians to operate, & vvorcke on mās bodye, for vvhat more praeciouse thinge is there on earth then man: and if then vve endevour to praeserve, the health of our bodyes it is then necessarye to have such boockes out of vvhich vve may learne the meanes vvherby vve might doe it, & I have the more vvillinglye translatede the same into the vulgare & Englishe tunge because everye one hath not the gift of langvages, & although it be not soe exqvisitelye done as it vveare convenient it shoulde, tamen est laudanda voluntas, I have done my best indevoure thervnto, for ther vvher abi­litye lacketh, my goodvvill notvvithstandinge is to be receavede, and not to be repugnede, & re­iected. Nether shalt thou heere (gentle Reader) have any exquisite methode, nor the flovving stile of Demostlenes, and eloquence of Cicero, but a playn common, and vulgare stile for it vvas not of the Aucthor composed in the firste for such mē as are experte in these operations, but for the commonaltye, and yonger Chyrurgians, that they heerbye might learne the true operations of [Page] Chyrurgerye. If my boulde audacitye, or audaciouse bouldnes shall administer occasione of of­fence to any man, I recurre to that common refuge, vvhich promiseth remissione to him vvhich giveth his first assaulte. VVherfore if the learned vvill vouchsafe to reade this my first beginning vvithout envye, or malice agaynst me, I shall thincke my industrye verye vvellimployede & not to have bestovved all my labour in vayne: but if through the harshnes of my illeterate & rude sti­le they are caused to lay it out of theire handes, & sight, yet I humblely requeste them to take him vp agayn not for my sake, but for his ovvne, vvhoe although defilede, & poluted vvith my impo­litede stile, yet they may gather in the garden of his exqvisite vvorckes, as fragrant gillovvfers of Chyrugicall operations (I dare avouch) as any ever vveare in Englishe. And if ther be anye of Momus his partakers, vvhich doe revile, scoffe, & floute me, vvho are soe scrupulouse, & praeiu­dicialle, that vvith noe Physicke they can be cured of their criticall dissease, tell them I pray thee (gentle Reader) from me, that it is farre easyer for them to repraehende, then to correct or melio­rize, and that they dare not for the best cappe they have take such a thing in hande, least they per­adventure shoulde fall into the pitt vvhich for other they had made, for there is an oulde, and in­veterate proverbe as I remember in Latine Quod tibi fieri non vis, alterine feceris, let them (I say) re­ade this proverbe & I trust it vvilbe a purgatiō for them. VVhat shall I say more? for indeed I can say nothinge as the Comicus sayeth quod non fit dictum prius, If therbe anye vvhich vvith their Argus eyes, vvill vue, & so narrovvlye princke, and looke, for faultes in this my labour vvithout doubte they shall finde faultes sufficient, but I vvoulde request them to leave their eyes at home vvith Lamia, vvhē they loock for any faultes heer in, & spitt in a boxe, the spittle of quippes, & quiddi­tyes, & cast them behinde some chest of oblivione that they never may anye more be spoken of, and let them not dispise this my poore farthing, for it may be heerafter shall finde my selfe doin­ge vvith some other peece of vvorcke more excellent. If therfor (benevolent Reader) vve finde this vvorcke to be acceptable vnto thee, my master shall thinck his motiō to have binne blessede and happye, the Printer his irritatione commodiouse, and I my labours, and industryes vvell be­stovvede, and it shall be as it vveare a Calcar vnto me therafter to imploy my selfe vvith the tran­slatione of some other excellent peece of vvorcke. If not I vvoulde frendly desire such as scoffe heerat, to reade, & dilligentlye consider these tvvo verses vvhich the Aucthor reciteth, and are these.

Candidus imperti meliora, vel vtere nostris:
Carpere vel noli nostra, vel ede tua.

Thus beinge loath to interrupte thee anye longer vvith vayne, & illiterate speeches I commit thee to the tuition of God thy Creator, & his sonne Ihesu Christe vvho vvith his effused bloo­redeemed thee, and of the holye ghoste, vvho inspireth thee vvith his spirite, continuallye vvis­hinge increace of all virtues, and longe lyfe vnto thee.

Thyn as his owne, or els not worthye of vitall breath. A. M.

THE THESAVRA­RYE, OR STOREHOVSE of Chyrurgerye: wherbye are also added Foure figures, or portrayctures of mans bodye: Two of the which doe demonstrate vnto vs, all the externall partes of the same: and the other tvvo, the most visiblest vaynes fit for phlebotomye, vvhich lye dispearced vn­der the skinne Throughe Iaqves Gvillemean of Orleans, Ordinatede Chyrurgiane to the Kinge, and svvorne in his Chastelet at Paris.

The Praeface.

WE say in Fraunce for an aunciente, & verified proverbe: That it is not sufficiē ­te enoughe that vve doe anye thinge, but that vve doe the same exquisitlye, & profitablelye. VVhich can not vvith anye convenience be excuted or accom­plished, vvithout knovvledge of the causes, vvhich doe leade, and conducte vs, to the perfectione of the effect: So that accordinge to the sayinges of the Philo­sophers, Science is nothinge els, then the knovvledge of that,What Sciēce i [...] vvhich vve have in handes, through his proper causes. Vnto the vvhich all Artificers must endevoure to attay­ne: throughe the vvhich Chyrurgerye, although notvvithstanding, vve can not attayne to the knovvledge, & cognisance of the presente subiecte, & the accidentes therof, throughe such oc­casions as vve have discribede, the same being as it vveare an inferioure science, and dependin­ge, on the Naturalle, and Physicall sciences: vve ought notvvithstandinge to knovv at the leaste this poyncte, and to observe, and follovve the same, and that throughe the most sensible, and apparent causes, vvhich are Materialle, and Instrumentalle.

VVhich hath movede me to represent,Wherfore the Au­cthor hath col­located the Instrumētes in the fore­frontutes of his booke. and as it vveare evidentlye vnto all mens eyes demonstrate, not onlye the materialle, and formalle principles, vvherof our subiecte, of mans bodye, is created, and compilede together, but the Instrumentalles, throughe the vvhich vve as by such meanes mayntayne the same in his naturall healthe, as longe as ther is anye he­alth afore handes, and also agayne restore the same, beinge imbecillede, & debilitated, through the combate vvhich vve have agaynst the dissease, or sicknes.

Nether to speake truthe is it a thinge conveniente, and seemlye, that anye greate, or vvor­thye Capitayne, shoulde assayle his enimye, before he apparantlye knovve him, and have for his ovvne commoditye, and advantage made electione, and choyse of the place, & feelde of cō ­bate, hath ordrede and alsoe armed his souldiours: noe lesse also, must he besiege anye stronge,The offi­ce, & du­tye of a good Ca­pitayne. and fortified Citye, vvithout first having advertisemente, & knovvledge, of the most feebleste place of the same, & vvher in storminge his souldiers may leaste of all be endamagede, he ha­vinge sufficiente admunitione, to make a breatch.

In like sorte also vveare it greate temeritye, and rashenes, for anye Chyrurgiane, to take in hande anye operatione, of Chyrurgerye, vvithout first of all considering one the subiecte,The offi­ce of a good Chi­rurgiane. one the vvhich he intendeth, and purposeth to operate, or vvorcke, convenientlye to situate, and collocate the same, and being fournishede of all his Instrumentes conveniente for such an o­peratione, therbye to attayne vnto his pretended intente. I humblye reqveste, the most bene­volent, and gentle Reader, to have me excusede, although I have not collocatede, them in such numbre, as I vvillingelye coulde vvishe and desire I had, havinge notvvithstanding causede the same to be representede: but throughe the iniuryes of this most disturbede, & molestede time, there are some of the Plates (vnto my greate molestatione, and sorrovve,) lost, and coulde not by anye meanes possible so suddaynlye be agayne pourtrayctede, & engraved: the vvhich not­vvithstandinge in the nexte editione I hope to collocate them.

Explication of the Characters which are contayned in the first figure of mans bodye: wherin G. signifyeth a Greecke worde, and L. a Latine worde.

A, That vvhich from A, to a 10, is contaynede, is called the Heade, in Greecke Cephale, & in Latine Caput. And that parte vvhich is noted vvith, A, is in G, cal­led Bregma, and in L, Synciput: In this place the fu­tures Sagittale, & Coronale doe assemble themsel­ves: on vvhich place vve may convenientlye applye the Cauteryes.

B, The forehead, G, Metopon, Episcyniō L, Frons, that vvhich frō the B, to a 10. is callede the face G, Pro­sopon, L, Facies, Vultus.

C, The Temples, G, Corcai, Cortaphai, L, Tempora, & that vvhich standethe besydes the same, G, louli, L, Lanugo, that vvhich is contayned, betvvixte, 2, 5, D, & E, is called the Eye, G, Omina, Ophthalmos, L, Oculus, the concavity of the same G, Pyelis, L, Ocu­li pelvis, the vvhite of the Eye, G, Legas, L, Albedo o­culi, the Apple, G, Core, L, Pupilla, the Circle, or cō ­passe of the Eye, G, Iris, L, Iris, the Corners of the Eyes, G, Canthi, L, Hirci, Oculorū anguli: The great D, corners of the Eye close to the Nose, noted vvith D, in G, Ranteres, L, Magnus angulus, The lesser E, corner, finitimating the Temples, E, in G, Poropias, L, Parvus angulus. The Brovves, G, Blepharon, L, Palpebra, the externall parte of the Brovves, G, Che­las Entricomata, Tarsos, L, Palpebrarū crepido, The edges of the Eye liddes, G, Blepharides; L, Cilia: that 2, parte above the brovves, G, Tyloiophryes, Episcynia Latine supercilia, that separatiō, vvhich is betvvee­ne 3, the brovves, noted vvith this figure 3, G, Meso­phryon, L, Glabella, Intercilium.

F, The Apple of the Eye, G, Melon, L, Malum.

G, The concavitye of the Face.

H, The Cheeckes, G, Gnathos, L, Bucca.

4 The Nose, G, Rhis, Nyctor, L, Nasus, the end of the Nose, G, Sphairiō, L, Globulus, that vvhich hangeth one the end therof, G, Chyron, L, Columna: The Nostrells, G, Pterygia, L, Alae, Pinuloe, the separation betvveen the nostrells, G, Isthmion, Stylis, L, Nates. I, The little gutture vnder the nose in the vpper lippe, G, Philtron, L, Lacuna, Amatorium.

6 The Eare, G, Ous, L, Auris, the vvhole, G, Cyrtoei­des, L, Cubiformis, the superioure parte therof no­ted vvith this figure 6, G, Pterygia, L, Pina, The infe­riour part of the Eare Tendrō, noted vvith this figu­re 7, 7, G, Lobos, L, Fibra, Ansa Auriculae, the redupli­catede semicircle, G. Elix, Coclia, L, Capreolus, The 8, concavitye of the Eare, noted vvith the figure 8, G, Conc [...]e, L, Concha, Cavum auriculae, the eminen­ce by the Tēples, G, Tragos, L, Antehircū. The audi­tory apertiō, G, Acoe, L, Meatus auris, The circum­volutions vvhich are therin, G, Camara, L, Testudo. 9, The Mouthe, G, Stoma Logeion, L, Os, the Corners of the Mouthe, G, Chalmus, L, Chalmus, The Lip­pe, G, Cheilos, L, Labrum, Labium the vpper parte of the Lippe, G, Proscheila, L, Prolabra: The Place vvher the Lippes ioyne themselves, G, Prostomione that place vvher the mustaches begine, G, Mystax. 10, The Chinne, G, Anthereon, L, Mentum, the conca­vitye vvhich is theron, G, Typos, Nympha, L, Nym­pha:

K, Λ, All that vvhich is comprehendede betvveen the K, and the a, Λ, is the Necke, G, Trachelos.

L, Collum the foremost parte therof is called the thro te, G, Hypodeins, L, Rumen, the nodatiō of the gor­ge, K, or throte, or Adams bitte, G, Branches, Larynx, Λ, L, Guttur, the Windepipe, G, Sphage, L, Iugulatio.

L, L, G, Leucama, L, Ingulis, proximum cavum.

M, M, G, Cleides, Ligulae, that vvhich is cōtayned from M, N, Q, is the Brest, G, Thorax, L, Pectus.

N N, The Brestes, G, Mastoi, Tittoi, L, Mammae, Vbe­ra, the dugge, G, Thele L, Papilla, the circumtacent place of the dugges, G, Phos, L, Areolae.

O, The Brestbone, G, Sternon, L, Os pectoris.

P, P, The situatione of the Harte, G, Procardion, L, An­tecardium.

Q, The concavitye, or pitte of the Stomacke, G, Sto­machoilis, L, Os ventriculi.

θ, The little Brestebone in the pitte of the same, vnder the thorax, G. Xyphoides, L. Ensifornis, Malūgrana­tum, that vvhich is comprehendede betvveene Q, and Z, is the Bellye, G, Gaster, L, Venter.

R, The superiour part of the Belly, G, Epigastriō, L, Su­perventrale, vnder the vvhich, is situated, the inferi­our orifice of the stomacke, as is the entrance ther­of vnder the fifte ribbe, of the Breste.

S, S, The sydes, G, Hypochondria, L, Praecordia, vnder the vvhich in the right syde is situatede the Liver, and in the left syde the stomacke.

T, The Navle, G, Omphalos, L, Vmbilicus, of some Vmbilicus castratus the middest of the same, G, Me­somphalon, L, Cavum, that vvhich is rimpeled, G, Graia, Vetula, L, Vetula, heer vnder is situated, the greate revolutione of the gutte Ieiunum, and this is the Centrum of the bodye.

V, V, The Loynes, or Lunges, G, Cholago, above the vvhich, the Kidnyes, are situated, and inferiourly in the right syde, the gutte Caecum, & in the lefte, the revolution of the gutt Colon.

X, The inferioure parte of the Belly, G, Hypogastrion, L, Abdomen, Sumen: vnder the vvhich is situated, the greate circumvolutione of the gutte Ileon, the Blather, the Wombe, and the Longanum.

Y, Y, The superioure parte of the Hippe, or Flanckes, G, Lagonas, L, Ilia: vnder the vvhich is situatede a parte of the gutte Ileon, the Testicles, or Hornes, of the Wombe, & the spermaticall vessells of the vvoe­men, vvhen they are gravide vvith Childe, and the Vreteres.

Z, The bone pubis, G, Epiccion, L, Pecten, Pubes.

Δ, Δ, The Flanckes, G, Bubones, L, Ingvina: they are also called the Emunctoryes of the Liver, and therfore Areteus calleth them Loimodes, Bubones, L, Sobo­les Iecoris.

[...]The yarde, or virile membre, G, Caulos, L, Coles, Pe­nis, Mentula, Virga: The Heade, G, Lalanos, L, Glans, the concavitye of the yarde, G, Ourita, L, Vrinarum iter: the topp therof, G, Posthi, L, Praeputium, the end of the toppe, G, Acoposthion, L Summum praeputij. γ, The purse, or bagge of the testicles, G, Oscheos, L, Scrotum, or Scortum: that suture, or seame vvhich passeth a long the viritilye and maketh a separatio­ne in the Koddes or Scrotum, G, Raphe, L, Sutura, and from thence tovvardes the fundament, G. Tau­rus, that vvhich is one both sydes of this suture is callede, G, Perineon Femen.

a, a, The shoulder, G, Omos, L, Humerus, the superi­our parte of the shoulder, G, Epomis, L, Humeri sū ­mitas: that vvhich is compraehended from a, vnto a, o, is called, G, Cheir, L, Manus, and from a, vnto a, b, is callede the lesser Arme, G, Brachion, L, Brachium. β, The Arme pitte, G, Maschale, L, Ala, Axilla.

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Declaratione of all the partes of mans bodye

[Page]This conseqventlye ensueth on the seconde leafe.

c, The Elbovve, G. Olecranō, L Cubitus. All the rotū ­dity of the left Arme, from a, to a, dis called, G. Bra­e [...]onos, L Humeri rotunditas: In the right Arme, d, d, demōstrateth, the end, and the Tendone, of the Mascle Delthoide,

e, The muscle of the Arme, G. Ancon, L. Lacertus.

Π, Π, The place on the Armes vvhere vve applye the Fontanelles.

f, The bendinge of the Arme: That vvhich is colloca­ted betvveene the foresayede, f vnto a, g, is called the forearme, G. Olenos, L. cubitus, & the superiou­re parte of the arme, G. Cercis, L. Radius, the inferi­oure parte of the same, G. Pechys, L, Cubitus.

g, The fist, G Carpos, L. Brachiale.

h, The foremost parte of the fiste, G. Metacarpion, L. Postbrachiale, vvherin the palme of the hāde is cal­led G. Do [...]on, L. Palma: The fingers G. Dactylos, L. Digiti.

m, The Thumbe, G. M [...]gas, L. Pollex.

i, l, Tenar, L. Hypotenar.

n, The Insignitoure, or forefinger, G. Lichanos, L. In­dex. Salutaris.

o, The middle finger, or as vve cōmonlye say the Foo­les finger, G Melos, L, Medius, Impudicus, Infamis, Verpes: the rovve of the fingers are called, G. Phala­ges, L. Ordines.

p, The Medicinalle finger, or Ringe finger, betvveene the little finger, & the middle finger, G. Paramesos, L Annularis, Medicus.

q, The little or eare finger, G. Micros otitis, L, Minimus Auricularis. The Ioynctes of the fingers, are sōtimes called, G. Phalanges, L, Digitorum internodia.

* The end of the finger, close vnto the Nayle, G. Cory­phe, L, Coryphe, the Nayle, G, Onix, L, Vngvis, the beginninge of the same, G, Anatole, L, Vngvis exor­tus, those little vvhite spottes vvhich at some times are one the Nayles, G, Nephelion, L, Nebecula.

Δ s, That vvhich is cōprehendede betvveen these tvvo lettres is the thighe, G, Meros, L, Femur.

14, 14, The superiour parte of the legge, G, Epigonides, L, Geniculares.

r, r, The internalle parte of the Hippe, G, Paramyria, L, Femina.

Π, Π, The flatnes of the same, vvheron vve apply the boxes, to suscitate the menstrualles of vvoemen, G, Mesometria. L. Interfemina.

ſ, s, The knees, G, Gonys, L, Genu, that vvhich is rotun­delye elevatede, is called Rotula or the shive of the Knee, G, Epimy [...]s, Epigonatis, Myli, L, Patella, Mola. t, t, The shinne, G, Anticnimion, Chrea, L, Chrea.

v, v, The instepp of the foot G, Tarsos, L, Tarsus al that vvhich is compraehended betvveene, v, vnto a. s, c, is the legge, G, Cneme, L, Tibia, the remanent of the soote called, G, Acropos, L, Extremus pes.

xx, The superioure parte of the foote, G, Metatarsos, L, Metatarsus vvhervnto the toes are adioyninge.

y, z, The Anckles, G, Sphyra, L, Malleoli.

The Declaration of the Characters which are compraehēded one the posteriore, par­te of the bodye.

A, The superiour part of the head, G, Coryphe, Meso­cranion, L, Vertex.

B, The hinder parte of the heade, G, Inion, L, Occiput Occipitium.

C, The place vvhere vve applye the Cauteryes agaynst surdity, tovvardes the mamillare productions.

D, The Nape of the Necke, on vvhich place allsoe vve apply the Cauteryes, that vvhich is compraehended betvveene the foresayede, D, vnto a H, is callede the Backbone, G, Rachis, L, Spina dorsi.

*,*, The Necke, G, Auchyn, Deires, Opisthocranion, L, Cervix, It is the place, vvherin vve applye the Seton, or in the place therof tvvo Cauteryes.

E, E, The place vvheron vve applye the boxes, G, Epo­mis, L, Summitas humeri: the superioure parte of the shouldre.

F, F, That vvhich is collocatede betvveene these tvvo lettres, is called the Backe, G, Metaphrenon, Noton, L, Dorsum, Tergum.

G, That vvhich is comprisede, betvveene the lasté F, & a, G, Osphis, Ixis, L, Lumbi.

I, The bone Sacrum, G, Hieron, Platy, L, Os Magnum, Sacrum, Latum, vvhich is contaynede, betvveen I, and a, H.

H, The Cropion, or Rumpe, G, Coccyx, L, Cauda.

K, k, The Shouldre blade, G. Homoplata, L, Spatula.

L, L, The right situatione, and collocatione of the Kid­nyes.

M, M, The beginninge of the Muscle Delthoide.

N, H, That vvhich is compraehendede betvvixte these tvvo letters, is called the forearme, G, Olenos, L, Cu­bitus.

O, The Elbovve, G, Olecranon, L, Cubitus.

P, Q, The fiste, vvhich is contaynede betvveene these tvvo lettres, G, Carpos, L, Brachiale.

Q, R, The fore most parte of the fiste, vvhich is cōprae­hendede betvveene these tvvo characters, G, Meta­carpion, L, Postbrachiale.

S, S, The Haunches, or Hippes, G, Ischia, L, Coxoe: On this place is the right combinatione, & the colloca­tione, of the heade of the bone in the Hippe, vvher­on vve must apply the remedyes agaynste the Scià­tica.

*,*, The Buttockes, G, Gloutoi, L, Nates.

L, L, The crassitude of the Hippe, L, Femen

V, V, The externalle parre, vvhere the membranouse muscle is collocatede.

X, X, The Hockes, G, Ignya, L, Poplex, vvhere vve opē the Popleticalle Vayne.

Y, Y, The Calfe of the legge, G, Castrocnemion, L, Sura.

Z, Z, The greate Tendone of the Heele.

ω, ω, The Heele, G, Pterna, L, Calx.

Π, Π, The plante, or sole of the Foote, G, Pedion, L, Planta pedis, the concavity therof, G, Coilon podos, L, Vola pedis.

Declaratione of the Characters con­taynede in the firste, and seconde figure, of the externalle Vaynes, which we vse to Phleboto­mize.

A, Demonstratethe the Vayne in the Foreheade.

E, In the seconde figure, the Vayne Pupis.

2, The Temporalle Vayne in each figure.

*, The Eare vayne.

B, The Eye, or ocullare vayne.

d, The Iugulare, or organicke vayne, of the Arabians callede Guides.

f, f, In the 1, and 2, figure, the Cephalicke shouldre vayne.

G, g, In the first, & seconde figure, the Basilica, Hepati­ca, the liver vayne.

g, i, L, 4, The Mediane: but the right mediane is that vvhich is notede, vvith, L, and 4.

H, 5, In the first, and seconde figure, the Heade, or ocu­lare Vayne.

1, 6, The Salvatella, of the Arabians Seynale, or Syelen.

L, The Mediane, or Blacke Vayne.

P, Q, The Iliaqve vayne, or Titillatis in Latine.

n, n, In the seconde figure, the Popliticalle vayne, V, V, p, p, The Saphena.

T, T, q, q, The Sciaticke Vayne.

R, R, The Crutalle, vvhich maketh the Saphena, no­ted vvith R, in the seconde figure.

S, The Sciaticalle vayne, vvhich also noteth the Scia­ticalle vayne, in the externalle anckle.

P, P, A, A, Demonstrate the internalle anckle vayne.

O, O, B, B, The externalle anckle vayne, *f, *f, The Heele.

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Demonstration of all the externalle vaynes

Declaratione of the Characters con­taynede in the Table of Instrumentes, wher with we extracte, and drawe out the Bulletes, and all other vnnaturalle, and alienate thinges, forth of the bodye.

A, Demonstratethe such an Instrumente, vvhich con­sideringe the figure, & similutude, is in Latinne cal­led Rostrum Lacerti: it is very necessary, to extracte, a bullet out of the body, vvhen they lye therin plet­tered, or els to dravve out of the vvound any smalle peeces of bones. The foresayed A, noteth only vnto vs the Pipe therof.

B, The vice, or meanes, vvherby this foresayed Instru­mente, is opened, & shutte agayne, as much, and as little as pleaseth the Chyrurgiane.

C, The little Iron rodde, vvhich openeth, & shutteth the foresayed Efts bille: for vve dravvinge the same tovvardes vs, it shutteth, and thrusting the same frō vs, it openeth,

D, D, The Dilatorye, behoulder, or Enlarger, in Latine Dilatorium or Speculum: This Instrumente is inter­nally concavouse, & dentified, or toothede, to retay­ne, & hould that fast vvhich shalbe ther betvveene: it may be vsed for tvvo purposes: first of all to dilate, & enlarge the vvounde, vvhether it be ether to vue the botome therof, or els to bring any other Instru­mente therin, vvhervvith vve vvoulde dravve anye thinge out of a vvounde: secondlye it is also of it sel­fe commodiouse to dravve anye alienate thinge out of a vvounde.

a, The chayned bullete.

b, A little Chayne.

c, c, Certayne parcels of Mayle dubbletes.

E, E, The Cranes bille, In Latine, Rostrum Gruinum.

F, The springe to Keepe open the same, leaste that the Chyrurgian might be hindered in the opening ther­of: & because he shoulde allvvayes be preparede to shutte the same, as soone as vve perceave any thing to be betvveene the same.

G, The Bullete vvhich must be dravvne out.

H, H, The Ganders bille, In Latine, Rostrum anserinū: It is also callēd Rostrum latum, the broade bille: the extremitye, & end therof, is also dentified & toothe­de, because he shoulde the surer, retayne the Bullet. I, The bullete vvhich is betvveene the teeth.

K, The soundinge Iron, or Esprovette: vvhich may be vsede also for a Needle to make a Seton: & is verye conveniente to sound, & serche for bulletes, and all other alienate thinges in a vvounde: as also vve may make thervvith any Seton, the same beinge neede­fulle: some ther are vvhich ar made of tvvo peeces, becaus it should so be more portable. This foresay­ed searching Iron is called in Latine, Astilla tētoria, Radiolus, Explorator: & in G, it is callede Mele: Ga­len calleth it Thaumatiche, Mele, and Hippocrates, Ischyri,

L, The Bulletdravver or Grounde dravver, vvithout his canulle: This Grounde dravver is verye acute on his end, becaus the bullet might sticke fast therone: it is called in Latine, Terebellum simplex.

e, The vise, vvhervvith he is fastened in the pipe, or ca­nulle, & vvhervvith he is boarede into the bulette, vvithout any great violence, or force.

M, The Pipe, or Canulle, vvith the hādefastening ther of. In Latine Canula simplex.

N, The hādle through the vvhich vve thrust the Groū de dravver.

O, The Bullet dravver, vvith his canulle, on vvhose end the bullet is fastened, to be dravvne out. We vse this Instrumente, vvhen the bullet is fastened in any bone, & vvhē the same vvith violence must be dra­vven therout: & is in Latine called Terebellum tor­culatum cum Canula.

d, The vise, vvhich entereth into her case, notede vvith Π.

Π, The vise vvhich is in ternallye occulted.

Q, An other Bulletdravver, the end vvherof is noted vvith R, vvhich causeth it to be so called, the bullet dravver vvith the ring, or vvith the spoone, must be hoaled, to give place vnto the bullet: and the other end, is recurved, & broad, & also somvvhat conca­vouse, vvith smalle teeth, to retayn, & hould the fa­ster all alienate thinges, vvhich vve intend to dravv out, vvithout escaping therout.

R, The bullet dravver vvith the ring, or vvith the per­forated spoon: this bullet dravver is very conveniēt, & necessary, becaus the bullet is the one halfe ther­in included, & is also by that meanes held stedfastly faste, vvithout sterring therout: And is called in La­tine, Globulitraha annulate, or Cocleare.

S, The Croockede bullet dravver, in L, Globulitraha connexum: This bullet dravver is also very necessa­ry, becaus he is dētified, becaus the bullet being ther in, it should not glibber therout, but may be therin retayned.

T, An other bullet dravver, vvhich through one of his endes, as through the superioure noted vvith V, he is also hoockishe, & recurvated: & at the other end noted vvith X, he is like vnto a hoock, vvhich is a­cute, & sharpe, notvvithstāding in such sorte, that in noe vvyse they may vvound, vvhether it vvear Syn­nue, Vayne, or Artery in the dravving out of any thi­ge: these extremityes, or endes may serve to dravve any Linnē out of a vvound or any such like thing as Cotten, Woolle, or anye Mayles, vvhich mighte re­mayne faste stitckinge in the Wounde.

V, it is a recurved, & croocked bullet dravver, called in L. Hamulus recinus, Latus, Obtusus.

X, The bullet dravver vvith tvvo crochetes, or hooc­kes, called in L, Hamulus bifidus obtusus: And are called in G, Vncinos, & of the Latinistes, Vncus: and in French Croc, or Crochet, or Hams crochus, a Hoocke.

There is noe Chyrurgiane, vvhich hath anye bullet dravver of his fashone, or manner vvherevvith he contenteth himselfe: but I have heere placed, & collocatede, those vvhich are fitteste for vse, omittinge, and lettinge passe manye other fashons, to prevente, and evi­te all confusions vvhatsoever.

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Sundrye Instrumentes to drawe out Bulletes

Declaration of the Characters con­taynede in the Table, of the Instrumentes of the Heade.

A, Demonstrateth, an extractor, or dravver out, vvith three feete, the one vvhereof is verye thinne, and 1, smalle, notede vvith this figure, 1, the seconde is a 2, little grosser, and thicker, notede in this sorte, 2, the thirde of a greater crassitude defigurede vvithe this 3, marcke, 3, to accomodate them accordinge to the convenientnes of the fractures, or depressiones. We may take him, for the Instrumente, vvhich Hippo­crates calleth Tripanon Periterion, and vve in En­glish the Percer. Avicenna, and Albucasis, have not onlye thervvith contentede, and suffisede themsel­ves to elevate, the depressede bones, but have allsoe thervvith perforatede the Cranium, and Trepanede it, vvherfore they accounte this Instrumente for a species of a Trepane.

B, The Handle, of the smalle Instrumētes of the Hea­de, vnto the vvhich everye of these Instrumentes a­re accommodatede, and fittinge. And is in Latine called Manubriolum.

C, The perforatione, or hole throughe the vvhich, the vises of the foresayed Instrumentes are thruste.

C, The smalle, and litttle Savve, In Latine Serrula, vvhich onlye serveth, to savve throughe the bones of the Heade.

E, F, H, Doe demonstrate vnto vs, the Raspes or scra­pers, callede in Latine, Radulae, or Scalpta rasoria, In Greecke Xytera. There are divers, and sundrye fi­gures heerof: that vvhich is noted vvith E, is round, that vvhich is marcked vvith F, is acute and poync­tede. And that vvhich is broade, & dilateth it selfe, is callede in Latine, Scalper excisorius Lunatus, be­inge not dislike vnto a halfe Moone: and callede in Greeck Cliscos, because it is like vnto a semicircle: The Aunciente, and Antiqve Chyrurgians have tre­panede vvith these Instrumentes, but vve novv a dayes have farre more conveniente instrumentes, and vve doe onlye helpe our selves thervvith in se­archinge vvhether the fracture doe penetrate both the Tables of the Heade or not.

G, The vise vvhich is thrust into the hole of the hand­le notede vvith C.

H, The Depressor, of the Membrane, vvhich vve vse immediatlye after trepaninge, thervvith to depres­se the Membrane, to espye vvhether ther be nothin­ge situatede, and collocatede betvveene the Mem­brane, and the Cranium.

4, The end of the foresaede Depressor, vvhich is flat­te, as a smooth Heade, of a vvell pollishede Nayle.

5, Scalper Lenticulatus, G, Phacotous, It is an Instru­ment like vnto a little chisell in forme of a penne-knife: soe callede, because in steede of a poyncte it hath a rounde, and flatt thinge like vnto a Vetche, leaste vve chaunced to hurte the membrane vvhen vve thervvith vvoulde playne the edges of the tre­panede perforarione beinge verye sharpe.

6, The little Vetch vvhich is at the end of the forsaye­de Instrumente.

K, A certayne Kinde of Elevatorye, verye necessarye, callede in Latine Elevatorium, Vectis, G, Ostraga, L, The pillare, or branche of the Elevatorium, vvhich is quadranglede.

*, The end therof vvhich must be situatede, on the sounde and firme bone.

M, The Crochet, or hoocke, vvhich descendinge, ele­vateth it selfe, and recollocateth as much as is nee­defulle.

8, The poyncte vvhich is flattye, because it might be thruste into the dilaniation, or fissure of the Craniū. 7, A lesser hoocke, or crochete.

N, Inscisive, or cuttinge pinsers, or tonges, to cutt of anye, peeces, or splinters of bone.

O, O, The Rostrum lacerti, vvhich is verie convenien­te. to dravve out anye splinters of bone, G. Anthe­tous, and Eistethois eccopeas.

P, The Ravens bille, in Latine called, Rostrū corvinū.

Q, An other Kinde of elevatorye, and is in Latine cal­lede Elevatorium bifidum.

*, This demonstrateth to vs, that vvhich vve must lay one the firme bone.

R, That vvhich must entre into the splitte, or els be­tvveene the depressede bones, to the elevatione of the same.

S, An other Kinde of Elevatorye, vvhich at one end is toothede, and at the other end formede, like vnto a halfe Moone.

T, A rescindente Instrumente, the one end vvhereof servethe for a rasore, to cut throughe thervvithe the musculouse skinne of the Heade, and also the Peri­cranium: vvhich end is notede vvith X, and on the other end is it blunte, vvhich is verye conveniente, to scrape the Pericranium, the same cleaving to fast V, vnto the Craniū: the vvhich end is notede vvith V, the Greeckes call it, Hypospathisma, Spatiō, or Spa­tomele.

Y, A soundinge, or serchinge iron, to feele vvhether ther be any fracture in the Cranium, the end vvher­of is rounde, and politelye polishede, and being Z, of a reasonable crassitude defigurede vvith Z, and a, on the other end a little elevatorye notede vvith a, b, Demonstrateth a parte of the Heade, vvhich is gre­atlye broken and hurte, as vve may behoulde, out of the vvhich it vveare needefull to have a greate pee­ce of the Cranium taken avvay.

c, c, c, The circumference, and magnitude, vvhich vve purpose to take avvay, vvhich conveniently may be done through thre places, vvhich must be trepane­de, to administre place to the savve.

d, d, d, The three places vvhich vve must trepane: by this meanes to take avvay directlye from Line, to Line the corruptede, and rotten bone, notede, vvith c, c, c, c, c, c, vvhich vvith the savve must be done. So­me ther are vvhich vse this forme of trepaning, but it is tediouse, and troublesome, and in thus doing is there a greate qvantitye of bone taken avvay.

I have heere endevourede, to presente, the moste convenienteste sortes of Elevatoryes, vvhich novve a dayes are most in vse, in such magnitude, & greatnes of forme, as might be most conveniente for the Chyrurgiane, consideringe all other smalle instrumentes or fer­ramentes of the Heade, as are the Raspers, vvhich of sett purpose I omittede, least I shoulde cloye the Chyrurgiane vvith to manye Instrumentes, becaus by those in place of others he might contente and suffice himselfe, because that such an infinite, numbre of instrumētes doe serve more for ostentatione, and pride then for anye necessarye vse.

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Diuers Instrumentes for the Heade

Declaratione of the Characters con­taynede in the portrayctures of sundrye, and di­vers sortes of Trepanes, and nipinge tonges.

A, A, A, A, Demonstrate the vvhole Trepane in his for­me, and fashone.

B, The coverture, or cappe of the Handle.

C, D, That vvhich properly is callede the Trepane, G. Trepanon Chynicida, or Chenicion & Priona charac­ton: vvhich vve must soe vnderstande, vvhen the sa­me is vvithoute coverture: In latine it is callede, Te­rebellum, Trepanum striatum Serateres, & of Cel­so, Modiolus, and vvhen the coverture is therbye, E, vvhich is noted vvith E, it is then G, callede Abap­tiston, & in Latine Trepanum securitatis, because it can entre noe deeper thē the arreste, vvill suffer.

F, G, The Piramide vvhich passeth cleane through the Trepane, vvhich must a little excelle the trepane be­cause in the turninge of the Trepane it might stan­de stedye, and havinge her circle, may be taken out, closinge that end vvhich is notede, vvith G.

H, The Perforative Trepane, vvhervvith vve only note the place, vvhere vve intende to sett the Pyramide.

I, The little vise vvhich vve vvinde into the coverture of the Trepane, to assure the same, that it may stand stedefastlye,

K, An other Kinde of Trepane vvhich is a little larger in her basis, then in the beginninge therof: & is in la­tine callede Terebellum alatum, & such a Trepane can not sincke invvardes.

L, The vvinges of the Trepane, vvhich delicatelye and easilye cutt.

M, N, The Piramide vvhich passeth cleane throughe vvhich vve must remove the Trepane having ma­de his circle.

O, An other Kinde of Trepane, vvhich onlye cutteth the fleshe: & is verye necessarye vvhē vve must sud­daynlye trepane, becaus vve feare any greate fluxiōs of bloode. It cutteth and perforateth throughe the musculouse fleshe of the Heade the same being first vvith a potentialle Cauterye cauterizede.

*, The circle, or circuite vvhich must cutt as vvel as a Kinfe, nether muste it be toothede.

P, The Pyramide as is in the other fore rehearsede.

Q, An other Kinde of Trepane, to perforate the bone, vvhich is not dislike vnto a thimble, & is also alate­de, and delicatelye cuttinge, as vvell above, as one the sydes.

R, The little poyncte, vvhich servethe in steede of the Pyramyde, leaste that shee shoulde stirre out of her place, vvhich must as long be vsede therin vntill the Trepane, be rightlye settlede, & fastenede therin.

r, The little poyncte beinge taken avvay.

Q, The handle of the Trepane.

R, The quoyse, or cappe vvhich turnethe.

S, The vise vvhich fastenethe the Trepane assuredlye.

T, The hole vvherin the foresayede vise must be turne­de.

V, The trepane beinge taken in peeces, vvithout cappe or Pyramide.

X, The Cappe.

Y, The vise vvich houldeth faste the capp, the vvhich is scruede into that hole, notede vvith. Π.

Z, The Piramide beinge alone.

1, The hole or apertiō, vvherout the Pyramide sticketh 3, A little eminence by the vvhich the Pyramide is ste­adefastlye helde fast, in the Trepane.

4, The end of the Pyramide, vvhich must entre throu­ghe the hole of the trepane notede vvith 1

6, 6, The exfoliative trepane.

7, 7, Rounde pinsers, or tenacles, very necessary to ta­ke avvay the trepanede percelle of bone.

The Declaration of the Characters contaynede in the capitalle Instrumentes, or Pin­sers.

A, Demonstrate the pinsers, vvhich are callede parates billes, L, Rostrum Psitaci.

B, B, The openede parrates bill,

C, That parte vvhich rescindentlye is removede vp, & dovvne,

D, on the end therof notede vvith, D.

E, The other end vvhich houldeth faste, vvhich is also rescindente.

F, The vise vvhich openethe the sayede Bille, & agayn shuttethe the same.

G, G, The little Glysorye, or Glidere vp and dovvne.

H, H, The recludede Parrates Bille.

a, b, A little pincette.

Declaratiō of the Characters, which are contaynede in the Trepanes with vises.

O, R, The trepane vvith vises beinge taken a sunder. P, P, The vise.

Q, The end, or extremity vvhich shutteth in the quoy­fe, or Cappe.

n, The Cappe in the vvhich is a vise.

f, The trepane vvith the vise, beinge readye.

g, The quoyfe, or Cappe.

h, The trepane.

i, i, The vise vvhich is on the end.

l, m. The Pyramide, vvhich passeth cleane throughe.

Declaratiō of the Characters, which in the Cranio are contaynede, being in two pla­ces Trepanede.

P, P, The Cranium, vvhich demōstrateth the tvvo bo­nes, to vvitt the Foreheade, and the Parietale, noted vvith a, a.

b, b, b, The fissure, or fracture vvhich crossethe the su­ture.

c, c, c, The Coronalle Suture.

d, d, The tvvo hoales, vvhervvith these tvvo bones vve are boarede, and pearcede throughe.

e, e, The tvvo rounde parcelles of bone vvhich are ta­ken out of the holes.

T, V, A ground dravver vvith three feete, or branches, the first vvherof is notede vvith V, & serveth for a soundinge irone, to knovve hovv * deepe vve have pearcede the bone.

X, A little Elevatorye, thervvith to move the bone, & marke vvhether it be allmost throughe.

Y, The grounde dravver, to sublevate out of the hoale, the Trepanede bone.

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The portrayctures of diuers sortes of Trepanes, and Tonges

Explicatione of the Characters con­taynede in the figure of the Hare mouthe.

A, A, Demonstrate vnto vs both the cloven lippes, as they are separatede the one from the other.

B, B, The distance vvhich is betvveen them.

C, C, Both these places vvhich vvithe the needle must be percede, & must be farre distante the one frō the other becaus the stitches doe not breacke through.

D, The defiguratione, or portraycture of the Hare­mouth.

E, E, Both the endes of the Needle.

F, F, Both the inscisions vvhich are semilunare, or hal­fe moone vvyse, & must onlye be made in the skin­ne vvithout penetratione of the mouth, becaus the superior skinne may stretch vvhen vve dravve the same tovvardes vs.

G, G, Both the endes of the clovene Hare mouthe the same beinge aegallye combine de together.

H, H, The threde vvhich is involvede rovvnde aboute the Needle.

Explanatione of the Characters no­tede on the syde of the throte, in the portrayctu­re of the Haremouth: which demōstrate vnto vs, a wounde receavede in the Ingulare Vayne: and the meanes also howe to circumligate the same.

e, e, Shevve the magnitude of the vvounde.

f, f, The superficies of the Iugulare Vayn vvhich is dis­cidede.

g, Demonstrate the seconde puncture of the Needle, vvhich is done, internally in the Wounde, on the sy­de of the Iugulare Vayne.

h, The firste pricke or stitch of the needle, vvhich hath his originalle one the skinne, on the other syde of the sayede Iugulare.

i, A little compressione, vvhich must be collocatede betvveene both the stitches, a little more inferiour then the lettre f, to knitte, the knotte therone, leaste that the threde shoulde to suddaynlye cutte throu­ghe the skinne.

l, l, Both the endes of the threde, vvhervvith the Iugu­lare Vayne is overthvvartelye tyede, vvith a little compression vvhich is notede vvith i.

Declaratiō of the Characters, which are contaynede in the drye Suture, or stitchin­ges.

K, The portraycture one the vvhich the drye suture is applyede.

L, L, The longitude of the vvounde vvhich is in the cheeke.

M, M, Tvvo Linnen cloutes, vvhich are gluede on the face.

*,*,*,*; The thredes vvhich passe throughe the Linnen cloutes, therbye to be dravvne, ioynede, and knitte­de together.

N, N, Bothe the peeces of Linnē clothe vvhich are se­paratede the one from the other.

*,*,*,*, The thredes vvhich are passe de throughe both the endes.

The Declaration of the Characters which are contaynde in the Instrumentes of a little portable case.

O, Demonstrateth vnto vs a thicke, concavouse soun­der, at the greatest parte, as easilye vve may perceave by the one starre, * vnto the other *, such a concavity receaveth the poyncte of a croockede Lancette, to make an inscisione because vve might contayne the same vvithout entring to deepe, vvhether shee gli­de this vvay or that vvay, the end heerof is recur­vatede, and explanede to purifye thervvith the cir­cumiacēte places of the vvounde, it may also be ta­ken for that vvhich Celsus calleth Speculū Latum, G. Plateie Mele.

P, A little pincet, in Latine Volsellae: the Superiour end therof may be taken for that vvhich the aunciente Greeckes callede Spatomele, like vnto halfe a Spa­tula. This little Instrumente, is verye necessarye, as vvell to purify the circumiacēte places of the vvoū ­de externallye, as internallye vvith the pincet.

Q, The scraper, thervvith to scrape a corruptede, carie­de, and putrifyede bone.

R, A Spatula of the Greeckes callede Amphimelon, & L, Spatula, the end beinge thinne, & may be vsede in place of a privet, or sounder, havinge a little but­ton on the end, & is then called Pyrin meles, vvhich signifiethe the buttone of the privet, as the same is a, noted vvith a and the same beinge hoockevvij­se, it is then callede Agrimeles, as that is vvhich is b, noted b, and vvhen it is concavouse like ane are picker it is then callede Cyatisire Meles, the fame is c, c, notede vvith c, c.

d, A little sounder, vvhich vve may also vse the same in the ligatione of the fistles in the fundamente, and is then callede of Hippocrates Scorodou Physinga: to conclude it is a sounder, vvith tvvo endes, vvher­of the one is perforatede in forme of a Needle, and the other rounde like vnto a buttone.

S, A little stone dravver beinge superiorlye hollovve, like an earepicker, and inferiorlye like vnto a hooc­ke this Instrumēte may be vsed, to dravve out a bul­let, a needle, or anye other alienate thinge beinge in the vvounde.

Explanatiō of the Characters con­taynede in the Discription of the Needle pipes, cases or Canons.

T, Indicateth the Needle case,, vvherin vve may stic­ke thredede Needles, & also vvinde threde theron.

V, The coverture, or opercle of the sayede case.

X, X, Y, Little round plates of the largenes of a french croune, vvhich are perforatede, vvherin the Need­les are reservede, and Kepte.

Y, The extremitye, or end of the sayede needlecase, vvhich is clefte, ther throughe to let the threde the easyer passe through, vvhen as vve thervvith vvoul­de sovve.

Z, Z, The tvvo Needles, the one to combine, & stitch the vvounde together, vvhich is quadranglede, and the other rounde to sovve together all the rovvlers of the dressinges.

1, The case onlye vvith the inferiour parte turned vp­vvardes, profitable for the sutures of the face, vvhē the same must be done close by the Nose, & in more other places vvhere the extendede, & rectifyede pi­pe can not be vsed.

2, The splitte vvhich is one the end.

3, The recurvede Needle for the sutures of the face, & other partes, vvhere the righte needle can not be v­sede.

4, The rectifyede, or extende de case or pipe.

5, The splitte vvhich is one the end.

6, The Needle for vvoundes, vvhich at her acuitye, or poyncte is triangulate and rescindente because by that meanes shee might the easyer entre: for in thru stinge shee inscideth vvith her edges.

7, The Needle to sovve together all cloutes, and rou­lers to dresse vvithall.

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Declaration of the Dry suture

Portraycture of the Haremouthe

Canons and Needles

Instrumentes for a little case

Explicatione of the Characters con­taynede in the table of these Instrumētes which are propre and necessarye to the extirpatione of membres.

A, A, Indicateth the Knife vvhervvith on the suddayn, vve may cutt the skinne, and the muscles to the bone vvhen vve desire to extirpate anye mortifyede Ioyncte, or membre. And is of the Latinistes callede Culter excisorius lunatus, in Englishe a semiluna­re cuttinge-Knife: it is in this forme composed be­cause it might the easyer comprehende all the fles­he in the circuite,

*, Demonstrateth the superioure parte of the backe, vvhich after a sorte ought to be somvvhate acute, & sharpe, to scrape thervvith the Periostium from the bone, vvhich at the firste time coulde not all at once be cutte throughe,

B, The persoratione, or hole vvhich is beneath in the blade, vvhich yealdeth backvvardes in to the hand­le and ther occulteth it selfe ther by to contayne the knife steadye.

C, A hole vvhich is in the handle, vvherin is a little iron barre, vvhich passeth cleane throughe vvher­vvithe the blade is fastenede.

D The end of the foresayed blade, through the vvhich he is impedited to stirre backvvardes in effectuatin­ge of the operation. Some ther are vvhich conten­te themselves vvith a common razer, vvhich behin­de they involve vvith linnen, leaste that it shoulde revolute backvvardes, and are of opinione that it vvould beter be done vvith a razor havinge an emi­nent bellye, then vvith a semilunare knife: and for confirmatione heerof they take example of the La­niators, or Bouchers, and of Coockes, vvhich much rather take a knife vvith an eminente belly, and in manner, and forme of a razor, then of such an one vvhich representeth a halfe moone.

E, E, E, Demonstrate the Savve vvhich is vvholye a­mountede, vvith the, Bovve, Blade, and handle, and is in Latine callede Serra, she is not heere placede in her magnitude, because the place, can not heere be soe greate, vvhich must notvvithstanding be a good foote, and tvvo inches of length in her blade, & the handle foure, or five inches longe.

F, A little pegge of Iron, vvhich houldeth together the tvvo peeces of the Bovve.

G, An other iron scrue, vvhich combineth the blade, & the bovve together.

H, H, Tvvo branches of the Bovve.

I, A vise.

K, The separatede Handle.

L, The Blade alone separatede.

M, The end of the Bovve, vvhich is clefte, in the vvhich, the end of the blade vvith the hole therof is put.

*, The hole, or perforatione, vvhich is in the blade.

Δ, The scrue, vvhich must have his penetratione clea­ne throughe the bovve, and the blade, as playnlye vve may behoulde the same notede vvith G,

N, Signifieth the vise vvhich is occultede in the end of the handle, vvhich attayneth to the end of the blade notede vvith O, by that meanes to dravve in the sa­me, and fasten the sayede blade.

O, The end of the blade, vvher there is a scrue to rece­ave the vise.

P, A splitte, vvhich is in the blade, to receave therin a scrue notede vvith the figure 4.

4, The scrue, vvhich is thrust cleane throughe the bo­vve therbye to houlde fast the blade.

Q, The end of the sayde Bovve, vvhich is receavede of the end of the handle, in the vvhich is a splitte, throughe the vvhich the blade passeth, vvhen vve desire to prepare the savves.

1, 2, 3, Demonstrate certayne little scrues, to vse the sa­me in time of necessitye.

R, A dentifiede, or toothede Crovves bill to clenche the vaynes, and take houlde theron, the Ioyncte be­inge extirpatede, and vve desire to religate the saye­de vaynes, it is in Latine callede Rostrum Corvi­num.

S, A resorte, or springe because it might allvvayes be aperte.

T, The bille of the same, vvhich on his end is rovvnd, and toothede because the threde might vvith the more facillitye glide therover vvith out beinge in anye place stayede.

V, The Needle, vvhervvith vve convenientlye may stitch, vvhen vve desire to religate a Vayne and is in Latine callede Acus.

X, A hollovve knife L, Culter fistularis, G, Syringoto­me this Instrument occludeth it selfe in the pipe.

Π, The puncture, or poyncte of the same, vnder the vvhich a little bullet of vvaxe is fastenede, or some other plaster, least that the poyncte shoulde hurte some other places vvhen as vve intrude the same in anye fistle, thrustinge as it vveare in anye founde fleshe, vayne, arterye, or sinnue, vvith this Instrumē ­te in a shorte time vve maye descide through a gre­ate qvantitye of fleshe, there are some also vvhich vvith this knife at one time cā cut of a greate quan­titye of fleshe.

Y, Rescindente, instrumentes to cut of fingers: L, For­ceps excisoria, this instrumente must be greate, and stronge.

The Finger vvhich is spoylede, and corruptede.

How we ought restraygne the bloode after the extirpatione of a Ioyncte, without v­singe anye hot Iron, onlye throughe ligature, which is of two sortes, ether with the Crowes­bille, or with the Needle.

a, a, Signifye a hippe from the vvhich the legge is ex­tirpated.

b, b, The Vaynes & Arteryes by the vvhich the bloode exsulteth, and springeth out.

c, c Both the endes of the Crovvesbille, vvhervvith the Vaynes are compraehendede, by that meanes to tye them.

d, The Crovvesbille.

e, e, Both the focilles of the Legge.

f, The springe, or resorte of the Crovves bille.

g, g, The Arme the fiste vvherof is extirpatede.

h, The orifices, or mouth of the Vaynes, out of the vvhich issueth bloode.

i, The situatione of the Vayne.

l, The place vvher the firste stitch must he placede on the one syde of the Vayne: and heere is to be note­de, that vve must first thruste, in the skinne of the Arme, vvithout vvholye dravvinge throughe the threde.

m, The evente of the seconde stitche, vvhich must, be begūne one the other syde of the Vayne internally in the Arme, and must pearce throughe the skinne. n, The little compressione, vvhich must be intersituatede betvveene the stitches, as tovvardes the lettre a & thē knittinge, theron both the endes of the thre­de reasonable stiffelye: this little compresse, preven­teth the cuttinge throughe of the threde, and cau­seth noe payne.

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Instrumentes fitt for the extirpatione of anye Ioynete

Declaratione of the Characters con­taynede in the Instrumentes, which are apte to opene anye Apostemations.

A, A, A, Indicate vnto vs thre copper, or silver plates, of the magnitude of a crovvne, or like acoūter, in the middeste vvherof ther is fastenede the acuitye of a Lancett, notede vvith B.

The vse of those sayede plates, is onlye to halluciona­te, & deceave, those, vvhich vvill not permitt an a­pertione to be made in theire Apostemationes, and are to timorouse, & fearfulle of the hande, or lancet of the Chyrurgiane, as commonlye are vvoemen, & little children: & to open the Apostemation besyde theire expectation, and intelligence: you must have in preparation your Caraplasma, and before the ap­plication therof you must have in a readines a play­ster of Diapalma, or some such like, vvhich must be somvvhat larger then your plate, on the vvhich pla­ster you must applye the plate, vvhich in like sorte also, vvith the acuity therof must be coverede vvith the salve Basilicon, vvhich beinge finishe de, you must applye this plaster beinge in this sorte prepa­rede, on the place, vvhere you coniecture the fore­sayede Apostematione must be openede, & therone the Cataplasma, on the vvhich you must thē stiflye crushe, and by that meanes make and apertione at one crushinge in the Apostematione, throughe the poyncte of the Lancette, vvhich is one the plate fa­stenede, into the concavitye vvherof the matter as then vvill issue out: I my selfe have oftentimes vsede this same manner of apertione, vvhich although it seeme to be but a simple shifte, it is notvvithstan­dinge an hallucionatione vvhich oftentimes is very necessarye.

B B, B, The thre poynctes of divers magnitude, accor­dinge to the Apostematione vvhich vve desire to open, vvhich must ether be greate or smalle accor­dinge to the Apostematione vvhich vve vvoulde o­pen vvithout intelligence of the Patient.

C, C, Demonstrate the Ringes, vvherin are occultede certayn croocked Lancettes, vvhervvith vve secret­lye can open an Apostematione vvithout the perce­avinge of the Patiente.

D, The Croockede Lancette, beinge openede, & erec­tede.

E, The Ringe vvherin the foresayed Lancette is occul­tede and hidden, as a razor in his handle. This lan­cet erecteth it selfe throughe a little eminence, or hoocke notede vvith *, *.

*,*, The little eminence, or hoocke.

F, F, The rectifyede Lancette, vvhervvith vve open an Apostemation, vvherin vve make incisiones, & sca­rifications: the Latinistes call it Scalprum Chirur­gicum, the Grecians Smiles, & also Smilion or Pte­rigotomon.

G, G, A little Razer,

H, The poyncte of the same, vvhich cutteth on both sydes.

I, A Flammette, vvhich is verye necessarye to scari­fye, & sometimes also the phlebotomize, or to open anye smalle Apostematione.

K; The Acute poyncte vvhich cutteth one both sydes.

L, The Lancet to phlebotomize called in Latine Scal­pellus.

M, The casede Lancette.

*, The blade of the Lancette.

N, A little croockede Lancet L, Falx incisotia, Culter fistularis, & of Celsus, Spatumen curvum, becaus it is recurved, and semilunare.

O, O, The acuitye or poyncte vvhich cutteth one both sydes,

P, The croocked lancet vvhich is occluded in her case. Q, Q, A Cauterye vvhich is verye necessary to opē the Viceratiō Ranula vvhich is situated vnder the tung.

R, The eminence, or buttone, vvhich is as vvell cōmo­dious, to retayne the hot iron e, as alsoe to bestayede throughe the hole.

S, S, The plate to lay in the mouth, because vve shoul­de nether burne the tunge, nor the mouthe.

T, The holde vvhich vve must situate on that place vvher vve purpose to make the apertione, and place the Cauterye.

V, The Empijqve Cauterye, verye necessarye to open the vlcerations, or Apostemations of the Breste, cal­lede Empiemata.

X, The poyncte vvhich must be flat, and rescindente.

Y, The holes vvherin vve thruste an Iron pegge, to pe­netrate, as deepe, & as shallo vve as vve please.

Z, The little pinne.

1, 2, The croockede plate, vvhich must be religatede thvvarte over the bodye: the perforatione vvherof 3, is notede vvith 3, vvhich must be collocated, on that place vvhere vve desire to make an apertione.

4, 4, 4, 4, Little Ligamentes, vvhich houlde faste the plate on that place, & must be tyede on the bodye. a, A propre Instrumente to launce the fisties from the one hole to the other, & make a greate inscisione.

b, The recurvede Lancet.

c, The arreste vvhervvith it is restraynede, & held fast.

d, The extremitye, & poyncte vvhich is croockede, to receave the Provet.

e, The Provet, or sovvndinge irone.

The vse of this foresayed Instrument is this: to vvit­te, that in those fistles in the vvhich are tvvo aperti­ōs, as in those in the vvhich is made a counter aper­tione: and vvher it is necessary, & requisite, to make of these, tvvo, holes or orifices one apertion it is first of all reqvitede, that vve sounde the depthe of the fistle, vvith this sounding irone vvhich is heere de­figurede vnto you: vvhich at the one end hath a lit­tle buttone, & at the other end is pearcede, & eyede like a Needle, vvhere vvith vve make our Seton: vvhich beinge thruste from the one apertione to the f, f, other, as from the one f, to the other f, accordinge to the magnitude of the fistle: vvhich being done, vve must thrust the little hoocke of the croockede lācet into the eye of the privete, & then dravve the same vnto the buttone: conducinge the foresayede lancette vvith the other hande: and althoughe it vveare the crassitude of tvvo fingers, you shall not othervvyse chuse, but cut throughe the same, if so be at the leaste the foresaye decroockede lancet be but reasonable sharpe.

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Diuers Instrumentes to open Apostemationes

Declaratiō of the Charcters, which are contaynede in the Speculo oris, Matricis, & other more Instrumentes for the Mouthe.

A, A, Shevveth vnto vs the Speculum oris, G, Glosso­catoptron.

B, The plate vvhich is layede in the mouth, to Keepe dovvne, & suppres the tunge.

C, C, The Brāches vvhich vve impose vnder the chin­ne, others, vse only the plate, vvithout the brāches.

G, G, The Instrumente, vvherevvith vve religate the Pallate of the mouthe, the same beinge to longe, & is in Latine callede Vinculum Gargateonis.

H, H, Both the braunches vvhich are placede in the mouthe.

I, The Knottede threde, in vvhich knott the Pallate must be layede, if so be vve desire to abbreviate the same.

K, The vise, vvheron vve muste impose the handle of the Instrumente the same being of tvvo peeces be­cause it might be the more portable.

M, The handle,

N, The little irone barre, rovvnde aboute the vvhich vve must circūvolute the threde, it must be in tvvo places perforated, to let the threde passe ther throu­ghe.

L, The Keye vvhich turneth aboute the little barre.

O, O, O, O, The miroure, or behouldre of the Wombe, L, Speculum matricis, G, Mycrocatoptron or Diop­tron: It is verye necessarye to open the entrance, or necke of the matrice by that meanes to applye anye remedyes vnto the vlcerationes, & other bad dispo­sitions of the Wombe.

P, P, P, The braunches vvhich must be 7, or 8, fingers breadth longe.

Q, The vise vvhich closeth, and disclosethe.

R, R, The handle vvhich causeth the vise to turne.

S, A verye necessarye Instrumente to Cauterize the Pallate of the mouth the same excelling his natural­le longitude, & crassitude, callede in Greecke, Sta­phylocoston.

T, A little spoone, vvherin may be layede any Caustic­ke poulder, or aquafortis, therin to madefy the saye­de Pallate or Vvula: It is right true that vve ought to cover the tunge, leaste there fall anye thinge ther o­ne. Others in steede of any Caustickes, or Aqua for­tis, vse Pepper, and Saulte, beinge together mixede, vvhervvith they touche the pendente pallate vvith this spoone, in the vvhich theye impose a little of this poulder.

V, Little Pincettes conveniente to apprehende the fo­resayede pallate, & turne about the same callede in Greecke Staphylagra, vvhich if they vveare rescin­dente, they are then callede Staphylotomon.

X, A Dilatory of the mouth, vvhich vvith a vise is tur­ned aboute, & is very necessary thervvith to dilate, and open the mouthe, vvhen the teethe are closelye shutt together, as it commonlye, happeneth in the convulsions, vvherin are little furrovves, becaus the teethe may be fastenede thereon vvithout glidinge thereof.

Y, The one leafe of the foresayede Dilatorye, vvhich ioyneth it selfe vvith the other leafe noted vvith Z. vvhich also in the externalle syde therof is linede.

*, Heerin entereth the vise vvhich is fastenede in the inferioure plate.

m, m, The vise.

a, b, Little thinne, & longe pincetes to dravve all man­ner of little thinges out of the throte callede in La­tine Spinarum eductorium, G, Acantabola.

c, c, c, c, An artificialle goulden roofe of the mouthe, vvhich is a gouldē plate, as thinn, as a frēche crovv­ne, L, Palatum, it is composede, to retayne thervvith the breath, from the roofe of the mouthe, therbye to evite the speaking throughe the Nose.

There are some vvhich can not verye vvell suffice thē ­selves vvith this plate, by reason that the gould smi­the can not soe conveniently make the same, that it aequallye of all sydes doe touche the Pallate of the Mouth, so that in steade therof they vse, a tente ma­de of linte, or of Sponge, to the vvhich intente the­re are divers vvhich are providede of them, because that if the one fell out, they incontinentlye have an other in a readines, & preparatione to put therin, be­cause othervvyse they shoude speake throughe the Nose.

d, Demōstrateth that syde vvhich must lye next to the tunge.

e, A little plate, vvhervvith the great plate is fastenede vvhich is on the other syde, vvhich is thruste into b, the hole of the roofe, noted vvith h, to this end that it there might as it vveare suspende: There are some of the Greeckes vvhich call this Instrumente Hy­peroe.

f, The extremitye of the sayed Plate, vvhich in the se­conde Plate is notede vvith h, vvhich is thruste into the hole of the roofe of the mouthe.

g, The superior planitude, of the Plate, vvhich, sticketh fast to the roofe of the mouthe, as if it vveare glue­de thereon.

h, The little plate vvhich is turnede vpsyde dovvne, & thruste into the hole of the roofe.

m, m, An artificialle toothe, vvhich is composede, and made of Ivorye, or some other bone, vvhich is faste­nede, throughe some certayne goulde vvyer.

n, n, Thre artificialle teethe vvhich are combinede to­gether, & fastenede the one to the other vvith some aureate filamēte, or gould vvyer, vnto the other tee­the one both sydes.

These artificialle teethe are somtimes made of Ivorye but because Ivorye by reasone of the spittle vvaxeth immediatly yellovve, and fulvide, they are more fit­ter to make of anye other bone, the same being ve­rye harde, and thicke and dence, or solyde, as is the bone of a fishe vvhich in French vve call Rovart. Farthermore anye bodye by atte may make teeth of vvhite vvaxe vvhich beinge meltede, & liquefac­tede vvith as much gumme Elemni, or a little Ma­sticke, vvhite Coralle, and preparede pearles & ther of a paste beinge made, of the vvhich vve may for­me as manye teethe as vve please. This paste is also verye commodiouse to replenish thervvith a hollo­vve toothe, because ther might noe viandes remay­ne therin, through vvhich the teethe doe more cor­rupte, and more intollerable payne is heer bye susci­tatede.

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The Speculum of the Mouthte, and Wombe

Declaratiō of the Characters which are contaynede in the figures of the Hoockes, and Knives which are necessarye, and conveniente, to drawe forth a deade Child out of the Mothers bellye: also of the Pessaryes, Plates and of other thinges necessarye to the Ligatione of the fistles of the fundament.

A, Demonstrateth the Crochet vvith a dubble hooc­ke vvhich must not be sharp, but blunte, leaste that internallye they chaunce to vulnerate the Wombe, by vvhich meanes the vvoeman might be in greate perille, and daunger of her lyfe.

*, The hole throughe the vvhich must be thruste so­me certayne string, to tye thervnto a Naptkinne be­cause there might tvvo at once pulle vvhen it is ne­defull.

B, The seconde hoocke vvhich is flatte and blunte.

C, C, A little croockede knife vvhich is verye acute, & sharpe conveniente to inscide the Heade, and bellye of a deade Childe, internally in the Wombe, because the vvater, & aqvositye might heerbye have his is­sue.

I have divers and sundrye times binne sente for, to di­vers Woemē, vvhich vveare in difficulte laboure & Childebearth, notvvithstandinge I never vsede any hoockes, or other ferrealle Instrumentes therto, for vvhich occasion I also councell all Chyrurgianes, to vse none of them, then in extreame necessitye, for if soe be there happen anye other accidente there vn­to, as excoriatione, or anye effluxione of blood, vve muste then attribute the same vnto the Instrumen­te, vvhich the Chyrurgiane vsede thervnto: Never­thelesse I have heere causede them to be set dovvne vnto you, to vse them in the extreameste necessitye: and heere is to be notede, that the Insculptor, or In­gravere to adorne, & imbellishe his laboures, hath participatede some propre, and perpolite fashone to the handle, vvhich indeede is thereon invtile, and needeles, because it is better, that they be playne, & smoothe becaus they fastē themselves on nothinge. D, The Pessarye in forme of an Apple vvhich is made of Corke, and is circumvestede vvith vvhyte vvaxe: this pessarye preventeth the descendinge, and sinc­kinge out of the Matrix. The Greeckes calle it Pes­son, and the Latinistes Pessarium. There are some also made after an Ovale figure, rovvnde, and som­vvhat prologatinge like an Egge, and of divers ma­gnitudes: but quotidiane experience hath taught vs, that they are not so necessarye, and commodious, as those vvhich are of this forme, because they are to slipperye, and cannot be hilde so faste in the entran­ce, or necke of the vvombe, so that oftentimes they sincke theroute, and in like sorte also the vvombe, vvhich notvvithstandinge reqvireth to be continu­allye therin contaynede.

The firste vvhich I have seene vse such manner of Pes­saryes, vvas the right vvorshipfulle Mr. Rousset, on of the Kinges Chyrurgians, and of the Ladye of Ne­mours, vvhich hath learnedlye, and excellentlye vvritten, of divers sortes of the Woomens parturiō, vvhere this forme of Pissaryes are defigurede, and the manner also of his vse.

E, The hole vvhich is in the middeste, vvhich serveth to dravve therbye the pessarye out of the vvombe, vve thrustinge our finger in the hole.

*,*, The linte vvherone the Pessarye is fastenede roun­de aboute the bodye of the vvoman.

F, An argentealle plate being semilunare, & somvvhat reflectinge invvardelye, tovvarde the internalle part beinge notede vvith G.

This plate, or this invention hath oftentimes binne v­sede, of Mr. Girart Raber Chyrurgiā at Paris, vvhich vvas a verye inventive, & perquiringe man, in sear­chinge out of Chyrurgicalle Instrumentes, and also the most experteste practitionere of his time.

G, the Knott vvhich is layede above the silver barre.

H, H, The argentealle, or silver barre, or pegge.

I, I, I, The little ringles, vvhervvith the little barre is fa­stenede, vvhen shee passeth therthroughe: this barre may be turnede as much and as little as vve please. Y, The Privet, or Needle to religate the fistles Hippo­crates calleth it Scorodou Physinga, vve may allsoe make theire poyncte blunte, to vse the same the fist­le beinge vvholye apparent, and may easylye be see­ne: but if she lye occulte, and invisible, and that vve must necessarily perforate any membrane, she must then conseqventlye be acute, and sharpe. She mu­ste also be of silver, and verye vveake, because she may be suple to bende at our pleasure.

Explanation of the Characters con­taynede in the figures of the Instrumētes to dra­we, breake, and cut of teeth.

L, L, Demonstrate the tonges, vvhich are verye conve­niente, to cut of all superfluouse teethe or at the least those vvhich are to longe: they are internally inflec­tede, by that meanes the better to fasten on the teeth.

e, A superfluouse tooth vvhich is halfe of.

M, The Polycampe, L, Polycampus, G, Odontagra, and Odontagegon. It is an Instrument vvith divers brā ­ches, vvhich are all of them intrudede in one hand­le, throughe a little serve.

N, The scrue vvhich is on the Instrumente.

O, One of the braunches of the Polycampe.

P, An other extendede braunche.

Q, The thirde braunche.

b, The vise beinge taken out:

S, S, Demonstrate the Instrumente, callede the Patre­tesbille: L, Denticeps, Dentiducum Celsus calleth it Forfex: G, Rhixan.

d, The tooth vvhich is helde fast betvveene the teeth of the Instrumente.

T, An Instrument vvhich loosenethe the gummes frō the teeth, callede in Latine Dentiscalpium, G, Peri­character.

V, The expulser, or thruster out L, Pulsatorium, G, O­terion.

X, X, The Roote dravver, G, Rixagra, It is an Instrumē ­te verye necessary to dravve out any roote of a too­the, vvhich remaynethe in the Chavve vvhen the tooth is broken, or corruptede, and rotten.

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Diuers Instrumentes to drawe and cutt of Teeth

Haeckes to drane forth a Childe

The Declaration of the Characters which are contaynede in the table of the actual­le Cauteryes.

A, Defigurate the a Cauterye vnto vs, vvhich hath a poyncte like vnto a Raper, and is callede in Latine Ensis, vvhich is partlye on both sydes rescindente.

B, The poynct vvhich must be of the crassitude of this lettre, because it might the longher Keepe hott.

G, Is the handle, vvhich is smaller then it is needefull, and must be foure, or five inches longe, and in like sorte also all the other handles of the other Caute­ryes, vvhich are heere notede vnto you.

D, It is a backede Cauterye, vvhich hath a backe like vnto a knife, vvhich cutteth but one, the one syde, and for that occasione hath a thicke backe, because it shoulde continue the longer hott, and effectuate his operatione so much the better.

E, The rescindente syde.

Π, Π, The backe vvhich must be verye thicke.

F, The poyncte vvhich must be foure goode fingers breadth longe

G, This Cauterye is rotunde concavouse, & rescinden­te: vve vse it to cauterize the skinne of the Heade, vvhen as suddaynly vve vvoulde trepane the same, as beinge in anye compagnye, and in cuttinge vve feare anye greate fluxione of bloode, to the end to give, or make place to the Trepane.

H, The circle, vvhich is rovvnde, and on his end is re­scindente.

I, The poyncte.

L, The punctualle Cautery, vvhich is quadrangulede, and acute, it is necessarye to open anye Apostemati­ons.

M, The poyncte of the Cautery vvhich is allmost four­cornerede.

N, This Cauterye may allmost be callede the Olive Cauterye, because it is allmost like vnto an olive: It is a little hebede, and flatte on his end: We vse this Cautery, to cauterize the Heade evē vnto the Scul­le, or Cranium: Alechampe calleth it Pyrinoides.

O, The Olive buttone.

P, A Plateformede Cauterye: vve vse it after the extir­patione of a membre, to cauterize the bone, & the fleshe, and the vvhole patte alsoe, vvhich might in anye sorte be aulterede by the corruptione, or Gan­grene.

Q, The crassitude of the sayede Cauterye, because it might the longer continue hott.

△, △, The perforations, or holes vvhich are in the plate, becaus heerebye the smoke might exhalate, vvhich throughe the cauterizatione is made.

R, The Cauterye vvith the buttone, vvhich is verye profitable to singe the skinne in anye place there to make a fontanelle, in steade of a potētialle cautery. Hippocrates calleth this kinde of Cauterye Falacra, L. Calvata, because they are smoothe and even, like vnto the baldenes of a mans heade.

S, The even, & smoothe buttone of the Cauterye.

T, The plate vvhich vve imploy least vve should bur­ne anye other thing, but that vvhich vve cauterize.

V, The hole throughe the vvhich vve thruste the end of the Cauterye.

1, 2, 3, 4, The little ribbons, vvhich are necessarye to rye the plate one the Arme, Hippe, or anye other parte of the bodye, vvhē vve vvoulde cauterize the same, leaste that in the operatione it shoulde glide avvay.

Y, A Cauterye vvhich is verye necessarye to cauteri­ze the Pallate of the mouth, callede in Greecke Sta­phylocauston.

Z, The end of the same vvhich is rescindente.

X, The canule, or pype, vvhich is verye necessarye, to conducte the Cauterye into the mouth, vvhen vve desire to cauterize the pallate of the mouthe, or any other parte.

*,*, The little vvindovve, or apertione, vvherin the pal­late of the mouth must be receavede, therein ether to be cauterizede, or extirpatede.

A, The place throughe the vvhich the Cauterye is ap­plyede.

Π, The ringe of the canule, by the vvhich vve houlde the same, becaus the pipe being fervefyed the Chi­rurgiane chauncede not to burne his fingers, in exe­cutinge his operatione, by the vvhich his vvorcke might be interruptede.

ω, The hole of the ring, through the vvhich vve may thruste our finger, to houlde faste the foresayede ca­nulle.

a, Another Cauterye, vvhich hath a rounde plate, and is verye necessarye to be vsede after an extirpatione, thervvith to correcte the corruptione vvhich is as yet remanente: it is allsoe necessarye to abolishe, all greate corruption of the bone, it is of the Greeckes callede Mylinō, becaus it is not mislike vnto a Mil­stone.

c, The crassitude, vvherebye the Cautery is longe con­tinuede hott.

b, The place vvhere the holes are, throughe vvhich the smoocke, & the moysture, of the adustion may eva­porate, as before vve have sayede in the Cavterye vvith the plate.

d, An other Kinde of Cautery vvith a sharpe buttone, necessary to restraygne all fluxions of bloode, vvhe­ther it be out of an Arterye, or out of a vayne cut a sunder, vve collocatinge the same above one the a­pertione: It may alsoe be vsede after the extirpatione of anye Ioyncte.

e, The smoothe buttone, vvhich is somevvhate acute.

f, A rotunde Cauterye according to the longitude the­reof, vvhich is verye necessarye, agaynste all caries of the bones.

g, The rotunditye of the foresayede Cauterye.

h, An other flatte Cautery, vvhich is also very commo­diouse to correcte the caries of the bone.

i, The one syde of the Cauterye.

l, That vvhich muste onlye touch, the caries of the bo­ne: We may alsoe heerevvith suffice ourselves in the Cauterisinge of the orifices of anye vaynes, or Arte­ryes, vvhich are situatede betvveen the bones of the arme, or of the Legge.

m, The handle, vvhich is somvvhat shorter, and thin­ner then it ought to be, because of the little qvanti­tye of place.

It is impossible for the Chyrurgiane to presente in this place all the figures, & portray­tures of the Cauteryes, vvhervvith he must cōtente himselfe: for he must sometimes cau­se them to be forgede accordinge to the reqviringe of the Operatione, & the parte, vvhere on he intendeth to vse the same, vvherfore I in this place have done my endevour to place & collocate together such Cauteryes as are moste necessarye, & novvadayes in vse, vvhere­in I onlye have cōsiderede, & observede theire magnitude, & crassitud: And as cōcerninge their braunches, & the handles of the same, have onlye binne observed in tvvo, vvhich are notede vvith A, h, the Exsculptor havinge ingravene the same, somvvhat shorter, & smal­ler then he ought: I moste cōmonlye vse such Cauteryes vvhich be reasonable shorte, be­cause those vvhich are of to greate a longitude, & bignes, doe affrighte the Patient, as allso those vvhich are too longe can not so easilye be conductede, & rulede, because they doe moste cōmonly vacillate, & turne this vvay, & that vvay in the hande.

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The figures of Diuers Actualle Cauteryes.

The Declaratione of the Characters which are contaynede in the Table of those Instrumentes which are propre, and conveniente, to the executione of all manualle operations which in the Eyes may be by anye meanes vsede.

Althoughe that I in this Chyrurgerye have not discribede the manualle operatiō, vvhich may be vsede in the infirmityes of the Eyes: Yet notvvithstandinge I vvoulde not, nether in­deede coulde omitte in this storehouse and treasurye of all Chyrurgicalle Instrumentes, the portrayctures, and figures of those Instrumentes, vvhich are necessarye, & commodiouse vn­to such an effecte of deliberate, & set purpose omittinge the operations of the Eyes, becaus at large I have discribede, & amplely set forth, everye severalle operation, in my Treatize of the Infirmityes, and diseases of the Eyes, vvhich I committede to the Presse in the yeare M.D. Lxxxv. to the vvhich I committe the gentle Reader, there to behould the practice, & severalle vse of all operations of the Eyes.

A, Demonstrateth a trianglede Cauterye, to apply ther­vvith a Seton, vvhich both prickethe, & cuttethe: the vvhich Cauterye is applyede cleane through the per­forate tonge, ortenacle, vvhervvith the skinne of the Necke is apprehendede, for the Seton to passe throu­ghe.

Π, The Needle for the Seton, or transforatione.

B, An other Needle for the same intente, and purpose, vvherevvith vve transforate the skinne vvithout the tenacles, or tonges.

C, C, The tonges for the Seton, vvhich ar pearcede, to thruste there throughe the Seton.

D, D, Tvvo holes, vvhich must adioyne vnto the reflec­tione, vvhich is notede vvith n,

n, The reflectione vvhich is notede, & vvhich is made because the hott Cauterye, shoulde not chaunce to touche the skinne of the Necke.

E, The Needle to remove the Cataractes, and pearles of the Eyes: And is in Latine callede Acus ocularis.

F, The same Needle beinge taken out of the Case.

G, The handle of the Needle.

H, The Needle beinge vvholye takene out of her case.

I, The Coverture of the Needle.

*, The perforatiō out of the vvhich the Needle issueth.

g, f, Demonstrate certayne little pincers, vvhich are very necessarye to voyde, & take a vvay any fithines out of the Eyes, or if the same cleave therin, vvhere of the g, is like vnto a little, smoothe, & playne Earepicker, to relevate the same out of the Eye: And f, demōstrateth a little pincer vvhich is flatt, & smoothe, to dravve a­nye thing therout, if so be it clefte therin, as a thorne, or some such like thinge. They are also very necessa­rye to plucke out the hayr of the Eyliddes, It is of the Greeckes callede Madisterion tricolavis.

1, The portraycture of an Eye, vvherin is presentede a Staphylome, L. Vua, notede vvith 2.

2, The Vua, or Staphylome.

3, 4, 5, 6, The thredes passing clean through the Staphy­me vvhich must be connectede together, vvhere of the 3, & the 5. must be connectede the one vvith the other & the 4. and the 6. also together, because every stitch might be tyed aparte the on from the other.

K, A Dilatorye of the Eyeliddes, or the Speculū of the Eye, vvhē vve endevoure to take anye alienate thin­ge therout, or els vvhen vve desite to tye the Staphy­lome, or els cut of an Vngula: It is in Latine callede Speculum oculi, Palpebrarum detentor, G Blepharo­catocos.

L, On this place the miroure of the Eye openeth it sel­fe, accordinge to the magnitude of the Eye.

7 The discriptione of an Eye, in the vvhich is on Vn­gula.

8 The filamente vvhich passeth cleane throughe the Vngula, to elevate the same, and by that meanes the easyer to cut it of.

M An artificialle Eye of Gould, vvhich is engravene, & vnder hollovve.

N, A forme of an Eye, vvherin is defigurede an Ectropi­on, vvith the externalle and internalle inscisiō vvhich is require de to the curatione of the same.

O, The externalle inscisione, vvhich is made according to the length therof.

P, P, An internall inscisione, vvhich is alsoe made in the length therof, right over agaynste the externalle.

Q, Q, Bothe the fydelong, or contradictorye Inscisions.

R, A little hoocke to elevate the Zebel.

S, The Needle for the threde to passe vnder the Zebel.

T, A little Cautery for the Eyeliddes vvhen the little hayres thereof turne invvardes.

V, The Aegilopicke Cauterye, to cauterize the bone, of the greate corner of the Eye.

X, The Plate to lay one the Eye least vve should chaun­ce to hurte the same,

Y, The hole vvhich is in the Plate, to thruste the Caute­rye there through, vvhich perforatione must be laye­de right on the Fistle.

a, A little canulle, or pipe for an other Cauterye.

We must heere note, that this pipe, or canulle, must ha­ve a little ringle, vvhere by vve might hould faste the same, for if soe be vvith a buttone vve houlde it, vve might then chaunce to burne our fingers, becaus the cauterye internallye passinge throughe the same, it shoulde not soe completlye be effectede, as it ought to be.

b, The Cauterye.

c, The handle.

d, The holes to thruste therein a little pegge, leaste vve shoulde penetrate to deepe thervvith, & may there­bye be somevvhat retaynede.

e, The little irone pinne, or pegge.

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Sundrye Instrumentes necessarie for the Eyes

The Declaration of the Characters, contaynede in the Figure, which demonstratethe vnto vs the meanes how we ought, and shoulde make a restauratione of a humeralle dislocation, by the meanes of an Instrumente callede Glosso­comium, which Hippocrates calleth Ambi.

A, A, The extended Arme, on the Glossocome, or Am­bi.

B, The Eare of the Ambi, vvhich houldeth faste shutte the superioure parte of the shoulder, because shee shoulde not stirre.

C, C, C, The Ligatures, vvhich firmelye contayne the Arme, leaste that he shoulde glide from the Instru­mente.

D, D, The pilare vvhereon the Instrumente Ambi re­st [...]th, and playeth, vvhen vve lifte the same vp, and dovvne.

E, E, E, Thre feete, of the foote of the Instrumente, to cause the Instrumente one a boarde to stand steade­fastlye vvithout motione.

F, The scrues, or vises vvhich fasten the feete.

Declaratione of the Characters con­taynede in the Glossocome, or Ambi, the same beinge taken a sunder.

G, The Instrument Ambi, beinge disamountede, & ta­ken a sunder.

H, H, The Eares betvveene the vvhich, the superioure parte of the Arme is situatede.

I, The end of the foresayede Instrumente.

K, The eminence of The Instrumēte Ambi, vvhich mu­ste be collocatede in the Pillare.

L, The splitte, or clefte of the Pillare.

M, The pegg vvhich fastenethe the Instrumente, in the pillare.

N, The pillare.

O, O, O, The three feete, of the standarde.

P, The hole vvhich is in one foote.

Q, The serve, or vise vvhich is thrust therein, to cause cause the foote to be helde faste, agaynst a boarde.

Declaratione of the Characters con­taynede in the Cassolle, or Case necessarye to laye a brockene legge therin.

A, A, The occluded case.

B, Thé shuttinge of the sayede case, vvherin the heele is layede, leaste he shoulde beare to much vvayght.

C, C, C, C, The vvinges of the case, or canal, vvhich through little ioynctes doe, revolve, & open, & shut themselves.

E, E, The little vvinges vvhich doe also open, & shutt throughe little hinges.

D, D, The separations vvhich are in the vvinges being of tvvo peeces.

*,*, *, *, The ioynctures vvhich are one the vvinges.

F, F, F, The latches, vvhich passe throughe the Eares.

G, G, G, The eares through the vvhich the latches passe

H, H, H, The Buckles through vvhich the latches passe

I, I, T, T, The foote of the Cassole, or Canal.

M, M, The extremity of the sayede foote, vvhich passeth throughe tvvo little mortayses.

N, The morrayces, or ioynctes.

O, O, O, The aperre, or open case, or canal.

P A place vvherein the heele is situatede.

Q, Q, Q, Q, The Winges.

R, R, The place of separatione in tvvo peeces.

*,*, *, *, *, *, The ioynctes throughe the vvhich the fore­sayede vvinges, doe revolve, opē, & shutt themselves.

S, S, The foote.

V, The botome on the vvhich the afflictede foote ta­keth his repose.

X, X, The vvinges, of the sayede foote.

Y, Y, The end, or extremitye therof, vvhich passeth through little mortayses, vvhich are on the vvinges.

Declaratiō of the Characters, which are contaynede, in the brokene legge, with the bandages there of.

a, a, Demonstrate the brokene Legge.

b, The vulneratione of the bullete, vvhich hath broke­ne the Legge.

c, c, Apettione vvhich throughe the bullete vvas made, on the other syde in the issue thereof.

*,*, *, *, *, *, A ligature three times dubble.

1, 1, 1, 1, 1, 1, The first dubble, beinge devidede in three.

2, 2, 2, 2, 2, 2, The seconde dubble, cut in three.

3, 3, 3, 3, 3, 3, The thirde dubble ligature partede in three,

All these foresayede dubble Ligatures, are revolute­de, first the one, & then the other, smoothlye and even­lye situainge of the same: and then they are each aparte, vvith the poyncte of a needle fastened, according to the situatione, or collocatione of the Legge.

The end of the foure portrayctures of mans bodye, and of the Vaynes, vvhich are most commonly phlebo­tomizede: and allsoe of the the saurarye, or storehouse of the Instrumentes of Chyrurgerie.

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Canalle which is open and shutt

The summary of the principalleste, and moste especialle poynctes, which are cotay­nede, and spoken of in the operationes of Chy­rurgerye.

  • The Preface of the Chyrurgerye. Contay­ninge foure Chapters.
    • Definitione, and originalle of Chyrurgerye, vvith the operatione of the same. Chapter. 1.
    • The prognosticatiō, & iudgemente of vvoundes. Ch. 2
    • Signes to knovve vvhate partes of the bodye are hur­te. Chap 3
    • Adverticemente to give assurede reporte before the Iusticiaryes. Chap 4
  • The firste Treatise, of the Operatiōs of Chi­rurgerye, vvherein is discoursede, the me­anes to dravve out all strange, and alienate thinges out of the bodye. Contayninge fi­ve Chapters.
    • The vitilitye, & necessitye of dravving out all strange, and alienate thinges. Chap 1
    • Hovv that the Chyrurgian vvith all dexteritye to dra­vve forth a bullet, must considere on the differēces thereof, and on the nature of the parte, vvherin the bullete is contaynede. Chap 2
    • The bullets, & all other alienate thinges, muste in the firste dressinge be dravven out of the bodye, if it be possible, and the meanes vvhich vve muste therein vse. Chap 3
    • Hovv vve ought to dravve out the bulletes if they sticke faste in the bone. Chap 4
    • The Chyrurgiane ought not to be to curiouse in ex­tractinge the bulletes. Chap 5
  • The seconde Treatise of the operatione of Chyrurgerye, vvherein is discoursede the meanes, to Trepane the panne, or Craniū of the Heade. Contaynīge sixe Chapiters.
    • The signes by vvhich vve may discerne the fractures of the sculle. Chap 1
    • The Coūtrefissure of the bones of the Heade. Chap 2
    • What fractures vve ought to trepane. Chap 3
    • Hovv lōge vve ought to deferre the trepaninge. Ch. 4
    • What quātity of bones vve ought to take avvay. Ch. 5
    • The methode, and manner of trepaninge. Chap 6
  • The thirde Treatise, of the Operations of Chyrurgerye, of the sutures, and sovvinge of vvoūdes. Contayninge sixe Chapiters.
    • What suture, or stitching is, & the vtilitye ther of. Ch. 1
    • What vve ought in stitchinge of a vvounde, to consi­dere. Chap 2
    • What is necessary vnto suture, & the manner of doin­ge of the same. Chap 3
    • The Species, & differences of suture, & hovv long vve must suffer them to continue vvithout resectione thereof. Chap 4
    • The meanes to thrust in agayne the guttes, & the Epi­ploon hanginge out of the bellye. Chap 5
    • The Gastroraphia, or suture of the inferioure parte of the Bellye. Chap 6
  • The fourthe Treatise of the Operations of Chyrurgerye, vvherein is discoursede of the apertione of Apostemations. Contay­ninge five Chapters.
    • Of the generalle apertiō of all Apostemations. Chap 1
    • Of the vlcerations, Ateromata, Steatomata, and Meli­cerides. Chap 2
    • The meanes hovve to cauterize, & inscide the Empie­mata. Chap 3
    • The manner of doinge the Paracentese, & to dravve out the vvater of the Dropsye. Chap 4
    • The meanes to cure the Hernia aquosā. Chap 5
  • The fifte Treatise of the Operations of Chy­rurgerye, of the disseases of the Nose, and Mouthe contayninge seaven Chapters.
    • Of the Polypus, Chap 1
    • The Haremouthe, or clovene Lippes. Chap 2
    • The tumefaction, & superfluous fleshe of the gūmes, called Paroulis, or Epoulis. Chap 3
    • The retractiō of the tung, called of the Greec Kes An­chyloglosson, & of the tumefactiō Batrachos. Ch. 4.
    • Meanes to tye the pallate of the mouth, and to cutt of the same. Chap 5
    • The tumor of the Almondes, and the Apostemations therof. Chap 6
    • Hovv to dravve, breake, & cutt of teethe. Chap 7
  • The sixte Treatise of the operations of Chyrurgerye, contayninge nine Chapters.
    • What vve ought to considere, before phlebotomye. Chap 1
    • Hovv vve shall convenientlye open a vayne. Chap 2
    • What vve ought to considere the vayne being opened: and the bloode issuinge out. Chap 3
    • The numbre of the vaynes, and Arteryes, vvhich are commonly phlebotomizede. Chap 4
    • Of the apertiō of the Arteryes, or Arteryonomye. Ch. 5
    • The Aneurisma, & the manner hovv to ligate, and in­scide the same. Chap 6
    • The Cirsotomye, vvhich is the manner hovv to insci­de the Varices. Chap 7
    • Horseleeches, & theire vse, and manner of applicatio­ne. Chap 8
    • Of boxes, and applicatione therof. Chap 9
  • The seaventh Treatise of the Operations of Chyrurgerye, contayning sixe Chapiters.
    • Of Caries, and corruptione of the bones. Chap 1
    • The fistle of the fundamente. Chap 2
    • Hovv vve shoulde dravve out the Childrene out of theire mothers bodye, vvhich can not of themsel­ves be borne. Chap 3
    • Whye vve ought to extirpate Armes, & Legges vvhate and place vve ought te to make choyce of. Chap 4
    • The executinge of the extirpation, and meanes to re­straygne the fluxione of bloode, the patiente being situatede. Chap 5
    • The extirpatione of the corruptede, and superfluouse fingers, & the separation of those vvhich are ioyne­de, and combinede together. Chap 6
  • The eight treatise of the operations of Chy­rurgerye, touchinge the Cauteryes: con­tayninge five Chapters.
    • What a Cauterye is, the species, & differences therof. Chap 1
    • The inventione, & vse of the Cauteryes, and on vvha­te partes, & diseases they muste be applyede. Chap 2
    • The potentialle Cauteryes, and meanes to make them. Chap 3
    • The applicatione of the Cauteryes. Chap 4
    • Of the Seton, and applicatione thereof. Chap 5
  • The ninth Treatise of the Operatiōs of Chi­rurgerye, of the bādages, or Ligatures, contayninge sixe Chapters.
    • What a Ligamente is, matter, quallitye, forme, & quan­titye thereof. Chap 1
    • Difference, and kindes of Ligamentes. Chap 2
    • Generalle rules to be considerede, in all bandages, or Ligatures. Chap 3
    • Hovv vve shoulde solve, & dissolve a Ligamēte. Ch. 4
    • The manner to involue, a brokē Arme, Legge, or thi­ghe. Chap 5
    • The situation, and collocatione of those partes, vvher­on these operationes muste be effectede. Chap 6
    • Apologye for the Chyrurgians, vvherein is evidentlye demonstrated, vvhich be the occasions of death, to certayne vvoūded Persōs, although theire vvoūdes are small: vvhere the Chyrurgiās are defended from all calumnies, vvhich oftentimes iniuriouslye they are sclaundrede vvith.
    • The treatise of the Dysenteria, or Bloodyeflixe.

Deo sit Laus.

THE FRENCH CHI­RVRGERYE OVT OF ALL the aunciente professors of Physicke, and Chirurgerye collected, and compacted together, vvith sundrye, and diverse figures of instrumentes, verye necessarie to the opera­tione or vvorcke of Chyrurgerye.
Throughe Iaques Guillemeau of Orleans, publique Chyrurgi­ane to the kinge, and sworene in his Chastelet at Paris.

The praeface. To the Chyrurgerye, contayninge foure Chapters.
  • The discriptione, and originalle of Chyrurgerie, and vvhat the operatione of Chirurgerye is. Cap. 1.
  • Of the prognosticatione, or foreknovvledge, and of the iudgemēt of the vvoundes. Cap. 2.
  • Of the tokens and signes, hovv to knovve, vvhat partes of the bodye are hurte or vvounded. Cap. 3.
  • Of the instructione hovv to give assured demonstratione, of all manner of vvoundes vvhats­oever, before the iusticiaryes. Cap. 4.

❧ The discriptione, and originalle of Chyrurgerye, and what the operatione of Chyrur­gerye is. Cap. 1.

HAvinge vvith my selfe resol­ved,The invē tion of sciences. and purposed to discribe the operation of Chyrurge­rye, first of all it seemed expe­diēt vnto me to observe the­se three necessarye thinges. Namelye and especiallye, vvhat Chyrurgerye is. Secondlye, hovv, and from vvhence, shee hath participatede and taken her originalle, and beginninge. Thirdlye vvhat the opera­tione of Chyrurgerye is. Concerninge ther­fore her beginninge & originalle, vnto all mē is it apparent and vve rightvvell knovve, that the inventione, and findinge out of all artes, and sciēces vvhatsoever, hath bin by all men in such greate esteē, and admiratione (vvhich Hippocrates in his boocke of aunciēte Physick vvitnesseth) that the inventors or aucthors of the same, have bin extolled even vnto the clovvdes, by the vvhich is vvitnessed, and testifyed, this inventione te have bin so perpoli­te, that it vvas adiudgede to be a thinge impossible to be discovered and brought into light, by anye other, thē throughe some God, or at the least, by such a persone vvhich hath bin infused, vvith divine inspiratione: In soe much therfore,Chyrur­gerye is aunciēter then Phy­sicke. if this may be testyfyede of a­nye artes vvith aeqvitye and right, it may true­lye and bouldlye be sayede of this arte of Chyrurgerye, the inventors, and aucthors of the vvhich, have bin canonisede, esteemede and extellod as Gods, as for example ther hath bin Apollo, Aesculapius, and Hippocrates, vvhoe ha­ve had divine honoure and reverence of all mē. The tvvo first of these aucthors, have al­lonelye leerned, that part of Physicke, vvhich through externalle medicamētes, and by in­scisions cured the infirmityes, and diseasses of mens bodyes. By the vvhich playnlye is to be vnderstoode and iudged, that Physicke at those times vvas not as then invēted created, or fovvnde out, vvhē that Chyrurgerye, vvas sufficiētlye practised and knovvne in all pla­ces: the vvhich Homer testifyeth and vvitnes­seth vnto vs in the seconde booke of his Ilia­des, vvhere he affirmeth that the sonns of Aes­culapius, Podalyrus, and Machaon, in the besie­ginge of Troye have vvith ther handes han­delede and cured manye and diuers vvoūded persōs vvithout molestinge or troublinge of themselves vvith anye internalle diseasses or sicknesses, as vvith agues, or vvith the plague, the vvhich notvvithstandinge praedominate­de and vexede sore the vvhole hoste or cam­pe of the Greeckes: and consequētlye Physick and the vse therof beinge knovvne, and in practise, Chirurgerye vvas verye confusedlye hādeled amongste Physicke. But for as much that it is verye difficulte & a harde thinge to excell in divers, and sundrye artes, and becau­se it is impossible, the vvorcke of Physicke, Chyrurgerye, and Apothecarye for one man to doe, therfore the arte of Chyrurgerye is se­cluded and separatede frō the other tvvo, ha­vinge [Page] alsoe her ovvne professors and practi­tioners. The vvhich because that it may be­rightlye vnderstoode, it is to be noted and observed, that in the oulde and auntient times, by Chyrurgerye, the thirde parte Therapeu­ticae vvas not vnderstoode, even as vvee in these times take it, & as consequentlye shalbe shevved:Divers miscon­strvinges of this vvorde Chyrur­gerie. But they vnderstoode by this vvor­de Chyrurgerye nothinge els, then that on­lye, vvhich throughe the operatione of the hādes is finishede and brought to passe vvherfore it is yet manifestlye vvritten by the aun­ciēt professors, that by Chyrurgians vvas no­thinge else vnderstoode then certayne ser­vantes, vvhich in those times vveare callede Chyrurgians, not because they had the per­fecte science, or knovvledge of Chyrurgerye, but because they earned there sustenance and livinge through the vvorckinge of ther han­des. Novv to conceave aright vvhat Chy­rurgerye is, it is expediēt and necessarye, that vve ascēde somvvhat higher, and industrious­lye seerch & trye vvhat Physicke is seinge ma­nifestlye that Chyrurgerye is therof seperated and secluded.

Descrip­tione of Physicke.Physick therfore is nothinge else (as Hippo­crates in his booke De arte vvitnessethe) then a knovvledge, or science, vvhich teacheth, hovv to cure anye sicknesses to frustraete, and anni­hilaete there impregnable forces, because of themselves they are incurable.

Partes of Physicke.This Physicke agayne hath sundrye par­tes, of the vvhich the first is Physiologia, vvhich handelethe and treatethe, of the structure and situatione of mans bodye, vvherin is to be re­garded and noted on the seaven vnnaturalle thinges. The secòde is Hygiena, that is a Nour­ce, and fosterer, or praeserver, of our health, vvhich instructeth, hovv vve shovvlde conti­nuallye preserve our presente health, & keepe the sovvnde bodye liber, and free from all dis­easses, & sicknesses: and this consistethe in sixe vnnaturalle thinges. The thirde is Pathologia, vvhich treatethe of the cause, and occasione of the sicknesses & of the accidentes vnto the sa­me, the vvhich three thinges are agaynste na­ture. The fourth is called, Simiotica, and trea­teth of the demōstratinge signes or tokēs, not onlye of that vvhich is all readye passed, but alsoe of that vvhich is as yet to come, in respecte as vvel of sicknesse, as of health. The fifth is Therapeutica, that is the curinge or sanable par­te of Physicke, vvhich instructeth, & learneth, hovve to repelle and cure sicknesses, and dise­ases,The par­tes of Therapeutica & restore agayne to former health: This praenominated Therapeutica is redivided and agayne dealed in three partes, the first vvherof is called, Dietetica, vvhich teacheth, hovv to observe a sober & good diete: The secōde parte, Pharmacia, vvhich instructed vs, hovv to com­povvnde our medicaments. And the third part is callede Chirurgia, vvhich cureth or hel­pethe the affected patients through manualle or handlye operation for Chirurgia hath his derivatione of a Greecke vvorde, and is com­povvnded of Cheir vvhich signifyeth a hāde, and Ergō vvhich betokeneth operatione: ne­ther may vve by this vvorde Chirurgia not on lye vnderstande, all operations vvhich are on­lye effected by the handes, but most of all and especiallye, all that is done, or may be done o­ne mans bodye tovvarde the curinge of all ex­ternall diseases.

And as cōcerninge this vvorde operatione,What this vvorde o­peratione signifie­the. it is nothinge else, then an artificialle and nor­maticke applicatione, vvhich is brought to passe, and vvrought by the handes, one mans bodye, vvhervvith the decayed health is reite­rated, and agayne restored. And if vve vveare desirous to knovve vvhat the office, & dutye of a true chyrurgiane is, or vvhat his operati­ons are, hovv and in vvhat manner he must vvorke, & effecte them, and vvhat conditions are expected, at a chyrurgians hādes, I have di­scribed them fullye, & at large in my generall table, and discriptione of Chirurgerye, vvher­fore I vvil make in this place noe more mēti­one of them.

❧ Of the prognostication or iudgement of woundes Chap. 2.

IT is certayne that the praedicti­one, or iudgemēt of vvoūdes,The vse of iudgement. yea alsoe the generalle knovv­ledge of all disseases, is a thinge most necessarye and expedient for a good Chyrurgiane: ther­fore Hippocrates alsoe estemed it verye conve­niente, & profitable, that a Chyrurgiane must excelle in the fore knovvledge of thinges, and be apt & redye to give iudgement and his opi­nione of all disseases, because by that he may attayne, and at chiue vnto greate credite, and fidelitye by all men, and havinge on this man­ner set forth, and published his knovvledge shalbe irrepraehendable, and of all men admi­red, & soe much the safer, &, vvith more pro­vidence finishe his vvorcke, & the boulder il­lustraete the operatione of his arte, and give iudgement ther of vvithout anye scoffe, or checke, and be able to give a true reporte, vvhen that by the aucthoritye of some learne­de chyrurgiane, or by the aucthorytye of so­me Potentate, he shalbe therin imployede, & ordayned to reporte his opinione, ether of the vvounded persons life, ordeath, haultnes or criplenes. Even as alsoe the foresayed Hippo­crates [Page 2] sayeth in his Porrhet that the Chirurgi­ane must ende voure him selfe to have a vvise & grave gesture,Hippocratesin his Porrhet. because that if it soe chaunce as he adiudged it shoulde, he might reape ho­noure, & goodvvil, not onlye of the patient, but alsoo of all the circumstants, and behoul­ders: Contrarilye if that othervvyse it happe­ned or chaunced then he sayed, and iudged it shoulde, and that his iudgemente fayle him, he shal not onlye of all mē be hated but alsoe be esteemed as an ignorant, & sottishe fello­vve. Beyonde all this Galenus sayeth, and testi­fyeth vnto vs, that by our vpright, and sincere iudgement, by the frendes & Kindrede of the patiēte, althoughe he come to dye, vve shalbe liberated, & freede from all badde reportes & sclaunders, because that throughe the death vvhich consequentlye follovved, nothinge shalbe alleagede agaynst vs.

What a Chyrur­giane ought to knovve in giving iudgemētAnd for the givinge of such a perfect, and complete iudgement, it is necessarye for the chyrurgiane not to be ignorāt, vvhich partes of the bodye beinge vvounded, easylye, or difficultlye may be cured, vvhich of thē are prae­sent death, and in fine, the tokens hovv to knovve vvhat partes are vvounded or hurte, because that out of ther natures, quallityes, & dispositiōs, vve may certaynlye hope, or mis­truste of theire health, and safetye.

Such iudgemente therfore ought to be ta­ken, out of the verye beinge, and substance, or essence of the vvoūded parte, alsoe of the vse, the actione, and situatione of the same, there must alsoe be noted, the proportione, and fi­gure of the same vvounde, and the accidentes or other chaunces, vvhich are incident vnto her, consideringe alsoe the complexione and temperature of the bodye, the sexe, the age, on his handelinge, and trafiqve, māner of livin­ge, the contrye, the constitutione of the time then praesent, and one the time and season of the yeare.

All greate vyoundes are dan­gerous,To conclude, all men that have receaved a greate vvoūde, are ether in daunger of death or in daunger of beinge mutilate. VVe eeste­me and accounte the vvounde to be large, for thre occasions:A great vvounde is taken three mā ­ner of vvayes. The firste vvherof is, because that through her latitude, or vvidnesse, & cir­cumiacente places, shee hath a threefoulde survayinge and measuringe to vvit, in length, brédthe, and debthe, as some there are vvhich be deepe & broadlye carvede: or right overth­vvarte or crosse vvyse vvholye percīge throu­ghe the principalle muscles of anye parte, by the vvhich alsoe somtimes the bones are he­vved & cutte quite through, & broken, vvherfore some times they must be stitchte, bound and ligated together: or because that the vay­nes, the arteryes, or the sinneus themselves, come to be squised and plettered. The secō ­de, cōcerninge the vvorthynes of the vvoun­ded parte, for although the vvounde be but little, in her meatinge yet notvvithstandinge vve esteeme her to be greate, because that the strengthe and actione, of the vvounded parte or member, is verye necessarye for the vvhole bodye 'and for the vvhole lyfe of man, vvhich parte havinge lefte his naturall vse and actio­ne, it consequentlye follovveth that the per­sonne, must immediatly discease & dye, as vve may by experience see that daylye chaunceth in the vvoundes of the Braynes, of the Harte, and in the vvoundes of the Liver.

Thirdelye, because that some vvoundes are of a vvorser nature, & dispositione, as beinge venoumede, rebellious, and entermingled vvith some badde and dolorous accidentes, vvhich sometimes farre surpasse & excell the vvounde it selfe, as it is evidentlye & planlye to be seene in the vvoundes of the Ioynctes, vvhich immediatlye, may fall into a verye ex­ceedinge badde estate, because that those par­tes and places are circumligatede or clothed vvith verye smalle store of fleshe, beinge on­lye decked & co verede vvith the Tendones, vvith sinnues, vvith Ligaments, & that verye tender, and sensible pellicle Perioflium, by the vvhich these partes or members are in more daunger of fallinge into a convulsione of sin­nues, into Phrensye, payne, and inquietude, as much as a farre more greater vvounde in a­nye other parte of the bodye.

Those vvoundes are accounted incurable vvhich doe happen in the Braynes,Woundes vvhich are estee­med incurable. or in the ventricle of the same, in the Harte, entrāce of the stomacke, in the Vena Cava, the entrāce of the Liver, the backe bone, quite throughe the Lunges, in the small guttes, or entralles, the stomacke, the Kidnies, or in anye greate vay­nes, or arteryes about the throate.Woundes that be difficulte to cure, But these vvoūdes vvhich vvil difficultlye be curede are they by the vvhich the Longes, the Liver, the mēbrane of the Brayns the Milte, the Matrix, or vvombe, the blather, anye of the greate guttes, or the Middelriefe, are vvoūded vvith verye small vvounde. Alsoe are those vvoū ­des daungerous, vvheras the greate vaynes,Woundes that are daunge­rous. & Arteryes, vnder the Emunctoria or arme pittes, & in the Hockes or bēdinge of the knees are vvounded: and indeed all vvoundes are suspi­tious, in all places vvheraboute anye greate Vaynes, or Arteryes are situated & placed, be­cause that throughe theire effusione of bloe­de, the vvounded persone is berefte af all his abilitye & forces: the vvoundes of the Secrete partes or privityes, and the vvoundes of the Testicles are alsoe by this reasone verye peril­lous & daungerous, as alsoe are these vvhich happen and chaunce to light betvveene the fingers.

[Page] The figu­re or for­me of the vvoundesThere is alsoe greate heede to be taken one the manner & forme of the vvoūde: for those vvoūdes vvhich chaunce, or come by crushinge, or pletteringe, are farre vvorse, then those, vvhich are onlye hevvede, so that it is much better to be vvoūded vvith a sharpe edgede or cuttinge svvorde, thē vvith anye other blunte vveapone vvhich is not sharpe.

The rounde or circle vvoundes are vvorste & difficultest to be curede, but the certayneste & easyeste to be cured, are those vvhich passe by the lēngth of the fibres right like a linye or line.

The vvoundes of the Hippe, vvhich are re­ceaved in the membranous muscle,What the vvoundes of the hippe are, are verye exceedinge daungerous, & especiallye if it be a thruste or stabbe,or else vvhē the apertione of the same is verye smalle, & hath noe issue, but it is soe much the vvorse if it soe chaunce ther be anye fracture or separatione of bones, it be vvhere it vvil in anye place of the hippe: & so farre forthe as if the vvounde be in anye internalle parte of the Hippe, about the greate vaynes, then the vvounde is passinge & excee­dinge daungerous, for there ensuethe out of hāde some greate inflammatione there vnto, & consequētlye thereafter a Gangraena, or mor­tificatione: he that happeneth to receave a vvounde in the foremoste parte of his arme, is alsoe subiecte vnto the same daunger of in­flammatione, and mortificatione, and cau­seth great payne & trouble, because that tho­se vvoundes most commonlye are praesente deathe.

What vve ought to iudge out of the ac­cidents of vvoūdes.Novv as much as belongeth vnto the jud­gemente & opinione, vvhich is to be conside­red & noted out of the accidentes of all vvoū ­des, Hippocrates teaceth vs: in so much as in the greate & badde vvoundes, as are the vvoundes of the Sinues, of the Tēdones, of the Ioynctes, & of the bones, little or noe svvellinge or in­flammatione at all apperareth, & illustratethe it selfe it is a verye evell and badde signe, for vvhye, it signifyethe vnto vs that those hu­mors vvhich consideringe the payne shoulde have assembled, & packed thēselves that vvaye & have circumcinglede themselves rovvnde aboute the vvoūded parte, have retracted thē ­selves into some principalle & especiall parte of the bodye.

Accidētes of a de parted svvellin­ge.Those vvoundes in the vvhich there appearethe anye svvellinge, or tumefactione verye selden or never fall into any Phrensye, or into cōvulsione of Sinnues, because that the veno­mous humors, vvhich might, ascende & dra­vve tovvarde the Braynes or into the sinuishe partes of the boddye, have congregate and ga­therede thēselves together aboute the vvoun­de: but if that one the suddayne the svvellinge vvithout anye evidente reason, as in example, in the applyinge of anye remedyes, throughe purgations, or throughe phlebotomisinge or bloode lettinge, came to departe & vvith dra­vve it selfe into some other place and that in such, as are vvounded behinde in there backe bone, that persone is troubled vvith convulsi­one of synnues, through the vvith dravvinge of the matter, into the sinnuishe partes of the backebone:and the vvounde beinge in the fo­remost partes of the bodye, and the matter of the svvellinge, ascēdinge vpvvardes, throughe the greate vaynes, tovvarde the Braynes, the patient strayghtvvay fallethe into a madnesse & Phrenesye: or if soe be that the matter dra­vve tovvarde the breste, then ther ensue grea­te & intollerable stitches, or Apostemations, because that those badde humors can not by anye meanes possible be consumed or vvaste­de, but descende & sincke dovvne into the cō ­cavitye of the breste. And if that the svvellin­ge novv departinge be of a verye highe & red­de colloured, & that thervvas store of bloode therin, vvhich is descended & suncke dovvne tovvarde the guttes, then it necessarylye & cō ­sequentlye fellovveth that the patiente falleth into the Blodye flyxe, or Dysenterye.

As farre forthe therfore as there procedethe anye convulsione of synnues out of a vvoun­de,The con­vulsione in vvoundes is ve­rye daun­gerous. & especiallye from anye greate inflamma­tione, that is a signe of deathe, for therbye vve may playnlye, note, & marke that the synnuis­he partes of the bodye, must needes be hurte, and that the Braynes are in some, or other pas­sione.

If that into anye vvoūdes, vvhich have fier­celye bledde anye Spasmus happen, that is a bad signe.

All thrustes of the sinnues, and Tendones,Thrustes in the synnues are very daū ­gerous. are verye daungerous, and especiallye, vvhen as the skinne and the fleshe chaunce to shutt together, for therin engenderethe a sharpe & corrodinge matter, vvhich resuscitatethe and causethe greate & intollerable payne, because she can not by anye meannes get issue, out of the vvhich procedethe & follovvethe convul­sione of synnues, inflammatione, and a Gan­graene, or mortificatione.The Or­ganicke partes, vvhich are vvho­lye cut of can noe more be restored agayn. In soo much as a­nye especiall and principalle, or Organicke parte, or anye instrumentalle parte, totallye & vvholye is hevved of, and sequestred and sepa­ratede from the bodye, it can not by anye me­anes be restored and cured, because that the blode, and the vitalle Spirites are vvholye ex­halated, throughe the greate vaynes, vvhich are cleane a sunder, and that by the vvhich the cure must be done, and the foregoinge health agayne restorede.

The temperature of the boddye, the time of the yeare, the age the handlinge and trafi­que, and the manner of the patients livinge, [Page 3] the knovvledge of the cōtrye are a greate hel­pe & ayde for the prognosticatione of vvoun­des: a childe, or a yongemā, vvhich as yet is in-his grovvth vvil better and vvith more ease be healed or curede, then an aged personne: and a stronge mā, a greate deale sooner then a fee­ble, and debile person. A leane and sclender persone, vvilbe curedevvith more facilitye, then a thicke, and grosse lived man. And a sounde bodye farre sooner, then a sicke and corrupte bodye. That man vvhich labou­reth, easier, then a stillsittinge and idle perso­ne. A soberman, farre sooner, then a banc­ketter, and one that haunte the hoores. The most conveniente time of the yeare, to cure & heale a vvoūde, is in the fore summere or Ver­nall time of the yeare, or at the least in such a time, in the vvhich it is nether to hotte nor to coulde, because that extreame heate, or ex­treame coulde,are the enymyes of all vvoun­des, and especiallye the changinge of heate, & of coulde, vvherfore alsoe the fore vvinter or Autūnus, is verye vnprofitable for the same. In some regions and countryes,Other cō sideratiōs to be his in prognostica­tinge. the vvoundes are ether easyer, or difficulter to becurede: for at Rome, the vvoundes of the heade are diffi­culter to be curede, then the vvoundes of the Legges, the vvhich notvvithstandinge at A­vignon vve finde cleane contarye.

As farre as the vvounded person keepe and continue his perfecte Sence, and memorye nether gettethe anye agues, vve may then as­sure our selves, that the vvounde vvil quick­lye and easylye be curede. VVe ought not thetfore to discourage the patiente, al­thoughe, he have an ague by the greate vvoū ­de, as longe as the inflammatione is yet befo­re hande, and as longe as there engenderethe anye matter. But an ague is verye daunge­rous,Signes to the con­trarye. vvhē she issuethe from a small vvounde and especiallye, vvhen she hath longe conti­nuance, after the inflammatione, and supura­tione, or vvhen she incitateth the patient vn­to Phrenesye. VVhen the patient parbra­kethe against his vvil, greene galle, or imme­diatlye vvhen he hath receaved the blovve, or at the time vvhile the inflammatione is as yet duringe, that is alsoe a badde signe, especiallye in these vvhich are vvounded in a synnue, or in annye sinnuishe place: But the parbrakin­ge, or vomitinge, vvhich commeth by the frevvil of the patiente. is nothinge suspicious, es­peciallye in those, vvhich are vsed to vomitinge, if that a man praesentlye after meales, or af­ter that the inflammatione is come, or the vvounde being in the heade,Conside­ration for the vvonds of the hea­de. doe not come to vomite. The Chyrurgiane must vse greate foresight, in givinge iudgemēt of the vvoun­des of the Heade, for the aunciente Chyrur­gians, have alvvayes esteemed thē doubtful­le & suspect, because of other badde acciden­tes vntil the Fifteenth day, and the moderne and, ionge professors, vntill the hundred the day.

The Iurists, or lavvyers, have constituted and ordayned fifteene dayes, for the iudge­ment of the vvoundes of the Heade, to kno­vve of a certayntye, vvhether the patient by occasione of that vvoūde came to dye or not or by reasone of his ovvne faulte, or by any other occasione. Because therfore, that the yonger Chyrurgiane, shall not be over ras­he, in givinge of his iudgement, leaste he co­me te glyde and falle into anye badde repor­tes, or in anye repraehensione. As much as appartayneth vnto me, I have knovvne so­me, vvhich have continued in a verye good estate vnto the thirteenth, fourteenth, or vn­till the fifteenth day, and then have fallen in­to agues, and manye other accidentes, by the vvhich they in the end chaūced to dye. VVee must alsoe note, that all naughtye and badde, accidents most of all publishe themselves, at the full Moone, more then at other times, be­cause as then all maner of moysture grovveth and increaseth more, then in the decreasinge of the Moone, & alsoe more in the sommer, then in the VVinter.

The signes and tokens of the deadlye frac­tures of the sculle, are agues in the VVinter,The sig­nes of the deadly fractures of the sculle. before the fourteenthe daye, and in the som­mer before the seaventhe day: Item, a naugh­tye and badde colloure of the vvounde: little matter of the same: mortificatione of that vvhich is inflamed: slimye or viscouse consi­stence of that vvhich is corrupted: drieth ari­ditye in the skinne of the heade, as it is in a peece of pouldrede fleshe, vvith a brouvvne, leadishe, and blacke colloure, vvhich signi­fyeth the beginninge of the corruptinge and putrifyinge of the sculle, vvhich thē vvaxeth ravve, as vve may see, vvhen it is rotten, and grovvne blacke: vvheras before it vvas even and smoothe. Finallye vve see therin, a pa­le, and yellovvishe colloure, to vvitt vvhen the foresayede bone is vvholye corrupted & rotten, throughe the purulent matter, vvhich vvas suncke to the grovvnde of the vvounde, and vvas there gathered together.

The patient beginneth to rage, he hath little pimples one his tonge, he getteth alsoe convulsione of synnues, one the contrarye syde of the vvounde: some fal inte an Apo­plexia vvheron follevvethe deathe. The Practitioners of our times, have observed in all vvoundes, vvhether allreadye therin vve­are a Paralisis, or els therafter happened ther­vnto: and onethe contrarye syde a Convulsi­one, [Page] or somtimes also in the vvounded part a Convulsione, and in the other syde a Paralisis, sometimes also in both the partes, ether a Cō ­vulsione, or Paralisis, and somtimes one each syde ether a Convulsione, or a Paralisis, vvit­hout the contrarye syde beinge in anye sorte thervvith infected. The goode signes of he­alinge, in the fractures of the Heade, after that it is trepanede, or els after that the brokē par­cells of bones, are taken out of the Heade, are these namelye vvhen that the Membrane of the Braynes hath her naturalle colloure, and her naturalle motione & stirringe: vvhen the engendringe and grovvinge Fleshe is redde. VVhen that the patient may easylye turne a­boute his Necke, and alsoe easylye vvagge his lovver chavve bone. But in somuch as the Membrana hath noe stirringe,Badde si­gnes. and is blacke, le­adishcolourede, & lividouse or vvith anye o­ther badde coloure taynted & defylede: Then the patient ragethe, vomiteth exceedinglye, falleth into a Paralysis, or in Spasmo, if that the Fleshe of the vvounde be leadishe colourede the necke & the chavvebone bothe of thē stād stiffe all these are verye bad signes. And vvhē the vvoōde, is at a good estate, thē beginneth the fleshe of the Membrane, or of the sculle to grovve, and to vvax dubble, and filleth all the voyde places vvith fleshe, that have binne open betvveene the bones, yea & somtimes covereth even as it vveare vvith pomgranate Kernells the scull it selfe.

❧The tokens howe to knowe which partes of the bodye are wounded Cap, 3.

TTe vvoundes most common­lye are knovven by ther first aspecte, alsoe sometimes the place of the vvoūde certifyeth vnto vs, vvhat partes are internallye vvounded: But seinge that it often times chauncethe, that these vvoundes', vvhich to our estimatione be not profounde or deepe, penetrate vnto the internall partes, vve vvil heere therfore recite the signes, by the vvhich vve may knovve, vvhat internall partes, vvithin the bodye aré vvoū ­ded, because ther by vve may knovve, vvhe­ther the patiēte may be cured of them or not.

Signes vven the braynes are hurt.If soe be that the Braynes or else ther Mem­brane is vvoūded, thē ther issueth bloode out of ther Noses, vvith some alsoe out at there Eares & commonlye ther follovveth a vomi­tinge of choler: some lye almoste out of the memorye & beside thēselves that althoughe you call & crye vnto them, they give noe an­svvere: others seē in ther faces as if they vvea­re afrighted & feared: some turne and vvinde there eyes, this vvay and that vvaye, as if they vveare touched & stricken by Gods hāde, the thirde or the fifth daye most commōlye they fall into madnes & Phrenesie: other gette the Spasmū, before they dye: some there are vvhich plucke the medicamētes from there Heades, soe that the vvounde commeth to lye bare, & vvaxeth coulde.

VVhē as the backe bone is hurte,Sygnes vvhē the backe bone is hur­te. or vvoū ­ded, thē beginnethe the patiēt to be feéble & lame in his synnes, or else he getteth cōvulsi­one of synues, vvhich is called Spasmus: leeseth the sence of feelinge, somtimes the patiēt can nether retayne his vrine, Sperma, or Stole, but of it selfe departeth from him.

If the Harte be vvoūded,Signes vvhē the harte is vvoūded. ther issueth out of the vvounde, greate store of blacke, dence, or thicke bloode, & especiallye vvhen the right side of the Harte is hurte: But vvhen the left syde of the Harte is hurte, then issuethe out of the vvounde fine & subtile redde bloode the pulse of the patiēt is verye debile & feeble, & variable, & is verye pale coloured in his face: The coulde svveate in all his bodye bursteth out, and hath a verye vnsaverye smelle, evē as vve may note in other sicknesses of longe cō ­tinuance. His handes and feete beginne to be coulde, out of the vvhich present death en­sueth.

VVhē the Lunges are hurte, thē breatheth the patiēt vvith greate difficvltye,The vvounds of the Lungs. & divers ti­mes reiterateth, & dravveth anevve his breath as if he there by sought & indevoured to doe him selfe som solace & cōforte: he voydeth of ten times through his mouth frothye bloode, & throughe the vvoūde fayre, redde, & vitalle bloode, vvith peepinge & hissinge breathe: he endevoureth for the most parte to lye one his vvoūded syde: others often times erecte them in ther bed vvith out anye occasione: Some lyinge one the vvounded syde, can speeke, but turninge thēselves one ther sovvnde syde are quite deprived of there speeche: sometimis they are bloesinge in ther faces, & sometime cleane pale, and at the last issueth out of the mouth of the vvounde greate quantitye of fil­thye matter,

The signes of a vvounded Liver are these;The Liver beinge hurt. nālye that out of there right syde they avoyde a greate quātitye of bloode: Both sydes of the bodye, are as it vveare plucked tovvarde the backe bone: The patiēt is verye pale in his face as if he vveare halfe deade: His eyes are fal­len invvardes, and hath intollerable payne, beinge ignorant throughe his impatientie vvhat he shal doe: he ist best at ease vvhen he lye thone his bellye: he hath a verye prickinge & stinginge payne, vvhich dravveth tovvarde his breste, and also toevvarde the sy­des of the same. Heavinge and contractinge his shoulders togeather must he breathe, and [Page 4] somtimes throughe, parbrakinge he avoyde­the choller. Hath a verye violent, & fervent pulse, he is easylye incēsed to ire, & sorrovve: somtimes he hath an ashe coloured face, his vrine alsoe sōtymes verye bloodye: his stoels like matter, and dye most cōmonlye, vvith the Hickcoughe.

VVhē the kidnyes are hurte, then descēdeth & as it vveare by degrees cōmethe the payne into the flanckes,Of the vvounds of the kidnies. and soe forvvarde vnto the testicles: the patient can verye difficultlye be released of his vrine, he pisseth bloode, or at the least his vvater is bloodye. Somtimes his vrine is quite retaynede, by the vvhich occasi­one, the patiēte beinge extreamlye svvollene dieth.

The mil­te beinge hurte.If the Milte be hurte or vvounded, then the bloode issueth out of the left syde of the paciē te, & is blak of coloure. The same syde, & alsoe the stomacke beginne to be indurated, & har­de: the patiēt vvaxeth thirstye & the payne re­tracteth it selfe tovvardes the breste, as in the vvoundes of the Liver.

The vvō ­be beinge hurte.Novv the VVombe beinge hurte the vvo­mā hathe greate payne in her flanckes, in her Haunches, & in her hippes: she avoydeth bloode partlye throughe the vvounde, and partlye throughe her privityes, after the vvhich som­times follovveth a parbrakinge of Cholera O­thers cā not speake: some lye out of memorye others vvhich doe not rage, say that they are troubled vvith greate payne in there sinnues, & in ther Eyes: & vvhen they dravve tovvarde deathe, they are troubled vvith the same acci­dētes, vvhich vve have recited of the Harte.

The Middle reefe,VVhen the middle reefe or Diaphragma is vvoūded, thē are the sydes of the patiēt dravv­ne, & shruncke vpvvardes: they have excee­dinge greate & violent payne, internallye in the backe bone: they have verye retardate breathe, and there issueth out of the vvounde fro­thye bloode.

The en­trance of the sto­macke,The entrance of the stomacke beinge hurte the patiente beginnethe to have the hick vp, & avoydeth choller: vvhen as he eateth or drinc­keth, he casteth it strayghte vvay frō him agay­ne: he hath a smalle, feeble, & obscure pulse: he getteth a little coulde svveate, vvith a coo­linge of all externalle partes.

The sto­make & the gutts,The stomacke, & that gutte Ieiunum, have hoth of them one manner of token, because that there meate & drincke issueth out of the mouth of the vvounde somtimes beinge hal­fe digested, and altered in Chylum: they feele a payne, as if a man vvoulde rente & teare there Harte out of there bodyes: they gett hardnesse in ther sydes, sōtimes alsoe parbraketh the pa­tient Cholera, vpvvards throughe the mouth, & his spittle is bloodye: betveen these tvvo is noe other difference, then that the gutt Ieiunū hath his place & situatione somvvhat lovver then the stomacke.

The bladder beīge hurte, vve feele payne,Hurtes of the blad­der, in the flanckes: that parte of his bellye a little a­boue his privityes extendethe & stretchete it selfe: in steade of vrine the patiēt pisseth bloo­de, or else the vrine issueth forthe of the vvoū ­de: the entrance of the stomacke is perturbed & out of ordre, vvherfore the vvounded vo­mite Cholera, or at the least are afflicted vvith the hick cough: they beginne to vvax coulde in handes & feete, and consequentlye ensueth death.

❧ Instructione, how to give a certayne reporte of all woundes whatsoever before the magistrates. Cap. 4.

ALl such vvhich before anye magistrates,Codside­ratione to be had before the giuinge of re­porte, of anye vvoūded or sicke personne, vvil & are disposed to give reporte & in­structione, shallby noe meanes intrude themselfves, before that of the magistraete they shalbe requested therto, & sent for, seinge that most com­monlye proferede vvitnesse is repraehēdable: & he that taketh such a thinge in hande ought first of all to visite and see the patient, because he might ripelye and dilligētlye consider of al thinges, namelye & especiallye one the great­nes of the dissease, one the situatione, & place of the same, not onlye, as thē may give good instru [...]one, but alsoe, one all occasiōs, & on the praedictione & fore sayinge of the vvoun­des, vvithout havinge vnadvisedlye therin hasted him selfe: for it is a harde and difficulte matter, to give a perfecte & cōplet iudgement of the end of all vvoūdes, or other sicke persō ­nes, because of the accidentes vvhich might chaunce thervnto, for those vvoūdes, vvhich vve doe not esteeme of sōtimes are occasione of death, & cōtrarylye those of the vvhich vve expected nothinge but death, are yet notvvithstandinge cured. VVe knovve, that some ther are cured & healed, notvvithstandinge althoughe they vveare vvounded in the Membrane or pellicle of the Braynes yea & some vvhich vveare hevvede in the substāce of there Bray­nes: as I alsoe remember some to have bin cured, vvhich vveare hurte in the luges, in the Middlereefe, in the Liver, in the smalle guttes or ētralles, the Bladder, the Kidnyes, or in the Matrix or vvombe. Althoughe vve accordinge to the iudgemēt & reason of the aunciente professors, esteeme such vvoundes to be dead­lye & incurable. Contrarylye vve se some mē men dye of smalle and vndiepe vvoundes: vve must therfore in such thinges make a distinc­tion amonge the vvounded for some ther are vvhich are of soo goode a temperature, [Page] and state of bodye, that of a greate and large vvounde vvhich in anye other mans bodye vvear praesent dea the, they are cured: contra­lye there are others vvhich beinge vvounded in anye externalle partes, vvhich are nothin­ge nocēte or daūgerous to the lyfe of the pa­tient, vvithout anye penetratione, of the vvhich, notvvithstandinge they chaunce to dye, ether of the badde cōstellatione, or con­stitutione of the time, or by the refluxione of anye badd humors vnto the vvounded parte.

Some mē dye of a small vvound.Althoughe therfore, that some vvoundes are curable, and alsoe of a good constitutiō & dispositione, vvithout anye badde or cōtrarye signe therin to be marked, but for all that vve may not give anye absolute iudgement or re­porte of the same, but muste onlye say that the vvounde is curable, soe farre forth as the­re be nothinge praetermittede, vvhich consis­teth and belongeth as vvell in the patient as vnto the Chyrurgiane vvhich hathe him in­handes, it belongeth alsoe vnto the circūstan­tes, and vnto other externall thinges.

The iud­gement must be provident lye given.VVe must thefore suspēde our iudgemēt, and keepe it in secrete for a season, vvithout givinge anye absolute reporte the first daye, because that the good or badde signes cā not soe sone reveale and disclose themselves: vve must alsoe cōsider that all vvoundes must ha­ve ther originalle, ther increasinge, and there estate, and duringe this time, seeke by all me­anes possible to represse the vntemperate­nes, vvhich is fallen into the vvounded parte, throughe the blovve, throughe the external ayre, vvhich striveth vvith nature, agaynst the vvhich nature strengthenethe and forty­fyeth her selfe, to expell and drive avvay the foresayed vntemperatenesse, duringe the vvhich time, vve can not certaynlye knovve, vvhich of thē shall obtayne the victorye, thē onlye some time therafter, vvhenas the fo­resayed vntemperatenesse maketh her selfe knovvne, throughe anye signes vvhich shee revealeth in the concurringhe humors be­cause nature, throughe certayne sygnes, doth demonstrate that shee hath obtayned victo­rye, and is become the mistresse of that vntē ­peratenesse. These signes and tokēs are espe­ciallye knovvne, by the matter afore hād: and because that the purulence or matter, is not engendred the first daye, it necessarilye follo­vveth that on the first daye, vve give not anye absolute reporte of a vvounde, but must first consider, vvhether it is bent, because that na­ture one the dayes of Crisis demonstrateth her selfe, by the vvhich vve may iudge of the end of the sicknes. The first, and certanest daye of the Crisis is, the seventhe, for the fourth, is not indeede the day of the Crisis, but vvel the demonstratinge day of the seaventh, vvhich is the vpright and trevve day of the Crisis. Af­ter the seventh, follovvethe the eleventh, of the vvhich the seaventh is the demonstratin­ge daye, then the fourteenth daye follovveth, after that the tvventithe, and then the last is the fortithe: For if that before the fortith daye, vve perceave noe badd signes, it is then evidēt and playne enoughe, that the vvoun­de vvilbe easylye cured.

It is best therfore that vve doe not reporte or give anye iudgement before the seaventh day be passed by, in vvhich time,Whē that the reporte must be done. the accidētes beginne to reveale thēse [...] [...]her on as thē vve must have a specia [...] [...] [...]de and care, vvhether ther be more good, then badde acci­dētes afore hādes, or the contrarye, vve must consider one these signes, three manner of vvayes: For they reveale themselves ether in the qualitye of the bodye, of the vvounded parte, or in the livinge, and vitalle in the ani­maele, or naturalle actions: Or in the excre­mētes, vvhich are common, or in the vvhole bodye, alsoe in the particulare excrementes, vvhich the vvoundes reiecte and repelle from them. The signes vvhich reveale themselves in the qvalitye of the bodye, are considered, vvhen vve regarde on the figure, and one her coloure: the animaele, and spirituale actions, consiste in the stirringe, in feelinge, and in re­ason. The vitall, or the livinge actions, con­sist in the pulse: and the naturalle actions, cō ­siste, in the appetite, in the digestinge, and in the expellinge and drivinge forth of the ex­crementes. The common excrements of the vvhole bodye are the filthynes of the No­se, the teares out of the Eyes, spittle out of the mouth, or the substāce and filthye matter of the guttes, the vrine, or that vvhich vve op­vvards parbrake: The particulare excremen­tes, are filthe, matter, ād the bloode: in vvhich excrementes, vve must marke and note the quantitye, the consistence, colour, smelle, and sometimes alsoe one the taste: seinge that if ther be more goode, that is soe much the bet­ter: vve must alsoe note, that throughe the ac­tiōs vve may best iudge of the forces. Havin­ge thus therfore togethere considerede and noted all these thinges, the Chyrurgiane shal be able to geve his sentence and reporte cer­taynlye, ether of lyfe, or of deathe, of lamnes or criplenes.

THE FIRSTE TRE­ATISE OF THE OPERATI­on of Chyrurgerye, wherin is discoursede and handelede of the meanes and vvay hovv te extracte and dravve forth anye alienate thinge out of the bodye contayninge five Chapters;

  • Of the profite, and necessitye that commeth to dravve all alienate thinges out of the bodye. Chap. 1.
  • Hovv the Chyrurgiane, convenientlye and fitlye extractinge and dravvinge forthe the bul­let, ought to consider & marcke theire diversityes, and in vvhat partes or places they lod­geor are collocated. Chap. 2.
  • VVe ought to extracte and dravve forthe the pellet, or anye other thinges, if it by anye mea­nes, be possible, at the first dressinge. And praemeditate, one the meanes, hovv vve shoul­de best and convenientest effect the same. Chap. 3.
  • After vvhat manner vve shal dravve forthe those bulletes, vvhich sticke faste in the bones. Chap. 4,
  • That the Chyrurgiane ought not to be too curious, in extractinge or dravvinge forthe of the bullet. Chap. 4.

❧ Of the necessitye, and vtilitye, of the extractione or drawinge forth of all strange thinges. Cap. 1.

The excellentie of Chyrur­gerye. AMongste all operatiōs of Chi­rurgerye, the aunciente Chy­rurgians of oulde times, have especiallye cōsidered, one the hādlinge, vvher vvith all vve most convenientlye, and apt­lye, drevve forth out of mās bodye all māner of straunge & alienate thinges, as are Bullets, Arrovves, and all other sortes of vveapons, or all peeces of brokene bones, and many other such like things as beinge moste necessarye, for this foresayed operatione.

It is a Chyrurgiane full of crafte,
That out of the bodye can plucke shafte.

An excel­lent simi­litude.And even as in the vvarrelike affayres, tho­se Capitaynes are esteemed to be moste cou­ragious and valiant, vvhich one the suddayne can beste discerne and knovve ther enimyes. and allure and as it vveare dravve them, forth to their ovvne furtherance, to battayle: oras in chasinge, those hunters are esteemed fittest and expertest, vvhich suddaynelye can disco­ver, or disclose, the harboure of the persecuted deere, and knovveth hovv he may vvith al fo­resight chase the same: Even so have the Phy­sitions alsoe, had those Chyrurgians in greate estimatiō, vvhich first of all, have founde out that parte of mans bodye, in the vvhich the bulletes, or Arrovves, or anye other alienate thinges have binne hidden and lodged, and vvhich have hadde knovvledge & science fit­lye & convenientlye to dravve them therout: consideringe that throughe there continuan­ce in the same, above al thinges they are clea­ne contrarye vnto vs & vnsufferable, as that vvhich is deade, & livinge: so it is a hinderance vnto vs, and especialye to that parte, vvherin the foresayede vveapon, stickethe, and that as vvel of it selfe because that it vvholye, hinde­rethe the curinge of the vvounde, or else be­cause it bringethe to gether manye & heavye accidentes, the vvhich is cause of lamnesse or criplenesse in the vvounded parte: or els cau­seth the health vvhich vve suppose to have gotten not to be perfecte, and sure, but is sub­iecte vnto a farre vvorse returne & renuein­ge of the same. Yet for all that I knovve so­me vvhich are cured,Some mē are cure­de contayninge the bullet in the bo­dye. in the vvhich the bullets as yet tarryae in some partes of ther bodye vvit hout beinge necessarye to have searched for the same to curiouslye, or to pluck it out al­thoughe that vve might easylye have attayned there vnto, & touched it, because of the daun­ger that therof might ensue: as for example, a violent bleedinge throughe laceratione of so­me vayne, or arterye: anye great & violēt pay­ne, throughe the stretchinge or dravvinge for the of some synnue, or Membranes: An espe­ciallye it is not necessarye, curiouslye to search after such thinges, or to dravve them forthe, vvhich cā not rott, or corrupte, as that vvhich easylye, or in time can come to rotte. But yet it is allvvayes better, that all vvhich is strange and alienate vnto mans bodye, and is contay­ned [Page] in the same, be dravvene therout, then to lett it tarrye therin, because that the health (as vve have al readye sayed) is farre surer, concer­ninge the daūger, that is then present, to cause the cured vvounde agayne to burst opē, vvhē as the bullet, or any such like thinge, cōmeth to repraesēt himselfe: or that vve shoulde not be cōstrayned to make an apertione anye vvhere, vvhether the fore sayed bullet throughe his ponderousnes might chaūce to be descen­ded.

Which are the strange things,The Strange thinges of the vvhich in this place vve have spoken, are of tvvo manner of sortes, for they are, ether externall, as Irō, vvoode, bullet, stone, or vvolle: or they are any sub­stance of our bodyes, as anye splinters or par­cells of bones, & the cōgealed bloode, vvhich vve notvvithstandinge esteme it straunge, be­cause they are separated from our bodyes, and are noe more partakers of our lyfe, or vitall spirites, as they vveare before vvhē they as yet vveare all one vvith them, vvherfore they are novve become strange.

The intē ­te of the Aucthor,My intente & purpose is nothinge els, then to describe vnto the yonge Chyrurgiane, the practice, of all bullets, and of al other strange thinges, vvhich might thervvith enter mingle themselves, or thervvith might be crushed to peeces, hovv to dravve thē out of the bodye: Because in th [...]se our dayes heere in Fraunce ther is noe other shott vsed: seinge that the knovvledge of the extractinge of the same, may easylye leade vs vnto the knovvledge, hovve to dravve forth shaftes, & Arrovves out of mans bodye, of the vvhich the aunciente professors have verye copiouslie vvritten.

❧ Howe that a Chyrurgiane aptly & fitlye to dra­we a bullet out of the bodye, ought to consider their difference, & the nature of the par­te, in the which it is shot. Chap. 2.

THe Chyrurgiane beinge re­quested and desired to dravve forth the bullet,Wherin consisteth the daunger of dravvinge forth of bullets. havinge pe­arced & penetrated some par­te of the bodye vvith leaste trouble, & hinderance to the patient fitlye, & finelye to accomplish the sa­me, because that sometimes they are dravvne forth vvith insufferable payne, shall first of all consider & marke, that the daunger consistes, ether in that parte, in the vvhich such bullets are shot, or in the species forms, and differen­ce, of the bullets: it is therfore firste of all ne­cessarye, that he observe, and knovve, the na­ture and qvallityes of those partes, for some partes vvil more gentlye and softlye be hand­led, then others: vvherfore he must consider, on the substance, qvantitye, figure and forme, compositione, vnitinge, originalle, tempera­ture, and one the necessitye & vse of the same parte. To the vvhich end & purpose, he must note vvhat vvoūdes, in the vvhich the bullets have binne shott, are incurable, or difficulte, or easye to be cured, because that vve may ad­monishe, the frendes, and kindrede of the pa­tiente, of those accidentes vvhich might hap­pen vnto the vvoūde, the bullet beinge dravv­ne therout, alsoe of the certayntye or feare, vvhich throughe the daūger, vve are to expec­te, of the healinge of the same.Advise of Celsus. For first of all Celsus sayeth, that a prudente, and vvyse Chy­rurgiane, shall not at anye time take in hāde, such a patient, for vvhome it is impossible to be curede, & escape death, because he admini­ster noe occasione vnto others to suspecte, & thincke, that he hath berefte the patient of ly­fe, vvhich othervvyse throughe the bad fortu­ne of his vvounds is disceased. And seinge that the daūger is greate, but yet notvvithstā ­dinge entermingled vvith some good hope, thē he shal admonishe the frendes of the pa­tiente, that the matter is heavye, and suspecte, because if so be the arte & science, be suppres­sed, and overvvonne of the dissease, that they should not as then thincke, ether that he hath not knovvne therof, or els that he hath sought to abuse the frendes. But that such is the offi­ce, and the dutye, of a vvyse and prudent Chy­rurgiane, also is it the facte of a Runnagate Qvacksalver and deceaver, to make anye thin­ge, seeme to be verye daungerous, vvhich of it selfe is easye, and light, because vve shoulde thincke, more arte to be in him, then indeede theris. It is alsoe seemlye, that the Chyrur­giane cōfessinge, the cure to be easye & light, doe paune his credit, & reputation, because as thē he might the more vvillinge, thincke one that, vvhich might be most commodious and profitable, to the curinge and healinge of the patient, and that the dissease vvhich of it selfe is smalle, throughe the negligence of those, of the vvhich the patient is kepte, be made noe greater.

To this end Paulus Aegeneta counceleth vs,Opinio­ne of Paulus Aegi­neta. that if so be, the bullet continue, or tarrye, in anye of the vvorthyest partes of the bodye, as in the Braynes, Harte, Liver, or throte, in the kidnies, bladder, or Matrice, and the signes, & tokens of death revealinge themselves vve cā not by anye meanes possible convenientlye vvithout greate paynes, & dilaniatione of the vvounded parte dravve forth the foresayed bullet, that as thē vve may not offer to touche it, because that vvithout doinge anye good or furtherance, vve doe not administer vnto the ignorant & common poeple, anye occasion, of evell speakinge or blaminge vs.

But allthoughe the issue of the vvounde, be [Page 6] as yet vncertayne, havinge admonished and fortoulde the daunger,Manye men pre­serve ther lives abo­ve the opiin of the Chyrur­gian. vve may vvith Gods helpe take the cure in hande: because that so­me havinge an Apostematione, in anye of the vvorthyest partes, agaynst the opinione & certayntye of the Chyrurgiane, have as yet be­helde & praeserved ther lyfe: yea vve have al­soe seen & behelde some, in the vvhich a parcell of ther Liver, one parte of the Epiploon, the vvhole VVombe hath frō them binne sepa­rated, or hevved & cutte of, the patient for all this hath binne cured, and praeserved to lyfe. VVe have alsoe at some times in a vehemēte & greate squinantie, perced & made an aper­tione in the throte. But if soe be that vve suf­fer the bullet to continue in the bodye, or in anye parte of the same, vvithout extractinge of the same, vvhen that easylye he may be dravvne forth, it necessarylye follovveth, that the patiēt must dye therofe, it might also bringe the Physicion, or Chyrurgiane into the na­me of beīge cruell, & mercylesse, vvher other vvyse the bullet beīge dravvne forth, it might be that the patient might as yet be curede, vvherfore the Chyrurgiane must alvvayes en­devoure & doe the best he can, vvhen he hath forttoulde, & admonished the frendes of the patient, of the daunger, because some times greate & fearfull vvoūdes beyōde the expecta­tiōs of all mē are cured, vvherfore vve ought not at anye, time to permit or suffer the pa­tiēte vvithout helpe or succoure, vvhere ther is anye smalle hope of beinge cured.We muste not at anye time leave the patient. And all thoughe that all thinges of this our operatio­ne fall not out accordinge vnto oure minde, yet notvvithstandinge, must not vve leave to effecte that vvhich this arte & science reqvi­reth, & that vvhich our cōscience vvitnesseth vnto vs.

Conside­ration of bulletes,Above all that the Chyrurgiane must con­sidere, on the vvounded parte, he must alsoe farther consider one the differēce, & varietye of bulletes, vvhich consisteth, in the matter, forme, qvantitye, number, and facultye of the same. As concerninge & touchinge the mat­ter, althoughe that the foresayed bulletes, most commonlye are of leade yet for all that sometimes the besieged, & they that skermis­he in the feelds are constrayned to vse tinne bullets, Copper, peeces of iron, steel, peasen, yea & alsoe little stones or pebles. As con­cerninge the figure or forme therof they are most commonlye rovvnde, although ther are some shotte vvith three corners, some foure corners, & some of other fashons. Touchin­ge the qvantitye, ther is great difference con­cerninge the greatenes of the peeces, by the vvhich the bullets are shott. As for the nūber, & constitutione of the foresayed bullets, ther are some vvhich shoote, vvith more. thē vvith one bullet, vvith some vvhich are fastened the one, vvith the other, vvith little chayned Bullets, vvith hayle shote, vvhich spreade thē ­selves, in the bodye of a man. Speakinge of the forces or facultyes, of bullets I have not as yet geven anye credite vnto them that sayed the bullets might be poysened, because as yet ther hath binne never a famous Chy­rurgiane vvhich ever had a venomous shotte vvounde in hande in these our tymes vvhich hath made anye mētione therofe, as is playn­lye shevved, in the discourse of the disceased the right vvorshipfull M Ambrosius Paré, chiefe Chyrurgiane to the kinge his maiestye vvhich hath verye learnedlye discussed & as it vveare grovvnded this questione in his booc­kes of Chyrurgerye.

❧ The bullets, & all other straunge things ought in the first dressinge to be drawne forth, soe farre as it is possible to be done: & of the meanes how to effecte the same. Chap. 3.

WHen that the Chyrurgiane shall have cōsidered, one the parte, & also a little observed, one the varietye, & difference of bullets, he shall chuse, a certayne nūber of instrumentes vvhich cōtinuallye he ought to have by him, especiallye those, vvich he supposeth to be most fittest to dravv forth the fore sayed bul­let vvith most facilitye & ease.We must endevou­re to dra­vve forth the bulle­te at the first dres­singe. The vvhich he shall at the first dressinge, vvithout anye lon­ger delaye, vnto the next daye, put in vre and practise: for the bullet beinge dravvne out, shall the patiēt, & Chyrurgiane alsoe be freed from great daunger, the vvhich both of them vvith all right ought to desire and longe for. The bullet may alsoe praesentlye, vvhile the vvounde is freshe & greene, be felt vvith the finger, or most fitlye vvith the privet or sear­chinge irō vvithout tarryinge vntill the next daye, because that the vvounded parte, throu­ghe anye concurringe humors, svvelleth out of hāde, throughe the payne of the vvounde, by the vvhich the entrance of the vvounde cōmeth to svvelle, as alsoe throughe the for­ce of the bullet, anye of the Mēbranes or Tē ­dones, beinge brused the foresayed entrāce of the vvounde, stoppeth: because most cōmon­lye shotten vvoundes doe not enter right, or liniallye into the bodye, but turninge, & alsoe vvith any Membranes, or tendones rovvnde about vvounde, & euen [...]ngled, as alsoe the bullet through his ponderousnes, runninge this vvay or that vvay, chaunceth to fall into some hollovve place, vvhich sometimes frus­trateth, & annihilateth the knovvledge of the Chyrurgiane, so that by anye meanes possi­ble, he can nether touch nor finde him: above all this, the foresayed vvounde, is the seconde day more sensible, & tender, then vvhen shee [Page] is freshe, as the patient allsoe vvhile that the vvounde is fresh & vvarme, is better able to abide the sovvnding or searchinge irō, or pri­vett: & that vvhich is more, the vvounded ha­vinge obtayned noe time to thincke,The vvoū ded fee­leth not his vvoū ­de at the first. & consi­der of his vvoūde, his harte beinge as yet puf­fed vp vvith vayn glorye, is not as yet at the first dressinge, posessed vvith anye timorous­nes or feare, as he is in the seconde or thirde dressinge: vvherfore in his frist dressīge, vvith more courage, & patience, is able to beare the payne, and dravvinge forth of the bullet.

First of all therfore, if so be that by anye meanes vve cā nether finde nor feele the bul­let, to acomplisshe & effecte this vvorke, fit­lye & convenientlye, vvith the leaste trouble & payne of the patient, vve are constrayned to cause the patient to sit or stande, in such a for­me, & posture, or, collocatione as he sate or stoode, vvhē as the bullet vvas shot into his bodye, yea alsoe vvith the same gesture, & be­havioure,One vvhat mā ner vve must set the patiēt vvhich he vsed: for the chaingin­ge of the forme as vvhen vve fight, or vvhen vve are layed alōge, or vvhē vve stāde vpright, or beinge sett dovvne, causeth a greate alte­ratione, in the beinge, and situatione, of these partes of the patiente, because the vaynes, ar­teryes, synnues, bones, & muscles, may one so manye vvayes & fashons be turnede & vvoū ­de, as they have divers vses, & actions vnto the vvhich they at fitt, it be ether in the erectīge, or in the stoupinge, or in the turnīge: vvhich often times is the occasione, that altough vve search, & feele for the bullet, any muscle lye a­nye other vvay turned, then it did, vvhen the foresayed muscle vvas pearcede vvith the bullet, the vvoūde in that place most commōlye beinge stopt, soe that for the most part the se­archinge iron can not enter that place vvher the bullet lyeth: But vvhen vve shall have set the patient on such a manner, as he stoode, or sat, vvhē he vvas shot, thē come all the partes into the same situatione, as they vveare vvhē he vvas shott, vvherfore, as thē the proofe or searchge iron, may passe verye easylye, vvit­hout any let, evē into that place vvheras the bullet lyeth. And soe farre forth as the patiēt, cōsideringe his greate imbicillitye & vveakenes, hath not the strengthe to stāde in that or­dre, vve must as thē at the leaste, ether sittinge or lyinge, turne, & vvinde him on such a mā ­ner, vvhether he sittīge or lyinge, in as much as is possible, as he vvas vvhē he receaved the shott.Why the vvound must be­dilated. Novve beinge in such a situatione, vve are first of all counceled, if soe be the vvoūde be narrovve, as alsoe all aunciēte Chyrurgiās teache 'vve must as thē dilate the vvoūde, be­cause the bullet, or that vvhich is therin, may have a free passage: for ther is nothinge, that causeth more in flammatione, then dilacera­tione, or tearinge of the fleshe, vvhē as vvith violence vve seeke to dravve out anye thinge out of the vvoūde, vvherfore it is better to make the, dilatatione vvith a little rasore then vvith violēce to teare op the vvoūde: further vve must note, that in the dilatīge of the vvoū de, vve chaunce not to hurte anye synnues, vaynes, or arteryes: the vvhich if you percea­ve, you shall eschevve & avoyde thē, or vvith a little & blunte hoocke pluk them one the one syde, & proceede betrvvixt them, as Celsus in his 5 cap. of his seavēth booke teacheth vs.

After that vve sufficiētlye dilate the vvoū ­de vve must them search for the bullet or that vvhich is shot in the vvounde,The secō ­de instructione. & feele first of all vvith your finger, if it be possible, as vvith out doubt it is, the beste searchinge iron & in feelinge vve must cōsider vvhat vvay the bul­let hath taken, & if it be deeper thē the length of your finger, as then vve must vse ther vnto the common searchinge iron, vvhich must be reasonable thick, and at the lovver end verye rovvnde, for if soe be, it be to sharpe pearceth, and goeth betvveene tvvo muscles, vvith out follovvinge that vvay vvhich the bullet vvēt.

VVhen as therfore vve have certaynlye fovvnde out the bullet,The thir­de instruction. the thirde instructio­ne is that vve dravve him forthe to the effec­tinge of the vvhich, ther is nothīge surer, thē to dravve him throughe the same place, by vvhich he entered, & especiallye vvhē he hath not penetrated to deepe, or passed throughe anye greate vayne, arterye, or synnue becau­se the vvay is allreadye made, vvherfore vve neede not make any other inscisione.

Amongst all instrumēts vvhich ever I have vsed, I have contēted my selfe best,In scisio­ne one the con­trarye sy­de. vvith that instrumēte, vvhich vve call, the spoonevvyse, or spoonefashoned bullet dravver, because this instrument, may both be vsed fore a sear­ge iron, & a bullet extractor alsoe, soe that as soone as vve heervvith feele the bullet vve may alsoe at that time, plucke him out: but pearcinge verye deepe, & one the cōtrarye syde is little substāce, & vvithout greate vaynes, & vve vvith our fingers may feele the bullet, it is thē better, & rather coūceled, ther to make an apertione, namelye, on the cōtrary syde, of the entrāce of the bullet, then to dravve the same by the vvay vvhich he entrede, consideringe the greate distāce, and space, throughe vvhich he beinge dravvne backvvardes, must of necessitye passe bye, as alsoe the payne is farre grea­ater, vvhē vvith the bullet, & vvith the instru­mēt, the vvoūde internallye cōmeth to teare, & bruse the Fleshe, thē vvhē by inscisione vve dilate the vvoūde, by vvhich shee is alsoe soo­ner cured, because that vvhich is cutt, more re easier & sooner is healed, then that vvhich through dilaniatione is vvounded: and if it be possible, the foresayed inscisione muste be made right vnder the bullet, but sō ­vvhat greater then the bullet, because thē vve neede not dravve him forth vvith anye violē ­ce, [Page 7] & doe not chaunce to lacerate the vvoūde: This beinge in this sorte finished, vve shall finde the bullet a great deale neerer vnto vs, & more easyer to be dravvne therout, vvithout passinge by to great & tedious a vvaye, in the dravvinge forth, of that vvay by the vvhich he entered,Vtilitye of inscisi­one. yea vvhich is more, the vvounde vvil a greate deale sooner be cured, and vvith lesse daunger, the vvounde havinge tvvo issues, to vvit the one vnder, & the other above, partlye because shee may receave the remedyes the better, as alsoe cōsideringe the matter, vvhich one both sydes hath her issue, vvhich other­vvyse might be retayned, & collect or gather it self together in the bottome of the vvounde.

As soone as the bullet is dravvē forthe, vve must shevve it the patiente, because he may be ioy full & gladde, to be released of that vvhich vvas such a molestatione & trouble vnto him, and vvas cause of so greate payne, and by the vvhich he might have gone so lange a time vvith payne, vvithout beinge therof cured: vve must endevoure by all meanes, ether by dravvinge him forth, throughe his entrāce, or else throughe the cōtrarye syde of the vvoun­de, vvell knovvinge hovve to effecte this dra­vvinge, vvith all fitnes, & conveniēce, because vve shoulde not forsake the vvoūded, nether discourage him, throughe our longe operati­one, or vvorkinge: & effecte that alsoe vvith the least payne possible, because that the pay­ne of the vvounded patient therbye, vvhich is greate might not be encreased,Instructione hovve to vvorke vvyselye. for it is to greate a shame, to bringe a vvounded person vvhich bath enoughe to suffer, into greater sufferāce & payne: vve must alsoe dilligentlye note, that vve doe not bye anye meanes hurte anye particulare parte, and especiallye the gre­ate vaynes, arteryes, or synnues, or anye other vitall partes, one the vvhich vve must have an especiall eye, and care: for it vvoulde be to greate a disgrace, & shame, thinckinge to dra­vve forth the bullet to doe more harme, thē if the bullet hadde stayed therin.

What sō ­times de­ceaveth the Chy­rurgyane.VVe are oftē times deceaved, nether cā vve alsoe finde the bullet, because he is clothed, vvith cotten, vvith vvolle, or vvith anye other parcells of apparrel, vvhich the f [...]re sayed bullet, carryeth into the bodye vvith him: or else because the fleshe, or the Membranes vvhich are brused, or vvith violence of the bullet have binne rēte, cover the foresayed bullet. It is alsoe somtimes evident, that the foresayed bullet, erreth frō his right vvay, & chaunceth to come somvvhether a syde, into some other parte, & yet notvvithstādinge, havinge in the passage met vvith anye bone, is for all that re­moved into some other place, as betvveene a­nye muscles, betvveene any Mēbranes, or be­tvveē anye ligamētes, vvherfore the Chirur­giane not findinge of the same, & searchinge for him accordīge to the rectitude of the vvoude, must turne, & vvinde the instrumēt one all sydes, & feele vvith his hādes one the out syde not onlye the vvoūded parte, but alsoe the circumiacent places, because therbye he might knovve vvhether that the bullet might be sūcke: vvhich he shall discerne, and marke, ether cōsideringe anye payne, spāninge of the skin­ne, hardnes, or throughe anye blevvnes or ce­rulitye, vvhich cōmonlye, is noted & seene a­boute that vvoūded parte, vvher, the bullet is cōvayed, & suncke. VVe must also dilligētlye note, that vvhē as vve thincke to have founde the bullet, vve doe not rashelye make an inscision, before vvea are certifyed of the place of the bullet, and soe dravve him forth of the sa­me: for that Chyrurgiane vveare vvorthye to be laughed to scorne, vvhich cā not accōplis­he his praetended purpose after that he hath soe intolleratlye tormented the patient.

Albove all this, vve must note, and marke,The bul­let somti­mes car­ryeth sō ­thinge vvith him in to the bodye. vvhether the bullet have trayled nothinge vvith him into the vvounde, as paper, vvoole, cottē, linnē, or anye thinge els of the patients clothinge, or apparrell, or alsoe anye parcell of the patiētes armour, or harnas, or anye peeces of vvoode, stones, or iron, vvhich the bullet mightby anye meanes have carryed vvith him into the vvound: as such a thinge might vvel chaūce, vvhē the bullet anye vvhere agaynst a vval, or agaynst ons harnas, on the vvhich the fore sayed bullet chaunceth to rebounde, breakinge, & receavinge some smalle parcell of that on the vvhich he plettered, carryeth it vvith him into the bodye: If soe be ther be a­nye such like thinge, carryed, into the vvoūde vvith the bullet, vve ought to have noe lesse care of that, yea rather more, thē one the dra­vvinge forth of the bullet, for such thinges are vvholye cōtrarye vnto nature, because they corrupte and rott in the vvounde, out of the vvhich needes, must follovv some great Inflā ­matiōs, or Apostematiōs, & so conseqvētlye, the vvounde in a lōge time cā not be cured, vvhich othervvyse might easylye be cured, & much sooner, althoughe that the bullet as yet tarryed therine, & especiallye if that the bullet be of leade, because that leade, vnitethe & maketh it self all one vvith our nature.Meanes hovv to knovv vvhether the bullet have takē any thin­ge vvith him. And per­fectlye to knovve, vvhether the bullet have carryed anye such thīges vvith him, vve must cōsider, one the harnas, if that be any vvheare torne, or brokē, & if it be a mayled doublete, hovv manye mayles ther are vvantinge, the vvhich one that maketh mayle doublets easy­lye cā tell you: vve must alsoe note, the patiē ­tes apparrell, his shirte, vvhether ther be any greate or small peeces therof torne & rēte: or vvhether ther be one, ōlye hole fovvnde ther.

❧How we ought to drawe forth those bullets which sticke fast in the bones, or in the iunctures or ioyne­tes of the same: alsoe what we ought to note whe­nas [Page] the foresayed bones are crushed, & beaten to peeces. Chap. 4.

Those bullets vvhich sticke fast in any bones, are verye dif­ficult to be dravv­ne out. THe greatest davnger that con­sisteth in dravvinge forth of a bullet is, vvhen the fore sayed bullet sticketh faste, in anyé bone, or in anye ioyncte be­tvveene the bones. If soe be the bullet, sticke faste in anye bone, it is most convenient that as thē vve dravve him forth, vvith that instrument vvhich vve call Extrac­tor, or Grovvnde dravver vvherof vve must sett the poynt one the bullet, & vvīde it verye fast in the same, & vvhē it is therin faste, vve must softlye & easylye trye, if he vvill not fol­lovve, turnige the handes, this vvay and that vvay, the better to make him loose, and stirre. But if soe be that vve can not soe soone gett out the bullet vve must then suffer him, to cōtinue therin some certayne dayes, vvith in the vvhich time, the externall fleshe vvill be­ginne to rotte, throughe the vvhich the vvoū de vvilbe somvvhat dilated, & vvyder, and the bone vvill somvvhat disclose & open, duringe the time, vve must everye day stirre the bul­let, & vvith the instrumēt lift him vp because that thus doinge, the foresayed bullet might by little & little be removed & Loosed: and if that vve perceave that the bullet sticketh to faste, & can not by anye of the fofsayed mea­nes bedravvne out: then is this the last reme­dye, that vve quite, & cleane pearce and boare throughe the bone, vvith the Extractor or elsi vvith the poynt orpiramide of a Trepane, pe­arce & boare, agaynst, & rovvnde aboute the bullet in divers places,Elevatorium or vpheaver. because ther may be made some place for an Elevatorium, on that sorte to lift vp the bullet & drevve him ther­out, if that vvith all gentlenes it may by anye meanes possible be brought to passe for vve are in noe vvyse counceled, vvith violence or vehemence to effect it. And if it be a little and small bullet, & that he stick in anye place fast, as in the middle of the greatest focile of the shinne bone, or in the middle of anye ribbe, or in the sternon, or in anye bones of the hea­de, vve are as then counceled, to trepane that bone, settinge the Trepane on the bullet, soe that the fore sayed bullet, be rovvnde about compassed vvithinthe circkle of the Trepane, and that then the trepane might abolishe and take avvay all that, vvhich retayned and helde fast the bullet.

On vvhat sorte vve muste dravve forth a bullet out of a ioyncte.But vvhen the bullet is any vvhere, in anye ioyncte pearced & penetratede betvvene tvvo bones, as for example, in the knees, vve must then as easyely as it is possible, endevoure vvith the instrument to stirre the bullet he­ther, & thether, hut allvvayes strayght fore­vvarde, novve tovvarde the hippe, and then tovvarde the legge because that therbye vve might the better, vnshutt & make loose, vvith the leaste payne that may be, the ligamētes, & tēdones, vvhich cōtayne & houlde the ioyncte soe close together: by the vvhich apertione, and dravvinge forth the space, & distance betvveene the bones, vvilbe a little dilated, soe that at lengthe, vvith lesse payne & trouble, & vvith the little spoonevvyse bullet dravver, vve shalbe able to dravve forth the bullets. But if vve feared, least vve shoulde put the pa­tiēt to some intollerable payne, throughe the distendinge of the ligamentes, & tēdones, my councell is as thē, that the yonge Chyrurgia­ne, endevoure, to follovve and vse the same, vvhich I did or have vsed on my lorde of Flo­yon: vvhich in the skirmishe of Maestricht,A notable Historye. got a shott in his knee, the bullet lyinge faste, & occulte in the iovncte betvveē the bones, the vvhich nether I, nor anye chyrurgianes, of Dō Ihon of the Eeaste, coulde finde, at the last it seemed good vnto me, agaynste the opiniōs of all the reste, vve shoulde shutt & foulde to­gether the knees of the patient: vvhich he doinge vvith some payne, the bullet, through the fouldīge of the Knees, & the bones vvhich placed & pressed thēselves together, vvas dri­vē therout, & revealed it selfe externallye, vn­der the skinne, and one the sydes of the fore­sayed ioyncte, vvher I havinge made a little inscisione, my selfe have takē the same forth of that place.

In like sorte, if soe be the bullet,We must dilate the vvounde if the bo­ne be di­lacerated have re­bovvnded agaynst anye bone, and the bone throughe the violēce therof be broke, & crus­hed to divers peeces, & the bullet as yet remayninge therin, or else havinge pearced quite throughe, it is as then the surest vvay to dilate the vvounde, as farre forth as the vvounded parte is able to suffer, it, & that ether in the entrance, or issue of the vvounde, at the least if it have an issue: the vvhich beinge finished, vve strayghtvvayes vvith the finger, or vvith anye other instrumēte, must search for the splīter, and finelye dravve forth, those parcels vvhich vvholye are separated frō the bone, & alsoe in like sorte, the bullet, if soe be as yet he sticketh therine: & if that ther vveare anye greate pee­ces, or parcells of the bone, vvhich as yet are not vvholye separated frō the bone, but are yet fastened vvithe the Periostium, or the liga­mentes, vve must not vvith anye violēce dra­vve thē forthe, because throughe such violēce vve might vrge great payne & convulsione of synnues, vvherfore it is farre beter to place & situate them by the bone, on the vvhich as yet they are halfe fastened: For nature, expellethe them most cōmonlye vvithe the matter forth of the vvounde, vvithout anye payne, they se­parate alsoe frō the bone, throughe the increa­singhe of the nevve fleshe, the vvhich re­pelleth the same from him, or els in time they [Page 8] conioyne themselves together, and are soe a­gayne cured, as I have of tē times knovvne the same to chaunce, and as yet in freshe memo­rye, Monsr. de la Tour, ordinated and chosen gentleman of the kinges chamber of presen­ce, vvhich in the Baricades, or Trēches of Par­ris, got a shot in his left legge, the entrance vvherof vvas in the oppermoste part of his shinne bone, breakinge the least focile, in di­vers peeces, of the vvhich also one peece of the same focile came forthe, through the apertione, vvhich the foresayed peece, throughe the violence, & blovve of the bullet, had ma­de himselfe, vvhich cleanlye pearced througe the Muscles called Gemini & Solores, vvherfore m'Habricot, Barber Chyrurgiā at Parris, made an inscisione in the foresayede muscles part­lye to extracte & dravve forth those splinters forth of the same, & partlye, to restore agayne those brokē peeces of bones, into the vvoun­de, vvhich as yet vveare not separated frō the Periostium: and is in the space of tvvo moneths agayne cured, the foresayed peeces of bones beinge therin verye sovvndelye healed, and I alsoe have treated him vntill such time as he vvas vvholye & fullye cured.

The bul­let somti­mes pearceth throughe the griss­les.Sōtimes the bullet pearceth cleane throu­ghe, som cartilage or grisselye parte, or throu­ghe some Tendones, vvhich beinge softer thē the bone, doth not breake, but onlye splitteth asunder or bendeth it selfe, & as soone as the bullet is passed bye, erecteth it selfe agayne, & occludeth, the passage, vvher vnder the bullet hide the himselfe, the vvhich, al thoughe vve endevoure to search for vvith our fingers or searchinge iron, it for al that is impossible vve shoulde finde him, vvhich cōmonlye chaun­ceth in the vvoūdes of the breste, vvhē as the brest bone is pearced. As I remember such to have chaunced, in my lorde of Malicorne beinge vvounded, & hurte before Maillezes in Poittou.

❧ How that the Chyrurgiane ought not be to curi­ous in searchinge out the bullet. Cap. 5.

Good doctrine for a Chyrurgiane. ALlthoughe, the bullet be of anye strange, & alienate, sub­stance, yea alsoe as intollera­ble for nature, as is the livin­ge vvith the deade, the princi­palle intentione, to cure all vvoundes is, that vve must first separate that, from the vvounde vvhich oppugneth nature, yet notvvithstandinge ought not the Chy­rurgiane be too curious, in seekinge all con­trarye thinges in the vvound or to too boulde & audacious, in dravvinge thē out, except he lightlye or easylye, can finde them, & vvithe small payne & greefe to the patient cā dravve them out. Because that often times, in the firste, vve can finde nothinge, but the vvoūde beinge come to good suppuratione, and mat­ter, the brused fleshe rovvnde aboute the bul­let corruptinge & rottinge, at the last maketh him an apertione, throughe the vvhich natu­re in the end, expellethe the bullet vvithout anye pane, as is the nature & qvallytye of the vitall & livinge partes, to expell frō them the mortifyed and deade partes: the vvhich vve ought to vnderstande of all other contrarye thinges, vvhich are retayned in a vvounde: as sometimes beinge the surest & best vvay, that vve recommende such thinges vnto Nature,The Chy­rurgiane is the ser­vant of nature. & follovve her instructions, then that vve in vayne tormente, and moleste the same, seinge that it is shee onlye, vvhich curethe the disse­ased, vvhē as she throughe the Chyrurgiane, as throughe her servāt is opitulated & helped: For I have knovvn manye, and divers, vvhich beinge shott, the bullet hath cōtinued in the bodye, are yet for all that perfectlye cured, and that in short time alsoe, vvithout at anye time therafter to perceave anye impediment ther­of: vvhich especiallye chaunceth the bullet beinge of leade, the vvhich in time by little & little commeth to vnite it selfe and vvith our nature agreeth: vvherfore for a renoumned example I vvill alleadge, the vvounde of Mō ­sieur of Chardon, the first gentleman, of my lorde the Cardinalle of Bourbō, vvho beinge the Chapelayne, of my lorde of Angviē, hath gotten a shot in the skirmishe of St. Laurent, in the middest of his legge, of the vvhich shot the bullet, remayned fast stickinge therin, the vvounde beinge vvholye, & compleatlye cu­red, vvithout perceaving in 28 yeare anye hī ­derance or molestatione of the same, vvher­fore he reqvested mr Pare, & me,Example. that vve shoulde remove & take a vvay the fore sayed bullet from his legge, fearinge least that the same, in time, might be anye hinderance or molesta­tione vnto him, the vvhich vve alsoe effected, findinge the bullet vnited and coalited toge­ther, as vvel vvith the bone, as vvith anye Mē ­branes, and soe fast grovvne, and ioyned toge­ther, as if the bone, the membrane, & the bul­let, had all of them binne but one substance. It happeneth alsoe somtimes that the bullet through his ponderousenes, & heavyenes by degrees, dessendethand sincketh dovvnvvar­des, tovvardes the exterior skinne,The bul­let throu­ghe his ponde­rousnes sincketh dovvn­vvardes. that parte notvvithstādinge beinge cured, throughe the vyhich he descēdeth or sincketh, vvithout the perceavīge of the patiēt, vvher, vvithout anye greate trouble or molestatione of the patiēt, he may be cut out, vvhich one this manner is farre surer, thē if in the firste vve hadd tormē ­ted him heervvith, & brought him into daun­ger [Page] of his lyfe, consideringe the great dilania­tione or tearinge of vaynes, arteryes, and syn­nues, vvhich the hardnecked and obstinate Chyrstrgiane, in searchinge and in dravvinge forthe of the bullet, might be the cause of: vvherfore I, in all sortes doe councel, that vvhē the bullet, can not by anye meanes pos­sible fitlye or convenientlye, vvithout anye great torment of the patiēt be dravvne forth, vve as then quietlye suffer him to tarrye ther­in: In thus doinge vve shal follovve the prac­tise of the aunciente professors, yea alsoe of Hippocrates, An example of Hippocrates. vvhich reciteth to have cured a certayne personage, vvhich had receaved a shot vvith an arrovve, in his flanckes, vvher of the heade, or iron, tarryed therin, and yet agaynst the opinione of all men, is therof cured & helped: vvhich foresayed arrovve heade or peece of iron, sixe yeares therafter he tooke from him. Paulus Aegineta alleageth,Paulus Aegineta. that he hath of ten times seene, that the arrovves have bin­ne lost in mens bodyes, & that the same, in a longe time therafter, the vvounde beinge cu­red, are throughe apostematione of that parte come agayne to light & revealed themselves. Albucasis sayeth, that he alsoe hath seene one,An example of Albucasis vvhich vvas shott vvith an arrovve into his shoulder, of the vvhich shott, the foresayed arrovve, therin stucke fast, & yet for all that is cured, but that the arrovve, seaven yeare ther­after at the length throughe the bone Coccix is come forthe and taken out. VVherfore vve must not be to curious, in dravvīge forth the bullet, vvith great daunger, & torment to the patient, & to our vtter shame & disgrace.

THE SECONDE TREATISE OF THE OPE­ratione of Chyrurgerye, wherin is discoursed, of the meanes, hovve to Trepane the Cranium, of the Heade, Contayninge sixe Chapiters.

  • Of the signes & tokens by the vvhich vve may knovve vvhen ther is a Fracture in the Heade. Chap. 1.
  • Of the counterfracture, of the sculle. Chap, 2.
  • VVhich Fractures vve ought to trepane. Chap. 3.
  • Hovv longe, vve ought to tarrye, before vvee proceede vvith the trepane. Chap. 4.
  • Hovv greate a quantitye of bone, vve ought to take therout. Chap. 5.
  • The manner, and methode of trepaninge. Chap. 6.

❧Of the tokens, throughe the which, we shal kno­we the fractures, of the sculle. Cap. 1.

Chyrur­gerye must not rashelye be effec­ted. THe operations of Chyrurge­rye, vvhich vvith greate pru­dence, & consideratione, vvil­be effected, vve must not all to rashlye or overbouldlye be­ginne them seinge, therfore that it is daungerous, to open the Cranium of the heade, before vve may attayne vnto the operatione, vve must dilligentlye and truelye consider, vvhether it be verye necessarye, or not, vvhich is revealed vnto vs, by those sig­nes and tokens vvhich the auncient Chyrur­gianes have beqveathed vnto vs: For the sig­ne or token, is the demonstratione vnto vs, vvhich discovereth, that vvhich before laye occulte, & hidden: The vvhich fore sayed to­kens, of the vvounded parte, muste be taken, and observed, ether of the accidents vvhich chaunce vnto the vvounde, after the blovve, or fall, or allsoe of the instrumēt, vvhervvith the vvounde vvas made.

VVe must therfore first of all note,Discrip­tione of the signes vvhich parte of the heade, hath receaved the strok & namelye, vvhether the Cranium, one this place be thin, or tender, thicke or stronge, because the bones of the heade, are not in all places of aequalle crassitude, or of aequall tenuitye: [...] ther vve must marke, vvhether the vveapōs, vvhervvith the blovve vvas given, have all­soe cut of the hayre, & that it shevveth it selfe right in the vvounde for if it be soe, it is to be­feared, that the bone is bared or vncovered, out of the vvhich vve may easylye iudge, the Cranium to be hurte, because that it is all most impossible, the hayre to be cut throughe, the [Page 9] vvhich for the most parte slippeth asyde, vvith out hurtinge of the Cranium or breakinge ther of. Havinge thus considered and noted all this vve must interrogate the patient, vvhether he have parbraked & vomited anye Cholera, vvhether he loste not his sight, and his eyes darcke­ned, vvhether he lost not his speeche, or hath voyded anye bloode through his nose, throu­ghe his eares, or throughe his mouthe, vvhe­ther after the blovve he fell not dovvne to the earth, and ther lay still, vvithout anye reason, as if he hadd bīne one sleepe: For it is impossi­ble that all these fore sayed signes chaunce vn­lesse the scull vvere dilaniate, or brokē. In like sorte if the patient, lye vvithout his memorye or reason, if he rage, if he be vexed vvith Parali­sis, Divers accidētes of the vvoundes of the heade. or vvith Spasmo, or vvith them both toge­ther, it is then credulous, that the Membrana called Dura Mater, is hurte, and suffereth grea­te payne. And althoughe that none of these accidentes have happened vnto the patient, yet notvvithstandinge all vvayes theris som­thinge doubtfull, vvhether the Cranium be hurte & broken, or not: and to be therof cer­tifyed vve are to note, vvith vvhat instrument the vvound vvas made, as ether vvith a stone, vvith a sticke, vvith an iron, or vvith anye o­ther vveapons: also vvhether it vvear greate, or reasonable greate, light or heavye, smooth or rugged, vvhether the blovve vvas smitten violentlye, or easylye, vvith greath ire, & fu­rye, vpvvardes or dovvnevvardes: of all the vvhich vve may be certifyed of by the patiēte, vvhen as vve aske him on vvhat manner he vvas stroken, or from vvhence he is fallen, & vvherone, to vvit on the earthe, or on the pa­vement, vvhether he have great payne, and in vvhat place, for hovv easyer the blovve hath bin stroken the lesse feare ther is of a broken scull: yet notvvithstandinge, there is nothinge surer,Celsus. as Celsus sayeth, thē that vve search the vvounde, & give iudgement throughe a more surer signe, vvherfore, if soe be, the vvounde be greate enoughe, vve must as then search it vvith the finger, scrapīge the bone vvith your nayle, one that manner to perceave the rēte, and dilaceratione, and if soe be vve can not ef­fect that vvith the finger, vve must as thē trye it vvith the searchinge iron, vvhich must not be to grosse and thicke, nether to sharpe and thinne, because, if that per adventure vve per­ceaved anye naturall hollovvnes of the scul­le,What for­me the searchin­ge iron must be of. vve should not thincke & esteeme it to be a dilaceratione, or fracture: nether must the privet or searchinge iron be to thicke, or gros­se, because it should not praetermit & overru­ne a little or smalle dilaceratione, vvithout perceavinge it, and stayinge ther at. VVhen as therfore vve leade and perfricate the privet or searchinge iron over the sculle, & perceave noe vnsmothnes, then all even, and smothe, then vve saye & esteeme the sculle to be vvith out daunger, & not dilacerated or torne. But if so be vve perceave anye thinge, vvhich is rugged and vneven, and that the searchinge iron stādeth therat faste, if soe be, it be not on the sutures or commissures, and ioyninge of the sculle, or anye naturall cōcavitye hollovvnes of the Cranium, it is then a signe, that the heade is broken, or lacerated, and rent vvher­fore the Chyrurgiane must dilligentlye mar­ke, that he doe not in steede of the fracture, ta­ke the suture, because that those cōmissures,The Chyrurgiane may easy­lye be de­ceaved. often times doe deceave the sight of the Chy­rurgiane in his iudgemente, and that as tou­chinge the similitude, vvhich the commissu­res, are participatīge vvith the fractures: And vve are to note, that in some persons, the fu­tures have no naturall situatione, or place,A suture, or com­missure, is the ioy­ninge to­gether of the bones of the he­ad. but to the contrarye vve must also note, vvhe­ther that ther be any dilaceratione one the fracture, or not: for it might chaunce, that the naturall similitude of a suture, might vvel be a rent or dilaceratione, vvhich is not soe easy­lye to be perceaved, & knovvne, because that a suture consideringe her nature is vnsmothe and rugged, even as a dilaceratione is vvonte to be. VVherfore Hippocrates, Hippocrates hath binne deceaved. acknovvledgeth to have binne deceaved, in the person of An­tonomus, of Omilos, vvhoe beinge throvvne vvith a stone in the middest of his foreheade, and a boute the sutures, died vvithin the space of fifteene dayes therafter, because that he vvas not trepayned, and because alsoe the fo­resayed Hippocrates, thought and iudged the skull not to be dilaniated or torne. VVherfo­re, it is the surest, and certaynest vvay, & prin­cipallye, vvhen by, or in the vvounde ther are these foresayed accidentes, vvith agues, that as then vve denudate, and vncover the sculle, be­cause the sutures sometimes have no certay­ne place, for sometimes vve espye thē, in the middest of anye bone, vvhich a man vvoulde thincke to be a fracture or dilaceratione: it might alsoe chaūce that the foresayed sutures, or the next partes, vnto the same,The futu­res of the heade are variable. might be dilacerated and torne, the vvhich vve can not certaynlye espye, vvithout makinge denuda­tione of the Cranium, and to our sight vncover it: vvhen as therfore vve doubt, vvhether ther be a fracture or fissure, and can not certaynlye espye it, because of the smallenes of the vvoū ­de, as then ther is lesse daunger, and the cure therof happeneth so much the sooner, & the surer, vvhen as therin vve make a resonable vvyde apertione, rather then beinge therof vncertayne, vve as yet proceede vvith such a small apertione, in curinge of the same vvoū ­de, because that it is vvholye impossible, othervvyse to knovve anye certayntye, of that [Page] vvhich thervnder lyeth hidden, as vve easylye see in the greate apertions, vvhich therafter, may verye easilye be cured. It sometimes alsoe chaunceth, that the Cranium beinge sufficiētlye denudated rovvnde about the fissure, yet for all that vvith the tacture, or vvith the searchin­ge iron, or vvith the eyes, vve can not by anye meanes possible espye the fissure or rente, be­cause it is as subtile and fine,Hovv vve shall e­spye the hayrye fissure. as a hayre, vvher­fore it is allsoe called the hayrye fissure, or rēt: to the vvhich purpose vve must above on the sculle or bone, vvype a little incke, or anye o­ther blacke medicamente, because that the ni­greditye or blacknes, may imprint in the fissu­re some signe of his blackenes, if soe be that ther be anye, vvhich bare bone, vve muste ther after scrape vvith an exfoliative trepane: For that vvhich is burst or rent, notvvithstandinge retayneth his blackenes, by the vvhich mea­nes, vve shallbe certifyed of the largenes ther of and profunditye of the same.

❧ Of the counter fissure, in the bones of the heade. Chap. 2.

THe auncient Doctours, and all soe certayne professors of our time, make mentione, that vve somtimes finde a counter tea­re or fissure in the sculle, as if vve had receaved a blovve in the occipitialle parte of the heade and had the teare or fissure in the antereore parte of the sa­me and ther revealed it selfe, or in anye other parte of the heade also, vvheras the blovve did not alight.Signes of a counter fissure. The coniecture vvhich vve ought to have of a counter fissure, is, that vve surelye knovve vvhether the patient vveare roughlye stroken, and vvhether after the blovve, anye bad accidētes have follovved, as if through the blovve he fell to the grovvnde, hath ther lien impotente, hath vomited Cholera, is full of a­gues, although it soe be that vve can finde noe fissure in the Cranium in the place of the vvoun­de, and ther vvher the scull is denudated. VVe must alsoe farther note, and observe, vvether the patient often times lay his hande, on anye other place of his heade, then vvher the vvounde is, complayninge of anye payne or heavines of his heade: vve must one that place vvhich vve suspecte applye some Cephalicke plaster, vvhich vvhen vve remove, the same, vve must then note, vvhether anye one certayne place of the applicatiane, be moyster then in ano­ther place, or els any vvher vnder the payster, the skinne be softened and a little more svvol­lene, then the other, vvhich findinge it to be soe, it is thē a signe, that in the sculle ther must needes be a fissure, & that it is necessarye, there and in that place to denudate the Cranium: for somtimes vve finde the bone ther to be brokē: The aunciente Chirurgians have beyonde all this vvritten,Opinio­ne of the aunciēte professors touchin­ge inscisi­one. that although vve have inscided the skinne, vvithout anye reason or occasio­ne, it easylye and lightlye vvilbe agayne cured­and if soe be that the sculle be dilaniated & tor­ne, and vve havinge forgot to detecte & denu­date the same ther immediatlye follovveth a great imflammatione, vvhich verye difficuttlye can be cured. But I as yet coulde never attayne to the knovvledge of such a fracture, nether can I perfectlye adhibite any credite thervnto that ther can by anye meanes chaunce to be such fissures shutt vp, and closed or ioyned on vvith the other and soe grovvne together, or beinge missinge of the broken bone vnto that, vvhich findeth it selfe in the fracture of the other syde, right over agaynst it. I have seene, that vvith the shott of a gunne, that the first table vvas vnhurte, and yet not vvithstandinge the seconde vvas crushed and broken, & vvhen I perceaved that the patient, had gotten manye bad accidentes, namelye, that throughe the blovve he fell to the grovvnde, had vomited, forth at his nose voy­ded bloode, vvas vvholye abashed feelinge pay­ne about the vvounde, havinge alsoe an ague: and fearinge least the patient might have dyed, I trepaned him, vvheras vvhen I had pearced the firste table I founde, that the seconde vvas burst, yea and that reasonable vvyde: vvherfore ther­after I vvas vrged to beleeve that the counter teare or fissure, in the other syde of the sculle, vvhich by the aunciente professors vvas discri­bed, must be vnderstoode in the same bone, for the first table, is right agaynst the seconde situa­ted. It might alsoe chaunce that nether the first table nor the seconde shoulde be hurte, or bro­ken, yet notvvithstanding the Diploe, that is the porositye vvhich is betvveene them bothe,An obser­vatione of the au­ctor. vvas soe plettered & crushed, that the little vaynes, vvhervvith it vvas, replenished, vveare broke & burst and avoyded bloode from them vvhich in time corrupteth and rotteth and alsoe corrup­teth the bone internallye, the vvhich in some ti­me thereafter vve perceave, for the bone vvax­eth leadishe coloured, on the vvhich the Chi­rurgiane must vvell note.

It may allsoe chaunce, that the sculle, be safe and sounde, yet throughe the violence of the blovve, anye vaynes vvhich contayne that membrane vvhich is called Dura mater, Vaynes vvhich burst vvithin the braynes. as vvell of tho­se vvhich passe throughe the sutures as througe anye of the other smalle holes internallye are situated vvith in the braynes, might come to breake, out of the vvhich ther vvill issue bloode, vvhich therafter cōgealeth and vvith great pay­ne changeth in to matter, vvith manye other fe­arfull accidents. In this dissease theris all vvayes payne about that vayne vvhich is burst, and if [Page 10] soe be vve chaunce to open in this place the skinne, the bone there vnder hath a pale and deade Coloure: but it is a difficult matter to iudge, and knovve it, vvherfore consideringe often times of the impossibilitye, to doe anye remedye or cure therine & by vvant of knovvledge, death suddaynlye ensueth theron. The vvhich Hippocrates reciteth of the daughter of Nerius,A historye must of the daug­hter of Nerius, described through Hippocrates. vvhich vvas but 20. yeares oulde vvho in playinge beinge smitten on the bone Breg­ma, vvith an outstreched arme, of one of her playfellovves, strayghtvvayes vvithout anye respiringe is, fallen into a Vertiginem vvho as soone as she vvas brought into the house is fallen into a violent ague, vvith payne in the heade, and rednes of face: & one the seaventh day she voyded a goblet fulle of reddishe mat­ter filthylye stinckinge out of her right eare, by the vvhich she seemed to be somevvhat lighted and easyed but vvhen the ague agay­ne returned vnto her, she vvas then vvholye abashed, and allmost lay vvithout anye rea­son or vnderstandinge, vvith Spasmo, in her right cheeke, or syde of the face, vvithout be­inge able to speake vvherone the foresayed Spasmus hath possessed the vvhole bodye, vvith shakinge, & qviveringe, vvith the tonge tiede, and vvith irremoveable eyes, and dyed on the ninthe daye.

❧ What Fractures of the heade we ought to trepane and wherfore we must tre­pane them. Chap. 3.

We ought not at all times to trepane. ALthoughe that in all fractures and fissures of the sculle, the yōghe Chyrurgians take ther light or refuge strayght vnto trepaninge: it is notvvithstā ­dinge better, that in the firste vve trye, vvith playsters, and vvith manye o­ther remedyes, and inventions therto consti­tuted, and ordayned: consideringe one the consequence and importāce, of the foresayed Fracture, vvhether, it be needfull or necessa­rye, to take avvay anye parcell or peece of bo­ne, consideringe the excellentie, and vvorthi­nes of the braynes, vvhich are such vvorthye partes: vvherfore vve must vviselye and dilli­gentlye consider and marke, vvhether the vvounde give a goode digestione forth of her, and purifieth her selfe, and vvhether there be­ginne in the vvounde to grovve, anye redde pomgronate Kernell vvise fleshe, or vvhether the ague vvhich consideringe the suppuratione in the vvounde, be abated or asvvaged, or hath left him vvhich soe in tollerablye vexed and tormented him, vvhether his apetite be agayne restorede, and vvhether the patient reasonablye taketh rest or sleepe, vvithout havinge anye troublesome accidente chaun­ce vnto him, vvherbye vve might suspecte, that the membrane called Dura mater, or the braynes, are molested, affected, or suffer any payne, ether throughe a splinter, or throughe anye bloode, or throughe anye matter, vvhich might be come and situated it selfe therone: And the matter luckylye & ominouslye pro­cedinge,The fissu­res recol­lecte then selves sō ­times. vve may continue the fore sayed re­medyes, and the vse therofe, because that so­metimes by this meanes the fissures, are replenished & filled vp vvith some obdurate sub­stance and callositye, vvhich agreeth and may be likened vnto the callositye or cicatrice of other bones.

Sometimes onlye the first table of the scul­le breaketh and renteth vvithout pearcinge or penetratīge the Diploe:Diploe is the porositye be­tvveene the botables. Some times allsoe is the fore sayed diploe crushed plettered, and broken & yet the seconde tablē safe and illaese or vnburte, vvherfore as then it is not neces­sarye to detecte and make bare or to trepane the membrane Dura Mater, yea and as then vve may perceave the manner as it vveare of a splinter, of the sculle therin lyinge erected. The fracture at sometimes alsoe is soe greate, vvith such a huge quantitye of massacred, and crushed bones, vvhich lye halfe, and halfe se­parated, or els for the most parte cleane bea­ten theroute, that vve may playnlye vvith our eyes behoulde the membrane Dura mater, soe that the bloode vvhich driveth therone, may verye easylye flovve out of the vvounde, in like forte allsoe may the remedies therin easyly be applyed: To the vvhich fractures, the trepane is nothīge behoovinge or nedefull: And if so be in anye sorte you perceave anye skil­fers or splinters, by the vvhich that membra­ne might be pricked, or crushed, you must ta­ke them verye easylye therout.

It happeneth alsoe some times, not onlye in the little children but in aged poeple,The bo­nes of the yonge Childre­ne are bēt invvard­lye. alsoe in vvho me the bones are soe thinne and ten­der, that vvith anye rude blovve they are in­vvardlye bente, (as vve see a tinne or a copper potte to be brused) vvithout the externall skinne beinge anye vvhere externally hurte: To the vvhich disease of the bones, vve must onlye take our refuge & flight vnto our ex­tractive, & dravvinge plasters, vvherbye that the depressede bone, might by anye meanes be elevated, and heaved agayne into his right place.

Hippocrates, comprehendethe in verye Shorte vvordes in his blooke De Locis in home­ne, The opi­nione of Hippocrates tou- the vvhole cure of the fractures of the scul­le demonstratinge those vnto vs vvhich vve [Page] ought to trepane,The opi­nione of Hippocra­tes tou­chinge the cu­ringe of fractures. or not. As farre forthe therfore (sayeth he) as if the bone be broken, or massacred, ther is as thē noe perrille, or daun­ger at all, & vvith moysteninge medicamen­tes must it be cured and helped, vvhich quiet, and take a vvay the inflammatione, & soften and mollyfye the bone, because that vvithout payne vve might take the brokē peeces of bo­ne therout: but insomuch as the bone onlye chaūcede to be burst, it is then verye daunge­rous, & must of necessitye be trepaned, becau­se that the matter vvhich distilleth throughe the rente, or fissure one the membrane, doe not in anye sorte corrupte and rott, the foresayed subiacent, or subiectede membrane: for as vvithout havīnge anye issue agayne, shee come to sincke throughe this angustnes, and narrovvnes, as then she causeth an ague, and somtimes allsoe distemperatenes of minde: vvherfore vve must needes trepane, and make a large apertione because that the sanious matter may not onlye have an entrance, but an issue alsoe: & vvhen as vve doe not in anye sorte suspecte that the membrane Dura mater, sufferethe any thinghe, or is in any sorte crus­hed, or pricked vvith anye peeces of the brokē bones, & that ther is noe matter runne ther­one, by the vvhich she might be troubled, it is not thē necessarye that vve trepane, or open the sculle.For vvhat occasione vve ought to trepa­ne. The Chyrurgiane is constrayned to vse the trepane for divers occasions, and take therout the broken bones: First of all to give an issue and passage to the congealed or not congealed bloode, vvhich was suncke on the membrane Dura mater, throughe the effluxio­ne of those vaynes, vvhich are as vvell situated in the fleshe of the heade as betvvixt both the tables, & vnder the sculle, vvhich as there doe restrayne that membrane fast vnto the sculle. Secundaryly, because the matter, vvhich con­tinuallye soacketh throughe the fissure on the membrane doe not chaunce to spoyle, or in­flame the same, because that throughe such an anguste passage she can have noe issue, the vvhich in the end might be the cause of the patient his death. Thirdlye, to dravve forthe the brokē bones & splinters, through the vvhich the foresayed membrane might in anye sorte be pricked or lye crushed:

Fourthlye, accordinge as the vvorke reqvi­reth, to applye convenient and necessarye re­medyes into the vvounde: Fifthlye, because it might serve in steede of a repercussive, & de­fensive ligature of inflammations, vvhich o­thervvyse may be vsed in all other brokē par­tes and ioynctes,The hea­de may not to strictlye be bovvnde, & the reason vvhy. exceptinge onlye the heade, because that this, consideringe the rotunditye & rovvndnes ther of can not by anye meanes possible therone be effected: for a ligature, vvhich must be stifflye & fast vvoūde, rovvn­de aboute the fracture, to praeserve and keepe the broken bones one by the other, might in the heade be the cause of paye, and inflamma­tione, it vvoulde alsoe hinder the agilitye of the arteryes, and the ascendinghe of the fuli­ginous excrementes, vvhich throughe the fu­tures of the sculle, doe evaporate: it vvoulde alsoe repelle the externall bloode of the vvoū de, & sende it tovvarde the braynes, & mem­branes therof, out of the vvhich might ensue verye bad accidentes.

How longe we ought to tarrye, before we beginne to trepane, and of the places which in trepanin­ge we must chuse, or eschewe. Chap. 4.

HIppocrates chargeth the Chyrurgiane,Opinione of Hippo­crates. in his booke concerninge the vvoundes of the heade, vvhen as in the first he hath binne therūto fetched or sent-for, havinge together noted, the fracture of the bone, vvith the molestinge and troublesome accidentes therof, that vvithout anye longer delaye, he shall vvithin the space of thre dayes beginne to trepane, and especiallye the vvether beinge hotte, therby to prevent the inflammatione: but not to the membrane, least she lye bare, and soe the ex­ternall ayre chaūce to distemper her, and cau­se therine some corruptione and rottinge, le­ast also that in so doinge vve might chaunce to teare the membrane, in boaringe through the sculle vvhich cleaveth vnto the same, or anye of the other fasteninges of the membra­ne: or in placinge of the instrument theron, she might therby be hurt or vvoūded. VVherfore, (as he sayeth) it is farre better, vvhen as ther is but a little more bone to pearce or bo­are throughe, & the barede bone beginneth to stirre it selfe, that as then vve desiste, vntill such time as it of him selfe falleth out.The Chy­rurgiane is someti­mes to late sent for. But if soe be that the Chyrurgian hath not in the first binne therat present, & the patient hath of some idiote or ignorāt fellovv binne dres­sed, vvhich hath not knovve the fracture, and because ther vvas noe apertione made in the bone, to give ayre or light, vnto the matter, ther are chaunced thervnto (as is a fore reci­ted) greate inflammations, and manye other fearfull accidentes: vve must then (if it be in the summer, and the putrifactione one the suddayne reveale it selfe) vvithin the seaventh day treparte the patiēt, before the braynes are vvholye infected, and chaunce to mortifye: [Page 11] But in the vvinter vvhen as the corruptione procedeth and goeth somvvhat tarder ofsloer forvvarde, vve must then effect it vvith in 14 dayes: because these dayes beinge passed, as vvel consideringe the imbicillitye of his for­ces, as the greatnes of the dissease is incurable, although as then vve trepane the scull, it is then to late, vvherfore in noe vvyse must vve effect or doe it.

Opinio­ne of A­vicenna. Avicenna vvil have that vve strayght vva­yes beginne to trepane, and if so be vve must needes deferre it, that vve shoulde defer­re it noe longer then tvvo or three dayes at the most, and that especiallye vvhen as the Du­ra mater is pricked or lyeth crushed, of anye broken bones.

Celsus sayeth, that he vvhich tarrieth anye longer from trepaninge then three dayes, are not to be excused, because that such delay cau­seth a concursione of humors, on the Dura mater vvhich findinge noe apertione, or is­sue, disordereth the foresayed membrane, and spoyleth it, out of the vvhich necessarylye must follovv greate inflammationes.

But our vse and practise in these dayes, is that as soone as vve are sent for, vvhether it be in time or out of time, earlye or late, and vve espye, ether through searching vvith our, fin­gers, through the searchinge iron, or by our sight, that the scull is broken, rente, or torne, and that the Dura mater suffereth anye thinge, vve out of hande proceede vvith the operati­one, and that soe much the sooner, vvhen as vve note, that ther accidentes demonstrate themselves, vvithout anye longer delay and especiallye, in debile aegritudinous, or corpu­lent bodyes, because in them ther are revea­led farre vvorse accidentes then in others, vvherfore to tarrye or deferre the trepaninge anye longer it vvould be smalle commoditye vnto vs, but better that altogether vve defer­red it.

And althoughe the Chyrurgiane vveare not in the first sent for, and that the seaventh day of the sommer, and the 14 of the vvin­ter vveare praetermitted, and let passe, he shall not therfore refuse to doe his vtter most endevoure, vvith trepaninge, for it is yet better somvvhat to late them never, consideringe the goode hope vvhich vve must have of doinge the patient anye good, helpe, and comfor­te, vvhich othervvyse vvithout trepaninge of the broken bone, or the elevatione of the sa­me, can by noe meanes be done, vvhich vve onlye vnderstande of those, vvhich are not cleane vvithout hope.

What places may beare the trepanin­ge.Seinge therfore that vve have the time & day limited vnto vs, in the vvhich vve ougt to trepane, vve must cōsider vvhat places, or par­tes of the sculle are able to abide the trepanin­ge, and vvhich not. VVe must first of all ther fore consider, that the bones vvhich vvholye are in peeces, or beinge crushed, or at the least a great parte of the same beinge separated, can not easylye be trepaned, because he might chaunce to crushe the trepane one the mem­branes, hovve easylye soever he leane theron. VVe must alsoe note, that vve doe not chaun­ce to sett the trepane one any suture, because in soe doinge, vve should vvith great payne, and vvith great bloode sheddinge, cut of the vaynes, arteryes, and synnuish filamentes, vvhich have a vnitye and fasteninge, vvith the Pericranium, and the membrane Dura mater, We may right vvell tre­pane one the sydes of the fu­ture. vvhich have the free passage throughe the fo­resayed sutures, to retayne the Dura Mater, and administer life, and nurture vnto her. But if it soe chaunced that the fracture chaunced to be one the suture, vve must then applye the trepane, on both the sydes of the suture, vvith out in the least touchinge of her: for if soe be vve trepane but on the one syde onlye and not at the other syde of the suture it vveare then impossible that the bloode or matter, should have at that hole anye issue or passage, the membrane beinge betvvixt them both: nether may vve trepane on the fontanelle, or openinge of the heade in yonge Children, be­cause that ther tendere imbicillitye as yet is notable to suffer and abyde the trepane. The inferior, or descending partes of the sculle, are not convenient or fitt to be trepaned, becau­se the braynes throughe ther ponderousnes, might chaūce to sincke therout, or the mem­branes throughe the apertione might chaun­ce to be extruded: But if soe be vve vveare vrged ther vnto, vve must make but a verye smalle apertione.

VVe ought in noe vvyse to trepane the temples of the heade,We may not trepa­ne the temples of the he­ade. because vve shoulde not hurte the temporalle muscle, considerin­ge divers synnues, arteryes and vaynes, vvhich are therin divided and entermingled throu­ghe the vvhich there might be caused to grea­te payne, fluxione of bloode, agues, Spasmus, and the patient might chaunce to dye: Be­cause that ther vnder the bone called Os petro­sum is situated, and that consideringe, the mo­vinge and stirringe in the temporall muscle, vvhich happeneth in speakinge or eatinge, the vvoūde might be farre more daungerous, and Hippocrates alsoe sayeth, that the inscisione of the same muscle, might be cause of a grea­te, and villanouse distortione out of the vvhich one the same syde, a Paralisis on the other a cōvulsione of synnues might chaun­ce to ensue. Nether ought vve to trepa­ne that parte of the sculle, a little above the eye brouvves, because in this place ther is a greate concavitye, fylle of ayre, and vvhite sli­mye, [Page] mye, humiditye, of nature, in that place cōsti­tuted & ordayned, to paepare the ayre, vvhich ascēdeth vp to the braynes, the vvhich indeed is vvorthye to be knovvne & observed, because that the Chyrurgiane, might not in anye sort be deceaved, takinge the foresayed conca­vitye to be, a depressione of the bone, vvhich needes must be trepaned: & if it so chaunced, that anye of these foresayed partes vveare brokē, as are the temples of the heade, vve ought then to applye the trepane, a little above the tēporall muscle:Vve may not trepa­ne that bone above the ey­ebrovves. if soe be that the part or por­tione of the sculle, be broke a little above the eyebrovves, vve must as then make choyse of that parte of bone, vvhich boundeth on the fracture, as above in the fooreheade: it is right true, that if so be the foresayed bones, vveare depressed, and crushed, that as thē vve ought to elevate them, and if they be cleane separa­ted vve as then must plucke them out in like sorte as vve must doe in the sutures.

The sutu­res and temples of the heade may so­metimes be trepa­ned.Yet consideringe all this, vve are oftētimes compelled & constrayned, to trepane in all places of the scull: The vvhich a renoumned, & experte Chyrurgiane called Andreas a cru­ce, confesseth often times to have done, vvith­out anye daunger. And I dare my selfe bould­lye affirme, that I in the yeares, of 1591 & 1592 have my selfe trepaned, and have seene others trepane, in the foresayed prohibited places, as one the sutures, and one the temples of the heade. Notvvitstandinge I vvould councell the yonge Chyrurgiane, that in as much as is possible he avoyde & eschevve, the trepanin­ge of these places, but rather make choyse of anye other parte, vvhich parte, may be a little descendinge, because havinge made the aper­tione, the bloode, the matter, & all impuritye might therout have ther free passage. Con­sideringe in the dayes vvhich goe before and vvhich conseqventlye follovve after the tre­paninge, on the singularitye, and vvorthines of tvose partes, vve must commaunde the aff­licted and vvounded persone, that in all thin­ges he vvilbe sober, and observe a good diet, both in etinge and drinckinge, abstayninge especiallye from vvine, and phlebotomye, as much as is needfull, because that the humors, shoulde not concurre vnto the vvoūded par­te, and that alsoe vve keepe his heade vvarme, vvith light coveringes of the heade, because coulde is a greate enymye vnto the braynes & all synuis he partes.

❧ What qvantitye, or vvhat bignes of the bo­ne in trepaninge vve must take out Chap. 5.

WE must in the firste, accordin­ge vnto the quantitye,Hovv greate the apertione must be for to tre­pane. and bi­gnes of the bone vve purpose to take out make an apertio­in the skinne & denudate the foresayed sculle: Therfore if so be ther be noe vvounde nor anye aper­tione, and the skinne externallye as yet vn­hurte, this shall as thē be the convenientest apertione, vvhich vvith handes may be made, vvhich vve shall make vvith tvvo crossevvyse overthvvarte inscisiones, in such a forme as this in the margine, demonstrateth vnto you, or els in forme of a borghondiane crosse, vvhich in his middle praesenteth four cor­ners. In somuch therfore, as if the hurte, have made a vvounde, and inscisione, in the skinne, vve must suffise our selves thervvith, vvith such as it is, if soe be she be thervnto fit and apt, making an other transversall inscisi­one, namelye overthvvarte the vvounde, be­cause these tvvo as then may present one. But if soe be, the vvounde be verye ample, & lar­ge, vve must as then onlye cutt the skinne one the one syde, begīninge the same in the midd­le of the vvounde, because soe the vvounde may present this letter T, in the vvhich vvilbe but tvvo corners.

These foresayed inscisions, are cenvenien­test done for the inflammations.The inscisione must be done be­fore the inflam­matione. But if soe be vve perceave the vvounde to be large e­noughe to give place vnto the trepane, or a­nye other instrumente, vvhatsoever, vvher­vvith vve might endevoure and seeke to ele­vate, and restore agayn the broken, or depres­sed bones, in so much as if ther be anye, vve must thervvith content our selves, exsten­dinge the foresayed vvounde at the first vvith linte, & vvith little plumaceoles, therof being made and therin crushed, on allsydes, & cor­ners of the vvounde.

But in vvhat sorte or fashone soever, vve make our inscisione in the skinne, vve must allvvayes note that vve doe not suffer anye portione of the Pericranium to remayne one the sculle: vvhich vnder the skinne, decketh and covereth the vvhole sculle: because if so be the foresayed membrane Pericranium, vvea­re per happes, torne vvith the teeth of the tre­pane, might be the cause of greate inflamma­tione, payne, and agues, vvher fore it is better that vve cleane, and vvholye separate it from the sculle, vvhich beinge done, vve must then damme & stoppe vp the vvounde vvith vvhi­te linte, by the vvhich the next day ensuinge vve shall finde the vvounde vvide open, & if as yet ther vveare anye parcell of the skinne, or lippe of the vvound, vvhich might be a hinderance vnto the trepane, the vvhich in the turninge about might chaūce to touche, vve [Page 12] shall vvith the scissors clippe it of, vvithout deferringe it vntill the next day.

Vvhen as vve havinge considered, one the place vvher to set the trepane, vve must then note, hovv much, & hovve broade, vve ought to boare the sculle.Vvhat qvā titye of bone vve ought to trepane. First of all therfore, vve must vvholye take avvaye all the broken and crushed bones, vvhich vvholye are separated from the sovvnde parte, and alsoe from the Pericranium, consideringe that they can never thervvith be vnited & ioyned agayn. But vvhē as the broken bone is depressed, & anye parte therof as yet theron vveare fastened, vvith the sovvnde partes therof, vvhich crushed the membranes of the braynes, or any acuitye of the same, as yet sticke therī, vve must not ther­for for all that cut it of, and vvholye take it a­vvaye. But must by all meanes endevoure, ea­syly to lift & elevate the same, & situate it next vnto the borderinge bones, exemptinge only out of the same the small peeces, vvhich might hurte the membrane, & pricke it, because by this curinge & remedye, the bones agayne re­nevve, vnite, and ioyne themselves together vvith the circumiacent bones. In soe much as if ther be anye more rentes or fissures before hādes, vvhich frō the one syde, disperse them­selves this vvay or that vvay, vve shall not neede to pursue thē vnto theire end, but vve shall onlye take some parte therof avvay, because most commonlye they ioyne, & saulder as it vveare together agayne, the vvhich is a farre more better opercle for the braynes, thē that nevve incarnated fleshe, vvhich after the tre­paninge grovveth therin, vvhere vve have ta­ken the vvhole broken bone therout, vvher­fore vve must take noe bones therout, then vvith greate discretione, & then as fevve as is possible,The scull is the na­turall o­percle, or cover to the bray­nes. soe that they doe not pricke, & trou­ble the membrane, vvith ther acuitye & edge, & that ther remayne distance enoughe, to gi­ve passage vnto the bloode, and the matter vvhich is therone gatherede, to departe, for as vvel the membrane as the braynes, shalbe better defended, through the bone vvhich as yet they Keepe, vvhich is ther naturall defēce, as if vve qvite & cleane toke it avvay, through vvhich discoveringe, the foresayed braynes might be hurte or hindered.

The Di­ploe is the distance betvvene the tvvo tables.It chaunceth often times that the first table commeth to be broken, & rente vnto the Di­ploe, yet for all that the secōde table remaynin­ge vntouched, vvherfore it is not thē needfull to applye the vvhol trepane therone, to boare the bone qvite out, but in this case vve must ōlye vse the exfoliative trepane,Vvhē vve ought onlye to vse the exfo­liative trepane. therby to ad­minister anye passage or apertione vnto the bloode, vvhich, beinge suncke betvvē the fo­resayed Diploe, through continuance of time beginninge to corrupte, might in the same ti­me chaunge & aulter the seconde table alsoe, and cause anye accidentes therof to ensue. If so be in the vvounde vve perceave any splin­ter, vvhich exalteth it selfe vvith some highe eminence, vve must not be soe curious, to ta­ke the same immediatlye a vvaye, or cut it out seīge that it is anye vvher fastened, but rather commit it vnto the vvorke of nature, vvhich vvil deminishe & separate noe more therofe, then shalbe necessarye & neede full, because she is vvise and prudent in all her vvorkes. It might alsoe chaunce that the bone, not bein­ge broken or rente hath onlye binne above contunded, hurte, or externallye denudatede, vvhich beīge soe, vve must onlye above scra­pe it even, and grate it.

❧ Of the māner & methode hovve to trepane vvell, and artificiallye. Chap. 6.

SOe manye and divers species & formes of fractures, as there are even soe are ther divers meanes vvher by vve may succoure the vvounded patient. Vvhen as therfore the fractu­re, is nothinge els, then a right runninge fis­sure, vve must then consider vvhether it pear­ce or penetrate throughe both the tables: the vvhich me may knovve throughe the Raspato­riū, or throughe the exfoliative trepane, vvher vvith vve must grate the first table, vnto the Diploe, & if that the foresayed fissure,Diploe is the space betvveen the tvvo tables. as there doth not departe or vanishe out of sight, ne­ther the accidentes desist, findinge allsoe the fore sayed Diploe plettered crushed, or brokē, & anye matter vvhich throughe the seconde table commeth to distille into this place, it is as then a signe that the foresayed fracture pe­arceth, vnto the seconde table, & stretcheth it selfe one the Dura mater alsoe:Methode hovve to trepane. vve are as then counceled to applye the vvhole trepane ther­one: & ordinarylye to effecte this, as it is nee­defull to be done, vve must cause the patiēt to sitt, one such a manner as the parte vvhich is broken reqvireth: vve must stoppe his eares vvith cotten, & decline and lay his head one a companye of pillovvebeares, vvhich must be indifferent harde, & cause his head of one or tvvo men to be helde fast, because he stirre it nether this vvay nor that vvay: then vve must cover the lippes of the vvounde, vvith anye plasters spreade vppen fine linnen cloth, least that of the ayre, of the turninge rounde of the trepane they might be hurte or vvoūded, Al-this beinge in such sorte fineshed, vve must si­tuate and settle, the perforative trepane verye fast or stedfastly, on the brokē bone, on such a place vvher as vve desire to have the acuitye or poynt of the trepane situated, ther to make [Page] a perforatione, vvhich beinge effected, vve must therone situate the vvhole trepane vvherof the poyncte, muste be set in the hole or perforatione, the vvhich before vvas made vvith the perforative trepane, and soe easilye turninge it, the bone first of all shall raceave the poyncte, & by and by the crovvne, or the teeth of the trepane, vvithout ether glidinge this vvay or that vvay, or remove out of there circkle, because of the acuitye or poyncte of the trepane vvhich must restraygne the trepa­ne, vvith out slippinge out of his place. There is a certayne industrye in the depressione of the trepane, soe that it both turneth rounde, & pearceth or cutteth alsoe: for if so be vve le­ane to lightlye therone, it then pearceth and cutteth litle, or nothīge at all: & if it soe chaū ­ced that as then vve depressed is somvvhat to harde, it vvill not then turne rounde, vvher­fore heerine vve muste vse a medium betvven them both, or mediocritye, & lifte it some ti­mes out, to purifye, & brushe it, and then an­noynte it vvith oyle of roses, because that it might the betre pearce and enter in. The tre­pane having novv made a reasonablve dee­ped circle, as then vve must take avvay the poynte out of the middle therof, for if it pear­ced deeper thē the crovvne or teeth of the tre­pane, he shoulde be sooner passed by or throughe the bone then the trepane vvith his teeth, by the vvhich the membrane called Dura Ma­ter might chaunce to be hurte, the foresayed poyncte therfore beinge taken therout, vve must agayne sett the trepane in his hole, or circkle, and markinge that the trepane hath pearced the Diploe, Signes to knovve vvhē the trepane is entred into the Di­ploe. and passed therbye, the vvhich me may perceave by the blood vvhich vvil issue therout, throughe those little vay­nes vvhich there are openede, vve must then finnishe the trepaninge vvith more discretio­ne and heede takinge ther vnto, vnto the con­cavitye of the sculle, turninge the foresayed trepane verye easylye & vvyselye, layinge the left hand verye lightlye therone, that therbye vve may the better espye, vvhen that the scul­le shalbe pearced qvite throughe, that vve doe not in anye sorte hurt the membrane: be­cause therof might ensue, inflammatione, and the daūger of death.Note the forme or figure of your trepane in the sculle. Novv to marke this, vve must often times lift vp the trepane, to try the thicknes of the bone, through the vvhich the trepane hath passed, vvhich vve must vvith a little privette or searcher try, or vvith a pro­pre instrument vvhich heere to fore is onlye for this intent discribed. By vvhich meanes, vve must alsoe note, vvhether it be in noe place cleane perced, for althoughe vve rightlye & aeqvallye turne the trepane, it may never the lesse happen, that the foresayed bone be one the one syde cleane througe, vnto the Dura Mater, and one other syde not soe deepe: vvhē vve therfore perceave this, vve muste procee­de vvith turninge, & depresse the trepane one the other syde vvhere the bone as yet is not throughe somevvhat more, because the bone may aeqvallye be pearced, or if it vvil not soe be, vve may then vvith the same turne of the trepane, pearce the bone one the one syde, & denudate the Dura Mater one the other syde, vvhich somtimes I have knovvne to be done. Such an in aeqvallitye, cōmeth partlye as vvel consideringe the heade, vvhich is rounde, as concerninge anye concavityes or furrovves vvhich are situated in the secōde table, vvhich toucheth the Dura mater, vvherfore the bone is in one place thicker then in an other.

In like sorte vve must alsoe plante the little groundedravver in the perforatione, the vvhich in the first vvas made vvith the poync­te of the trepane: Or vve must, stick that Eleva­torium vvhich is at the poyncte of the little fo­resayed grovvndedravver in that circkle, vvhich by the trepane is made, thervvith to lift out the little peece of bone, or make it loose, by the vvhich vve shall easylye espye, vvhether it yet hould verye fast, & vvhether it nee­de anye more to be boared, & if vve see that it hath pearced vnto the Dura mater, vve shall then vvith the foresayed Elevatorium, After vvhat sorte vve ought to lifte out the perforated bo­ne. or vvith the groundedravvere, vvholye lift it out, vvith out breakinge of it or doinge anye violen­ce therone, because ther throughe vve doe not chaunce to hurte the membranes but gi­ve it rather one turne or tvvo, because that soe much the easyer vve might lift it out, at one ti-time. This beinge done and the rounde bone beinge taken therout, vve must then smoothe and make playne, the edges of the perforatio­ne, and grate them, and take avvay all his acui­tye and ruggednes, from him, for if soe be the­re remayne anye small splinter therone or a­nye other vnevennes, the vvhich not beinge clenlye taken therof, it might be agreat hinde­rance unto the membrane: and if soe be that through trepaninge ther chaunced anye of the poulder of the bone to fall one the membra­ne, vve must endevour by all meanes to get it out: If so be it is sufficient to remove the first table, vvithout touchinge of the seconde, vve shall not then playne and scrape the edges on­lye of the pearced hole, but allsoe the vvhole bone, because that therafter vvithout any trouble to the patient the skinne may grovve ther­over: for if soe be that it come to grovve over the rugged and vnsmooth bone it vvil be a great hinderance to the patiente, and cause a nue payne, because that the fleshe vvill not be soe goode, vvhervvhithe the rugged bone shal be covered.

And this is our practise,Manner vve to trepane vnto the membrane. and manner of tre­paninge [Page 13] vnto the membrane Dura mater, and the manner allsoe hovv immediatlye to lifte the bone out of the perforatione, althoughe that Hippocrates, in his booke of the vvoundes of the heade, strictlye prohibiteth to boare the hole vnto the membrane, and presentlye to take it therout, because the external ayre, sud­daynlye alightinge one the same, might chaū ­ce to hurte the same, by the vvhich occasione she might therafter chaūce to rotte: and more alsoe if that vve take the bone out of the same the vvhich as yet might be fastened vvith the foresayed membrane, vve might chaunce to teare the same, or anye smalle vaynes therone fastened: or if that vve stucke the trepane vnto the membrane, vve might hurte the same: it is therfore the surest vvaye, sayeth he, that vvhē as the bone is all moste cleane throughe, and beginneth to stirre, that vve then desiste, and tarrye vntill such time as it of it selfe falleth out: But our trepane vvith the crovvne, or teeth is such, that vnlesse the Chyrurgiane be verye ignorant, might in anye sorte ther­vvith, hurte or crushe dovvne the membra­ne.

Nue invēted trepa­nes.We have invēted other formes of trepanes, vvhich vve have in this booke also set dovv­ne ther forme vvhich vve cal Terrebellum alatū, the vvinged trepane, vvhich taketh noe pee­ces of bone vvith it but diminisheth, and consumeth them, vvhervvith by noe meanes vve may hurte the membrane: there are some vvhich havinge vsed them, finde them farre surer, and expediter in ther operationes, then those vvith the hoode. But if soe be there be anye greate massacringe of bones, or depres­singe of the same, thē the membrane is there throughe depressed and crushed, and is alsoe sometimes pricked vvith the splinters, of the broken bone. In these tvvo daungerous mat­ters, vve must helpe, and succoure the patient or vvounded persone one some other sorte, & that as soone as it may be possible, in the extractinge of the same, if so be they be vvholye seperated:What vve ought to doe vvhē as the Dura mater is crushed throughe the brokē bones or splinters. To vvhich purpose, it is oftentimes necessarye to trepane, & cut avvay some parte of the sovvnde bone, vvhich bordereth and is situated next vnto the plettered bones, becau­se that our Elevatorium, might in the elevating of that vvhich is depressed dovvnvvardes have sufficient place, & rest it selfe one the sovvn­de bone, vvith out in the elevatione to depresse the brokene bones any more dovvnevvar­des: for as Hippocrates sayeth, the bones vvhich are broken, and depressede, can not vvithout greate daunger be boared or perfotated, be­cause that the depressinge of the trepane, or Elevatorij, by anye meanes of them can not be suffered. It often times happeneth that the seconde table is more depressed thē the first, vvherfore to that intent vve must let the Ele­vatorium passe throughe the perforatione of the trepane, betvveene the seconde table,Elevato­rium is an instrumēt vvher­vvith vve vse to lift vp anye thinge out of a vvound. and the membrane Dura mater, because in that sort vve might lift vp the broken bones and splin­ters agayne, and take them out if they lay loo­se or separated. And if so be there vveare noe hole, & above all this, the place of the fractu­re, could by noe meanes suffer, to have therin made a hole, it is as then my manner to take my grovvndedravvere vvith three feete or poynctes and set therone,Practise & inven­tione of the au­cthor. & then make choy­se, of the greatest, & vvhich is most fittest for me, consideringe the fracture vvhich is in the bone, to intrude the same therin, and easylye vvinde the same therin, houldinge your han­de alvvayes hanginge, and not depresse the sa­me to harde, because he vvil easylye enough enter therin, & vvhen he hath a little pearced vve must as then vvith a certayntye, & the ea­syest vvay possible endevoure, to lift vp the broken and crushed peeces of bones. But if soe be, there be anye peece of bone soe farre shoved vnder the sculle, that it laye above the membrane, and the same consideringe his greatnes, and the angustnes of the apertione, coulde not by anye meanes be taken therout, ether by Elevatories, or Pincets, vve must thē take our refuge, (if so be vve vvil not through the trepane make the apertione anye bigger) to the cuttinge pincers, & to the Parrates bil­le, vvith the vvhich vve may cutt of as much bone as vve please, vvith out anye paynes, or daunger, makinge one this sorte the apertio­ne somvvhat vvijder, to take out of the same the foresayed peece of bone, vvhich driveth one the Dura mater. Touchinge the inflecti­one or bendinge invvardes, vvithout fractu­re, vvhich commonlye chaunceth in yonge children, or in these vvhich have a vveake & tender sculle, vvhen this is crushed, or bendt invvardes, as is a copper or time potte, those ar better to be cured vvith extractīge plasters, then vvith the trepane or vvith the grovvn­dedravvere.

The Frenche Chirurgerye THE THIRDE TRE­ATISE OF THE OPERATI­on of Chyrurgerye, wherin is discoursede and handelede of the sovvinge or suture of vvoundes. Contayninge sixe Chapters.

  • VVhat the suture, or sovvinge together of avvounde is and the vse therof. Chap. 1.
  • VVherone vve must note in the sovvinge of a vvounde. Chap. 2.
  • VVhat is needfulle, to the sovvinge, and of the meanes, hovv to doe the same. Chap. 3.
  • Of the species, or differences of sovvinge, and of the time to remove the same. Chap. 4.
  • Hovv vve ought to repose agayne the guttes, vvith the net, vvhenas they hange out of the bo­dy. Chap. 5.
  • Of the Gastroraphia, or sovvinge of the bellye- Chap. 6.

❧ What sowinge is, and the vse therof, and in what impedimentes she is necessarye, and in what partes. Chap. 1.

Sixe thinges vvhich in sovvinge must be cōsidered THe Chyrurgiane ought to consider sixe especialle thinges, vvhich concerne the sovvinge of vvoundes: First the vse ther­of, that is, in vvhat impedimēts it is necessarye, & in vvhat par­tes: vvhat vve must therin consider: vvhat ther is vvantinge to effecte the foresayed sovvinge: after vvhat manner vve ought to doe it, & ho­vve manye fashions, & differences ther are of the same.Descriptione of so­vvinge. Therfore sovvinge of a vvounde is nothinge els, but a vnitinge, and couplinge together of the dissevered partes: vvhich vveare contrarye to nature, separated and parted one frō the other, vvhich fore sayed vnitinge must be effected vvithe a threded needle.

Inventio­ne & vse of sovv­inge.The occasione, vvhy vve in anye vvounde, or separated parte, vse this sovvinge, is to vni­te agayne, & ioyne them together, vvherof the convenientest meanes is, this sovvinge, & the vse of this combinatione, and that especiallye in all such partes, vvhich vve can not conve­niently oraptlye binde together, even as vve may playnlye see, in the greate vvoundes of the armes, & legges, vvhich are overthvvart­lye vvounded, in like manner alsoe in the bo­dye vvvich happen in the length therof, for the lippes or edges of the same, are soe much separated one from the other and causeth the vvoūde soe to gape, that shee coulde not vvit­hout great daunger be cured, vnlesse that in anye place vve sovved it, to bring them toge­ther and vnition: because that all incarnate, or fleshye partes of the bodye, are dravvne throughe vvith certayne sinnuishe fibers or filamētes, the vvhich beinge overthvvartlye, or contradictorylye separated the one, from the other, the one lippe of the vvoūde is dra­vven opvvarde, & the other dovvnevvard or the one on the right syde, & the other one the left, all accordinge as the vvoūde or the sepa­ratione is more or lesse, overthvvarte, cōtra­dictorye, lōge, deepe, or vndeepe. In like sorte is the sovvinge, verye necessarye in a vvoūde, vvherin a peece or parcell of fleshe hangeth one the one syde, and one the other end as yet connexed, even as it commonlye chaunceth most commonlye, in a great hevve or slashe, throughe the vvhich the eare, hangeth by the heade, or in any other parte, as in the nose, the vvhich helde fast but at one end onlye.

It happeneth alsoe some times,Sovvinge in a sepa­rated pla­ce, is vn­profitable and nee­deles. that the vvhole parte is cleane cut of, vvherin the sovvinge is nothinge profitable, vvherfore therin vve must not vse anye sovvinge at all, to cure thē agayne, for then in the separated par­te is noe more life, & therfore can noe more be nourished of the bodye, by the vvhich the curinge ought to come.

And althoughe that all those partes, vvhich agaynst the course of nature are separated frō the other, might behove to be healed agayne, cā not beare or suffer to be vnited or coalited, even as are the synnues, Tendones, & Cartila­ges or grissells, because after the opinione of aunciente professors, and as alsoe the vse and practise teacheth vs, ther must consequentlye follovve of one pricke, or thrust vvith a nedle, in the synnues, or tendones, great payne of all sortes, inflāmatione, convulsione of synnues, and some times alsoe death it selfe, throughe the sympathye, or compassione, vvhich they have vvith there firste originalle, the vvhich Galenus, hath shevved vnto vs, in a vvoūde, be­lovve the Hockes in the vvhich,The tēdones are daunge­rous to sovve and vvhy. consideringe the greatnes therof, it vvas verye needefull that there shoulde be a profounde suture, & that not onlye to bringe the supersituated places, together, but alsoe the profoūde lyin­ge partes of the vvounde: the vvhich he ende­vourīge to effecte, hath separated the tēdones frō the muscles: for because ther is great daū ­ger consisteth in the hurtinge of the synnues, even in like sorte is ther daunger in hurtinge [Page 14] of the tendones, & that consideringe the syn­nuishe fibers vvhervvith the muscles of the bellye are connectede, vvhich in time chaūge themselves into a tendone, vvhich vve com­monlye call the great synnue.

What we ought to consider in the suture, and so win­ge of a wounde. Chap. 2.

Why vve may not in the re­sovvinge of a vvoū de dravve the lipps or edges close together. WE must not at anye time sovve vp a vvounde, least in the first shee be vvell purifyed, & cle­ansed, as vvell externallye, as internallye, if at the least vvith out any great daunger or per­rill it may be effected: extractinge and takinge therout all that is contrarie vnto the sayed vvounde, as is congealed bloode, vvhich com­minge to corruptione, might cause greate in­flāmatione, & oftē times alsoe a convulsione in that parte, throughe vvhich the sovvinge breaketh, & teareth, & soe conseqventlye hin­derethe the vnitinge & healinge of the vvoū ­de: vvherfore in the resovvinge of a vvoūde, vve must deligentlye note, that vve doe not contracte & dravve together on all sydes) the lippes or edges of the forsayed vvounde (ex­cept it vveare in the haremouth, & in the cle­aved or severed lippes of the mouth) but must leave some distance betvveene the one & the other lippe or in anye place some or other a­pertione, because the matter which gathe­reth it selfe together, in the bottome of the vvounde, may issue therout, and by that mea­nes the medicamentes may be therone appli­ed. In like sorte the Chirurgiane must in sovvinge consider, & vse medicoritye, and not ta­ke to great a qvantitye, ether in the length, or in the depthe of the fleshe, and of the skine, throughe the vvhich there might ensue and follovve great payne, vvhich vve ought not to esteeme for smalle, & therof allsoe vvoulde remayne an illfavored & vnseemlye cicatrice or scarre: As to the contrarye the not deepe sovvinge of the vvounde, myght easylye brea­ke and burst agayne, & then in vayne it vvea­re sovvede. For if soe be, that the needle, be to neere thrust throughe the edges of the vvoū ­de, thē the threde because of his tenuitye tea­reth throughe the skinne or fleshe, & vvhen as vve thruste the needle to deepe and farre, from the lippes or edges of the vvounde, then there resteth and remayneth a greate parte of the skinne,Fleshe vvith Fleshe com­meth far­re sonner to vnite, thē skin­ne vvith skinne. vvhich vvill not be vnited: vvher­fore indifferentlye vve ought to pearce toge­ther as much of the skin as of the fleshe, be­cause the fleshe farre sooner and easyer com­meth to heale and cure, vvith the fleshe then the skinne vvith the skinne, and that is consi­deringe the naturall temperatenes of the fo­resayed fleshe, vvhich is vvarme, and moyste. And as touchinge the distance of the stitches, and soovvinge, vve ought not to laye them to close one by the other, nether to farre separa­te & sequestred one frō the other, as thē they can not retayne the vvounde: And vvhen all to nye the other they are layed, cause payne, through all the stitches, and dravvinge to­gether of the same, through the vvhich payne is caused a concursione of Humors vnto that place: vve must therfore vse a meane therine vvell consideringe, the largenes, and length of the vvounde: but above all vve must marke, that vve thrust not, throughe or in anye syn­nues or tendones, consideringe the payne, the Spasmus and manye other fearfull accidentes, vvhich therof might ensue, as allreadye vve have sayed. Sovving of a vvounde may not be effected vvith anye violence, in those partes vvhich vve endevoure to vnite and bringe together, but thē is sovvinge laudable, vvhen as the skinne stretcheth it allmost together, of it ovvne accorde, & vvheras in this sorte it vvill not be effected or brought to passe easylye, & that the lippes of the vvound vvith violence must be ioyned, it is as then most convenient, that vve relay the stitches some distāce one frō the other, & lettinge them be somvvhat loos­lye sovved: for if it chaunced vve drevve them somvvhat stiflye together, the skinne might then easylye rente or teare, & soe burst a sun­der throughe the tumefactione vvhich therof ensueth: If that therefore,Sovvinge may not by anye violence be done in the lip­pes of the vvounde. vve disire perfectlye to cure a vvounde, vve ought as thē soe to dis­pose of the sovvinge, because that in thus doinge, the humors, bloode, matter, and the exter­nall ayre might be repelled, from the lippes, or edges of the vvoūde, because such thinges, may hinder, or at the leaste deferre, the curin­ge of the same: and in soe much, as the lippes of the vvounde are not vvell vnited the one vvith the other, and kept in that stature, & vni­tinge, the vvound can verve badlye & hardlye be cured.

And alsoe if the lippes of the vvounde,We may in noe vvise sovve the lippes of an in­flamed vvounde. doe greatlye chaunce to svvell, & inflame, & theye shrinck in themselves, or els if they be to much brused or plettered, vve must not thē in anye sorte resovve it agayne: for the suture vvould strayght vvaye breake, and soe conse­quentlye the inflammatione increased, but must delay it soe longe vntill the foresayed in­flammatione be seaced & the vvounde be co­me to goode suppuratione and matter, and is prepared and readye, to be vnited & brought together.

What is necessarye vnto the sowinge of a wounde, and howe we ought convenientlye to doe it Chap. 3.

[Page] WHen as the Chyrurgiane desi­reth aptlye & convenientlye to sovve a vvounde, he must first of all have in his hande a needle, & therto a threde, and a canulle: Cōcerninge the nee­dle, shee must be of a reasonable length, som­times right, & sometimes croocked, accordin­ge as the partes reqvire, nether must shee be made of to harde a steele or mettle, vvher of they easylye might chaunce to breake, but of gentle steele, because they might rather ben­de then breake: althoughe shee ought to be stiffe, smooth, & infrangible, havīge a sharpe triangled poyncte, because that in her entrin­ge she might both cut & pricke, & soe the ea­syer perce or goe ther through, & because that in her govvinge throughe, she might make a longe little vvound or hole, & not rounde, because those little rovvndes, are more difficulte to be cured,What for­me the needle must ha­ve. then the longe holes. In the heade she must be one both sydes hollovve, in form of a gutture, because the threde might therin­ne be hidden & buried, & not hinder the per­cinge or entrance of the needle, in the dravvī ­ge throughe therof, because shee then touch­eth the bodye in that sort more easyer and softer: It vvill not alsoe hinder accordinge to the sayīge of Avicenna, that vve somvvhat anoynt the needle vvith oyle, vvherbye the payne of the pricke night be somvvhat easyed, & the foresayed needle enter the easyer.

What for­me the threde must ha­ve.The threede must be smooth, soft rovvnde, and vvithout anye knott, all eqvivalent vvith the thicknes, & greatnes of the needle, but not in any sorte to thinne, least he chāce to breake or cut through the lippes of the vvoūde. VVe may rather take a threde, thē silke, because the knott of the silke easylye vnlooseth, throughe his vveaknes: it is right true that the foresayed threde, must not be to harde, because there throughe he might hurt, the vvoūde, & not to softe least he breake nor chaūce to corrupte, before the time the vvounde be fullye healed, vvherthrough the lippes of the vvoūd, might agayne dissolve & vvaxe loose yet notvvithstā dinge novve a dayes vve had rather vse a thred of carmosyne silke, thē a hempen threde, or of flaxe, vvhich Galenus disprayseth & misliketh, in his third booke of methode, vvhere he best liketh of a threde of vvollen vvhich may be likened vnto, a brovvne threde, or a vvhyte silke threde ravve, vvithout beinge dyede, or coloured:Why the threede may not be dyed or colou­red. because that in the dyinge someti­mes is entermingled poysen, as in the scarlet dye ther cōmethe Arsenicū. The fore sayed Galenus vseth stringes made of smalle guttes, as are lutestringes, but cōsideringe there moysture, they quicklye beginne to svvell, & rotte, vvherfore vve had rather vse a stronge brovvne threde, vvhich vve must dravve throughe vvaxe & vvaxe it because soe much the lesse he might corrupt & rott, & houlde the faster. And to ef­fect this & surelye to sovvea vvoūde vve must have a Canulle vvhich one the one end must be roūde, splitte, & vvith a hole, partlye becau­se the edge or lipp of the vvoūde, vvhich vvith the needle vve vvoulde pearce, & because that the fore sayed lippe may stay, & rest it selfe, on the pype, vvithout stirringe this vvay or that vvay, & throughe the vvhole to espye, vvhen the needle is halfe perced throughe as then to dravve her through vvith her threde, vvithout ether the nedle, or the thred to dravve the lip­pes of the vvounde tovvard, them, & because throughe the splitte of the pype, it might the the easyer frō thence be removed, to rest therō the other edge therafter, vvhē she allsoe must be thrust throughe. And convenientlye to ef­fect this sovvinge of a vvounde,Hovv to sovve a vvounde conveniētlye. vve must first thrust through the vpper lippe of the same, si­tuatinge at the first the holed ende of the pype vvith the left hande, internallye vvithin the lippe of the foresayed vvounde, because she may rest therone, and not stirre this vvay or that vvay, then vvith the right hande vve must thruste the needle throughe the externalle parte of the lippe, invvardes, & then set the Can­ulle on the externall parte, of the nether lippe of the vvounde, & thrust the needle internal­lye outvvardes, of the foresayed lippe, & gent­lye dravve throughe, the threde, because as then vve may couple & ioyne agayne the lip­pe together: & if it be needfull to lay more stitches, vve must lay them as is a fore sayed: some mē hould the lippes vvith ther fingers in stee­de of a Canulle.

The kindes and differences of sowinge, or sutures, the the time, and the methode, or rule to take thē away. Chap. 4.

THe aunciēt Chyrurgianes ha­ve invented & fovvnde out divers & sundrye vvayes of sovvinge of a vvounde,Divers formes of sovvinge, accordige vnto the diversitye of the vvounde. cōsiderin­ge, & markinge one the vvoū ­ded parte, & nature or qvally­tye of the disseases: for the vvoundes of the ar­mes, or legges, as in those places vve may bet­ter & vvith more cōvenience vse the dry sutu­re: the vvoūdes of the bellye, are alsoe on an o­ther fashone sevved, then the vvoundes of the guttes. The profounde & deepe vvoundes are sovved, on an other fashon, thē the not deepe vvoūdes: Alsoe are the debile & imbicille per­sōs sovved one an other fashō, as are vvoemē, thē those vvhich are robuste & stronge, & by great paynes takinge and labour have a harde skine, ther in to eschevve & flye the deformi­tye vvhich after the sovvinge vvilbe seene.

All auncient professors have vsed,Three sortes of so­vvinge by the auncient pro­fessors. & have [Page 15] had in esteē, thre sortes of sovvinge of vvoun­des, as naemelye, the incarnative, the bloode stoppinge, & the conservative sovvinge. The incarnative suture is soe called because that throughe her vnitinge, shee ioyneth together the separated partes,Incarna­tive sutu­re, & her vse five manner of vvayes. if soe be vvithout violēce & cōveniētlye they may be brought together: vve vse this māner of suture in all freshe vvoū des, or in these, vvhich are renued. And this sovvīge is effected after five māner of vvayes. VVher of the first is called,Incarna­tive or knotted sovvinge. the knotted suture or sovvinge, because that in evetye stitche, vvhich perceth throughe both the lippes of the vvoūd, is every time cutt of, & vvith both the endes of the thred above the vvounde is knitte together: betvvixt the vvhich stitching, vve lay as yet other. This suture is done vvith a vvaxed threde, as is all readye sayed, notinge that bothe the lippes must aeqvallye be ioyned the one vvith the other, vvith out that ether the one or the other, yelde it selfe more this vvay thē that vvay, placinge the firste stich in the middle of the vvoūde, vvith a perforation of both the lippes of the vvoūd, by the vvhich the threde beinge passed, shall one the one syde of the lippe be dravven together, & abo­ve dobblelye knitte to gether, cuttinge both endes of the threde shorte of, because they should be noe hinderāce, vnto the remydyes vvhich vve shall applye: The vvhich in the re­nuinge of the dressinge might be the occasi­one of payne, or brekinge of the stitches, vvhē as vvith the plasters vve chaunced to plucke them. If the vvoūde he greate, vve must as yet lay more stitches, in the middle of the Spaciū, & one both endes of the vvounde, so procee­dinge forvvardes vntill the vvhole vvounde be layed vvith stitches or sutures, everye stich a fingers bredth the one frō the other, because at the least the lippes of the vvoūde might be brought close together, consideringe, & due­lye perpendinge the generall observatione a­bove mētioned, & especiallye that the stitches be not layed the one to neere to the other, or the one to vvyde frō the other because as heer tofore vve have sayed, through the great mul­titude, and throughe soe many prickes, they bringe & are cavse of vehemēt payne: & cōtraryly they lyinge to fare the one frō the other, the vvoūde as thē beinge not sufficientlye oc­cluded, or shutt vp, doe little profite, & cōmo­ditye, therfore they may not be layed to close by on another, nether to farre separate the on frō the other, they alsoe vvhich are layed to looselye, suffer the vvoūde to gape to vvyde, & they vvhich to fast, & strictlye dravve together the vvounde, cause inflammations, & cōpell the vvoūde burst open, vvherfore heerine vve ought te observe a mediocritye.The se­cōd incar­native su­ture.

The seconde incarnative, or fleshe making suture, is done vvith one, or vvith more need­les, as if soe be the vvounde be greate, & deep, as thē vve beginne to sticke & thruste the nee­dle in the lippe or edge of the vvoūde, vvith­out dravvinge of the foresayed needle qvite through, althoughe shee be threded, but must suffer her to continue therine, and vvinde the threde about her, in form of an S as the Tay­lers doe, vvhē as they are mynded safely to keepe there threeded needle, anye vvher one ther apparrell, as you may see in the figure or form of the haremouth: & soe put as manye needles therin as shalbe needfull, accordinge to the greatnes of the vvounde, & vvinde the threde ther about, and let them cōtinue therin vntill such time as the vvoūde shalbe healed & ioy­ned agayne. This sovvinge or suture is vsed, in such vvoundes as stande vvyde opē, & in those in the vvhich the lippes are separated the one sōvvhat vvydlye frō the other, & they vvhich vvith the common stitchinge might not be contayned, or Kept together.

The thirde incarnative sovvinge, is called,The thir­de incar­native su­ture. the penned stitchinge, because most commō ­lye it is done vvith little quilles, or shaftes of a penne, not that the foresaved qvilles, doe ef­fecte the sovvinge, but because they contayne it, & alsoe are a lett & hinderāce that the thre­de dothe not cut the lippes of the vvoūde cle­ane throughe, vvhich if vvith al expeditione & vvith the least payne vve desire to make thē vve must doe as heerafter follovvethe. VVe shall first of all take a stronge double threde vvhich is separated in tvvo, at the end having a knotte, vvhich vvith the needle vve must thruste throughe both the lippes or edges of the vvounde, redoinge the same soe often, & in divers places, as the greatnes of the vvoūde shall reqvire, allvvayes remēbringe that eve­rye stitch must be a fingers bredthe the one frō the other situated & layed, or therabout.

This beinge in this sort finished we must as then one that syde of the vvound vvhere the knott lyeth of the threde, betvveen eve­rye dubblethrede sticke a little shaft or qville, or els a little stick of vvoode, vvhich is vvounde in linnen clothe, & must be as lon­ge in the vvounde it selfe: vvhich after­vvardes vvith the threde, vve must dravve clo­se vnto the lippe of the vvounde: and one the other lippe of the vvoūde, vve must through that same dubblethrede, in like sorte alsoe put a qville, or a little sticke, vvound about vvith linnē vvhich in the first must be dravvn vvith one of the foresayed thredes, and vvith a dub­ble knott be knitted together, bringinge by this meanes the lippes of the vvounde as close together as is possible, in this vvyse proceedinge vvith dravvinge together and knittinge, all the thredes vvhich ther are, in such sorte as the first vvas dravven together & knitte. Such sovvinge, is vsed, in greate, & deepe vvoūdes [Page] in the vvhich vve feare least the cōmon sovv­inge or stitchinge might chaunce to breake, & cut through the edges of the vvounde.

The fourth is called the drye stich, or sovv­inge,The fourth incarnative suture. because this may be done vvithout pear­cinge of the skinne or fleshe: vvhich vve are vvonte to doe vvith tvvo strōge peeces of lin­nen cloth, vvhich are cut of the syde or edge of the clothe, and vvhich in the endes are cut sharpe or picked, as heere before in the figure vve may see, on the vvhich other ende vve must spreade a verye dravvīge & fast houldin­ge playster, vvhich qvicklye may be dryed, vvhich must thus be praepared, vve shall ap­plye this same one both sydes of the vvound, a little higher then the foresayed vvounde, & in such sort that bothe the sharpe endes of the peeces of cloth, may be situated close vnto the edges of the vvounde. This beinge cleaved ve­rye fast to the skinne, vve must as then so­vve bothe ther endes close together, vvith­out touchinge of the skinne, and dravve them together vvith the threde, through the vvhich meanes, vve may compacte the lippes of the vvounde as close together, os vve please. Such a māner of stitchinge is very vvillingelye vsed in the vvoundes of the face vvhēas vve desire to have noe great cicatrice left therin.

The fith kind of sovvinge is noe more in vse.The fifth incarnative sovvinge or stitchin­ge, is effected vvith iron hoockes, vvhich one both there endes vveare crooked, vvith the vvhich vve must hould both the lippes of the vvounde, bringinge the foresayed lippes close together: but because they cōtinuallye pricke & are never vvithout causing of payne, & mo­reover might chaunce to sticke in anye mem­brane, vvhich might suscitate & cause payne, concurringe of humors, & inflammatione, in the vvoūded parte, it is novve a dayes noe more in vse.The secō ­de gene­rall suture The seconde suture is, the bloode-stoppinge suture, soe called, because she sten­cheth & stoppeth bloode, and hindereth that the ayre can not enter into the vvoūde, vvhen as in manner of revolutione vve turne the needle, (as the furriers are vvōte to doe, vvhen as they sovve together the skinnes, & lay the stiches, reasonable close, harde, & on by the o­ther. Some vse this suture, or stitchinge, vvhē as the great vaynes or arteryes, are hurt or cutt of, cōsideringe the great sheddinge of bloode, through the vvhich they are compelled to doe soe, & soe the more easyer to ioyne & bringe together and shutt the lippes of the vvounde.

But this stitchinge, is nothinge to certay­ne, because the one stitchbrekinghe, all the other breake & goe loose, moreover the bloode vvhich is therin cōtayned causeth that part to svvell, and leeseth as it vveare himselfe be­tvveen the muscles, vvhich alsoe therafter by cōtinuance of time corrupt & are mortifyed. VVherfor I vvoulde councell the yonge Chi­rurgiane, that he should rather tye or binde the mouth of the vayne or arterye, or vvith a Cauterium cauterize it together, thē to vse such a stitchinge, vvhich is farre cōvenienter, in the vvoundes of the small guttes, or entralles, of the blather, or in the vvoūdes of the stomacke to be effected, if at the least in the tvvo last it may anye vvay possible be brought to passe.

The thirde sovvinge,The thir­de Stit­chinge. or stitchinge vve call the conservative, or the praeservinge suture, because she praeserveth, & Keepeth, the lippes op the vvounde vvhich are verye vvyde sepa­rated the one frome the other, or els because they are plettered, & crushede, or els because ther is anye parte of them lost, throughe the vvhich they cā not by any meanes be brought & ioyned agayne, the one vvith the other, re­qviringe onlye to be defēded, & mayntayned in that estate, till such time as the vvounde be come to a goode suppuratione & incarnatio­ne: vvher through the vvoūde, is soe much the the sooner cured & cicatrised, vvithout anye greate, or deformed cicatrice, remayninge in the place. This stitchinge is alsoe vsed vvhen vve suspecte, that ther is anye thinge cōtrarye to nature in the vvoūde, vvhich vve vvilling­lye vvould have therout , vvherfore vve doe not bringe the lippes of the vvounde so close together, as in other sutures, contentinge our selves, that in such sorte vve may continue it.

Touchinge the time, vvhē vve ought to cut a sunder the stitchinges, ther is noe certayntye therof, because in some bodyes, the vvoūdes are sooner cured, then in others, alsoe the one parte healeth sooner then the other, vvher­fore vve ought not to cutt loose the stitches, before the vvounde be soe far come, that she hath noe more neede of the stitches, vvhich cuttinge, must alsoe be done one divers man­ners, as the stitchinges are divers: for the knotted stitchinge, must be done, by cuttinge eve­rye stitche aparte, right at the knott, liftinge vp the threde vvith the privette or searchinge iron, havinge in this sorte cut of the knott of everye stitche, vve shall as then vvith the pin­cet or pinsinge iron dravve them out by there knot layinge the one finger one the stitch, to hould that fast that the one lippe of the vvoū ­de, be not dravvē out vvardes.Sovving of hare­mouthe. That stitchinge vvhich happeneth to be done vvith one or more needles, as in the haremouthes, in these vve cut a sunder the vvhole threde, vvhich is vvoūde roūde about the needle, thē gentlelye takīge the same avvaye, & therafter the needle alsoe. The pēned suture,The pen­ned sutu­re. is takē avvay through the discidinge or cuttinge avvaye, as is above sayed, that vve ought to cut everye stitche above the knotte, and ther gentlye dravve forth the thredes therout. The drye stitch is taken [Page 16] avvay, vvhen as ether vvith vvater or vvith a­nye oyle vve moysten the same.The fur­riers fas­honed suture. And the sutu­re of the furriers fashone, is verye difficulte to be taken avvaye: in this stitchinge, vve must first of all beginne to cutt, the first stiche, and soe proceedinge forevvardes, vvith the scis­sors, or sheares, vnto the end, if at the least it be to be done, and then easylye and gentlelye take every stitch out apart, allvvayes houldin­ge fast the lippes of the vvoundes vvith pour finger, least that they in anye sorte lift vp them selves because if it soe chaūced vve coulde not easylye resovve them agayne.

❧How we ought to thrust in agayne the guttes, and the nett, which is suncke out of the bellye. Chap. 5.

Gastrora­phia or bellye su­ture. IN the great vvoundes of the bellye, vvhich enter into the concavitye of the same, therin is vsed an other māner of sovvinge, vvhich the auncient pro­fessors call Gastroraphia, that is as much to saye, as the bellye suture or sovvi­nge. But because in such vvoūdes, most com­monlye the guttes & the net come to sincke out, it is therfore first of all necessarye, that vve hādle of the meanes, throughe the vvhich vve might agayne restore in to ther former place the guttes, or the nett, for othervvyse can not the sovvinge be effected, or brought to passe.

The small guttes beinge hurte, & cleane cut a sun­der, can not by anye me­anes be­cured.VVhen as therfore it chaunceth, that the guttes are suncke out of the bellye, vve must then first of all dillygentlye consider, vvhether in noe place they are vvounded, or hurte, se­condly, vvhether as yet they retayne the natu­rall coloure, for if soe be the small guttes are cleane cutt of, & especiallye that emptye one, vvhich vve call Ieiunum, it is then impossible that he may be healed agayne, because of a great companye, and divers greate vaynes, vvhich are therin, allsoe consideringe his sub­tyle and synuishe tunicle or koate, and becau­se he continuallye receaveth the Cholera, and is situated more neerer the liver, then anye o­ther. But the great guttes beinge hurte, vve may rightvvell sovve them, yet not vvithout a stedfast hope that vve are able to cure them, althoughe in respecte of the smalle guttes, by the great ones, vvhich are hurte, it is allvvayes better to have a doubtfull confidence then a certayne dispayre, as much as belongeth vnto ther curinge. If soe be anye of thē be blacke, or pale, (vvhich is a certayne signe they have lost ther feelinge) there is nothinge to be do­ne vnto them, or at the least verye little. But if soe be as yet they retayne the vitalle colou­re, vve must by all meanes endevoure to bringe them in agayne, and that vvith all possible expeditione, because the externall ayre, in the vvhich they are not vvōte to be, doth straight vvayes change and spoyle thē. And first of all if they be vvounded, vve must stitch thē vvith the furriers suture, vvhich above vve have di­scribed, & vvhē they are sovved, bringe them into there naturall place or situatiō, dilligent­lye notinge that vve doe not let the end of the threde hange in the vvoūde, because vvhen as they are cured, vve may dravve the threde ther out, & not let it sincke into the bellye, for the vvhich occasione he ought be reasonable longe, vvithout cuttīge of him from the sovvīge.

But vvhen as vve vvill beginne or take such a thinge in hand,After vvhat mā ner vve must set the patiēt vve must as then conveniēt­lye set, or lay the patient: even as if the vvoun­de vveare in the bottome of his bellye, vve then laye the patient one his backe, vvith his thighes & his buttockes alofte: if soe be the vvounde vveare in the vpper parte of his bel­lye, the patiēt must lye one his backe hyghlye situated all most sittinghe, because that the vvoūded partes may suspend & hange in the bellye: if soe be the vvoūde be in the right sy­de, vve must thē situat the patient one his left syde, and if in the left syde he be vvounded, he must then lye one his right syde: vvhen as the vvoūde is soe narrovve, & soe smalle, that the svvollē gutt, vvhich hāgeth out, cānot agayne be put therin, it is then necessarye, ether that by arte vve drive avvay, & consume the vvyn­des vvhich cause the tumefactione and svvel­linge, or that vve dilate the vvounde: but it is allvvayes best that vve trye first of all to repell the svvellinghe of the guttes, vvhich must be effected vvith some resolvinge and strengtheninge medicamentes,What vve ought te doe vvhē the descē ded and svvollen gutt can not be put in ag­ayne or restored into his place. amongst the vvhich must be entermingled some mollify­inge and softeninge medicamentes: as vvhen the guttes are to drye, vve must then bath thē, in vvarme vvater, in the vvhich must be done a little quantitye of oyle of roses, or els vvith some grosse blacke vvyne, because it streng­theneth and vvarmeth the guttes more then vvater: & if soe be the guttes vvith these reme­dyes, vvill not as yet relaye ther svvellinge, & tumefactione, it vvas then the vse of Mr Pa­re, chiefe Chyrurgiane to the kinge, in divers places to pricke them throughe, vvith a need­le, through the vvhich the vvyndes as then de­parte. Havinge thus finished all this, if soe be there be such a quantitye of guttes suncke out of the bellye, that they can not in anye sorte be put in agayne at the same entrāce, or vvoū ­de, because shee is to little, vve must as then dilate it vvith a crooked Lācet, vvhich cutteth but one the on syde, dilligētlye notīge that in any sort vve doe not hurt the entralls, vvhich beinge finished, a cōveniēt persone thervnto shall vvith his fingers, hould a sunder the ed­ges of the vvoūde, & the Chirurgiane impose [Page] foresayed guttes agayne into ther places, first of all intrudinge of those vvhich vveare last, in the comminge or sinckinge out, exactlye notinge,The en­tralls must eve­rye one be brought into his naturall statione. that everye circumvolutione of the guttes, or everye revolutione of the same, may obtayne ther ovvne place, intrudinge the sa­me therin vvith the fingers, and one such a manner that the one may follovve the other: othervvyse that vvhich is allreadye thruste in, the finger beinge taken avvaye, might chaun­ce retire and come forth agayne, vnlesse that vvith anye other finger vve retayned the sa­me, vvhylest that the other finger is finishin­ge his operatione or vvorke, vvith bringinge an other portione or parte, into his place, and vsinge this manner,they may easylye be reduced into ther former places. VVhich beinge done, (imposing or layinge the hande one the vvounde) vve must as then a little stirre and iogge the bodye of the patient, vvhere throu­ghe the entralles, vvill situate, settle, or place them selves everye one in his naturall & pro­pre place, even as they vveare, before they vve­are removed out of the same.After vvhat sort vve ought to put in the net. If the net, issu­eth out of the vvounde, and the same be not hurt, or vvithout anye vvounde, and as yet sovvnde, vve must genttlelye cause it to sincke one the guttes, but if soe be anye parte ther of or portione is become blacke or leadishe co­loured, vve must as thē a little above the blac­kenes bynde it, to praevent the bleedinge, and cutt it of vnder the foresayed succincture, and immediatelye reduce that into the bellye a­gayne vvhich is not as yet blacke, & is yet soū ­de, layinge the end of the threde hanginge out of the vvounde, because therafter vve might easylye extracte and dravve it forth, vvhen as it shalbe therof loosened, and the vvounde be come te goode suppuratione and voydinge of matter.

❧ Of the stitchinge of the bellye which we call, Gastroraphia Chapter. 6.

The sovvinge of the bellye must not be done as the o­ther sutu­res. THe guttes or entralles, and the nett, beinge brought into ther severall places, vve must as thē sovve, & stitch vp the vvoun­de: but because such suture, accordinge vnto the opinions & sayinges of divers, may not be done in that sorte, as other stitchinges, or sovvinges, to vvit the ioyninge together of that, vvhich is of one nature and dispositione, the one vvith the other, as the Peritoneum, vvith the Peritoneo, (& soe forth of the skinne and the muscles) but vve are vvilled and councelled that vve ioyne and stitch the Peritoneum, vvhich is a membra­ne, vvith the muscles, and vvith the skinne E­pigastri, because the same beinge verye synuis­he, vvill verye difficultlye be cured or healed, vvith the other parte Peritonei, vvhich opposi­telye is situated agaynst it vvhich is allsoe of the same synnuishe substance. In fine vve are councelled, to sovve vp the edges of the vvoū ­de vvhich is in the right syde Peritonei, vvith the muscles, vvhich are in the left lippe of the vvounde, soe that one this manner the musculous fleshe, of the right lippe Peritonei, vvhich healeth vvith the left lippe of the foresayed Peritoneum, vvith the musculous fleshe one the one syde, and the muscvlous fleshe vvith the Peritoneo on the other syde. Because that Peri­toneum, vvith the Peritoneo, can not be healed, vvherthroughe the vvounde onlye above in the fleshye parte might chaunce to heale, out of the vvhich might ensue a tumefactione, as if it vveare a roushing, or issuinge forth of the navel, consideringe the foresayed Peritoneum, vvhich throughe erectione & heavinge vp of the guttes, could not in anye sorte conioyne together: and such a meaninge muste be done one this manner. The vvounde beinge grea­te, vve must have a convenient minister or servāt, vvhich must vvith his hand one the ex­terior parte of the vvoūde depresse it dovvne, because as then shee may be shutt & closed, & nether the guttes, nor the nett, roush therout sufferinge only a small portione of the vvoū ­de vncovered for the Chyrurgian, vvho vvith his threded needle, must begīne his first stitch in the end of the one lippe of the vvounde, thrustinge through the externall skinne, and the musculous fleshe of the vvounde, vvith­out touchinge the Peritoneum, vvhich is there vnder situated, dravvinge the needle frō out­vvardes, invvardes vvith her threde, & thrust the secōde stitche, cleane throughe the vvho­le lippe of the vvounde, vvhich oppositelye is situated agaynst the first stiche, to vvitte, the Peritoneum, the muscles and the skinne, first bringinge the stitch cleane through the Peri­toneum, and dravvinge the foresayed needle, from invvarded, outvvardes: And the same beinge dravvē out, vvith her threde, he must then lay his thirde stitche, as he did the first, beginninge the stitch in the skinne, & in the musculous fleshe, of the first lippe, vvithout touchinge the musculous fleshe, of the first lippe, vvithout touchinge the Peritoneum, dra­vvinge the needle from out vvardes, invvar­des, thē he must bringe his fourth stitch, as he hath done the seconde, thrustinge cleane throughe the Peritoneum, all the musculous fleshe, & the skinne, dravvinge out the need­le from invvardes, outvvardes, & in this sorte he must proceede, and goe forvvardes, vntill the vvhole vvounde from end to ende be cle­ane sovved vp, thrustinge throughe on the [Page 17] one syde, onlye the skinne & the musculous fleshe, and one the other syde the Peritoneum, the musculous fleshe, & the skinne: because the sovvinge of the Peritoneum onlye, vvith the other part Peritonei, is not sufficiente, nether the suture of the fleshe onlye, but this suture must as vvell be done in the one as in the o­ther, endevouringe allvvayes to vnite the Peritoneum vvith the musculous flesh.

An other fashon of sovvinge of the bellye, accor­dinge to some mēs sayinges.Some there are vvhich effect this suture on this manner, follovvīge, beinge of opinione, that those partes, vvhich are of one nature & propertye, verye easylye vnite them selves the one, vvith the other, as the skinne vvith the skinne, the fleshe vvith the fleshe, and the membranes vvith the membranes, vvherfore they bringe ther first stitch, quite, and cleane throughe the skinne and the musculous fles­he, from the first lipp, vvithout touchinge the Peritoneum, vvhich is thervnder situated, dra­vvinge there needle from outvvardes, invvar­des, vvith her thred, layinge ther seconde stit­che, in the lipp right opposite agaynst that, thrustinge then onlye throughe the Peritone­um, & throughe a little fleshe, dravvinge the needle, from invvardes, outvvardes, thē they bringe there thirde stitch, in the first lippe of the vvounde, thrustinge throughe the Perito­neum, & a little fleshe, vvithout ether thrustin­ge through the muscles, or the skinne, dra­vvinge there needle from invvardes, outvvar­des, & then they bringe there fourth stitch in the opposite lyinge lippe, & thrust throughe the skinne, and throughe the musculous fles­he, vvithout touchinge the Peritoneum, and in that sort proceede forevvardes, vntill the vvhole vvounde be sovved, soe that throughe one edge of the lippe, but yet at divers times they thrust throughe the skinne and the mus­ous fleshe, and allsoe the Peritoneum.

The manner of sovvinge of the bellye out of Celsus-Amonge all other sortes of sovvinge the vvoundes of the bellye, or stitchinge of them this vvhich vve have taken out of Celsus is the least daungerous and the best alsoe, & easyest to be done. That vve must have tvvo threded needles,By the left lippe vve must not onderstāde the left syde of the pa­tient for it is the right syde of the vvounde, but rather the left syde of the Chy­rurgiane. vvith one threde, the one needle at the one end, and the other needle at the other end of the threde, vvher of vve must take the one needle in the right, & the other in the left hande, vve must beginne in the end, of the su­perior parte of the vvounde one the left sy­de, first of all pearcinge throughe the Peritone­um, then the musculouse fleshe, and the skin­ne, dravvinge the needle vvith the threde out, vnto the one halfe, from invvardes, outvvar­des, then vve must vvith the other needle of the left hande, make the seconde stitch, right opposite agaynst the first, in the right syde of the vvounde, beginninge vvith Peritoneo, as vve have sayed of the first stitch, on this sorte the acuitye or poyncte of the needle is farre e­noughe frō the entralles or guttes, & yet not­vvithstandinge the heade close vnto the fora­sayed guttes: VVhen as therfore the needles have pearced & passed throughe from the one syde to the other, vve must as thē chāge hāds, in receavinge agayne of the needles aforesay­ed, & take the needle, of the right hand, in the left hand, & the needle of the left hand in the right this permutatione or changinge beinge in this sorte effected, vve must then agayne thruste throughe the lippes of the vvoūde, as al readye hath binne done, to vvitt, from the internall parte, tovvardes the externall, & soe proceedinge forevvardes, as much as is suffici­ent, and allvvayes consideringe that the one stiche be allvvayes layed right opposyte a­gaynst the other, in this sort proceedinge, vn­till the vvoūd be vvholye sevved vp, allvvayes remembringe to leave a little apertione, in the bottome of the vvoūde, throughe the vvhich the congealed bloode, and the threde may be avoyded, vvhich apertione, vve must alvvayes keepe aperte or open vvith a little leaden hol­lovve pipe, vvhich in the end must be tyede & bovvnde vvith a threde, because that by chaū ­ce it doe not come to slippe into the bellye of the patient. And vve must vvel and dilligent­lye note, that this suture or sovving allvvayes bedone vvith a goode strōge threde,What mā ner of threde & needle vve must haue. & vvith a needle, somevvhat crooked at the poynct, lay­inge the stitches, somvvhat closer the one by other, then in other vvoundes of the bodye, because the stirrīge of the bellye, farre sooner causeth the stitches to burst and breake a sun­der, then in anye other partes of the bodye, & because alsoe the vvoundes of the bellye, are not so subiecte vnto inflammation or incen­sions, as other althoughe that often times the bellye is thrust throughe.

Chirurgerye THE FOVRTH TRE­ATISE OF THE OPERATI­on of Chyrurgerye, wherin is discoursede and handelede of the openinges, and apertions of Apostemations, Contayninge five Chapters.

  • Of the generall vvay to open any Apostemations vvhatsoever. Chap. 1.
  • Of the tumefactions, vvhich vve call, Ateromata, Steatomata, & Melicerides. Chap. 2.
  • Hovve vve ought to cauterize, & make any inscisione in the Apostemations of the brest. Ch. 3.
  • Hovve vve ought to make the Paracentese, and take avvay the vvater from them vvhich have the Dropsye. Chap. 4.
  • Hovve vve ought to cure the Hernias aquosas, or vvater burstinges. Chap. 5.

❧Of the generall way te open Apostemations. Chap. 1.

What vve ought to consider before vve make the appertione. WHen as vve endevoure to opē anye apostematiōs, to lett the matter rūne therout, vve must first of all before vve com to the inscisione, or apertione, consider, vvhether the matter might not in anye vvayes be resolved or con­sumed, throughe the forces of the naturall ca­liditye, or heate, or els vvhether needes and of necessitye be chaunged into matter. VVhen as an Apostematione, must needes be brought to suppuratione of matter & can by noe mea­nes possible be consumed or resolved, the sig­nes therof are these, namelye a burninge hea­te, erectīge of the tumefactione, or svvellinge, more rednes,Signes of suppura­tione. & vvhich is also harder thē before, prickinge, knockinge, or beatinge payne, ponderousnes, as if there did hange anye hea­vye thinge at that ioynte: And if soe be this a­postematione be situated in any principall parte, then there is a chillnes and shiveringe thervvith associated, the ague allsoe is more violent by day, then by night: sometimes al­soe the next kernells vvhich are in the bodye situated thervnto come or chaunce to svvel, & be distempered.Signes vvhē the matter is fullye ri­pened▪ But the suppuratione, or re­solutione to matter beīge finished, or accom­plished, the tumefactione as thē diminished, vve thē sensiblye feele prickinge, vvith a little itching therbye, alsoe a little deafnes or num­nes, vvherbye alsoe some times is felte a great prickinge, especiallye the matter lyinge verye deepe: For the matter lyinge close vnder the skinne, there thē demōstrateth it selfe a little heade vvhich in feelinge is softe, and vvhen as vve depresse vvith the finger it glideth a syde, vvher of the skinne, in the superior parte of the same heade openeth it selfe, & separeteth it selfe from the inferior partes of the same.

When vvith the lancet vve ought to opē an Aposte­matione.VVhen as therfore all these signes reveale themselyes, vve may thē bouldelye & freelye, opē the Apostematione, vvith the lācet, vvith out tatryinge anye longer, that it might of it selfe breake through, because the matter may thē issve forth therat, & because that through to lōge tarryinge, vvith the openinge therof, shee doe not come to diminishe into the cir­cumiacent partes, & make other concavityes. Althoughe Celsus sayeth,Opinione of Celsus. that verye seldome vve ought to make anye inscisione, vnder the armepittes, or in the flanckes vvhen the mat­ter is ripened, & come to a full and good sup­puratione, in like sorte alsoe, vvhen the Apo­stematione is not to greate & is placed vnder the skinne, but that as thē vve make the aper­tione vvith Cataplasmes, & let them of them­selves breake throughe, vnlesse throughe the intollerablenes, and greate dolor or payne of the patient, the Chyrurgiane vveare compel­led, to open the same, because sayeth he, that if vvith out inscisione or cauterisatione vve make the apertione, noe deformed cicatrice, or signe, therof, may remayne. VVhē the matter lyeth deepe vve must thē cōsider,When the Aposto­matione must be opened vvith a hott Iron. vvhether the part be synnuishe, & if soe be that it is soe vve must as then open the foresayed Aposte­matione vvith a hott Iron, vvhich is thervnto verye convenient, because that apertione, al­thoughe vve make it somvvhat smalle, it tar­ryeth a longe time opē to make issue vnto the matter, through the vvhich alsoe the cicatrice continueth verye little. VVe vse novve in these dayes potentialle corrosives. If soe be about the place of the apertione any synnues be situated, vve ought then to feare vvhen vve must make the apertione vvith a hott irō that then the patient might fall into Spasmo, or els the ioyncte might be criple, and tarrye lame, therfore vve ought rather to vse the lancet.

It happeneth alsoe sometimes, that although the apostematione be not yet ripe,What apostematiōs vvilbe opened before there cō ­plete ri­penes. & vvith­out greate store of matter, yet notvvithstan­ding reqvireth to be opened, especiallye, vvhē [Page 18] as it is situated by, or next vnto some vvorthy parte, the foresayed matter beinge venomous or pestilētialle, vvhich if vve suffered them to continue vntil there complete ripenes & ma­turitye, might dravve invvardes, & throughe there venomous dampes, might infecte some of the vvorthyest partes, out of the vvhich, as then follovve most fearfull accidentes. And althoughe Celsus counceleth vs, that vve must stay vntill such time as all apostemations, are come vnto an accōplished maturitye, vvhich are situated in the synuuishe partes, because the skinne beinge grovven thinner, and the matter neerer approchīg thervnto, vve might then the easyer & neerer attayne therto, not­vvithstādinge our best practisioners councell vs, that vve shoulde open such apostema­tions: as they alsoe councell vs, to open all a­postemations, vvhich are situated close to the ioynctes, bones, synnues, tendones, and to the ligamentes, yea and before the time of the ac­complished maturitye, because therin, they might not cause anye great rottennes, or cor­ruptione of other partes.

In like sorte must the apostemations of the privityes be opened, before they be come to ther full maturitye, because there chaūce noe corruptione in that parte, as all such partes throughe there greate, moystnes, are verye much inclined vnto corruptione & rottēnes, as allso beyonde this, the matter throughe to longe beinge therine continued, causeth the Intestinum rectū, or the gutte of excremētes, to corrupte, & rotte, vvhich is farr softer, thē the externall skinne, vvherthrough the foresayed matter oftētimes internallye bursteth out, by the vvich cōmonly follovveth a Fistle, vvhich is all most incurable.

VVhen [...] therfore vve see that ther is anye matter in the Apostemation, vvhich hath noe issue, & by her selfe can make or effect anye e­ther consideringe her crasitude, her crudetye & viscositye, as therby not beinge possible for her to attayn vnto complete maturitye, or els because the skinne is harde, or that the foresa­yed matter lyeth to deep, through the vvhich there remayneth a great thicknes betvveē the skinne & the matter, or els consideringe cer­tayne inconveniences, vve may not delaye soe longe, vntill it be fully mature, and ripe, as are the Apostemations, vvhich are situated next vnto some vvorthye parte, as by anye greate vaynes, or synuishe partes, vvhich are incli­ned to great corruptione. The Chyrurgiane must vvithout any lōger delay, make the aper­tione vvith his lācet, rather thē to expecte any of these daūngers above rehearsed. The fittest time therfore first of all to doe an operatione, is in the morninge by time, cōsidering that in such a time, the persone is farre better qvieted & better animated and incouraged, except the greate daunger reqvired othervvyse the cōtra­rye Secondly vve must note, that the apertion be made in a conveniēt place, vvhich cōveniēt place, is knovven by the tumefactione,Secondly of the parte, in the vvhich there revealeth it selfe a little heade, & ther is greate vveakenes & sof­tenes founde therin, vvhich glideth vnder the feelinge of the finger, & vvhere the skinne is thinneste: it is right true that such an apertiō might bedone in the inferior partes of the tu­mefactione a foresayed, because the matter might the easyer issue out,Four principalle cō ditions, vvhich the Chy­rurgiane must consider before he opē any svvellinge. vvith out dravving of the medicametes, or through the harde de­pressione of the same because all evacuations vvhich chaunce in the hanginge sores, cā farre better avoyde the matter, thē any medicamē ­tes, especially in such partes, of the vvhich vve cā not chaūge the situatione, as in the vvhole Chaos of the bodye: For although, in the armes, or legges, any apertione is made in the superi­ore partes of the tumefactione, throughe the situatione, such a faulte may be remediede.

The third conditione is, that vve must con­sider, one the rimpelinge of the skinne,The third cōditione & one the fibres of the muscles, and because the mus­cles allmost runne throughe the length of the bodye, the apertione must thē be made in the length of the bodye, and accordinge vnto the right concurringe of the muscles. Notvvith­standinge althoughe, the rimples, or forefrōte of the heade lye thvvarte over, yet the inscisiō must therin be made accordinge vnto the lēg­the, follovvīge the fleshye fibers, of the broad muscle: othervvyse the skinne beinge cutt ac­cordinge to the rūninge of the rimples, might chaunce to fall on the eyes, In the heade vve must observe the grovvinge of the hayre. Vn­der the armepittes, & in the flanckes, vve must consider the shuttinge, or one the rimples of the same places, because the deformitye of the cicatrice, vnder the fouldinge of that part may be hiddē, & to praevēt the imbicillytye, vvhich is an occasione, of the receavinge of the cōcurringe humors: Thē to praevēt, that vve doe not chāce to touche, any synnues, Tēdone, Vayne, Arterye, or any other partes of esteeme, & that the apertion, may be done vvithout ane daun­ger, vve make novv the inscision in the length as thē overthvvarte, accordinge as every parte reqvireth: vvhich cā not rightly be done then of those vvhich have a complete knovvledge of the Anatomye: othervvyse they ignorātlye might chaunce to touch a synnue, or a vayne, or might chaunce to cut an arterye, vvher­throughe the Spasmus, the Paralisis, or any great sheddinge of bloode, yea alsoe & at somtimes might because of his death.

The fourth conditione is,The fourth cō ditione. that vve must re­mēber dilligentlye to make as smalle an aper­tione [Page] as vve may, survayinge the apertione, vvith the magnitude of the Apostematione: For if so be it be little, vve may as then make therine a meane and reasonable inscisione, vvhich alsoe must not be deepe, but the apostematione beinge great, vve are thē sometimes vrged, to make tvvo inscisions, or more then tvvo, beinge therin made, that one of them all vvayes, be in the inferior cōcavitye of the fore sayed Apostematione, because the humor doe not chaūce heere or there to make any more cōcavityes, evē as the humors, allvvayes internallye, corrupte & eat through the circumia­cent partes, and ther in diminishe.

An admonitione conside­ringe all great ApostematiōsAnd if soe be that any apostematione, vvith great concavityes cam into our handes, & the skinne ther over might as yet becured agayne vvith the fleshe, vve must as then make but o­ne apertiō or inscisione, throughe the vvhich the matter may issve: but if soe be the fleshe internally is eaten, & corrupted avvay, vve must as then cutt throughe vvith a right cutte, the vvhole concavitye, accordinge vnto the leng­the therof, vvhich beinge done, & the edge of the vvounde in all places beinge very skinne, & bereft of all ther fleshe vve must clippe or cutt them cleane avvay: because such skinne restrayneth and keepeth backe the matter, vvhich causeth the circumiacent partes to corrupte, & hindereth the applicatione of the medicamentes: but vvhen as vve cutt the skinne, vve must doe it triāgle vvyse, or in forme of a mirtle lease, because the apertione soe much the sooner, might chaūce to heale, because all rotūditye in vlceratiōs is difficult to be cured.

Frō vvhē ­ce vve must take our indi­cation, of the great­nes of the vvounde.And touchinge all great apertions, vvhich may be made in the apostemations, must be made, accordinge to the abūdance, or the qvā ­titye of the matter, & accordīge as the subiecte partes therof require. As alsoe vve must con­sider, on the depthe, & marke that vve thrust not the lancet to deepe therin, but reasonable deepe: for vvhē as vve thrust to deepe, it is thē great dolour, & payne to the patiēt, & causeth alsoe much bleedinge: & thrustinge not deepe enoughe, vve effecte & brīge nothīge to passe.

The fifth cōditione, must be observede, ac­cordinge to the apertiō of all greate apostematiōs, that at one time vve suffer not all the matter to rūne out, but rather by little, & little, es­peciallye, the patient beinge debile, oulde, yonge, or any vvomā vvith child, because all suddayn evacuatiōs, doe cause great imbicilli­ty & fayntnes because ther through the vitall spirites, evaporate & flye avvay, vvhich in the cōcavitye of the Apostemation vvith the mat­ter vveare shutt therin, althoughe they are a­gaynste nature.

An other conditiō vvherone vve must consider after the apertione of the svvelling.The apertione beinge done, vve must hādle the vvound, accordinge vnto the diversitye of those partes, vvherin the Apostematione vvas situated, & alsoe accordinge vnto the time & season of the yeare. The Chyrurgiane ought especiallye to eschevve the great tētes, vvhich Celsus prohibiteth to vse in the vlcerations of the arme pittes, & flanckes, & that because of the great vaynes, arteryes, & synnues, vvhich in those places are situated, layinge onlye ther one a sponge vvhich is madefied, & vvetted in vvyne. VVe cōmonlye lay theron a flatte plumaciolle or tent made of linte, and therone a plaster, levinge soe the solutione apert, becau­se that the remayninge matter might issue & come forthe therat vvhich othervvyse throu­ghe a great lōge thicke tente, might therin be retayned, & kept backe. This beinge done, vve must then dresse that parte, & vvinde it begin­ninge to vvinde from the sovvnde parte, vnto the bottome of the cōcavitye if there be anye, endinge at the apertione because the matter may be pressed & crushed therout, vvithout beinge therin retayned, any longer, because by to longe tarryinge therine, it doe not cause a greate hollovve fistulous concavitye to come therin: then vve must lay that part in such a sort that the apertione may depend or hange, because soe the matter may the better issue out therat.

Of the tumefactions, or swellinges called, Ateromata, Steatomata, and Melicerides. Chap. 2.

THe auncient professors,The difference of these thre Vlcerati­ones. have allvvayes noted, onlye the species & formes of vlcerations, that they onlye differed the o­ne from the other, in the mat­ter, vvhich is founde therine. For in the vlceration Ateroma, Signes to knovve them. is a kinde of matter like vnto thinne pappe: the vlceration Steatoma, a kinde of fatte matter, like suet. In Melicerides, is a matter like vnto honnye: Soe that by the forme of coniecture vve may say, vvhat matter therin lyeth inclosed, but for a certayntye vve can not say it, before such time as vve have fetched some of the matter ther­out: and one this manner they are allvvayes knovvne the one frō the other. vvhen as vve chaūce to touch the vlceratiō Ateroma, it spre­adeth abroade, in that place vvherō vve chaū ­ce to depresse it, & doth not so suddaynly, ioy­ne it selfe together. The vlceration Meliceres, differeth frō the Ateroma, in his forme, & sub­stāce of his humors for his figure is much roū der, and the substance of the humor vvhich is therin, farre subtiler. soe that it spreadeth mo­re abroade, then the Ateroma, vvhen vvith the finger vve depresse it, it separateth it selfe far­re soener, & alsoe ioyneth much sooner, vvhē vve take the fingers therof. The vlceratione [Page 19] Steatoma, is much harder, then both the other, & in the touchinge of it, it stirreth not, but re­sisteth the depressinge of the fingers, & com­mōlye in the bottome is it somvvhat broade, and verye seldome or never may vve se any vvhich are vnder narrovve & broade above.

We oftentimes fin­de harde matter in these vl­cerations.These foresayed vlcerations, are in ther be­ginninge allvvay little, but in continuance of time, they grovv to be greater, some are verye harde, & vve finde sometimes therin vvond­rous matter, as if it vveare little stones, bones, rovvled hayre, mixed vvith any matter vvhich is thicke.

The mat­ter lyeth enclosed in a little blather. Philexomus sayeth, he sometimes hath fovvnde, in the matter vvhich therin lay inclosed, little creatures, as if it had bīne gnattes, vve must note that al those foresayed humors, & al the­se vvonderfull thinges, are inclosed as it vvea­re in little blathers.

But as much as concernethe the apertione of the same, it hindereth nothinge vvhether the matter be like pappe, or like honnye, or li­ke suet, or vvhat matter soever it might be: for vve have but one onlye intentione, to vvitt that vve extracte & dravve out the blather, or little bagge, vvherin the matter is inclosed, for the manner hovve to open it is this.

The ope­ratione to cure the vlceratiōs is nothing different.VVe must first of all lift vp the skinne frō the bottome, & then cutt it of, makinge insci­sione accordinge to the greatenes of the vlce­ratione, dilligētlye markinge least vve cut the blather or purse vvherin the the humor is in­closed, because the matter doe not chaunce to issue out: For the matter beinge issued, the vvhole remanēt operatiō is perturbed, & an­nihilated, because alsoe there by the operatiō falleth flatte dovvne: soe that as then vve may or can verye difficultlye flea, peele or separate the foresayed membrane of the matter, from the fleshe, vvherthroughe the vvhole curati­one, consisteth vvithout reciduitye.

VVhen as in this sorte, vve shall have cutt the skinne, thē the little bagge demonstrateth it selfe vvhyte, and outstretched, vvhich vvith greate dilligence, vve must endevoure to sepa­rate thereof, vvith a Spatula, to vvitt, from the skinne, & out of the fleshe, or vvith any other instrument, vvhich is thereto serviceable, vvher vvith vve must take it out, vvith all that vvhich is therin, vvithout sufferinge anye iott therof to remayne in the bottome, because it chaunce not to increase agayne: And is it soe happened that there chaunced to tarrye anye thinge therof in the vvounde, vve must not as thē heale together the apertione verye soone, but vvith puryfyinge medicamentes, purifye that therout vvhich as yet remayneth therin.

We must in the operatione dilligent­lye consi­der, that vve doe not chaū ­ce to breake anye Vaynes, synnues, arteryes, or tendo­nes.VVe must alsoe heer note, that some of the­se vlcerations, are rotede betvveene anye vay­nes, arteryes, synnues, & tēdones, vvhich era­dication, reqvireth a greate & longe cōtinued & convenient manuall, operation, because, thinckinge qvite and cleane to take avvay the little bagge or purse from thence, vve might chaunce to burst anye vayne, arterye, synnue or Tēdone, therfore if so be therebe anye par­te therone fastened it is then bētter to desiste from our operation. VVhē this operatione is thus finished, in anye smalle svvellinges, ther is as thē noe more daunger, vvherfore there resteth no thinge for vs to doe, then vvith any curinge medicamentes, to heale op the insci­sione, layinge therone a Compresse, madefied in some defensive or other, because that in the dressinge, all inflāmations may be praevented, & the separated partes the on agayne conioy­ned vvith the other. But if soe be the vvounde vveare great, & coulde not be cured, one this manner, it vvill not then seeme discommodi­ous, that vve stitch it vp, layinge the stitches somvvhat vvyde the one from the other, to let anye medicamemt or other droppe betvveen them, & to give passage to the matter vvhich engendreth therin: & then vve must vvholye cure these vlceratiōs as all other vlcerations.

Touchinge the curing of Queēs evil vvhich is alsoe done through manuall operatione, is alsoe one this māner effected, takinge the fo­resayed Queens evill vvholye therout, if soe be it be possible dilligentlye markinge, that vve chaūce not to hurte anye vaynes situated ther about, & especiallye of those vvhich are divi­ded amongst the muscles, vvhich are servicea­ble to the speach, or voyce, as are the recurrentes, or retrogradinge muscles, & those vvhich are situated, abute the Laringa as vvell the principalls as commō: For it hath oftē times hap­pened that some have had this dissease of the Qveenes evill cut out about ther throt, vvhich all there life time therafter have remayned hoarce & vvithout speeche.

❧The manner how to cauterize, & make an insci­sione in the vleerations of the brest, called Empiema. Chap. 3.

BEtvveene the ribbes,Hippocrates in pro­gnosticis and in his thirde booke of diseases. and be­tvveene the intercostalle muscles & betvveene the mēbra­ne Pleura, concurrethe & ga­thereth sometimes certayne bloode together, vvhich chaū ­geth it selfe into matter, although the Physiti­on, as vvel throughe Phlebotomye, throughe purgations, through fomētations, or through any other appliclations, hath done his best,This tu­me facti­one externallye so­metimes demōstrateth it selfe. to resolve & cōsume that. This foresayed matter, sometimes externallye demostrateth her sel­fe causinge a tumefactione vnder the skinne of the brest. Then the foresayed membrane [Page] Pleura, The vice-ratione of the brest, vvhich vve call Empiema often ti­mes dē ­monstra­teth it sel­fe. allvvayes most commōlye breaketh, & and bursteth a sunder, to give passage vnto the matter, vvhich therafter sincketh into the cō ­cavitye of the breste, & is sometimes voyded throughe the vrine, or throughe the mouth, the longes dravvinge the same vnto them, and then throughe the throte is coughed vp.

The signes, if any matter be retayned in the brest, are these, to vvit, difficultnes in brea­thinge, stinckinge breath, heavines in the sy­de,Signes of the mat­ter vvhich is retay­ned in the brest. a drye cough, vvith great prickinge in the brest, a cōtinualle ague, vvhich agaynst night redoubleth her forces, svvetinge in the ende of the digestione, little sleepe, & noe appetyte at all. Somtimes in the place of matter, there is vvater gathered in the brest, vvhich vve espy vvhen as the patient through great thirst, hath druncke great store of vvater: vvhen he con­tinuallye cougheth, vvithout spittinge, vvith Shortnes of breth, vvith svvellinge in the fee­te, & vvhen vve stirre the brest one the one sy­de, vvherin the vvater contayneth it selfe, vve heare a shogging, as vve ar vvōte to heare in a pott half full of vvater: & this dissease may be called, the Dropsye of the lōges & of the brest.

Dropsy of the brest and her tokēsVVhen anye of these disseases have conti­nued any time, & noe remedyes have helped, & noe hope left, that the vvater, or the matter might by anye meanes be expelled out by the mouth, or els be purged throughe the vrine, 40. dayes beinge passed, vve must as then co­me to the manualle operatione, & endevoure to opē the brest, & make a passage for the mat­ter to issue forth, because the longes doe not in anye sorte chaunce to corrupte, or rotte. VVhich may bedone through the inscisione, or throughe a potentiall, or actuall Cauterium. VVe must first of all cōsider, vvhether in anye partes of the brest,Hovve vve ought to make the aper­tiō in the Empiema vvith a lancet or vvith a corrosive vve espye noe svvellinge or tumefactione: vvhich havīge espyed, vve must then make the apertione, vvith the lancet, or vvith the Cauterio, & that in the fittest & con­venientest place vve can finde. But our com­mon vse is, to applye the potentiall Cauterium, because the apertiō, vvhich vve made therine, through the Cauteriū, may the longer be kept opē and apert, vvithout troublinge of the pa­tient, vvith the impositione or puttinge in of greate tentes, to keepe open the inscisione. And if soe be vve perceave noe tumefactione, or svvellinge, externally in the brest, vve must then betvveene the thirde and the fourth true ribbe, beginninge to account from vnder, a­bout the midest of the one syde,The place of the a­pertione. sixe, or sea­ven fingers bredthe from backebone, make an apertione vvith the crooked lancet, into the concavitye of the brest, not all at once, but by little and little, or by degrees, beginninge from vpvvardes, dovvnevvardes, thrustinge, the poyncte of the foresayed lancet, frō vnder the fourth ribbe, the cuttīge syde of the same, reachīge, to the vpper end of the thirde ribbe, least that vve should cut in anye vayne, arte­rye, or synnue, vvhich lyeth occult and burie­de vnder the inferior concavitye of the ribbe. VVe may in the same place sett a Ruptorium, vvherof the Escara beinge made, vve must cut it throughe, into the concavitye of the brest, settinge agayne the foresayed Ruptoriū, or cor­rosive therō, if soe be at the first tim it had not made his operatione sufficient deepe enou­ghe. This apertione may alsoe be made vvithe the actuall Cauterium, heer before discribed, vvhich vve may crus he as deepe therine, as is necessarye, to pearce the matter.

VVhen as therfore the apertione is in this sort effected,Admoni­tione of lettinge the mat­ter or vva­ter goe from the brest. vve must not as then suffer the matter all at once to decurre out, because that to many of the vitall spirites, doe not chaunce to flye avvay, vvhich therin lye included, or inclosed: soe that vvhen as one parte of the foresayed matter is runne therout, vve must then put therin a tente, and lay therone a plaster of Gratia Dei, or of Betonica, Hippocrates coūceleth, that vve should make the apertione,Opinione of Hippo­crates. one the thirde ribbe, vvhen as vve have discovered, & bared the ribb, of her skinne, & membrane, vvhervvith externallye shee is clothed, settin­ge ther one, a Forret, or Trepane, vvhervvith vve must bore her cleane throughe the vvater vvhich is inclosed in the brest: the vvhich easy lye may be done, in those, vvhich have an vlceratione vnder the ribbes, the foresayed rib­bes, beinge broade enoughe, to set a trepane therone, betvveene the Mediastinū, vnder the brestbone, may also gather vvater,The trep­ninge of the brest bone through the advi­ce of Co­lumbus. vvhich Co­lumbus vvitnesseth, that vve trepaning throu­ghe the selfe same bone, let forth the vvater therat. But vve must note, that there are some auncient professors, vvhich houlde this aper­tione to be verye suspicious, because they pe­arcinge into the cōcavitye of the brest, might chaunce to cutt alsoe the membrane ther vn­der situated: fearinge least the patiēt, immedi­atlye after the suddayne apertione, throughe the evacuatione of the animale and vitall spi­rites, might chaunce to dye, vvhich vvith the matter flye avvay, or alsoe consideringe the in curable fistles, vvhich might therof ensue: but novv a dayes vve finde the cōtrarye because there throughe are cured, vvhithout havinge retayned anye fistle therof. In steade of such an apertione, they place in the brest certayne actuall Cauteries, or potentialle,The manner novv a dayes to make an apertione to the num­ber of 7. or 8. yea alsoe sometimes cauterizin­ge onlye the skinne 14. times vvithout pear­cinge anye deeper, making the Escara reasonable brood but not deep, vvherof they kept the vlceratione soe long opē vntill al the coughe and all other impedimentes are, cleane gone.

Howe that we must make the Paracentese, to drawe awaye the water out of the bellyes of those which are troubled with the dropsye. Chap. 4.

Descrip­tione of the Drop­sye. THe Dropsye, is a tumefactio­ne, or inflatione, agaynst natu­re, or Phlegma is engendred, or also of some certayne vvindes and ventosityes. This svellin­ge sometimes alsoe, spreadeth herselfe throughe out the vvhole bodye: som­times allsoe onlye in the inferior parte of the bellye. The first kinde is engēdred, of a phleg­maticke humor, & the secōde kinde of Drop­sye,Thre sor­tes of Dropsye. is engēdred of vvater & vvinde tohether: vvherfore the aūciēt professors have thought that there have binne thre sortes of Dropsye. VVherof the first is called,The first kinde. Anasarca, Hiposarci­dios, Leucophlegmatias, vvhen as the vniversall bodye is through soaked vvith vvater, through the vvhich, everye parte of the bodye seemeth to be tender, or vveake softe, pale, & vnseem­lye to the sight, soe that crushinge therone, the printes of your fingers for a little continu­ance tarrye therin:The secō ­de. The seconde, is called Tym­panitas, and of Hippocrates the drye Dropsye. vvhen as the inferior parte of the bellye is full of inflation, or vvindes, and stiflye stretched out and spanned, soe that smitinge therone, it giveth from him a sovvnde like vnto a Drom­me, it is right true that sometimes ther are al­soe a fevve humors mixed theramongst, be­cause by continuance of time the vvindes co­me to condence them selves, and chaunge in­to some vvaterye substance.The third kinde. The thirde kin­de of Dropsye is called, Asites, vvhich is an in­flation, and strectchinge out of the bellye, be­cause of the aquositye vvhervvith it is replete, havinge vnparted her name of Ascos, vvhich is to saye, a lether vessell, vvherin in former and auncient times, they vsed to keepe anye moy­sture in, as vve doe in the hydes, & in the buc­kes skinnes: vvhen this dissease increaseth, & grovveth,Accidētes of the Dropsye. sometimes the hippes, and the Scro­tum beginne to sveelle, vvhich is a signe of Leu­cophlegmatica, as differinge, from the selfe same beinge or essence of Ascites: as in the contrarye it is not soe, vvhē as anye aqvosytye ascendeth vp to the breste.Ascites is subiecte to Paracē ­tese.

Amongst all these three species, and kindes, ther is but one of them subiect vnto our ma­nuall operatione, to dravve forth therof all that vvater vvhich lyeth enclosed in the con­cavitye of the bellye:In vvhat persons the dra­vvinge of of vvater must be used and in vvhat persons it must be left. but before vve come to the apertione heerof, vve must first knovve, vvhich of thē are curable or incurable, becau­se in vayne, & to the hinderance of the patiēt vve take it not in hande, in those vvhich throughe age are grovvē debile, and feeble, or in those, vvhich are corrupt & not sovvnde of bo­dye, the intestines or entralls, beinge verye ill disposed and ill at ease, vvithout anye hope of amendment, & in those, vvhich vvholye are grovven impotent, or in those vvhich are ther vvithe borne, vve must not in anye vvyse through this operatione lay hādes one them. But in those vvhich as yet are yonge, stronge, & are of a goode constitutione, nether have a­nye agues, havinge all there entralles sovvn­de, and tempered, & in these, in the vvhich the vvater as yet hath made noe cōcavityes, vvherby the liver, the milte, and the guttes, might chaunce to be altered, in those remayneth as yet some hope, ominouslye to effect and brin­ge to passe this operatione: & in this manner vve must vvith the same procede. Namelye,Hovv vve ought to effect this openinge and especiallye, if the Dropsye, resume his ori­ginall from the liver, the patient lyinge one his bedde, vve must gentelye lay him one his right syde because vve may make the inscisio­ne one his le [...] syde: & is soe be this fore sayed Dropsye proceede, throughe anye dissease of the milte, vve must then turne him, one his left syde, to make the inscisione, in his right syde, soe that the inscisione, must allvvayes, be done one the contrarye syde, of that parte, from vvhence the Dropsye taketh her origi­nall, & that because the patiente must lye one that syde, frō vvhence the originall of the dis­sease commeth, for if soe be he lay othervvyse then soe then the obdurated parte, throughe the ponderousnes therof, might chaunce to sincke and descend dovvnevvardes, & makin­ge internallye any solutione, migt ther throu­ghe be the occasione of great payne and do­loure.

And the patiēt lyinge one the obdurate li­ver or milte, might throughe the vvarmeth of the bedde, be eased and stengthened. And if soe be, the patient chaunce to lye one the opē syde, the vvoūde vvould then be a great trou­ble & hinderance vnto him, & the vvhich he mervaylouslye might be debilitated,The place vvhere the aper­tione must be made. & in fee­bled. Morover it vveare inconveniēt that the debilest syde of the obdurated liver, or milte, throughe inscisione, as yet shoulde be more vexed.

The patiēt beinge in this manner situated, vve must note, in vvhat place the inscisione might easyest & vvith most conveniēce be do ne, to vvitt thre fingers bredth vnder the na­vell, dravvinge ether tovvardes the left syde, or tovvarde the right, but not lineallye right forth, betvveene the navell, & the privityes, be cause vve must eschevv, and avoyde, the vvhyt lyne vvhich in this place is situated, & the en­des, of the muscle Epigastri, & alsoe the synnuis he tēdonousnes, of the right muscle:Excellent conside­ration. because these vvoūded or hurt, might suscitate, & cau­se great payne, vvith manye other daūgerous [Page] accidētes, vvherfor they difficultlye vvilbe cured, vvhen as fayne vve vvould heale vp the vvounde. Havinge noted all this, the Chirur­giane must vvith his left hande, & his servant, vvhich assisteth him, nype in the length, the one, on the one syde, and the other, one the o­ther syde, first of all the skinne, & the incarna­te or fleshye pānickle, of this syde, to lift it vp, & cut it clean through overthvvarte, vnto the muscles, vvhich beinge effected, they must lett the foresayed elevated skīne, & pannickle fall agayne: And to finnish the rest of our opera­tione convenientlye & fitlye, after this first in scisione, (because the fore sayed skinne may fall agayne, one the inscisione, vvhich inscisi­one must alsoe bedone, in the muscles, and in the Peritoneo, to stoppe them, & to prevent the runninge forth of the vvater, then vve shall lift vp the foresayed skinne) vve must agayne lift vp vvith the hande the skinne, & the fles­hye pannickle, and then as high as is possi­ble follovve the fibers of the muscles, vve must easylye thruste in the crooked lancet, & cut throughe the muscles, and Peritoneum, as broade as vve are vvonte to make the apertio­ne in bloode lettinge, or phlebotomye, dilli­gentlye notinge, that vve nether touch anye vaynes, noe guttes, or any other parte vvhich is situated in the cōcavitye of the bellye. Novv therfore to effect this, vve may vvith great cō ­veniēce, & dexteritye, in steade of the crooked lancet, vse our punctuall instrumēt, heere be­fore discribed & defigured, the inscision novv beinge done, vve must thrust cleane through the inscidede skinne, the fleshye pannickle, the muscles, and throughe the throughe cut Peritoneum, in to the concavitye of the bellye a goulden,The vse of the pi­pe. or silver, pipe, as thicke as a qville or shaft, vvhich must have a broade end, that nothinge chaūce to slippe betvveene into the concavitye of the bellye, and therone a little string, or threde tyed, by the vvhich foresayed pipe, the vvater must be tapped as it vveare, & dravvn out, but not all at once, but by degrees & not to superfluos at one time, but on divers dayes, to vvitt, so longe till nature, beinge re­leased, & lighted of her pack or butthē, vvhich mitigatinge this evacuatione, & governinge of the forces accordīge to the fortitude of the patient: vvhich vve may knovve, by feelinge of the Puls. Because there are some, vvhich havinge made to great an evacuatione at one ti­me, have alsoe evacuated the vitall and livin­ge spirites, vvhich vveare therin inclosed, and finally have caused the patiēt his death. VVhē as therfore vve shall have dravven vvater e­noughe of at one time, vve must then stoppe the pipe, vvith a tente of linnē, or vvith a tent of sponge, to retayne the rest of the vvater, & lay theron a great plaster of Diacalcitheos: some there are vvhich dravve out the pipe, and let the vvounde vvhich is in the muscles and in the Peritoneo, the skinne, and the lippe of the vvoūde, vvhich before the inscisione vvas ni­ped, and lifted vp, because that the foresayed vvounde, might thervv [...] be stopped, and co­vered.

Novv certaynlye to retayne and keepe bac­ke, the vvater Mr. Floris Phillippes, Practise of Mr. Flo­ris Philippes, a re­noumned Chyrur­gian at Orleans. a verye re­noumned Chyrurgiane, at Orleans, sticketh his needle qvite throughe both the lippes of the vvoūde, comprehendinge sufficient qvā ­titye of skinne, vvherin he letteth his needle sticke, as vve are vvonte to doe in the har [...] mouthes, and vvindeth his threde rovvnde a­boute the needle, vvhervvith he contayneth & houldeth the lippes close together, soe that there may not one droppe of vvater passe forth, and vvhen he desireth to dravve, or tap­pe more vvater therout, he then vnvvyndeth his needle, & openeth the lippes of the vvounde, vvithout dravving the threded needle ther out. VVhilest that these thinges are this doinge, vve must strengthen the patient, vvith good cibaries and foode, vvhich easilye may be chaunged in to bloode, & lett him soe rest vntill the next day: on vvhich day, if soe be he be stronge enoughe, vve must yet dra­vve of some more qvantitye of vvater, ether through the dravvinge out of the tente, vvhervvith the pipe is stopped, vvhen as vve put the pipe therin, or vvith the elevatione of the skinne, vvhervvith the apertione is covered, vvith out puttinge the pipe anye more therin, if soe be there can issue anye vvater out, allvvayes egallinge or proportioninge the qvantitye of vvater, vvith the forces and strengthe of the patient, and in this manner must vve procee­de in the dravving, or tappinge of, the vvater.

Others there are vvhich in the opening of the belly lay ther one a carrosive,Corrosive vvith in­scisione in the Es­cara. vvher by the skinne is bitten & corroded through, thē they make an inscisione throughe the Escara, vnto the concavitye of the bellye, makinge a verye, smalle apertione, throughe the vvhich the vvater shall droppingly distill forth, & havin­ge dravven therout sufficiēt vvater enoughe, thē they stoppe it, vvith scraped linte, vvhich vvhen they are desirous to dravve more vva­ter therout, they thē remove, & take it of. Yet ther are others, vvhich after the inscisione of the foresayed Escara, thrust therin a little pipe therebye to dravve the vvater out, as vve have above sayed. Others set there on divers, and sundrye, corrosives, on the place of the liver,Applica­tions of divers corrosives. and of the milt, penetratinge nothinge deeper then the skin in [...]tatinge therin the doctrine of the aunciēt professors, vvhich vveare vvōt sometime, to apply nine at once. Others ma­ke small inscisions, like vnto little scarificati­ons, [Page 21] one the sydes of the bellye, or els they lift vp the skinne, & thrust there throughe a nee­dle vvith a silke thred, vvhich threde they suf­fer to continue therin.

The na­vell vvhich heaveth vp it selfe may be pricked thorough And consideringe that oftentimes, in those vvhich are troublede vvith the dropsy, there navell heaveth vp it selfe, yea and somtimes as bigge as an egge, vvhich standeth as cleere, as if it vveare a blather vvith vvater, there throu­ghe I have seene to be dravvne, a silke or vvot­lē threde, by the vvhich the patient perceaved great ease, consideringe the great qvantitye of vvater, vvhich through this apertione, is drop­pinge vvyse runne out.

Allsoe beyonde all this are the legges, the hippes, and the Scrotum often times, svvollen: for the vvhich there is noe better remedye, thē that vve scarifye them throughe the skin­ne, once as broade, as the apertione is in phle­botomye: Some there be vvhich doe this by the innermost anckle or foure fingers above it.In vvhat places the scarifica­tions may be made. I have sometimes my selfe very luckylye & ominouslye done the same, above the knees, and in the insyde of the hippes, in the bagge of the testicles, out of the vvhich first of all is­sueth a little vvaterye bloode, but immediat­lye therafter the vvater superfluovslye issueth therout vvithout any inflammatione, soe that the foresayed scarifications, can not shutt, or heale, before all the vvater therof be issued, & runne out, & the patient all moste grovven smaller, & the bellye evidentlye vvaxed thin­ner, vvhich in short time vvilbe effected, vvith out anye troublesome accidentes, happenin­ge thervnto, & vvithout anye inflammatione in the foresayed partes. More over vve are not to expecte anye daunger heerof as vve might vvel doe, vvhen as vve open the bellye of the Dropsy Ascites, because one this manner, the vvater vvith great qvātitye, at one time is not dravven of: and if soe be the patient, after that ther is a great qvantitye of vvater dravven of, beganne to be vveak, vve may as then restray­ne the droppinge of the vvater, vvhē as vve co­ver the scarifications, vvith scraped linte, or vvith a fevve burned peeces of linnen, and soe stoppe it, & binde it. Out of the vvhich scarifi­catiōs, if soe be vve are disposed to dravve mo­re vvater therout, vve as then vntye the fore­sayed place, & take avvay the linte from the sa­me cause the patiēt somvvhat to vvalke, or ri­de in a vvaggen or koache, if it be possible, & vvith the legge hanginge out, To cause the vvater,Councell of Hippo­crates, to dravv of the vva­ter. verye superfluouslye to runne or issue out of the legges, Hippocrates comma [...]eth vs, to rubbe the foresayed scarificatiōs vvith saul­te, & therafter stue them, & vvith anye fervēte or hott medicamētes vve must allvvayes & cō tinually keep opē the same, to vvitt, vvith me­dicamentes vvhich are sharpe & bitinge: be­cause in such scarifications, the auncient pro­fessors, as Aetius, Asclepiades, Leonides, Hippocra­tes, and Archigenes, have allvvayes hadde great confidence therin.

But before vve must come to these scarifi­cations, vve must consider one the strength, & one the age. of the patiēt: for these apertions, are to noe vse, or cōmodytye, to those, vvhich are vvholye overcome of the sicknes, nether those vvhich are very oulde, & macilēte, because that as vvell the one as the other, of these scarified partes, might easylye out of hande be mortifyed, vvithout beinge able in any sorte to retayne & keepe backe the same, vvherō immediatlye follovveth death, & by the vvhich oftē times, the Physicions, or the Chyrurgiās, are iniuriouslye & vvithout right blamed, and of all mē hated & had in little vvorthe, as I my selfe have knovvne it happen vnto some, for the vvhich I vvas not a little greeved.

How that we shall cure the water burst, called Her­nia aquosa. Chap. 5.

IN the Scrotum, vvhich vve call the bagg vvher in the testicles are contayned, is cōgregate & gathered together a certayne, vvaterishe moysture, through the vvhich the fore sayed bag­ge commeth to svvel, vvhich tume factione, or inflatione, of the Greeckes is called Hydroce­le, Hydroce­le. vvhich seemeth to be a particularre kīde of Dropsye: & must heere note that this svvellinge, sometimes cōmeth but in one syde onlye: if soe be that this dissease proceedeth out of a­ny antecedent or foregoinge occasions, it ne­cessarilye follovveth, that the bloode, vvhich into all partes of the bodye is sent as nurritu­re, is permutated & chaunged. into some vva­terye substāce: & if so be of any blovve, or fall, it produceth his originalle, then is conteyned in the svvellinge a blooddye kinde of moystu­re. This aqvositye, remayneth not,The sig­nes of a vvater burst. in one certayne place onlye because sometimes she is congreated & situated betvveen the first & se­cōde membrane of the testicles: vve may kno­vve this, vvhen as vve depresse the svvellinge, because as then the foresayed moysture agayn by little & little runneth therin: the bagge as then is more safter, nether can vve perceave a­nye hardenes, or tumefaction therin as the vvaterye moysture, vvhich is situated, vvithin the concavitye of the Scrotum, because the foresayed aqvositye, is not drivē therin: yea also in the same syde, vvher the moystnes demonstrateth her selfe, there lyeth the svvellinge in for­me of an egge, or in an ovale figure, nether as then can vve ether throughe the sight percea­ve, [Page] or throughe the touchinge therof feele, a­ny parte of the testicle, because the foresayed testicle lyeth therin hidden, and vvhen vve as­semble & liken them both together, he appe­areth somvvhat greater, & more svvollen, and vvhen as this svvellinge or inflation of the tes­ticles is greate, thē is the bagge of the testicles, vpvvardes somvvhat longe stretched out, and elevated, soe that the vpper end of the yarde, partlye alsoe vnder the tumefaction lyeth hid­den, & occulte. Somtimes alsoe is this vvater­ishe humidty secluded in a severall membra­ne, as in a little blather, the vvhich onlye for that purpose is constituted & ordayned, as cō ­monlye chaunceth in the tumefactione Ate­roma, and vvhen it is soe, then is the svvellinge rovvnde, & closelye compacted together, soe that it seemeth to be a thirde testicle.

There is alsoe oftentimes, a ventosytye ga­thered together, in the bagge, or Scrotum, as if it vveare a vvaterye humiditye or moysture, vvhich rightlye to discerne & knovve the one frō the other vve must consider that the vvin­dye Hernia, Whereby vve may knovv the vvin­dye Her­nia. or burst, is partlye harde and light, and is at one time engendred, on the suddayn, & subitlye cā it leese it selfe, & departe: vvhere to the contrarye, the vvaterye Hernia, doth not vvholye departe, but vvaxeth somtimes a lit­tle smaller, consideringe anye smalle ague, or els consideringe the greate abstinence, & that especiallye in yonge childrene. If so be therfore that there be noe great qvantitye of moysture, or humiditye, then is the tumefaction soft, but if that there be greate qvantitye, it causeth then such a renitatione, or stretchinge out, as a bottle vvhich is full, and closelye stopped, & is heavye in elevatinge, or liftinge vp: such a svvellinge by little & little increaseth: the vay­nes of the bagge of the testicles svvell, vvhē as vvith the fingers, vve thrust theron: the humeditye flyeth befor the finger, & spreadethe her selfe rovvnde about the finger, & that vvher­on vve doe not crushe, beareth vp it selfe: and this vvaterishe humiditye, revealeth her selfe over thvvarte, as in a glasse, or in a blather: as easylye vve may espye, vvhen as vve houlde a cādle close thervnto, one the syde of the svvel­linge, and looke then one the other syde: And soe farreforth as the humiditye, therin contayned, and occluded, be vvaterishe, then the in­flatione or svvellinge glistenneth, & is of such a colour, as the circumiacent partes therabout lyīge are: if soe be it be blodye, or like the vvi­ne mother or dregges, and faeces of vvine, then is the svvellinge reddishe of coloure, or pur­ple coloured:To kno­vve vvheter the Hernia be one both sy­des. & if soe be vve finde all these si­gnes, and tokens, in both sydes of the Scrotum, or bagge of the testicles, it is then a signe of tvvo kindes of Hernia, to vvitt, in everye syde one. All these svvelinges, of themselves, cause noe payne, vnles it vveare great spanninge, of that parte might chaunce, throughe the great tumefactions, and that especiallye, vvhereas the vvatery moysture lyeth inclosed, betvveen the membranes of the testicles. Novve to abo­lishe such aqvositye, there is nothinge more profitable, and commodious, then to make an apertion therinne, on this manner as follovv­eth and succedeth.

Havinge shaved avvay the hayre,Hovve vve ought to make the aper­tione. rovnde a­bout the privityes (if soe bo the patient be noe childe) vve must then cause him to lye one his backe, ether one a bedde, or benche, beinge vvel stored of linnē, then vve must cause a ser­vant, or helper, to stande one the one syde of the patient, & on the other syde of thē vvher­in vve vvill make the apertione, vvhich fore­sayed servant, must dravve the yarde tovvarde him: then must the Chyrurgian vvith his left hande crushe, on the inferior parte of the bagge, because that parte vvhich he vvill thrust throughe might shevve it selfe the more stret­ched, and fuller of substance, and pricke vvith his right hande, vvherin he must have a stron­ge crooked lancett, from vpvvardes,Inscisione of the Scrotum. dovvne­vvardes, vnto the concavitye of the bagge of the testicles, because that the aqvosity may rū ­ne out. And if soe be the foresayed humiditye, lye inclosed in the mēbranes of the testicles, vve must as then most gentlye, & artificiallye, once agayne thrust therin, dilligentlye notin­ge, that vve chaūce not to touch, the foresayed testicles, nether anye of the spermaticke ves­sels: and if the humiditye vveare inclosed in a blather, the Chyrurgiane must then vvith his left hande, crushe one the inferior parte of the bagge, on this manner to drive vpvvardes the svvellinge, and the svvellinge beinge there re­tayned & kept, vve must cōtinue it in this pla­ce, least that she sincke dovvnevvardes agay­ne, and vvith the crooked lancet, cut in the ne­thermost part of the foresayed Scrotum vnto the blather, or bagge, vvherin the humiditye lyeth inclosed, & let it runne therout, as mu­che as is possible: And if soe be, it be able to be done, vve must take therout, some parte of the bagge, or blather, because it should not heale agayne, & other vvater therin be engendred: then vve must put therin a great tente made of linte, vvhich must not be to harde vvounde, thervvith to keepe open the vvoūde, and not so quicklye heal it: for if soe it come to be too soone healed, & shutt ther might then chaun­ce to be an other collectione, and gatheringe together of vvater, soe that it might be right needfull, to be sure of the curinge of the same, that as much as vve cā, vve cause the membra­nes, to be purified, and cleansed, of all the hu­miditye, and moysture vvhervvith they are throughlye soaked.

[Page 22]Some there are vvhich applye alsoe in the superior parte of the Scrotum, a potentiall cau­terye, the operatione vvherof beinge done, they thē make an inscisione in the Escara, vn­to the concavitye of the Scrotum, vvherin the foresayed vvater lyeth inclosed, & then suffer the foresayed Escara of her selfe to fall out and separate. Such an apertione, vvhich is made vvith corrosive, can not soe easylye be cured, soe that in the meane season the vvater hath time enoughe to issue out therat.Apertion by the thrusting through of a silke threde. Others, dravve through the svvellinge, vvith a strong needle, a silkē threede, in steade of making an inscisione, or applyinge of the corrosive, in place of a Setō, or transforatiō vvher through the foresayed vvater by little & little leaketh out.

But the apertione vvhich is least daūgerous of these three foresayed, is, the inscisiō, vvher­of noe, or at the least, verye small accidentes, can ensue, if soe be she be done expertlye, and one a conveniēt place. It appeareth according as vve have above tought, in the openinge of Apostemations, that the apertion of the Scro­tum, or bagge, reqvireth to be done in the inferior partes of the same:The apetione is better to be done above [...] vnder. notvvithstandinge ex­periēce teacheth vs, that ther happeneth farre more payne, & inflammation, vnto it, vvhen the inscisione is made belovve, thē vvhen she is done & made above, tovvardes the flāckes: for ther is lesse daūger of hurtinge of the testi­cles above, or ther membrane, because it is si­tuated more inferior, vvher all the fibers, of the foresayed Scrotū, doe finishe & end, vvher­fore, they are verye sensible & paynfull. So that Celsus, & Paulus, coūcell vs, that vve should make the inscisiō close by the flanckes.A dubb [...] inscisione in a [...] ­ble Her­nia. VVhē as therfore this species, and kinde of Hernia, is double, vve must then make & doe such an o­peration one both sydes, & especiallye vvhen vve se, that they doe not in any sort assvvage.

THE FIFTH TRE­ATISE OF THE OPERATI­on of Chyrurgerye, wherin is discoursede and handelede of the disseases of the nose, & of the mouth, contayninge seaven Chapiters.

  • Of the Polipus. Chap. 1.
  • Of the Haremouth. Chap. 2.
  • Of the vlcerationes, & of the excrescēce of the fleshe of the gummes, called Paroulis, ende Epou­lis, Chap. 3.
  • Of the tunge tyinge, or of the shortnes, or brevitye of the tunge, vvhich the Greeckes call An­ciloglossum, & of the vlceration Ranula, vvhich is allsoe called Batrachos. Chap. 4.
  • Hovve vve ought, to cauterise, and cutt of, the Vvula, or pallaet of the mouthe. Chap. 5.
  • Of the svvellinge of the almondes, & of the vlcerations of the same. Chap. 6.
  • Hovve that vve ought to dravve, breake, or cutt of teethe, Chap. 7.

Of the Polipus. Chap. 1.

Roote, & originall of the Po­lipus. SOme men there are, vvhich have a certayne excrescēce, of fleshe in the nostrells, vvhich resumeth her originalle, out of the bone, Etmoidis, or Chri­bleus, & out of the bones of the nose. This excrescence happeneth or com­meth to a man, by little & little at once, and at the last, she vvaxeth soe bigge, & huge in qvā ­titye, that she stoppeth the vvhole nostrells, & sometimes alsoe hangeth dovvne to the lip­pes, by the vvhich the patient, is mervelouslye molested, as vvell in speakinge, as breathinge. Sometimes also shee grovveth in the entrāce, or conductione, through the vvhich the ayer, & the breath, are dravvne into the throte, the vvhich vve may easilye see, vvhen as the pa­tiēt openeth his mouthe, behinde the pallaet of the mouth, & in such a greatnes somtimes, that she stoppeth the throate, vvherthroughe the patient cōmeth in the end to be chōaked, if that in time vve doe not prevent it, And be­cause such an excrescēce of fleshe, most com­monlye is softe, and pale, havinge divers small sproutes, not mislike vnto the feet, of the fishe Purpura, it is therfore of the Greeckes called Polipus, & allso in our langvage Polipus.

There are noe sortes of Polipus vvhich being venoumous,Noe sor­tes of Po­lipus, can throughe Chyrur­gery be cured. have neede of the operatione of Chyrurgerye, because vve may not touch thē, in like sorte vve may not touch those vvhich are infected vvith the Cancer, because ther na­ture [Page] is thervvith polluted, & they ther through spoyled. The yōge Chyrurgiane, may knovve them by there sensiblenes,Signes of a veno­mous Po­lipus. because they are verye dolorous, & full, of payne, & extreame hard, beinge allmost purple coloured, vvith a very stinckīg odoure, or smelle, on the vvhich the Chyrurgiane shall doe nothinge, but must be handled as if it vveare the Cancker, to vvitt, throughe koolinge, dryinge, & throughe mollifyinge medicamentes, throughe the vvhich her excrescence may be praevented.

Signes of a tractable Polipus.That Polipus, vvhich is insensible, or vvhere there is little, or noe payne, vvhich is vveake, loose, tractable, vvithout beīge irritated, pale, or vvhich is of a reddishe coloure, those vve may throughe the operation of Chyrurgerye take in handes.

Hovve vve ought to cure the Poli­pum.To the effectuatinge of vvhich, the aunciē ­te Chyrurgiās, & those vvhich have follovved there doctrine, have effected this operatione cruellye enoughe: for some there are vvhich vvith an instrument cutt rovvnde, or circkle vvyse this Polipum, vvhich to that end & purpose, therto they have caused to be made, and is called in greeke Polyticon Pathion, vvithout tou­chinge of the cartilage, or grisle, vvhich bein­ge effected, they dravve forthe the foresayed descided Polipus, vvith an instrument much li­ke vnto an eare picker, or els vvith some kinde of hoocke, & then they cure & heal the vlcera­tiō, as it reqvireth to be don. And as cōmonly there remayneth some little peece of roote, in the bones Etmoides, & of the nose, the vvhich they scrape of, alsoe from the foresayed bones turninge, & thrustīge therin, vvith an instru­mēt, to fetche all therout, that by any meanes possible might tarrye, and remayne therein.

An other manner.Others endevour to consume, & annihilate the foresayed Polypum, vvith certayne caustic­ke, or vstive medicamētes, as vvith Aqva for­tis, vvith oyle of vitrioll, or vvith the liqvefac­ted, & moulten corrosive, in the vvhich they dippe, & madefye little smalle tentes, vvhich they lay therone, vvith or throughe a little pi­pe, because they shoulde not hurte the nose o­ne the internalle or inner syde. Others ther a­re, vvhich vvith an actuall cauterye, cauterize it, vvhich throughe a pipe they thrust therin. Others, after the exāple the four famous Chy­rurgians,An other manner to cure the Poli­pum. vvhich not beinge of opinion, that in noe vvyse, or in anye sorte vve vveare able to cauterize the Polipus, vnto his roote, because he is soe deepe ingraffed, they thē make an in­scisione, one the one syde, of the cartilage of the nose, vnto the bone of the same, & havin­ge in this sort discovered, & denudatede the Polipū vnto his roote or first ofspringe, & origi­nalle, then they there cutt, & cauterise him, & stitch together agayne the sayed inscisione, as vve are commonlye vsed to doe in the hare mouthes. The vvise, & Learned man Guido de Cauliaco, liketh & commendeth this, or such like operatione, but in noe vvise, counceleth, to stitch vp the inscision, before the foresayed Polipus, be vvholy eradicated, & rooted out, because if soe be, that anye parcell therof remay­ne, it agayne increaseth, vvhich happening he, to be soe, all the trouble, & paynes of the pa­tient, hath binne done for nothinge, & to noe purpose. All vvhich operations, beinge as suf­ficiently and completlye effected as they possible may be, yet for the patiēt they are tedious & trouble some, as often times, vve have vvith our eyes behelde, vvhich to speake the very truthe indeede, they have never attayned vnto ther perfecte, and former health agayne, but rather farre vvorse, then better: vvherby vve vveare moved, to trye. & make experiment of a far more ominous, and more convenient o­peratiō, to the curinge of this dissease, vvhich consistethe in the vvhole eradicatione of the same.The manner hovve to drovve out the Polipus, more certayner, & conveni­enter, through extirpati­one. To the vvhich end and purpose it see­meth vnto vs convenient, that vve situate, & dispose the patient, on the most convenient māner vve may, in a seate, tovvardes the light, & the Chyrurgian, vvith his left hande openinge the nostrell, vvherin the Polipus is situated, shall vvith his right hande, thrust therin the flat tōges, as deepe as possibly he may, (vvhich tonges must be sōvvhat broade, & like a Duc­kes) bil vvhervvith he must nipe the foresayed Polipū, & gentlelye vvith both his handes tur­ne & vvinde the same, & thervvith alsoe dra­vve tovvardes him a little, & not at one pluc­ke, because the roote vvhich is fast setled in the foresayed bones, might alsoe follovve, & the foresayed Polipus at one time be dravven forthe, and extirpated: vvhich I my selfe may vvith the truthe alleadge to have done, vvith verye little payne. Mr. Sourlin, a verye experte Chyrurgian, hath assured me, that he alsoe di­vers times hath done it one the same manner, vvithout anye inconvenience.Admoni­tione for the Chy­rurgiane. But the Chy­rurgyane must consider, that he doe not advē ­ture on such an operatione, then in that Poli­pus vvhich is tractable, and not canckerouse, & vvhich is greate enough, to be griped, & vvith out breakinge to be extirpated, vvherfore, if it be not great enoughe, vve as then let him gro­vve, & increase. And soe farre forth as the foresayed Polipus, drevve himselfe vpvvardes, avoy­dinge the nipinge, of the little tōges, vve must thē dravve it dovvnevvardes, vvith a little hooke, because as then vve may the better, take houlde therone: the operatiō beinge finished, ther ensueth an effluxiō of bloode presētlye, therafter, vvhich vve shall permitte, & suffer to bleed, because that parte may be therof re­leased, & vnburthened: vve must then cause the patiēt, through his nose to snufle vp redd [Page 23] vvyne, & that as oftentimes a daye, vntill such time as it be internally cured, vvithout apply­inge any pingveditye, or oyles thervnto.

❧Of the haremouthe, or splitted and cloven lippes. Chap. 2.

Colobo­ma, Cur­tum. THe cleavinge, or splittinge, vvhich daylye vve see, in the lippes, in the eares, and in the nose, is of Galen called Colobo­ma, & in Lattin Curtum, vvhen as these partes throughe anye naturall dissease, are splitted, or clovene, as if there vveare a peece cutt out.To rege­nerate a­nye sub­stance is a vvorke of nature and not of the Chyrurgiane. It is impossible, that vve should ingendre, anye other matter, & restore, the substāce, vvhich therin is vvan­tinge, because it is the vvorke of nature & not of the Chyrurgiane: but he may bringe the se­parated partes the one, by the other, and cause such a substāce, vvhich in that parte is deficiēt, & vvantinge shall seeme as it vveare there in ingendred, soe that verye hardlye vve shall e­spye, & marke such an vnseemlines, & defor­mitye, especiallye if the slitte have binne but small: for these disseases might per adventure be soe greate, that they shoulde be incurable, and vveare not conveniente for vs to lay han­des one them, & if soe be vve endevoured to cure them, vve might chaunce to make them farre vvorse, & more vnseemlye, then before they vveare. VVherfore the Chyrurgiane ought dilligentlye to consider, that one such kindes of fissures or splittinges, he impose not his handes, and especiallye in those vvhich are to vvyde seperated the one from the other, & vvhere there is to much substāce deficient or vvantinge, betvveene them bothe, for vvhen a Chyrurgian endevoureth to cure such a dis­sease, then must necessarylye the seiunged and separated partes, ether ioyn, & heale together agayn, or els not: if soe be they grovve, & ioyn together, the lippe thē is merveylouslye stret­ched, & lyeth close to the teethe, & one the gū mes: And if soe be they cā not souder, & ioyn the on vvith the other, the fissure, or splitting, vvilbe much greater, then before it vvas, be­cause & cōsideringe that, vvhich one both sy­des vvas taken & cutt avvaye, through vvhich occasione, the patiente, as then can farre and much more difficulter eate, and also speaketh vvorse, because that a cōplete, & vvhole lippe, is verye cōveniēte, & necessarye, as vvell to the commestione, as to the loquution, & speeche.

In vvhat persons this ope­ratione is daunger­ous.This manuale operatione, is verye daunge­rous in aged persons, & in those vvhich are vnhealthesame, of bodye, or in those, vvhich (as vve commonlye say) have noughtye healinge fleshe, because, that in mās bodye there is noe parte or place, vvhere in the Cācker cā sooner come, and beinge therin, vvherin he may be vvorse cured, & vvith more difficulty healed. The meanes to cure such a dissease, is on this manner: VVhe must first of all situate the pa­tiēt tovvardes the light, & vvith our left hāde, lift vp the right syde of the cloven or splitted lippe, & as then cut vvith the crooked lancett, in the middle or vpper end of the foresayed syde of the lippe, through the skinne, & alsoe betvveene them both beginninge as highe, & as neere the nose, as possible might be done, dravvīge the foresayed lācett, vnto or tovvar­des beneath or end of the lippe,Hovv vve ought to cure the cloven lippes, or haremouthes. because that the vvhole interiacēt skinne, might be cleane therof separated and severed: then vve must change handes, takinge in our right hāde, the other syde of the clovē lippe, vvhich is situa­ted in the left syde, & then vve must cut vvith the left hande, even as before vve have done vvith the right, because the clovē lippe, may on all sydes be cut, & on the edges be brought to ravv fleshe, vvithout leavinge the least par­te thereof vntouched, vvhich is not cut, or made ravv, ether in the infierior, or superior par­tes therof, & that nothinge differinge from a greene, freshe, & bloodye vvoūde, before vve assay to stitch them the one vvith the other.We must let that parte somvvhat bleede. This beinge one such a manner effected, and that parte havīge somevvhat bledde, vve must as then contracte & ioyne together both the cut partes, as close, and as smoothe as by anye meanes possible vve may, and thrust a needle throughe both the foresayed revnited partes, thrustinge deepe enoughe through the fleshe, & suffere the needle to remayne therin, one the vvhich vve must rovvnde about vvīde the threde, as the Taylers are vvonte to doe, vvhē anye vvhere one there apparrell they sticke there needle there to keepe it: As farre as the fissure or splittinge be greate, vve may as then sticke tvvo needles there in, the one vnder, & the other above. If soe be the separated partes, of the foresayed lippe, can not vvith any faci­litye, or ease be brought together, vve must thē make tvvo inscisions, in eache syde of the lipp one, informe & likenes of a halfemoone, both the korners therof tovvardes the vvoūd,Vievve the figure before. as heer befor in the figure vve may see, vvhich inscisiones must onlye penetrate the vpper skinne, because that the edges of the vvounde beinge dravvne together, might the better ioyne the one vvith the other, for vvith anye violence they may not be compelled, but ra­ther, vvith gentlenes, and vvithout any force, because that, they beinge brought and ioyned the one vvith the other, be not agayne vvith­dravvne backvvardes.

It chaunceth alsoe sometimes, that the skinne one the on syde of the fissure, can not completlye vnite her selfe vvith the other, vvhere throughe, that place of the vvounde, is [Page] deformed & mishapē, because it is not vvho­lye cooperte, & coverede, seinge therfore that this soe chaunceth, vve must as then cut this sayed parte halfemoone vvyse, vvithout in a­nye sorte touchīg the other syde.We must nipe of the poyn­cte of the needle. If so be the acuitye or poyncte of the needle vvhich stic­keth in the vvounde, or lippe, sticketh some­vvhat lōge throughe the other syde, vve must nipe, or breake it of vvith certayne pinsers or tonges because it shoulde not pricke or hooc­ke in anye other place, & vve must applye the­ron, a plaster of Betonica, & in those inscisions vvhich are made in the forme of a halfemoo­ne, vve must applye therone onlye drye linte, because the lippes, or edges therof, might not heale, & because that the fleshe vvhich therin increaseth, doe not replenishe the vvounde, & the lippe ther throughe be made broader.

The foresayed suture, is commonlye healed together the seaventh day, and soudered the one vvith the other, vvhen as therfore vve es­pye & marke that it is soe, & that they are ioy­ned the one vvith the other, vve must cut of the threde vvhich is vvounde rovvnde about the needle, & plucke the needle therout, & cu­re the remanēt of the vvoūde, & alsoe the stit­ches of the needle, as necesitye reqvireth the same to be done, and effected.

Lippes vvhich are cleft in tvvo places.The lippes are some times splitte, or cleft in tvvo sundrye, & divers places, but therō is not soe much consistinge, if they be not soe farre separated the one frō the other, as if there vve­are a noteable peeces cutt therout, because o­thervvyse it is as vvell & easilye to be cured as the single fissure. If soe be there be any excres­sēce of fleshe, or any cartilage, fovvnde abou­te the lippes, or in anye place, vvhich necessa­rilye is to descided vve must alsoe cut that out, because, in all places it might be of an aequalle smoothenes.Cleaving of the ea­res, and nostrelles As cōcerninge, & touchinge the fissures, of the eares, or nostrelles, vve must therevvith proceede, on such a māner, as heer­tofore vve have sayed of the splittinges and fi­ssures of the lippes.

Of the vlceratione, and excrescence of the gummes, called Paroulis, and Epoulis. Chap. 3.

AFter the inflammation, or ins­censione of the gummes, commōlye succede the & follovve the an excrescence of fleshe, vvhich of the aunciēte profes­sors vvas called Epoulis, & that especiallye about the checke, or hindermost teethe. Such a humor, & excrescēce encreseth by little, & little, till at last it increaseth as big­ge as a hennes egge, soe that sometimes the teeth there throughe fall out, and the patient not able to open his mouthe.We may not pro­voacke the Canc­kerouse. If soe be these excrescences be blacke, and Canckerouse, vve must not applye there one any sharpe, or cor­rodent medicamentes, nether vvith byndinge separate, & roote them oute: but must entrea­te, & handle them, in such sorte, as before vve have spoken of the Cancker, and like all palli­ative cures.

If soe be this excrescence be tender, soft,The manner to cu­re Epoulis & tractable, vve must vvhilest it is smalle, descy­de & cut it avvay, if soe be it be great, vve must thē bynde it of, vvith a stronge threde, vvhich vve must alligate, and tye vnder at the roote therof, and by degrees knitt it closer, till that in thus doinge, the roote by the threde be cutt throughe, and the excrescence fall out of the mouthe.Such a li­gature is more cer­tayne thē inscisione Such a ligature or byndinge is farre surer, thē the discidinge or cuttinge of, the sa­me, because that therthroughe, vve neede fea­re noe superfluous bleedinge, & the roote bet­ter one this manner be taken out, & allsoe the patient have lesse payne, and feare to expecte, then of the inscisione, or cuttinge, and cauterisatione, vvhich after the inscisione cōseqvēt­lye follovvethe.

VVhen as therfore througe byndinge,Hovve vve ought to handle the Epou­lis that returneth vve have discided this carnositye, or excrescens, & that she reverteth & cometh agayne, as often times chaunceth, vve muste as then religate & binde agayne the same, or cut it, and cauterize the roote therof, it be ether vvith a little actu­all Cauterium, or vvith a little oyle of Vitroll, vvith Aqvafortis, or vvith anye other liqvefac­ted corrosive, vvhich vve finde thervnto most convenient. A parte of the aunciente profes­sors, vveare vvōte to applye therone, some or other corrosive poulder, on the same, vvhere of the excrescence might clean be corroded a­vvaye, vvhich in mye opinione is verye incō ­veniente, especiallye in these partes.

There is as yet an other kinde of vlceration,Paroulis, and the meanes hovv to cure it. or tumefactione incident vnto the gummes, vvhich of our praedicessors vvas called Paroulis: vvhich perseavīge it to be come to his full ma­turation, & ripnes, vve must immediatlye ma­ke therin an apertione, & inscisione, vvith the crooked lancett, vvhich must be of an indiffe­ferent latitude, because it might not agayne chaunce, to cause a revlceratiō or svvellinge, & soe chaunce to chaunge it selfe into a fistle: be­inge aperte, and open the patient must vvas­he his mouth vvith some grosse redde vvyne, vvhich must be sōvvhat vvarme, to exsiccate, & drye, to confort, to repelle, & drive backe & if neede soe reqvire to stoppe, and restayne bloode: the next day follovvīge he must vvas­he his mouth vvithhonye vvater, to the pur­ginge, and purifyinge of the dissease.

This vlceration, must immediatlye be ope­nede, because the matter, chaūce to make noe more concavitye, and the cheecke bone ther­throughe [Page 24] chaūce to be polluted. If soe be ther chaunce any corruptinge, and rottenes in the gummes, vve must then annoynte them vvith a littie Aqvafortis, A reme­dye a­gaynst the cor­ruptinge of the gū ­mes. but vvith due considerati­one, and discretione. And because that often­times immediatlye after the disseases Paroulis, or Epoulis, there commonlye engendreth, and commeth a fistle in the gummes, vvhich penetrateth, & pearceth vnto the cheeckebon, vve must note, if the root of the tooth be not rot­ten, & corrupt or altered, for if so be it vveare soe, (as oftētimes it happeneth) vve must dra­vve forth the toothe, and correcte the place, vvherin the tooth hath stoode ether vvith a cauterye, or vvith oyle of Vitriolle, and if soe be ther be any parte of the cheecke bone cor­rupt, by this meanes, nature vvill expell and drive from her the corrupted peece of bone, vvithout vvith violence to dravve forth the same.

❧Of the retentione of the tūge, which of the Greec­kes was called, Anciloglossum, and we nowe call it tungetyed: And of the vlceration vnder the tunge, which of the Greeckes is cal­led Batrachos, & of our moderne Physicions Ranula. Chap. 4.

The dissease of a hortened tunge. THe tunge in some persons, or children, is shorter then shee ought to be, vvhervvith they are borne, and by the vvhich occasiō, they must vvith diffi­culty vtter the vvordes vvhich they vvoulde speake, the tunge beinge inter­cepted, and hindred, by a certayne ligament, vvhich vve call the spāned vayn, vvherthrou­ghe the tōge, is restrayned, & as it vveare, see­meth to be brydeled, or throughe any mem­brane thervnder situated, vvheron the tunge resteth, & because shee can not soe move her selfe, and turne, as it vveare convenient, shee shoulde. The children are verye longe time before they beginne to speake, & vvhē as they beginne, they as thē speake verye festivouslye & hastilye, & vvithout any hinderance, excep­te in vtteringe of those vvordes, vvhich are difficulte to pronounce, as are those, in the vvhich manye R. R, R. and L. L. L. come.

This dissease, is alsoe sometimes accidētalle vnto a man,The dissease of the tunge af­ter a cal­louse vlce­ratione. vvhen as after anye vlceratione vnder the tunge, there remayneth a harde cal­lousnes, & anguste cicatrice, vvherof the tūge sometimes, inspeaking must dubble & redub­ble her selfe, & they vvhich are troubled vvith this imperfection, doe speake vvith great pay­nes & difficultye, vvherfore the auncient pro­fessors of foretimes, have called thē Mogilaous. The fore sayed dissease must be cured onlye throughe the manualle operatiō. To vvhich ende & purpose, vve must situate & place the patiente as the matter is reqviringe,Hovv vve ought to cure the tunge tyinge. the servāt of the Chyrurgiane havinge both his fingers vvounde vvith fine linnē (to vvitt, the thum­be, & the first finger) vvherevvith he must ta­ke the foresayde tūge by the end, & lift her vp, tovvardes the roofe of the mouth: vvhich be­inge done, if soe be the membranes vvherone the tunge is fastenede, be cause, of the difficul­tye of speech, thē must the Chyrurgian vvitth a smalle hooke, as is before describede, houlde the same thervvith fast, vvith his left hande, & vvhen indiffierentlye he shall have stretched out the same, he must as then ether vvith the poyncte of his scissors, or els vvith his croo­ked lancet, cutt, and discide it of. If soe be the shortnes be caused because the liga­ment of the tunge, is to shorte, & stretcheth it selfe more then is needefull tovvarde, the middle of the tunge, or els because of anye ci­catrice: vve must then alsoe in like sorte take houlde on all that vvith the hooke, & plucke or dravve it, & cut it of, vvhich is obdurated & harde, alsoe all that vvhich vvith the naturall fleshe of the tunge is not moved, or stirred. This operatione then beinge effected, the pa­tiēt must vvas he his mouthe, vvith a little vvater & vineger, & dilligentlye stirre the tunge, & often times thruste her forth of his mouth, & rubbe or vvipe his finger thervnder, & oftē times vvith his teethe crushe her vp tovvardes the roofe of the mouth, because that the fore­sayed ligament, or mēbrane, doe not chaunce to ioyne & grovve fast agayne therō:Hovve vve may hin­der the healinge. for as the stirringe, & removinge vp & dovvne, are a hinderāce, vnto the healinge of the same, soe is all so qvietnes, & stillnes, an occassion of the vni­tinge, & cōbinatione of the same: yea he must alsoe in the night seasō lay a compresse vnder his tunge, there by to hinder, & delay the cu­ringe of the vvounde, vvhich easilye sleepinge might chaūce & come to passe, & that because the tunge, nether by eatinge, nor by speakinge is in anye sorte stirred or moved.

Some of our aunciēt professors,Membra­nous liga­ment or tunge tyinge. to prevent the daūger, of bleedinge in such an operation, thruste through the membranous ligamēt, or through the cicatrice, vvherby the tūge is kept boūde & tyed, a needle vvith a threde, vvhich by degrees they dravve & plucke together vn­till such time the membrane heervvith be cut a sunder.

VVhen as vve vvould cut the tunge tyednes in yonge childrē, vvhich are nuely borne,Hovv vve ought to cutt the tunge ty­inge of yonge children. vve must first of al vvith the finger lift vp the tūge, & vvith the poyncte of the scissors, descide, and cutt of the membrane vvhich is situated vnder the tunge, & thē vvith the finger vvipe a little sault therin & rubbe it, vvithout doinge anye thinge els there to, commaundinge the nour­se, to doe the same once, or tvvice more.

[Page] The vlce­ratione Ranula, and the orginall therof.It may alsoe chaunce that the speech is im­pedited & hindered, by reason of some vlcera­tione, vvhich commeth vnder the tūge, called Batrachos, or Ranula, in vvhich vlceratione, ther lyeth a vvaterishe humiditye therin inclosed, vvhich often times is not dislikinge vnto the vvhyte of an egge, as vvell consideringe the consistence therof, as concerning the colour, allvvayes commonlye beinge included in a little membrane, like vnto the vlceratione A­teroma, & manye other coulde vlcerations or svvellinges. In have seene such manner of svvellinge, & tumefactions soe greate and soe often times (after they have binne thruste through to lett out the matter) returne agayn, that the patiēt, by reasō of the greatnes coulde not speake, yea allsoe in davvnger ther throu­ghe of styfelinge, or smotheringe, soe that I have knovvne them to have binne opened foure times in one daye, and at everye season a hādefull of matter to issue therout, like vnto slime, and the vvhyte of an egge. The vvhich hath binn soe difficult to be cured, that in the end vve have binne compelled, to applye ther one an actualle Cauterium, in vvhich large and vvyde apertione, vve have imposed & layed in linte, being madefyed and made vvett in oyle of vitriolle, by the vvhich at the last the patiēt is sovvndlye, and completlye cured.

Novv to cure this dissease, vve must first of all make an apertione, vvith the crooked lan­cet, accordinge to the length of that parte and not thvvart or crosseover, to give issue & pas­sage to the humiditye & matter to runne out, vvhich is the occasione of this tumefactione, or vlceratione: and if soe be this svvelling re­turne, the surest remedye, as thē is the actuall cauterye.

Hovve vve ought to cure this vlce­ratione & his return agayne.To vvhich intent, vve must vvel, and con­veniētly situate the patiēte, & cause his heade to be stayed, & helde by his servant, vvith the one hande one his heade, and the other vnder his chinne, there aboute vvhere the foresayed vlceration is situated, because partlye there throughe it may be elevated and lifted vp, for the Chyrurgiane vvith more ease & facilitye to attayne to his purpose, vvhen as vvith the lācet or vvith the cauterie vve vvill make ther in an apertione: For those partes beinge ten­der, & softe, hovv little soever they be crushed yet notvvitstādinge yeeld thēselves invvardes vvher throughe the apertion might be hinde­red & fayled, and all our laboure be lost, & be­stovved in vayne. The patient therfore in this sorte beinge settled and disposed, and beinge by some servāt helde faste, must opē his mou­the, then shall the Chyrurgiane vvith his left hande lay a peece of lattinne or a silver plate vnder the tunge of the patient, vvhich hath a hole in the middest therof right on the place, vvhere vve desire to make the apertione, then must the Chyrurgiane take in his right hande a glovvinge or redde hotte Cauterium, vvhich he must sittuate right one the hole of the foresayed peece of Lattinne & thrust the same in­to the concavitye of the foresayed vlceration: in soe doinge are the circumiacent partes de­fended from all combustione or burninge, & the vlceratione verye convenientlye opened. This apertion beinge on such a manner effec­ted, & brought to passe, vve must cause the pa­tient to vvash his mouthe, vvith a mouth-vvater, or gargrise, vvhich must be made of barley-vvater, of Plantine, and of honie-vva­ter.

❧Howe we ought to cauterize, cutt of, or bynde, and tye, the pallate, or Vvula of the mouth. Chap. 5.

NAture hath in the posteriore partes of the mouth created, a spongiouse, & carnall or fles­hye dugge, as thick, & rovvnd. as is the end of a shaft, or qvill as easilye vve may see, vvhen as vve open the mouth. This reservinge his naturall proportione, the Greeckes as thē call it Gargareon, the Latinistes, Gurgulio, Gurgulio & vve the pallate of the mouthe: but the same beinge amplifyed, and grovven greater, then natural­lye it is, through the discendinge of any super­fluous humors, beinge of one crassitude abo­ve, & beneath, it is as then of the Greeckes cal­led Chiou, in Lattin Columella, Columella. as if vve vvoulde say, a little pillaer: but if soe be it be belovve rovvnder it is as then of the aunciente profes­sors called Staphila, of the Lattines, Vva, Vva. and of vs, the sincking or fallinge of the pallate. It hath sometimes such a longitude, depending one the tunge, that the patient allvvayes sup­poseth, to have somvvhat in the throt, vvhich verye vvillingly he vvoulde svvallovve.

That vvhich is blacke,Wen vve ought not to cutt a­vvay the pallate. vve must not in a­nye vvyse meddle vvith, or take in handes, in like sorte alsoe the same being vvholye infla­med, because as then vvith out daunger vve can by noe meanes possible, descide and cutt it of, because of the superfluous bleedinge vvhich conseqventlye follovveth, vvherfore as then vve ought rather to vse all such medi­camentes as still, and assvvage payne, vvhich moysten and madefye, and gentlye fortifye & strenghthen the patiēt. But if soe be that there be noe inflammatione, & the pallate be tho­roughe soaked vvith humors, & is vvaxed ve­rye longe, vvhyte, pale, and sharpe,Thre me­anes or vvays to cure this dissease. vve must as then cutt it of: as vve must alsoe doe vvhen it is above thinne, and belovve thicke.

This dissease may be cured, by takinge avvay [Page 25] that, vvhich in the pallate is oppugnant vnto nature, ether throughe dissectione, or throu­ghe cauterizinge, or els throughe bindinge of the same. If soe be vve feare anye superfluous bleedinge, it is then the surest, shortest, & ea­siest vvaye, to discide it, because the patiēt ther throughe might be freede from manye more miseries, calamityes, & mischaūces, vvherine othervvyse he might in time chaunce to fall as is the cough, through the cōtinuallirritatiō of the forefayed longe hangīge pallate, omis­sione, & losse, of sleepe, & somtimes alsoe the choackinge, soe that vve notinge & observin­ge all these thinges, are of tē times compelled, for the succoure of the patient, to effect our extreame,The first vvay to cure the sinckinge of the pal­late. and laste remedye, to preserve and keepe him from greater daunger ensvinge.

And aptlye to bringe this to passe, vve must cause the patient to sit in a verye lucent and lightsome place, and alsoe to set apert & vvide open his mouth, and depresse his tunge vvith the Speculum oris, then take houlde one the fo­resayed pallate, vvith a litte instrument, or tō ­ges made onlye for that purpose, leavinge as much hanginge of the pallate vnder the fore­sayed tonges, or instrumente, as is to longe, nought, & as must be cutt of, pluckinge of the same a little tovvardes him, because that vvith the poynct of the scissors, he may convenient­lye cutt of, that vvhich hangeth vnder the fo­resayed instrument or tonges but not that vvhich is above the foresayed instrument as easylye it may be done, for vven as this pal­late, is tender, spongious, and covered vvith a mēbrane,Accidētes vvhich may insue through cuttinge to highe of the pallate. vve as thē easylye take houlde ther­on vvhen as vve vvoulde plucke him, vvher­fore some Chyrurgians have oftentimes bin­ne deceaved, supposinge him to be much lon­ger, vvherfore they have cutt him to shorte, & allmost cleane avvay, vvhere throughe allsoe verye troublesome, and difficulte accidentes have follovved: because this beīge happened, al the pectorall partes, are haynouslye & mer­veylouslye therthrough offended, vvith grea­te difficultye of vvel speakinge, yea & someti­mes allsoe vvith vvant of speech, or dumnes: vvherfore vve ought not onlye to leave the roote, vvheron that this dugge, or this pallate is fastened, but somvvhat more, and onlye cut of that, vvhich above his naturall constitutio­ne seemeth to be toe longe. Others there are vvhich take houlde on this pallate,An instrument or tonge, called Staphilagres. vvith an instrument called Staphilagres, vvhervvith they vvringe it rovvnde about, & havinge vvrunge it rovvnde, it vvaxeth crooked, & purple co­loured, and in the sectione therof issveth little bloode therout. Beinge novv descided & cutt of, if soe be there follovved a greate effluxione of bloode, vve must as thē cause the patient to gargrise his mouth vvith vvater and vineger, and then vvith some constringent decoctione vvhich hath bī boyled vvith grosse redde vvy­ne, or els touch the place,Remedye agayst the bleeding of the de­scided pallate. orvvype it vvith so­me stronge cauterisinge vvater, vvhervvith the opened vaynes might be seared together.

The seconde manner, of effectinge this sa­me, is done vvith an actuall,The secō ­de māner to cure the sine­kinge of the palla­te throug cauterisa­tione. or a potēciall cau­terye: as concerninge the actuall cauterye, vve must therevnto have in a readines and praepa­red, a sylver, or copper pipe, vvhich in the one end therof must have a little apertione in sor­me of a little vvindovve, to receave there in that parte of the pallate, vvhich you resolve to cauterize, then you shall put into the pipe your glovvinge actuall cauterye, vvhich vvith his end vvill abolishe and take avvay that, vvhich shall hāge there in as if it vveare vvith a little cheesell strokē of, and one this manner vve must cauterize, and cutt of the pallate evē, and smothe. Touchinge the potentiall caute­rye, or corrosive, vve must first receave, into the apertiō or vvindovve of the foresayed pi­pe, that parte of the pallate, vvhich vve desire to corrosive, and then vvith a privett or sear­chīge irō thrust into the foresayed pipe, a pee­ce of corrosive, aganst the foresayed peece of pallate of the mouth, and continue the same therone a certayne time, dilligentlye conside­ringe, that not anye parte of the corrosive, fall one the tunge, or the throte, vvhen as throu­ghe the humiditye of the pallate it beginneth to liqvefye.This cor­rosive is discribed before amonge the instrumentes. And vvhē vve desire to take avvay the foresayed pipe, vve must thē first of all lay the Speculum oris, one the tunge, because as thē noe parte of the foresayed corrosive, chaunce to light or fall one any of the subteriacēt par­tes, nether touch any parte, but the pallate on­lye because therby they might be indamma­ged, and hurte. Thus havinge brought this to passe, vve must annoynt the pallate vvith a lit­tle oyle of roses, vvith a little cotten or linnen there in beinge madefied, and made fatt, then shall the patient vvashe his mouth vvith a lit­tle roosevvater.

A sorte ther are vvhich doe not vse the foresayed pipe, but they dippe, & moysten, a little cotten, or linnen, vvhich is tyed to the privet, or searchinge iron, in oyle of vitriol, or Aqua­fortis, vvith the vvhich they touche the pallate, and cauterize it, the tunge before beinge layed dovvne vvith the Speculo oris, & thē a little sea­son follovvinge they vvashe it vvith Plātine­vvater. Others take a little kinde of spoone,Staplulo­causton, a certayne kinde of spoone soe called (vvhich of our praedecessors vvas called Staphi­locaustō) full & implete vvith poulder, of corro­sive, full Aquafortis, or oyle of Vitriolle, vvher­in they cause the end of the pallate to depēde, allvvay before havinge layed dovvne the tun­ge vvithe the Speculo oris, and by this meanes they cauterize, & consume, the pallate vvhich [Page] before vvas to longe: it is right true, that some of this corrosive in the spoone might chaūce to fall one the tunge, vvherfore I vvoulde ra­ther councell to vse that corrosive vvhich is thicke and of some crassitude, as that is vvhich may be pulverisated & beaken to poulder, be­cause vvithout beinge pulverizated it can not shevve his forces one the pallate. VVhen as therfore, throughe the applicatione of anye of the fore sayed corrosives, or cauteryes, the place of the pallate beginneth to be blacke, it is then a signe that it is sufficiētlye cauterised, and if soe be the coloure therof be not, as yet chaunged, vve must then yet once agayne ap­plye the corrosive thervnto, & then cause the patient to gargrise his mouth vvith Oxicrate or vvith vvarme redd vvyne.

A tryed remedye.I have knovvne the suncken pallate to be lifted vp agayne, vvith a little povvnded pep­per & saulte, by a spoone, beinge therone fas­tened: others vse there to some astringēt poul­ders. The thirde meanes, to cure this dissease, is effected by ligature, because of the timorousnes vvhich the patient conceaveth of the cut­tinge of, or cauterizinge the same, or effluxion of bloode.The tyin­ge, vvith the third meanes hovve to cure the pallate beinge suncke. VVhich is effected and completlye brought to passe, vvhē as vvith a stronge thre­de vve tye the fore sayed pallate vnderneathe, in that place vvher it surpasseth his naturall lengthe: throughe vvhich ligature, the inferi­or parte can obtayne noe nouriture, because the vaynes by the threde are suffulced & stop­ped vp, soe that in a short time the threde cut­tethe of, and causeth to separate that vvhich hath binne bovvnde, the superior parte bein­ge allmost cicatrized, vvith out any feare of a­nye superfluous bleedīge. The meanes hovve verye neatlye, and convenientlye to effect this operatione, and allsoe the instrument thervn­to servinge, is described vnto you before amō ­ge the figures of the instrumentes.

The vse of the foresayed pallate of the mou­the,Vse of the pallate. shevveth vnto vs, that vve ought to obser­ve a meane, in cuttinge of the same, vvhē as it surmountethe the naturalle longitude, or els the vse therof is brought to nought, and loste, because therthroughe, the voyce of mā is for­med, and retayned, as the mouth or apertione of a Citerne, vvhen as vve touch the stringes therof, she as then geveth a sovvnde, even soe the breath of man, vvhich is the substance of the voyce, issuinge forth of the longes bein­ge divided, and spreade over, and throughout the vvhole roofe of the mouth, there and in that place to receave the articulatione, and by the tunge, teethe, lippes, and nostrelles, in the vtterance therof to be formed. VVherfore those vvhich have the same surpassinge the naturalle length, or in any other sorte, troub­leth them, have such a feeble, & imbicille voy­ce, that verye difficultlye vve may heare them, or at the least speake throughe there noses: & if soe be it be cleane cut of, they leese ther spe­eche, and vvaxe mute and dumme. Above all this it hath as yet a tvvofoulde vse, viz the one to prohibite, the duste, and anye other substā ­ce, to enter into the throte, by our breathe, vvhich constinuallye vve must dravve invvardes, and hangeth as it vveare dilated and sprea­de abroade like vnto a tapistrye, over the thro­te. The other, and second vse of this pallatis, that it vvarmeth, and temperethe, the coulde ayre vvhich vve dravve in throughe the nose and throughe the mouthe to the lunges, be­cause throughe the extreame coulde therof, it might not chaūce to indammage the foresay­ed tunge, vvherfore they vvhich have no pallate, finde themselves allvvayes very much al­tered, & changed, and a great coulde allvvayes one the brest.

Of the swellinge of the Almondes, and of the vl­cerations of the same. Chap. 6.

ONe both sydes of the pallate, and in the hīder partes therof, in the angustnes of the throte, vvhich of the Greeckes is cal­led Isthmos, hath nature crea­ted and formed, tvvo Almon­des, the one right opposite agaynst the other, vvhich are therfore called Paristmia: vvhich be cause of the forme, figure, and qvantitye ther­of, are vvholye likened to an Almonde, & are for that occasione called Almōdes: ther func­tione, and office is, that they retayne in them, a certayne sputaminous humiditye, vvhich sincketh & descendeth out of the heade, ther­bye not onlye to refreshe & moystē the mou­the, & the circumiacent partes of the same but alsoe the throte, and the entrance of the sto­macke, because the tunge in speakinge might not vvholye be exsiccated and dryed, and that the cōtinuall speech might not therby be hin­dered, and interrupted.

These foresayed Almondes, are situated,The vse, situatione & compositione, of the Al­mondes. in a moyste, and vvarme place, and consideringe ther spongious, nature, are subiected to all cō ­cursions of humors, and all inflammations, vvherthroughe oftētimes they vvaxe harder, and greater, thē naturally theyought to be out of the vvhich, procedethe an vlceratiō or tu­mefactione, called of vs Antiades, A tume­factione called Antiades. vvherthrou­ghe the passage of eatinge, drinckinge, & brea­thinge is stopped, & interrupted, soe that tho­se afflicted patientes, can not vvithout great difficultlye, svvollovve, or respire & breathe, & even as the patiētes, heere throughe are co­me into great perill, & daunger, soe they must [Page 26] immediatlye be succoured vvith excellent & good remedyes.

Reme­dyes a­gaynst the tumefac­tion An­tiades.The assuredest and most convenient reme­dye is, that vve cause thē praesentlye to be phlebotomised, after that they shall at the first ha­ve vsed a glister: and thē in like sort cause him to be lett bloode vnder the tūge: that vve boxe thē behinde in the necke, that they vse gargri­ses, vvhich are indifferentlye frigifyinge, and astringent.

Signes hovve to knovv vvhē the tumefac­ted Almō des, exvl­cerates and ther remedyesThis tumefactione oftentimes is of such a magnitude, that it exvlcerateth: vvhich easilye vve may espye, vvhen as vve perceave it to be rumpeled, and vvhytishe, and vvhen as before ther hath binne any prickīge therin. VVhich havinge espyed to be soe, vve must vvith an instrument, vvhich onlye to that intent, & pur­pose vvas made, open the foresayed vlceratiō, or els vvith a lancett, vvhich rounde about vn­to the poyncte is vvounde vvith linnen. The apertion must be reasonablye dilated, because theris noe especiall greate vayne situated in that place, vvhich vve might hurt, except it vveare in the bottome or roote of the foresay­ed Almondes. VVe are sometimes cōstrayned to opē this vlceratione, before it be fullye ma­ture, and ripe, to vnburthen, and release that parte therof, because the bloode vvhich issu­eth out of the foresayed vlceratione, diminis­heth & intercepteth the payne, and inflammatione therof, adminestreth better passage vn­to the meate, and drincke, and finallye, prolō ­geth the breathe. It is right true, that vve allvvayes in the first, ought by all meanes ende­voure to mitigate the payne, and coole the caliditye of the vlceratione as much as is pos­sible.

If soe be these sayed Almōdes, are groovvē soe longe & harde, vvith out anye hope to re­duce them agayne to ther former & naturall estate, & beinge, vve must as then vse the ma­nuall of Chyrurgerye thervnto, ether by cut­tinge of the same, or els throughe inscisione: if soe be there be nothinge to hinder or be a let heere vnto, then the ligature vveare most convenient thervnto, and especiallye, vvhē as vve feare anye superfluous bleedīge. VVhich verye conveniētlye may be done,Ligature, or inscisi­on in the almōdes, vvhē they are gro­vven to longe & harde. vvith an in­strument, one the same forme and fashon, as before vve have rehearsed, in the tyinge of the pallate, ever observinge, that vve cutt therof noe more, then is needfull, contentinge our selves thervvith, not to cut therof anye more, then that vvhich surpasseth his naturall mag­nitude, & greatnes: because that throughe the largenes and romthe of the throte vvhich by this dissectione might chaūce, there be not ir­ritated and occasioned to follovve, all such ac­cidentes and inconveniēces, as before vve ha­ve discribed, of the pallate vvhich is to shorte cut of, or anye daungerouse bleedinge, if soe vve descide and cutt it of vnto the naturall, & sovvnde fleshe, of the forerehearsed almon­des, because of the greate vaynes vvhich there vnder lye dispearsed.

But before vve proceede unto this operati­one, vve must consider,The canckerouse almondes may not be tyed, not cut of. vvhether they be not of some canckerouse nature, because those vvhich are canckerouse may not by the ma­nualle, operation of Chyrurgerye be cured: they are most easyest knovvne, vvhen as they are harde, of a purple coloure, rugged, full of payne, and have a great roote. But if they be pale rovvnde, tender, smoothe, and belovve thinne, vve may as then vvithout daūger tye, and cutt them of. And in as much as concer­neth this operatione,Historye of Albu­casis. the historye of Albucasis shall at this time suffice, to instructe the yon­ger Chyrurgian, to imitate the same, vvhich affirmethe to have had a vvoman in handes, vvith such an vlceratione vvherbye her thro­ate vvas allmost occluded and stopped, that vvith great difficultlye shee respired, & brea­thed, nether coulde shee anye more eate, or drincke, beinge in greate perill, & daunger of death, if soe be that in that estate she had con­tinued but one day longer, in vvhome this vl­ceratione vvas soe extreamlye svvollen, that it had yet spreade it selfe abroade into tvvo branches more, into the nostrelles. In vvhich greate necessitye, and perplexitye, vvith al ex­peditione he tooke, a little hooke, vvhervvith he layed houlde one the one branche therof, vvhich vvas come into the nostrelles, vvher­vvith he drevve forth therof a reasonable qvā titye, and then as deepe as he coulde, he cutt it of, & havinge done the same, in the other no­strell allsoe he hath aperted and opened her mouth & depressinge the tunge dovvnevvar­des, hath taken houlde on the svvellinge and tumefactione, vvith a hooke, & allsoe cutt a great qvantitye therofe, vvithout anye greate store of bloode issuinge out of it: This beinge finished, the miserable & poore vvomā hath immediatlye opened her mouthe & beganne to eate, & drincke vvater. At other seasons al­soe therafter he hath cut avvay ther frō other peeces, but yet notvvithstādinge, as oftē & as much as he descided & cut therof, is increased agayne & grovvne thervnto: vvhich vvhē he had marked, he cauterised the same, & by this meanes in the end hath praevented the excre­scence of this tumefactione: but beinge con­strayned to take his iourny to some other place, coulde never heare, or by any man vnder­stande, hovv it happened therafter vvith her: & it may right vvell be thought, that the cau­terisinge of this dissease vnto his roote, could not in anye sorte increase agayne, as before it had done.

[Page]It happeneth allsoe sometimes, that the Al­mondes soe chaūce to svvelle, that ther is noe hope left, that vve shoulde perforate, or thrust them throughe, or to binde & tye thē, because somtimes it is impossible for the patient to o­pen his mouthe, & not beīge able in any sorte to respire, must of necessitye dye: vvhich per­ceavinge to be in such an estate, vve are then constrayned in our extreame necessitye, to ta­ke our last refuge, vnto the makīge of an insci­sione in the throte, or Trachea arteria, rather thē vvith our eyes behoulde the patiēt to smother & choake. VVhen as therfore vve vvoulde effect this, vve must cause the patient to lye, & leane on his backe, and hange his heade back­vvardes, because the throte, or Trachea arteria, may evidentlye shevve it selfe, then vve must vvith our fingers, take hould on the skinn, of the third, or fourth ringle of the throat, vvher vvith the foresayed, circles, or rovvndes of the throate are covered, & lifted vp, novv this be­inge, soe heaved vp, vve must accordinge vnto the lōgitude therof make the inscisiō, vvhiche beinge cut throughe, & agayn let fall, vve shal as then perceave the throte bared, & if soe be therone vve espyed any vayn, vve must detru­de it one the one syde & eschevve, or avoyde the same. VVhich beinge effected, vve must vvith the poyncte of a croocked lancet, make our inscisione thvvarte over, betvveē the thir­de or fourth rotūditye or circle, qvite through the mēbrane, vvhervvith both the foresayed cartilages, or circles are the one vvith in other vnited, & holden together, of vvhich betvveen thē both is situated, vvithout touchinge ether of both these cartilages, or rovvndes, into the concavitye of the foresayed Trachea arteria, or throate, vvhich easyly vve may perceave vvhē as the breath issueth forth of the vvounde: in the vvhich vvound, immediatlye therone, vve must impose a silvern, or gouldē pipe, because ther throughe duringe some shorte space the patient may breathe. This sayed pipe must in the one end be somvvhat broade, vvith a thre­de theron fastened, because that through the dravvinge of breath, it doe not chaunce to be dravvne into the throate. Novve the daunger of choakinge beinge passed, vve must as then take it therout agayne, because that the vvoū ­de, vvith convēnient remedyes may be cured.

Howe we ought to drawe, thrust out, and cut, of the teeth. Chap. 7.

Divers Chyrur­gicall operations. THere are divers disseases insci­dente vnto the teeth, vvhich throughe the manuall opera­tion of Chyrurgerye must be cured: as by cauterisinge, of the same, & by dissipation of the gūmes frō the toeth, by filinge, by cuttin­ge of, by dravvinge by settinge, by cuttinge in therofe, & by allegation & bindinge together of the teeth. Those teeth vvhich are slimye, & therō, a blacke, yellovve or vvhyte tough mat­ter, & sōtimes like vnslissed lime, or as it vvea­re some putaminous substāce, chaunced to be therō obdurated, & hardened, vve must vvith a little scraper, or instrument, for that purpose make thē cleane & purifye thē, vvithout hur­tinge of the gūmes, & looseninge of the same, because that such teeth vvhich are heervvith polluted, are not most cōmonlye very fast: the aged poeple, & the rheumaticke, they vvhich are trovbled in the lūges, or vvhich have anye dissease in the stomack, vvhich in times passed have binne infected vvithe the poxe, are com­mōly subiect vnto disseases of ther teeth: vvhē as this increscēs is not as yet obdurate or hard vve may then vvith more facilitye remove the same, & in the first vve must vvashe the gūmes as vvell of the one as the other vvith a little al­ume vvater vvherby the increasinge of this matter is sōvvhat praevented, & retarded,Practise & inven­tione of the au­cthore. & it fasteneth allsoe the gummes vnto the teethe, vvhē as they hāge looselye therō. Some there are vvhich esteeme this a greate secrete vvhich heertofore I my selfe have vsed, to vvitt, that vve take a little Aquafortis, and a little sticke, as thicke as a quille, the one end therof beinge dipped in this vvater, vvith vvhich end of the foresayed sticke, vve must vvel rubb the tooth thervvith, dilligētly observīge, that noe drop­pe therof chaūce to falle one the lippes or gū ­mes, & immediatly the tooth being heervvith rubbed, vve must as then vvith a linnē cloute vvipe the toothe, the linnē clothe beinge ma­defied in could vvater therbye to dissipate frō the tooth the tartenes therof, vvhich the Aquafortis hath left behinde it, causinge the patient immediatly to spitte, & therby the toothe vvil be exceedinge vvhite as snovve.For rottē hollovve & stinc­kinge teeth. If ther bee any tooth corrupted, foraminous, concavous & stinkinge, & that cavseth sometimes great doloure, & payne, yet notvvithstādinge vve alvvayes endevoure to praeserve him, ether be­cause he is cōmodious for chavving, or servi­ceable for the speech, or els is for a decorū or grace vnto the mouth: to the repellīg of vvhich payne, vve must vse a little oyle of Sage, of ro­semary, of cloves, or any other oyle, of aroma­ticalle spices. And if soe be thervvith the pay­ne, & the corruptione be not seased, vve must as then vvith Aquafortis cauterise the teeth, or vvith oyle of vitroll vvherein vve must dippe and moystē a little cotten, vvhich neatlye vve must thrust into the cōcavity of the toothe: & if so be all these remedyes be not sufficiēt, ther is as thē noe surer, or better remedy, thē is the vse of the actuall Cauteriū, vvhich must be pro­portioned verye little, & accordinge vnto the concavitye of the tooth.

Other Chyrurgians ther are vvhich hovvld in greate esteem the filīge of the teethe,Whye vve file the teeth. vvher [Page 27] they be corrupted, vvhich I alsoe esteeme to be commodious, vvhen as convenientlye it may be effected, & vvhen the tooth is corrup­ted but on the one syde therof: for by this me­anes vve shall intercept, & hinder the corruptione of the next toothe ioyninge thervnto, that he be not thervvithe polluted above o­ther commodityes, vvhich therthrough vve shal effect.

Teeth vvhich grovv forth vvith an acuitye.Ther grovveth oftentimes a tooth higher, then the other of the teeth, ether vpvvardes, outvvardes, or invvardes, the poyncte vvher­of is soe accute, that in speakinge it ether hur­teth the tunge or the lippes. Alsoe sometimes the teethe ar rugged & vnsmoth above, vvherfore they, one the toppes & summityes therof be filed, by this meanes to make them smoo­the, as the other. And convenientlye to vse the file theron, & to cause that the toothe doe not chaunce to stirre in the filinge, vve must hould fast vvith our fingers the foresayed too the, layinge certayne peeces of linnen on the gummes,Teeth vvhich stand out of ther ordre, vvhich are brokē & vvher­in as yet remay­neth som little peece. vnto the rootes of the toothe. VVe must file of all such teeth vvhich extrud them selves externally, vvill not be cōtayned in the semicircle of the other teeth, or they vvhich are brokē, & a little peece therof as yet remay­ninge in the place, least they might chaunce to hurte the tung, or the mouthe. Conserninge the supernaturall teeth, because it vveare to great paynes & labour to file thē, it is alsoe so­metimes daūgerous to dravve thē because cō ­mōlye they are grovven, & sticke verye fast in the cheekebone, vve cut thē of vvith our cut­ting pellicane,Superna­turall teeth. or instrumēts vvhich onlye for that purpose are cōposed & made, & are befo­re figured & set dovvne in ther formes: vve all soe breack thē sometimes i [...] place of cuttinge of thē, vvith such instrumētes as heere before are praefigured vnto vs: but the best vvay is to cut thē of, if by any meanes possible vve cā ef­fecte it.For great payne & doloure in the teethe. The payne of the teethe is at someti­mes soe vehemēt & in tollerable, because that the tooth, is corrupted vnto his synnue, pear­ced, & is hollovved, that the persone, is almost phrēsye, & cōsideringe that there is somtimes noe remedy to be hadde, for the quallifyinge of this payne, he is as then cōstrayned to cause the sayed tooth to be dravvne, vvhich as then is the certaynst vvay.

Hovv vve ought to dravve a tooth.VVhē as therfore vve vvoulde dravve forth a tooth vve must cause the patiēt to sit in such a sorte as is most cōveniēt, & thē make choyse of the corrupted & rotten tooth, because vve doe not mistake the one for the other, vvhich vve must make loose frō the gumes, & fill vp the cōcavity or hollovvnes of the tooth vvith a little peece of leade, or vvith a little lint, or cottē sticke it full, because in the Pellicane he chaūce not to breake, through the harde shuttinge of the same: havinge houlde theron, vve must gētly & easyly crushe the tooth dravver together, least the tooth chaūce to breake, and thē dravvinge the foresayed tooth a little a sy­de plucke him out, because that if to rigorou­slye vve vvaggle the tooth vp or dovvne that parte of the cheeke bone vvherin the roote stoode soe fast, might easylye be brokē, vvhe­refore he vvill not vvith to greate violence be dravvne out, as alsoe by to violent dravvinge, vve might disioyne, and plucke out of ioyncte the nethermost cheekebon, & cause great perturbation in the vppermost chavve evē to the eyes. The tooth beinge dravven,The bleedinge of the gum­mes vvhē as the tooth is dravvne out, is not to be litt­le estee­med of. vve must vvith both our fingers shutt, & ioyn together agayn the gummes & cause the patiēt to vvas­he his mouth vvith a little Oxycrate, vvherin vve must also put in a little sault. If soe be ther vveare any effluxiō of bloode, vve ought not to esteeme it to be a small matter because I ha­ve knovvne some to bleed thēselves to death.

The assuredest remedye vvhich I ever have knovvne to be vsed, is this, that divers times, vve must thrust therin som cottē, vvhich hath binne madefyed in iuyce of lēmones, vvhich allvvayes vve must put in that place, out of the vvhich the tooth vvas dravven.

And touchinge the conveniēce of the liga­tione, or tyinge of the teeth,After vvhat sor­te vve ought to tye the teeth, shutt, & sett them fast vvhich a­re loose, & alsoe inserte those vvhich throughe art are made. to ioyn thē toge­ther, & to inserte & set fast those teeth, vvhich are loose, & grovvē to be moveable & may be vvaggled vp & dovvne, & alsoe to inserte anye therin vvhich by arte ar made, all this may ve­rye conveniētlye & fitlye one this manner be effected, vvith a fyne gouldē vvyer of fine ori­entall goulde, vvhich vve may easylye bende & bovve, betvveen the foresayed teeth vvith­out any violence. First dubble the vvyer, laying the same vvith his duplication, betvveene tvvo sovvnde teeth & then bringe both the endes, to that tooth vvhich is loose, vvhether it be one or more, vntill such time as vve shall have dravvne vnto the seconde sounde tooth one the other syde, then vve must reduce the vvyer vnto that tooth vvhence vve tooke our originalle, gentlye dravvinge the foresayed vvyer together, close to the roote of the tooth least that he goe loose: This beinge done vve must vvith a pare of sheares cutt of both the endes of the foresayed vvyer vvhich are to lō ­ge, & vvinde the rest therof rovvnd about the sovvnd tooth, as close to the roote that the fo­resayed gouldē vvyer, may very difficultlye be espyed, nether in anye sorte may perturbe, or hinder the tunge. The teethe not onlye bein­ge loose but alsoe vvholye fallen out, vve may for all that inserte them in there place, & tye them, vvith a gouldē vvyer, as is before rehe­arsed, or els vve may set other teeth in ther places, vvhich are by art made of Ivory,Looke a­fore in the figure or formes or of any other matters, as here before vve have set dovvne the figures and discriptions therof.

The Frenche Chirurgerye THE SIXTE TRE­ATISE OF THE OPERATI­one of Chyrurgerye Contayninge nine Chapiters.

  • Of that, vvherone vve must consider, before vve make an apertion in avayne. Chap. 1.
  • Hovv vve ought to phlebotomive, or open avayne. Chap, 2.
  • VVherō vve ought to cōsider, after vve have opened the vayne, & vvhē shee bleedeth. Chap: 3.
  • Of the number of vaynes, & arteries, vvhich are vsed most cōmonlye to be opened. Chap. 4.
  • Of the apertione, of the Arteries. Chap. 5.
  • Of Anevrisma, or broken arterye, hovve vve ought to make an inscisione therin, & after vvhat manner vve ought to binde them. Chap. 6.
  • Of the Cirsotomia, vvhich is, hovv vve ought to make our inscision in the Varices, or bursten vaynes. Chap. 7.
  • Of horseleeches, and of ther vse, and hovv vve ought to applye them. Chap. 8.
  • Of boxes, and hovve vve must applye, and vse them. Chap. 9.

❧Wheron we must consider, when as we desire to open a vayne, or phlebotomize. Chap. 1.

Intenti­one, & porpose of the aucthor. MYe purpose, and intent, is not in this place to discrib vnto you, vvhat sicknesses reqvire phlebotomye, in vvhat age, in vvhat time or season of the yeare, in vvhat countrye, in vvhat cōstitutiō of the body, it must be done, & of vvhat occasione, namelye & especiallye, vvhether it be for anye simple evacuation, or for anye deprivatione, or derivatione, or for any revulsione. In like sorte alsoe in vvhat vayn vve ought to make the apertione, vvhat qvantitye of bloode vve ought to detracte out of the same, in vvhat sorte, and hovv much at one time, hovve often after the other or in vvhat time of the sicknes vve must make the apertione in the vayne.

But my purpose, and meaninge is, onlye to shevve, hovv vve ought to opē a vayne: vvheron vve must thinck, & dilligentlye consider, before vve make the apertione therin, after vve have opened her: & vvherone vve ought to not, vvhē the blood issveth out of the same. This doinge, shall the Chyrurgiane, be noe lesse vvorthye of prayses, because he cā verye excellentlye phlebotomize, then the physiti­one is prayse vvorthye, by his perfect knovv­ledge, vvhether the patiēt have neede of phle­botomy, or not:Why phlebotomye is difficulte, & daū ­gerous. For although, that it seemeth to be a smalle sciēce, to phlebotomize aright, & very vvel, yet notvvithstandinge is it often­times, a difficulte matter & verye daūgerouse, because the vaynes, ar situated somtimes close to the Arteryes, yea alsoe thervppen, as alsoe are the synnues,Acci­dentes vvhich are cau­sed, & ta­ke ther originall of ther hurtinge of anye vayne, synnue, arterye, or tendone. & the tēdones. If soe be ther­fore vve chaunce, vvith the lancet to hurte a Tendone, therafter most commonlye issueth a Spasmus, or a Gangrene and mortificatione, vvherthroughe the patiēt pitifullye & rueful­lye, and vvith great torment endeth his lyfe. If ther be then any arterye touched, & opened, shee verye difficultlye vvil be cured, vvherby the patiēt bleedeth to death: & vvhē as vve de­scide a vayne qvite asunder, both the endes therof are immediatlye retracted, and dravvne invvardes, the one end this vvay, & the other end that vvaye, soe that vnder the fleshe both of the endes are lost, & noe bloode cā possibly issve therout: if shee be then vvith to great ti­morousnes & feare pricked, the skinne onlye vvhervvith shee is covered is as thē inscided, & the vayn not opened: or els if shee be onlye pricked vvith the poyncte of the lancet, the bloode as thē issveth therout droppingevvyse and the subtilest bloode onlye cometh out, vvher cōseqvently therafter she exvlcerateth.

Sometimes alsoe lyeth the vayne occulted soe deepe in the fleshe, that vve can not vvith the lācet finde thē, vvithout great paynes, yea also & although vve espye them, yet throughe there perpusillitye, & rotūditye, they avoyde, & eschevve the poyncte of the lācet, hovv ac­cute & subtile soever the same be. Soe that ther are oftētimes divers occasions, vvherfore phlebotomye is difficulte, vvhich to an other vvhich never hath done it seemeth to be very easye.

Before the Chyrurgian maketh his apertiō in the vayne, if soe be the patiēt be restringed & bovvnde in his belly, & hath in a lōge time not bīne at stool, vve must thē first of all cau­se him to vse a Clistere, because throughe the phlebotomye, the vaynes beīge evacuated, & emptied, doe not attracte, & dravve vnto thē out of the guttes or entralles, any corrupted, & rottē humors, vvherbye anye of the vvor­thyest partes might be offende, & hindered.

Nether is phlebotomye expediēt,Wheron vve ought to cōsider before phlebotomye. vvhen as the stomacke, is burthened, ether vvith anye cruditye, of vndigested meat, or drincke, or vvith anye other viscositye vvhatsoever, as also it is vvholye dissvvaded to doe after anye [Page 28] greate evacuatione, or anye other occasione, vvherby the patient might be debilitated, as is superfluous parbrakinge, a great laske, great abstinence, continualle vigilatione, and great conversation vvith vvoemen. VVhē as ther­fore the Chyrurgiane in the absence of the Physition, hath on all these foresayed thinges dilligentlye cōsidered, he must as then deferre the phlebotomye. And if it soe chaunced, that anye persone to praevent any dissease desired to be phlebotomized, he must then cause it to be done, vvhē as he is best of courage, as bein­ge freede from all care, of sorrovve, of ire, and besyde all this, vve must not phlebotomize anye persone, vvhich is to timorouse, & fear­full of phlebotomye, because the afrighted­nes, & the feare, causeth the bloode to vvith­dravve it selfe tovvardes the internall partes of the bodye.

Hovve vve shoulde convenientlye phlebotomize.And the patiēt as yet beinge lustye, & strōg, vve must then cause him to sit in a stoole, but if soe he be feeble & debile, & is subiected vn­to fayntnes & sovvndīge, as those are, vvhich are of a hott nature, vve must in the first let him suppe in a soft dressed egge, or a morsell of breade sopped in vvyne, & then cause him to lye one the bedde, halfe sittinge vpright, & stuff him vnder vvith cushēs as if he sate. And above all vve must dilligentlye note, that the light of the ayre, or shining of the candle, doe rightlye shine one the vayne, because that through the shaddovv therofe, the knovvledg of the vayne, & of the place vvhere she must be pearced, be not vanished out of your sight: then must the Chyrurgiane, vvith his right hande, take the right hand of the patient, or vvith his left hande, the left hāde of the patiēt, out of the vvhich he meaneth to dravve the blood out depressinge the arme sōvvat dovvn vvardes, and then vvith his left hand, or vvith a vvarmed table naptkinne, rubbe the insyde of the arme vvher he intendeth to ma­ke the apertione:Dubble bande in Phlebo­tomye. And then binde the arme dubble a little above the elbovve, vvith a little narrovve liste of vvollen clothe, not to stiffe nor to loose, because to looselye bovvnde, or to stifflye tyed doe both of them hinder the bleedinge: thē must the patiēt, shutt his hand close, vvherby as vvell throughe the binding, as throughe the closinge of the hāde, the vay­nes lye fast & stedfastlye in the fleshe, and not move this vvay or that vvay vvhē vve should pearce them, vvherthroughe also they rayse themselves, and svvell the more, throughe the bloode, that by this meanes is dravvē thether vvardes, by the vvhich alsoe vve may the ea­syer see, and feele them.

❧How we ought convenientlye, to make an aper­tione in the vayne. Chap. 2.

HAvinge dilligētlye considered all these thinges if the Chyrurgiane,Continv­ance of the man­ner right­lye to phlebotove. determine to phleboto­mise in the right arm, he must then take houlde one the fo­resayed arme vvith his left hande, by the ben­dinge of the arm, or about that place, vvherin vve purpose tO make the apertione, & lay his thumbe one the vayne, a little belovve the place, vvher vve vvil pricke, because that soe he may hovvlde the vayn stedefaste, vvithout glidinge this vvay or that vvay because some­times the vayne beinge, spanned like a little cord, might chaunce to rovvle, & glide vnder the lancet. And because the foresayed vayne is oftentimes implete vvith vvinde, & vētosi­tyes, shee therefore yeeldeth, & slideth avvay vnder the lancet, vvherthroughe vve can not fullye pearce her, & by this meanes the aper­tione falleth to small: all this beinge in this sorte noted, vve must vvith the first finger of the right hand feele vvhere vvith most conve­nience vve might make the apertione, setting an impression on the skinne above the vayne vvhere vve purpose to pricke, vvith the nayle of your finger, & then immediatlye, take the lancet in the right hande, vvhich betvveene our lippes vve must have in a readines, vvith the vvhich vve finelye must make our aperti­one, in the vayne, causinge the poyncte, and a­cuitye of the same, gentlye to enter into the concavitye of the vayne, & not abruptly, and rudely, vvith a hastye thrust. And to make this apertione vvith more certayntye, & vvithout tremblinge of the handes, the Chyrurgiane must take the lancet in the middle, vvith his thumbe & his first finger, sufferinge his hande vvith three of his fingers to rest on the arme, & so lay his thumbe and his first finger vvhich hould the lācet one the thumbe vvhich houl­deth fast the vayne, on this sort to hould fast his hande, & vvith out anye tremefactione to vse the same. Some there are vvhich annoynt the place vvherin they intende to phleboto­mise, vvith a little oyle, or vvith freshe butter, thervvith somvvhat to mollifye, & soften the skinne, & soe vvith more ease and vvith lesse payne, to pearce ther throughe.To molli­fye the skinne. Others an­noynte the acuitye of ther lancet vvith oyle because shee might the easyer perforate the same, & cause lesse payne, the perforatione, or vvounde might better contayne it selfe apert & the blood if soe be it vvear grosse, might the subtiler, & vvith more ease have his passage.

If soe be then that the apertiō be made vvith one thruste, it is thē good, but if not, vve must immediatly give an other pricke, ether a little belovve the same, or els a little above the sam, if the vayne sufficiētly demōstrateth her selfe. If therfore the apertiō be to small, & the blood [Page] issue out of the same to subtilelye, soe that vve feare that vve shall not dravve sufficiēt blood enough therout, then immediatlye vve must thrust into the same hole, or apertione agayn, & a little dilate the same: because that oftenti­mes throughe to small an apertion, the grosse bloode congealeth before the apertione, and ther conseqventlye exvlceratethe.

Why vve must give a staffe to them in ther hāde vvhich vve Phle­botomizeHavinge convenientlye brought to passe this apertione, vve must then give the patiēt, in the hande of that arme vvherin he is phle­botomized, a roūd staffe, partlye therō to rest his arme, as alsoe to turne rovvnde the fore­sayed staffe in his hande, because by this mea­nes the bloode might the better shoote out: the vvhich if it doe not rightlye issue out, vve must thē marke, if the ligature be not the cau­se therof, as if it vveare to harde tyede, vvhich as then vve must a little districte and make it loose, vvithout vvholye looseninge of the same.

Broade, & nar­rovv lan­cets.The Chyrurgiane must alsoe have divers lancets, vvherof the one must be a little broa­der then the other: The broade lancets are ve­rye necessarye vvhen as the vaynes lye highe exalted, & vvhen vve desire to make an ample apertion. The smalle narrovve lancets are ve­rye necessary, vvhē as the vaynes lye profoūd­lye occulted in the fleshe, and also vvhen as in the highe exalted vayne, vve desyre to make a smalle apertion: because sometimes the sicke personne, reqvireth a great, & festivous phle­botomy, to the vvhich end, vve must make an ample apertione, as vve must alsoe doe, if vve coniecture the bloode to be grosse, & dēce, & vvhen the patient is lustye, and stronge.

Contrarilye, if soe be vve retract, & dravve back the bloode, vvhich supernaturallye hath issued out of any parte of our bodye, as in tho­se vvhich, spitt bloode, or those vvhich bleede much out of the nose, as then vve must make our apertion smalle, because that great evacu­ation of blood is not necessarye for them, be­cause through there noses they have avoyded sufficient, then onlye in such accidētes, vvher in is onlye reqvired a regressione of bloode. Besydes, it is necessarye & expediēt, that in the foresayed evacuatione, and sicknes, vve suffer the bloode to issve longe enoughe out of the apertione of the vayne, vvhich the patient shoulde not be able to suffer, if the foresayed apertione vveare ample, because ther vvould issue to much blood othervvise therout.

In the Phrenesy vve ought to make but a small apertione.VVe are also in phlebotomye vrged to make a small inscisiō, in those, vvhich are troubled vvith Phrenesye, & in those vvhich are grovv­ne madde, because that little vvounde might vvith all expedition be cured agayne, because that such raginge▪ & franticke persons vvill all vvayes make loose the ligature or dressing be­fore vvear therof avvare, vvherof they might com in daunger of bleedinge to death, but the apertione being smalle, although they loosen the arme, yet notvvithstandinge they can not violently bleede because in such a small aper­tione, the bloode congealeth, & occludeth, & stoppeth the vvounde. VVe ought to make in smalle vaynes, a smalle apertione, & in gre­ate vaynes an ample apertione: for if so be vve make in a greate vavne a smalle apertion, thē shoulde necessaryly follovve, that the blood, vvhich coagulateth in the small vaynes, be a hinderāce vnto the issuinge or runninge out of the bloode.

Touchinge the forme, & figure of the insci­sione, it is effected in three sundrye sortes, and fashons: vvherof the first is made overthvvar­te, the secōd accordinge vnto the length of the vayne, vvherthroughe the vayne is cleft or splitted, & not pricked: the thirde is the meane betvveene them both, vvhich vve may vvell call the contradictorye apertione, because cō ­tradictorilye shee is made.Three formes of in­scisions in phlebotomye. VVe make the a­pertione overthvvarte, vvhen as vve are not minded to reiterate the phlebotomy: for vvhē vve bende the ellbovve, thē both the endes of the vayne ioyne together agayne, This figure or forme is necessarye, vvhen as vve desire to make a large apertione. VVe must make the apertione sydelonge or contradictorye, vvhen vve purpose to iterate the phlebotomye: and vve makinge the apertione in this manner, ve­rye seldome or never misse the vayne: and vvhich is more, it is better for the circumstan­tes, and standers by, vvhen the bloode in this manner issueth therout. That inscisione, vvhich is made accordinge to the lēgth of the vayne, is verye expedient, vvhen vve intende to renue the bloode lettinge, & that not onlye the same day, but one the next day alsoe, be­cause that vvhen vve bende the elbovve, both the labia, or lippes of the vayn, do separate & devide themselves.

But in vvhat forme soever vve make the in­scisione,The vay­ne must be insci­ded in her middle. yet notvvithstādinge the vayne must be pearced in the middle, vvithout vvholye cuttinge a sunder of the same. Because her lip­pes, might chaunce to be inverted invvardes, and the bloode could not resulte out of the a­pertione, but runne dovvn a longe by the ar­me, or both the endes of the vayne, are dravvē invvardes, vvithout deliverāce of anye blood from her, or at the least, in the first very little.

❧Wheron we ought to marke, after the thruste, & apertione of the vayne, and when the bloode issueth therout. Chap. 3.

[Page 29] Although the vayne be vvel opened, yet shee droppeth throughe the afrightednes of the patiēt WE may knovve, that the vayne most commōlye is vvell ope­ned, as easily vve may percea­ve by the bloode, vvhen as in the firste, it rousheth and as it vveare leapeth out in great haste, but immediatly altereth vnto droppin­ge, vvhich throughe the afrightinge of the pa­tient is caused, for vvhich reason the bloode is dravven invvardes. VVhich vvhen it chaun­ceth vnto vs, vve must vvith patiēce abyde, & and vnbinde it somvvhat, and incourage the patient, causinge him to move his fingers, & turne,Grosse bloode doth no­thinge but drop­pe. and crush the same in his hande. The apertione in the vayne is sometimes ample enoughe, but because the bloode is grosse, it can not issue out therat, to the vvhich end vve must put a little oyle therine, vvhich to that purpose is verye profitable.

If soe be therfore the Chyrurgyane, in ab­sence of the physitione, findeth the patiēt ve­rye feeble, and yet notvvithstandinge, follo­vvinge the rule, & ordinance of the physitio­ne, is verye necessarye to be vvell phlebo­tomized, vve must them doe it provident­lye, that althoughe, at the first vve have not dravvne soe much blood as the sicknes or dis­sease reqvireth, vve must then, some certayne hovvres therafter agayn renue the phleboto­mye for the seconde time, and if it be needfull yet once agayne, for the thirde time, vvithout over charginge of the patient vvith to great phlebotomye at one time.

It might alsoe chaūce, that before vve could detracte such a qvantitye of the patiēt as vvas ordayned, and reqvired, the patient might chaunce to be debilitated, and in daunger to fall in great fayntnes, & sovvndinge, vvheron the Chyrurgiane must dilligentlye consider: as he may easyly perceave it, vvhen the patiēt vvaxeth pale, and oppressed at his harte, his puls diminishinge, & vvhen the bloode run­neth dovvne by his arme.What vve ought to doe vvhē vve per­ceave the fayntinge to ap­proch the patient. VVhich vvhen it chaunceth, the Chyrurgian must then imme­diatlye sease the bleedinge, layinge his thum­be, one the apertione of the vayne, & lay the patiente on his backe, vvith his heade one a cushen, sprincklinge could vvater in his face, and give him a little vvyne in his mouth, and cause him to smell at some vineger, and then have a little patience, vntill that agayne he re­viveth, & comme to himselfe: for as soone as he shalbe come to his former strength agay­ne, vve may as thē finishe the phlebotomye.

The pa­tiēt lying fiat on his backe cā verye vvel suffer phlebotomye.Some ther are vvhich in anye sorte can not indure phlebotomye, hovv lovve soever they sitt, althoughe it vveare on the bed, or althou­ghe vve cōtinually helde vineger before ther nose, or gave them vvyne to drincke, yet not­vvithstandinge they lyinge prostrate on the bedd, vvith ther heade reasonable highe, they can as thē verye vvell suffer and abyde the fo­resayed phlebotomye, althoughe vve dravve a goode qvantitye of blood from them: As of late I my selfe have knovvne to happen, in an honorable, and coragious gentleman.

After that vve have detractede a reasonable qvantitye of blood out, vve must then dissol­ve and make loose the ligature, and crush out the bloode of the vayne, least that the bloode chaunce to congeale therine, and coagulate, and soe exulcerate: and if soe be ther appeere­de anye little parcell of pingvedity, or fat, vve must thē gentlye thrust it in agayne vvith the heade of a pinne, and not cutt it of, and then vvipe of the blood vvhich cleaveth & is dryed or exciccated to the arme, lay a little cōpresse, one the apertion, vvhich is madefyed in coul­de vvater, and vvinde the ligature, tvvice or thrice aboute the elbovve, like a borgondian crosse, vvithout tyinge both the endes fast, before you have caused the patient to bende his arme, to laye the ligature therafter.The Ligatione of the elbo­vve after phlebotomye. This liga­tione may not be to stiflye bovvnde, because the cicatrice by this meanes, may qvicklye be sitvatede on the apertione of the vayne. The arme beinge thus fouldede together if so be the patiente be able to vvalke he must vveare his arme before on his breste in a scarfe & if so be he lye on his bedde, he must gently lay the same besyde him, vvith out much mo­vinge of the foresayed arme, nether must he lye therone: for ther have binne some, vvhich in ther sleepe have hadde ther armes vio­lentlye to bleede, vvith great daunger of ther lives.Hovv vve may stopp & restraygne blood The bloode issueth sometimes vvith such violence out of some partes of our bo­dye, that vvith noe cōpresses or ligatures vve can restraygne the same: vvhich happeninge, vve are thē constrayned to lay above one the toppe of the apertione, the one halfe of a gre­ate beane, and the compresse therone, and in this sort bind it together,

Ther remayneth somtimes a nigreditye or blacknes,Daunger that hap­peneth to phlebotomye. & viriditye or greenes about the a­pertione, but therof ensueth noe evell, vnles anye other accident chaunced thervnto.

VVhen as therfore vve desire to renue the phlebotomy,To renue the phle­botomye. vve must then lay one the insci­sione saulted oyle, because that hindereth the curinge of the vvounde, and the sault keepeth the blood from coagulation, vvherthroughe the apertione of the vvounde is stopped, And if soe be the vvounde vveare soe stopped, that the bloode vvould difficultlye issue therout, vve must not then rigerously stretch out the arme, vvhich the patient hath carried on his brest dubbed, nether depresse the vayn vvith to great violence, to get the bloode therout: Because such violēce might cause great payn, [Page] and inflammatione,To renue the phle­botomye. but vve must rather vvith a small privett or searching iron, remove that blood vvhich therin is exciccated & dryed, or rather once agayne make an inscisione, after that vve have bovvnde the arm somvvhat hi­gher, then the elbovve, as before vve have sa­yed.

Hovv vve ought to open the vaynes or arteryes of the tē ­ples of the head.VVhen as vve desire to make an apertione in the vaynes or arteryes of the temples of the head, of the foreheade or vnder the tunge, vve must then cause the patient gentlye to vvring about his neck a table naptkīne, or a tovvell, therby to cause the bloode to ascēde, on high, & the vaynes to svvel, vvhich vve intend to o­pen.Hovv vve ought to open the vay­nes of the handes & feete. And vvhen as vve desire to open the vay­nes of the handes or feete vve must bath them in vvarme vvater, because throughe caliditye & vvarmethe of the vvater, the foresayed vay­nes might erect themselves, & the bloode, the vayne beinge opened, might the better issue out therof.

❧Of the number of vaynes, & arteryes, which commonlye, vse to be opened in mans bodye. Chap. 4.

THe aunciēte professors of Chyrurgerye, have observed, cer­tayne vaynes, vvhich in mans bodye must be opened, accor­dinge as everye divers dissease shall reqvir: vvherof the Chy­rurgiane must not onlye knovve ther situati­one, & ther divisione or separatione, but alsoe the names of the sam, because that he doe not mistake the one from the other.Vayne of the fore­heade. They vvhich most commonlye are opened, are 41. vvher­of ther are in the heade 17 een: the first vvher­of is called the vayne of the foreheade, vvhich is situated in the middest of the foreheade, and is opened vvhen as vve have anye inveterated payn in the occipitialle partes of the heade to trouble, & molest vs. The seconde is called Vena Pupis, Vena Pu­pis. vvhich is situated right in the mid­dest of the occipitialle, or hinder partes of the heade: this vayne is opened, agaynst the sopo­riferousnes, & payne of the heade, vvhich is si­tuated in the foreheade.The tem­porall vayne. The thirde is called the temporalle, or vayne of the tēples, vvher­of in each syde ther is on, vvhich in divers brā ­ches ascēdeth in the temples of the heade: vve open those vaynes agaynst the superfluous la­chrimation of the eyes, agaynst vehemēt pay­ne in the eares, agaynst the Hemicrania, vvhich onlye commeth in on syde of the heade.Eeare vayne. The fourth is called the eare vayne, one eache syde one, & have ther place, & situatione behinde the eares: this vayne is opened agaynst surdi­tye,Eye vayn. payne, & vlceration of the eares. The fifth is the eye vayne, the vvhich in the greate cor­ner of the eye, close by the nose, vve may per­fectlye see: shee is opened, agaynst all disseases of the eyes, & eyeliddes. The sixt is,Nosevayn the nose­vayne vvhich hath her place in the middest of the end of the nose, betvveene the tvvo grisles or cartilages: shee is opened, agaynst the hea­vines of the head, & agaynst all reumes, of the eyes, & eyeliddes. The seaventh,Lippe­vayne. is the lippe vayne, vvherof one each syde are, tvvo, in the internall partes of the opermost, and nether­most lippe: vve opē them agaynst all tumors, & excrescenses of fleshe, agaynst all vlceratiōs of the mouth, & agaynst the vehement rednes of the face. The eight is called Ranularis vena, Ranula­ris. vvhich is situated vnder the tunge, one each syde on, vve make therin an apertion, agaynst the Sqvinantie, agaynst the incensione of the Almondes, of the pallate, & more other disse­ases of the throte. The ninth is very publique, lyinge in the necke, and is called the Iugularis, Iugularis. vayne, & of the Arabians Gvides, on each syde of the necke one. Shee may very conveniētlye be opened, agaynst tht Sqvinantye, & agaynst all rheumes of the throte, vvhich bringe vs into greate angustnes, and trouble.

In the armes are sixe, in every arme three vvhich in the fouldinge of the armes are phle­botomized. The first is the head vayn,Head­vayne. Cephali­ca. vvhich is situated highest & most outvvardlye, in the arme, vvhich vve opē agaynst the payn of the heade, eyes, eares, & payne & svvellinge of the throte. The second is the nethermost in the insyde of the arme, & is called Basilica, Basilica, being the foundatione of both the other vaynes, and is also called Hepatica, or liver vayne:Hepatica or Liver vayne. VVe open this vayn, agaynst the stoppinge of the Liver, & agaynst all inflāmations of the vvhole bo­dye, & all disseases, vvhich are situated vnder the heade. The thirde, is the Mediane,The Me­diane or Mediana. as vvell concerninge her situatione, as originall, be­cause shee taketh her beginninge out of the Heade & Liver vaynes, as also considering her conditions, because vve open her as vvell for all disseases, vvhich are situated in the vpper, as vndermost partes of our vvhole body, and ther trouble, and molest vs.

In the handes, vve have sixe, in each hande three.Eye vayn in the hande, The first descendeth a longest the Meta­carpion of the hande, and passethe betvvixt the thumbe, & the first finger, vve call her allsoe the heade vayne, or the eye vayne. VVherfore shee is onelye opened agaynste payne in the heade, & eyes. The seconde is called Salvatella, Salvatel­la, or Liver vayn, betvvixt the little, & thirde fin­ger, shee is phlebotomized, agaynst the yello­vve gaundise, & in all disseases of the liver, on the right hande, and one the left agaynst all disseases of the milte, vvherfore of som in the left hande shee is called the miltvayne.Blacke vayne, The thirde, is alsoe called the Mediane, Blacke, and [Page 30] Common vayne, & descendeth by the finger called Medicus, Blacke vayne or thirde finger, vvhich vayne vve may open, vvhen vve can finde nether of the other tvvo.

In the belly are tvvo in each syde of the bel­lye one,Vena Illi­aca. vvhich vve call Venam Illiacam, or Ti­tillarem, & demonstratethe her selfe betvveen the hippes, & the flanckes. She vvhich is ope­ned in the right syde, agaynst the Dropsye, and other disseases of the Liver: shee vvhich lyeth in the left syde, agaynst the disseases of the Milt.

In the fundament, or privityes of a mā, are one each syde tvvo, the one vvherof vve calle the Hemorrhoidalle vayne,Hemor­rhoidall vayne. & is onlye opened in melanckolye disseases.

In the legges are eight, in each legge four: vvherof the first is called Vena poplitis, Vena Po­plitis. situated in the hockes, or fovldinge of the knees, & is opened agaynst all disseases of the nethermost part of the bellye. The second Saphena, or mo­ther vayne,Saphena or Mother vayne. vvhich vve opē one the insyde of the legge vnder the anckle, in all disseases of the kidnies, & of the vvombe, & to provoac­ke in the vvoemen ther monthlye sicknes, or mestruousnes, in all runninge of the raygnes, and in Venus botches, or as vve call them in lattin Bubones. The third is the Schiaticke vayn, vvhich externallye demonstrateth her selfe, a­bove the āckle, vvhich is only opened agynst the dissease called Sciatica, The vayn Sci [...]tica. The kid­nye vayne & agaynst all payne, and doloure of the hippes, and flanckes. The fourth is the mediane, or kidnyevayne, situa­ted belovve the foote, and is phlebotomized agaynst all disseases of the kidnyes.

Amongst all the other vvhich are most cō ­monlye opened, are those three vvhich in the foulding of the arme are phlebotomized: to vvit the head vayn Basilica & the mediā.Basilica, or liver vayne is daunge­rous to be phlebo­tomised. VVe must dilligētlye cōsider that vvhen vve make an inscisiō therī that vnder the Basilica or Liv­er vayne lyeth an artery or great harte vayne: vnder the Median a synnue or tendone of the muscle Biceps or both of these together, but vnder the Cephalica is nether synnue artery or tendone sitvated,Cephali­ca or head vayne is opened vvithout daunger. vvherfore amōgst all other vaynes, ther is none vvhich vvith lesse perril & daūger may be opened.

If so be that through mischaūce in opening of the vayne Basilica vve chaūced to hurte the artery vvhich ther vnder is sitvated as I have knoovvne to have chaūced, vve must praesēt­lye for the stoppinge and restrayninge of the bloode, and to the curing of the arterye, vvith­out leavinge anye Aneurisma, Remedye for a vvoū ded arte­rye. cleave a bean in tvvo peeces, & laye the one halfe of the bea­ne, one the apertione of the vayne, vvith a cō ­presse therone, gentlye tyed, vvithout visitin­ge of the same in thre or foure dayes, or once offer to touch it. If so be in the apertion of the mediane, vve chaunced to pricke the subter si­tuated synnue, or tendone, vve must then im­mediatly phlebotomize the patient in the o­ther arme: and vve must droppe in the vvoun­de of the pricked synnue, a little hott oyle of Terpentin, and a little vvoolle, beinge dipped therin vppon the same, therby to keepe the apertione aperte, & then lay a playster of Dia­calcitheos, rovvnde aboute the vvounded par­te of the vvhole arme, vvhich hath bīne lique­facted, vvith oyle of roses, and vineger.

Of the Arteriotomia, or apertion of the Arterys, or hartvaynes. Chap, 5.

COncerning the Arteriotomia, or apertione of the Arteryes, the praedicessors & auncient pro­fessors vveare vvont to effect it especialle behinde the eares, & in the temples of the heade, a­gaynst all continuall, & rebellious fluxions, & Rheumes of the eyes, in like sort alsoe, agaynst all diseases of the heade, vvhich have takē ther originall, frō hotte, dampishe, or subtile rheu­mes: as yet novv a dayes vve doe, but not vvho lye as they vveare vvonte to doe, in openinge of the same: for soe farre forth as if the Arterye be small they then cut her cleane a sunder, & they also cut a peece therof avvay, & both the endes are dravven invvardes, vvher by shee as then bleedeth noe more.

And if the Arterye, be greate, & violentlye beateth, it is the surest vvay, that vve tye her vnder & above and then betvveen both those ligations cut her of, but the thredes vvhervvi­th vve binde her, must be strōg & closly tyed because that through the continvall beatinge of the arterye, the thredes loosē, & the arte­rye openeth, if so be it be not stiflye bovvnde: & because that she should not chaunce to corrupt, before the inscision be replete & grovvē full of flesh: vvher through the mouth of the foresayed artery is stopped.Hovv vve vse novv adayes to to open an artery But novv a dayes vve only make a simple inscision in the artery in such a manner as vve make an apertion in the vaynes, vvithout cutting of the same cle­an of & having dravven as much blood ther­out as vve desire, vve thē lay a litle playster of masticke on the apertion, & a litle compresse tyed theron rovvnd abovt the vvhole head as close as is possible. I knovve right vvell that ther are some vvhich houlde this apertione of the arteryes verye suspecte, because it cā hard­lye be stopped agayne, and in doinge this, ther remayneth a cicatrice, in those partes vvhich are situated rovvnde about the foresayed arte­rye, before the same is fullye cured, and ther [Page] throughe often times an Aneurisma caused, vvhich is verye troublesome,Aneuris­ma is a daunge­rous dissese. and daungerous for the patient. But I may vvith verity affirme it to be true, that oftentimes I have seene ope­ned the arteryes of the temples of the heade, vvithout any of the foresayed accidentes bein­ge happened thervnto, the vvhich I coūcel the yonge Chyrurgiane to doe it onlye in this pla­ce, because such an inscisione, is more fitter, & lesse daungerouse, thē the vvhole cuttings of, and ligature of the same.

❧ Of the swellinge Aneurisma, and of the mea­nes howe to binde, and cut of the same. Chap. 6.

Discripti­on of the tumefac­tion Ane­urisma. THis tumefactione Aneurisma, is caused most commonlye, throughe the dilatation of an arterye, vvhich only vve must vnderstande of the smalle A­neurismata, beinge impossible, that the arterye, shoulde so dilate, & as it vvea­re vnshutt in the greate Aneurismata vvhich oftentimes vve see: vvherfor vve vvill rather say, and houlde vvith the opinione, of the aunciēt professors, that Aneurisma is then caused, vvhē as the bloode, and the vitall spirites, are repul­sed out of the arteryes, throughe the apertion, or orificia of the same, vvhich vve call Anasto­mosin, or els vvhen as the tunicle of the arterye is burst, it be ether throughe a vvounde, or by anye other occasione: as vve may se, vvhen as the Chyrurgiane, purposinge to opene the vayne in the elbovve by chaūce prickethe the arterye vvhich is therūder sitvated & the skīne vvhich is therō lyinge, cicatrizeth it selfe and the perforatiō of the artery, through her cōti­nvalle reverberatiōe, tarrieth vncured, & opē & is not stopt, or vvith anye carnall substance replete, as beinge vnprofitable for anye vse & in noe sorte can be bound so close as the arte­rye of the temples of the heade, but throughe the blood & vitalle spirites, vvhich by degrees issue therout, & are congregatede vnder the skinne, & soe conseqventlye cause the svvellīg supposinge they verye vvell did knovve, ther­in to be matter, or any other slimye substance, or viscositye, for vvhich reason, they have ma­de an apertione therin, vvhervppon a little ti­me therafter death hath follovved, because of the bloode, and of the vitall spirites, vvhich in great hast have rushed therout, vvithout anye remedy hovve to restraygne them. Novv per­fectlye to knovve such a svvellinge, and to dis­cerne it from other tumefactiōs,Signes of this tu­mefactiō. vve must ob­serve, that in this tumefactione ther is, a con­tinuall reverberatiō, the foresayed tumor, be­inge of one coloure vvith the skinne, hovve great or smalle, the inflatione be, it is alsoe tē ­der, and soft in the touchinge of the same, gli­dinge avvay vnder the finger vvhen as vve depresse it, yea and almost throughe the foresay­ed depressione vvholye vanisheth out of our sight, considering the bloode of the vitall spi­rites, vvhich through the foresayed depressiō, are crushed in the arterye, vvherfore they al­soe, as passinge throughe a little apertiō vvhich violence, do make a noyse, or sovvnde, vvhich havinge taken avvay, and removed the finger immediatlye shoote agayne in ther foresayed concavitye, as alsoe agayne in ther forth com­minge, of the foresayed angust apertione, vve may heare a certayne sovvnde: vvhich cōmonlye chaunceth vvhen as this Aneurisma, is cau­sed throughe an Anastomosis, and not of anye vvounde, because, the Orificium beinge apert, the vitall spirites, as being most subtile, are be­fore the bloode driven out, soe that the vvhole tumefaction, is almost replete vvith vitall spi­rites. But if soe be the Arterye be burste, there as then issueth much bloode therout, vvhich bringeth in the tumefaction more blood, thē vitall spirites, vvherfore alsoe it is more obdu­rate, and harder, and the sayed bloode coagu­lateth, and therin rotteth, and corrupteth.

As much as concerneth the curatione of this tumefactione, it consisteth onlye,Curation of Ane­urisma. in the bindinge of the foresayed arterye, and especi­allye the same beīge somvvhat thicke, for they vvhich are greate, and especiallye the arteryes of the necke, the arme pittes, or of the flanc­kes, may or can in noe sorte be tyed, because it is impossible to finde them, & make them ba­re, and if vve allsoe make an inscisione therin ther then follovveth such a quantitye of bloo­de, and of the vitall spirites, that most commō ­lye the patient, dieth vnder the handes of the Chyrurgiane.

That arterie, vvhich is situated in the ben­dinge of the arme may easilye be cured,Of an ar­terye vvhich of the Au­thor vvas tyed abo­ve the A­neurisma as out af this subsequent historye vve may note. My lorde of Maintenon, desired me to visite the sonne, of my lorde, of Belleville, vvhich throu­ghe phlebotomy in the bendinge of his arme, had gotten a little Aneurisma, vvhich through continuance of time, is grovven as greate as a fiste, vvherin, in the ende the bloode vvhich therin vvas included, coagulated: so that in the foresayed tumefaction Aneurisma, ther came a corrupting and rottennes, vvhich he one the out syde of the foresayed skinne, of the svvel­linge he espyede, vvhich from the vitall and livinge coloure vvas chaunged into a blacke, and purple coloure, vvherebye alsoe ther vvas an apertione caused in the skinne: To the remedyinge, and curinge of the vvhich, especiallye the superfluous effluxione of [Page 31] bloede, vvhich might therof ensue, & the losse alsoe of the vitall spirites, if soe be the apertiō as yet vveare dilated: I as then councelled, the Physitions, and Chyrurgians, to praevent far­ther evells, that vve ought to tye, & binde the Arterye, (vvhich vvas situated, and his place in the bending of the arme) somvvhat higher then the Aneurisma, to the vvhich opinion, & propositione, in the end they all consented, & agreed: The vvhich alsoe vvith happye succes­sione of all causes vvas brought to passe, in the praesence of the vvorpshipfull master Dro­vet, Doctour of Physicke, at Beauvais, and of the Chyrurgiane dvvellinge at Avet, vvhich vveare come thether to cure him.

On vvhat sorte the Aucthor tyed this Arterye.First of all, I cōsidered, on the arterye, in the vppermost, and inner parte of the fore arme, as shee from above descēdeth vnder the arm­pittes, vnto the bēdinge of the arme, three fin­gers bredth therabove, on the vvhich place vvhen I had seene, and fixede myne eyes the­rone, I made an inscisione, in the skinne ac­cording to the length therofe, vvhich lay ope­ned right above the Arterye vvhere by tactu­re vve might feele her, vvhich vvhen I had found, and discovered her, I thrust a crooked needle thervnder, vvherin vvas a strōg threde, vvhere vvith I tyed the foresaeyde Arterye, vvith a dubble knott: this beinge done, I took avvay, and purifyed, all the congealed, or coa­gulated bloode, & all other impuritye out of the vvounde or svvellinge, and have vvashed the same vvith Aqvavitae, Remedye agaynst the putrefactione. in the vvhich I mix­ed a little Aegyptiacum, by this means to clean­se it the better from all putrefactions: and the patient, is vvithin a moneth therafter ensuin­ge, vvholye cured, and grovvne sovvnde, vvith out retayninge any lamnes in his arm: vvher­in I my selfe have vvondered. If soe be that in anye other externall parte, there chaunced to come any Aneurisma into the Chyrurgians handes, he must then knovv, that allvvayes for certayntye, he shall finde the arterye in her vppermost parte, or discover, and bare her, & soe bynde, and tye her vvith out anye more ceremonies.

❧Of the Cirsotomia, that is, of the manner, howe we ought to cutt of the vari­ces. Chap. 7.

Discrip­tione of a Varice. VArices, or burstene vaynes, are troublesome, because of ther greatnes, their extracting, thicknes, and their gibbositye above ther nature, & property. VVherfor, ether because they cause payne, and hinder the actione of that parte, or els because they soacke in some cer­tayne vlceratione, vvith some humiditye, (vvherby she can not be cured) vve are vrged to open them, and cut themof,Curation of a Vari­ce. or els vvith so­me actuall cauterye, to cauterize them, & soe consume, and bringe them to nought. To vvhich purpose, the auncient professors,Councell of the auncient professors for the curinge of the Vari­ces. have ordayned, that vve should cut out, and cleane take avvay, those vvhich lye croockedlye and dubbelye foulded, in divers rovvnde revolu­tions, or els lye intangled the one vvith the o­ther. But before vve proceede to such an o­peratione, it is necessarye, that first of all, vve bath that part vvith hott vvater, to cause the grosse bloode somvvhat to separate, and vvexe or grovve subtile, and the vaynes to svvel and exalt themselves.

But the most gentlelest remedye, is that vvhich daylye vve vse vvhich is the simple a­pertione, and inscisione of the foresayed Va­rices, at one, tvvo, or thre places, as if vve in­tended to phlebotomize, makinge the aper­tion somvvhat greater and larger therin be­cause of the grosse, melancholicke bloode, vvhich vve desire to let therout: Throughe vvhich foresayed apertione, vve extracte as much bloode, as vve suppose to be goode, and sufficient, or els as much as the patient cā abi­de, one vvhich foresayed apertione, vve must lay compresses, vvhich therone vve must bin­de, as vve are commonlye vsed to doe one the vaynes, vvhē as vve have phlebotomised, pro­hibitinge the patient, not to stirre, or goe, vvhich sayed Varices, if so be they chaunced to svvell agayn vve must as before a little distan­ce ther after make therin an other apertione.

But if soe be vve intende vvholy to disci­de, and cutt them out, vve must first of all,Hovv vve ought to cut avvay a bursten vayne. de­notate the same vvith incke, one the skinne, vvhich is placed one the Varice or burstē vay­ne, the skinne beīge annotated, vve must vvith tvvo fingers of both the handes, lift vp the sa­me, the one this vvay and the other that vvay, vvhen vve have fast houlde therone, then vve must make an inscision, in the middest of the elevated skinn, on the selfe same place, vvhich before vve had denotated vvith incke, of such a magnitude, and greatnes, as is reqvired & ne­cessarye: the inscisiō beinge effected, vve must suffer the skinne agayne to descende, through vvhich inscisione, the Varice, or bursten vayne vvhich is therūder situated, shalbe discovered, an denudatede of the skinne: VVhervnder, as then vve must thrust, a crooked needle: becau­se therafter vve may vvith both the endes of the foresayed threde,The pla­ce vvhere vve may cut the varice, or burst [...]n vayne. dravve the one vpvvar­des, and the other dovvnvvardes. This be­inge effected, vve must make an apertione in the varice, accordinge the length, of the same [Page] betvvixt both the thredes, vvhich must be se­parate & aparte the one from the other a thū ­bcs bredthe, throughe vvhich apertione, vve may dravve as much bloode, as vve please: and thē dravve & binde together verye fast the fo­resayed thredes, & thē alsoe cut, the foresayed varice, or bursten vayne, cleane avvay, vvhich is situated betvveen both the thredes, if soe be it seeme expedient vnto you, sufferinge the thredes, by continuance of time, putrifye and rott out of themselves, vvithout vvith violēce to dravve them out, because that nature, may have some respite, & time, to close, and reple­nishe the cutt, and ligated vaynes.

The aun­ciēte Chyrurgians have cau­terized the Vari­ces,That bursten vayne, vvhich runneth right, althoughe she lye overthvvarte, if she be sim­ple, & smalle, vve vveare better tye her then to cauterize her: But first of all vve must purge the patient, & phlebotomize him ether in the arme, or in the varice, or els in both places at once. Our praediscesors & auncient Chyrur­gians, make mētione of the actuall Cauterye, but before they applyed the same, they first in scyded the skinne, vvhervvith the varice is cooperted, & covered, in such māner, & form, as vve doe vvhē vve binde the same: the varice therefore beinge bared, they then imposed theron, a smalle stamped Cauterye, vvhich vvas vvell glovvinge, & redd hott, vvhich rea­sonable stifflye they impressed theron, but yet not soe violently that the advstione penetra­ted any deeper, thē throughe the vayne, vvith out touchinge the lippes, or edges, in cauteri­zinge, of the foresayed inscisione, vvherfore they vvith vvett, & madefyed cloutes or vvith some certayn playsters, recincted, & defended them.Vse and practise in these times, This operatione beinge after this sorte finished they applyed therone, some certayn remedyes, to the qvallifyinge of the payne & doloure, and profitable for the combustione. And because it is incident vnto all mē, to feare the hott iron, and alsoe the inscisione of the skinne, vvhich first of all must be done. Our vse therfore novv a dayes is, that vve (vvithout makinge any inscisione in the skinne) applye on the selfe same place of the varice, a great, & stronge potētiall Cauterye, because it should not only combure qvite throughe the skinn, but alsoe throughe the vvhole varice, or bur­sten vayne: but vve may not in any sorte tou­che the Escara, but gentlelye of her selfe suffer het to separate, vsinge at this season those re­medyes, vvhich for that vse expresslye amon­gest the cauteryes, vve have discribed. The vvhich I have seene to be vsed, of Mr. le Ieune the kings Chyrurgiane, and of the Duke of Gvyse, vvhich vvas a verye experte man, in all operations of Chyrurgerye.

❧Of the Horseleeches of there vse, & howe we may applye them. Chap. 8.

THe Horseleeches are little,Descriptione of Horselee­ches, and perpucill creatures, like vvor­mes, of the longitude of a fin­ger, or theraboute, nether are they of anye great crassitude, or thicknes, vnles, it be vvhen they vvith suckinge of bloode are grouvven thicke. The end of ther head hath a rovvnde hole, much like vnto a litle lamprell, vvherin are to be behelde, and seene thre stinges, or a­cuityes, proceedinge out of three corners, vvhich soe violentlye, & stronglye pricke, that thervvith they can pearce the hides & skinnes of all creatures vvhatsoever, & vvherone they depēde faste hanginge, vntill such time as they have sucked themselves rovvnde, and fall of vvith ther one accorde. They live, & are ingē ­dred in the vvater, & especiallye in all stagnes, & standinge vvaters, because they delight, and are solaced, in filthye, and muddye places. I esteeme, & suppose, that ther is noe Chyrur­giane, but verye vvell knovveth them because of all men they are knovven, but everye one doth not knovve vvhich are the venoumous, or not venoumous, vvhich notvvithstanding, is verye necessarve to be knovvn, considering the accidentes, & mischaunces, vvhich might therof insue, and follovve, as in example, great tumors, Inflammations,Messali­nus dyed of the by­tinge of a venou­mous Herseleech, & venoumous vlce­rations, through ther venoumous momorsi­ones & bitinges, yea also & death it selfe, as the historie of him, vvhich of a venoumous one, vvas bitten in his knee, & dyed therof, is vvit­nessinge vnto vs.

The vonoumous, are as vvel knovvne, & discerned by ther greatnes, as ther colour,Signes of a venou­mous Horse­leech, and alsoe by the place vvher they are caught. For those vvhich are thicke, and have a thicker head then the rest of ther vvhole bodye, shi­ninge, like vnto glistninge vvormes, and are greenish, and vvhich have on ther backe, ble­vve, or blacke strokes, or lines, and vveare caught in standinge pooles, vvher all manner of foetide, & stinckinge Carrions, vvith more other filthines is throvvne in, they are all ve­noumous, vvherfore in anye sorte vve must not vse them.

But those, vvhich are small, rovvnd,Signes of goode Horse­leeches. & have a little heade, & are of coloure much like vnto a liver a rovvnde belly, & the backe stripped, stroked vvith gouldeyellovv strokes, vvhich live in cleane runninge vvaters, they are not venoumous, vve may safelye, and vvith all securitye vse them. And yet notvvithstāding, those vvhich ar soe as is before sayed, may vve as soone, as vve have caught them, applye them to the bodye, but must first of all, keepe [Page 32] them tvvo, or three vveekes in a glasse of fayre vvater, because therin they may avoyd the vis­cositye, & impurenes, refreshīge the foresayed vvater everye three dayes once, vvashinge the sayed horseleeches,What vve ought to doe befo­re vve vse the Hor­seleeches. vvith your handes from all ther viscositye & slimishnes. Galen councel­leth vs, that the first day vve shoulde give them a little blood, & then, put thē in freshe vvater. VVe may praeserve, & keepe thē a vvhole yea­re, or longer if vve please, to vse thē, vvhen the necessitye soe reqvireth.

The vse of Horseleeches, vvas invented in place,Vse of the Horselee­ches. of scarifyinge: vve apply thē most com­monlye one such places of the bodye, vvhere vve can not set any boxes at all: as in example in the privityes, one the gummes, one the lip­pes & somtimes alsoe one ravve fleshe of anye vvounde, on the nose, above on the hande, & fingers, & vvhē the patient too much feareth the boxinge, or els vvhen as vve desire to dra­vve & extracte anye venoume, out of a thrust, or bitt of anye venoumous creature.

Before therfore vve apply them, & because they might be hungrye, nether retayne anye thinge in ther bodyes, & because they shoulde the sooner take houlde, vve must take thē out of the vvater, & suffer thē thre or foure dayes before vve vse them to lye in a nue little vvod­den boxe.Horselee­ches are enimyes vnto all fatnes. VVhich beinge in this sorte praepa­red, to apply one the body, vve must first vvas­he that place vvher vve purpose to applye thē verye cleane, & if so be the place, by reason of of anye salve or plaster, vvear fattye, vve must alsoe vvashe that place & vvype it very cleane, because they are enimyes vnto all pingveditye & fatnes: this being effected, vve must thē take them the one after the other, in ther middles vvith a vvhyte cleane clothe, (for if soe be vve touch them vvith bare fingers, they as thē vvil not bite) & praesēt, or place ther heades to that place vvher vve desire to have them sucke. If so be the Horseleech vvill nōt at the first byte, & take houlde, vve must then annoynt the sayed place vvith pigeons bloode, or hennes blood, or cause the place ether vvith the poyncte of a lancet, or vvith a pinn, to bleed, vvherthrough immediatlye she vvill beginne to sucke.To make a Horse­leeah vio­lentlye to sucke. And soe far forth as she sucketh not stronge enou­ghe, or if soe be vve desire to have her to sucke violentlye, before she leave, & is not vvholye full, & satisfied, vve must vyith a payre of scis­sors clippe her a sunder, about the thirde part of her bodye: vvher by, she beginneth to sucke farre stronger & vvith more violence, and the bloode as fast as she sucketh de parteth frō her through the hindermost partes vvhich are cut avvaye.Hovv vve vve shall cause thē to fall of. As soone as the one Horseleeche is fallē of, if vve please, vve may applye an other theron: for they being replete & satisfied, prae­sently of themselves, fall of: & if soe be vve de­syre to have them fall of, before they be satisfi­ed, vve as then stravve a little saulte, or ashes of vvoode on ther heades & immediatlye they fall of. Ther as yet droppeth blood out of the bitt vvhen as they are fallen of, vvhich is a sig­ne & token, that they have dravven & suckede the blood from farre, vvhich blood, vve must not one the suddayne restraygne, & stoppe, because that parte may the better purge, & puri­fye it selfe, from all venoumous humors, if soe be there be any at hande: vvherfore some ther be vvhich to that end, apply some small boxes, on the bitinge of the Horseleech, or els they vvashe that parte vvith hott vvater, beīge saul­ted, & cause it to bleed somvvhat longer, if soe be that parte require the same, & the patiēt be able to suffer the same: If soe be the blood run­ne therout somvvhat to longe, & vvil difficult­lye be restraygned, throughe anye compresses, vve must then apply theron a little adusted, or burned linnē, or a splitted or cloven beane, re­tayninge the same vvith his finger soe longe therone,Hovv vve shall re­strayne the blood vntill such time as she cleaveth fast theron, vvheron therafter vve must lay a small compresse, & binde the same therone, if soe by anye meanes possible it may be done.

❧Of Boxes, and howe we may applye them. Chap. 9.

A Boxe, is an instrumēte, of Chyrurgery, the magnitude vvher of, must aeqvallye be proporti­oned, accordinge to the great­nes of that parte, vvheron vve purpose, and intende to apply them, & alsoe divers formes, & figures:Differēce of Boxes▪ for so­me ther are vvhich are shorte, & thicke, others vvhich have a longe necke, & belovve vvyde, vvhich cōmonly dravve better thē any other. Others are of divers substance, for ther are so­me of Copper, others of Horne, of Tinne, and of glasse, vvhich vve most commonlye vse, be­cause throughe the glasse vve might see, vvhe­ther they dravve much bloode or not. Ther a­re alsoe some vvhich are made of vvoode, and some baked of earthe: yea for vvant of Boxes, vve may vse little vvooddē dishes, or little ear­then pottes. Touchinge ther forme, they must have a vvyde mouth, and a reasonable broade bellye, thicke & rovvnde edges, because in the applyinge therof they should not chaunce to hurte.

And if soe be they are very greate, they must thē have a little hoale on the one syde, vvhich vvith vvaxe must be occluded, befor vve apply thē that vve may give thē ayr, vvhē vve vvill take of the same, some ther are, vvhich lay a little sticke, crosse over in the mouth therof, on the vvhich they impose a little peece, or inche of a [Page] candle, vvhich in the application therof they incende, and light.

Hovv vve shall ap­plye the boxes.The manner of applicatione is this. That vve first of all, perfricate, and rubbe the place Vvherone vve intend to applye thē situatinge that parte of applicatione, in the right forme therof, because the muscles, may lye in ther right situatione, and places, and not be recur­ved this vvay, or that vvaye, because the boxes beinge theron fastened, might not vvithe the reflection of the parte, or ioyncte, fall therof, vvhen as the foresayed recurved muscles, shoulde reverte agayne to there accustomed locationes, and places. This beinge done, vve must impose therone a counter or any other peece of coine, vvith a little, flocke of flexe, or tovve incended in the middest of that place, vvherone vve desire to applye the Boxes, least that the fyer chaunce to touche the skinne, vvheron immediatlye, vve must vvhelve the Boxes, turninge the same a little rovvnde, be­cause he shoulde the better fasten theron: the vvhich as then vve must cover, vvith a dubble vvarmed cloute. Some there are vvhich in the bottome of the Boxes applye and laye a plaster, and therone a little tovve, in place of an inche of candle, vvhich in the applicatiō, theyt set one fire, vvith a candle.

Discrip­tione of the horne Boxes.As touchinghe the hornes, they are vvyde above, and narrovve belovve, havinge a little perforatione in ther middest, and internally, a little leatherne tūge, vvhich is very thinne, vvhich stoppeth the foresayed hoales. They are applyed vvithout fyer, & sucked vvith the mouthe. To vvitt vvith a little pipe, or vvith a quille, vvhich vve impose in the foresayed perforation, vvhervvith the foresayde tunge is thruste backevvardes, vvhich stoppeth the horne, vvhen it hath dravven and sucked suf­ficient, & dravvinge the pipe therout, the fo­resayed tunge, internally shutteth, & cleaveth it selfe soe close to the hole, as vve may see in a kind of ballon, vvhen he is blovven vp.

Those vvhich are ignorant of this secrete, stoppe, & occlude the hole vvith a little vva­xe, vvhich in deede is not so necessarye, and needfulle. Those little Boxes vvhich are lay­ed in vvarme vvater, are aplyed, after that vve have putt the flame of the candle, therin and must then vvith all expeditione be theron imposed.

The vse of small boxes.The vse of these small Boxes, is thre fould: Namely thervvith to vvithdravve, and repell, the blood, and humors, vvhich are concursed to anye place: to dravve forth any particulare thinge vvhich nature cā not expell from her: & to dravve, out or cause to consume, any oc­cluded ventosityes, in any partes of our body: vvherfore vve applye them one divers, & sun­drye places: they are very goode and commo­dious to be placed behīd in the necke, agaynst all rheumes vvich are incident vnto the eyes: behinde in the middest of the necke are they necessarye to be applyed, for those vvhich are shorte of respiratione, and troubled vvith the cough: one both the shoulder blades, agaynst payne, and doloure in the heade agaynst He­micraniam, agaynst ophthalmye, and payne in the teeth: vve apply thē alsoe in place of phle­botomye one the right hippe, agaynst bleedī ­ge at the nose: in like sorte alsoe close to vvoe­mens brestes, vvhen as there menstruositye, too superfluouslye flovveth from them, and vvhen there lye included anye ventosityes in the Liver: on the left syde, vvhen as ther is any vvynde retayned in the Milte: on the Navelle aganst the vvynde colicke: on the Vreteres, to cause the gravell to descēde, vvhich is con­tayned, in the kidnyes: on the rumpe, agaynst the vlcerations, and the Hemorrhodes of the fundament: on the hippes, agaynst all vesicall disseases, and of the vvombe, and provocation the monethlye sicknes, or menstruositye.

To conclude, vve may applye them,The Box­es may be applyed one all partes of mans bo­dye. on all partes of mans bodye, yea allsoe one the selfe same place vvhere the payn is, vvhich vve en­devoure to cure, to retract and dravve therout all humors, vvhich are therī secluded, as vvhē vve desire to dravve any humors outvvardes, vvhich lye profoundlye & deepelye occulted, and hiddē, or els alsoe, any ventositye, vvhich in the foresayed parte lyeth inclosed, as on a­nye bitt, or pricke, of any venoumous creatu­re, least that the venoume might chaunce to penetrate and pearce, into some of the vvor­thyest partes: one the Venus botches, or Bubo­nes, one the venoumouse, & Pestilentialle Pa­rotides. But desiringe to applye them agaynst anye superfluous efluxione of bloode, vve must then situate them on the contrarye syde consideringe the allyance, & communitye of the vaynes vvhich is betvveene them, throu­ghe the vvhich the bloode is retracted, & dra­vven backe. It chaunceth also somtimes, that vve nether applye the Boxes, on the disseased, or dolorouse place, nether one the contrarye syde therof, but one that parte vvhich nexte, and proximately thervnto is situated: as vvhē vve desire to suscitate and provoacke, the re­tayned and kept backe mestruosityes, vve as then place the Boxes, one the bone Pubis in the flanckes, and allsoe one the flatnes of the hippes.

The Boxes, or hornes, are sōtimes applyed vvith scarificationes, and somtimes vvithout: If soe be vve applye them vvithout scarificati­ones, they then onlye dravve certayn dampes vnto them: but if ther be anye badde humors, in those partes, vve as then scarifye it: And the dissease proceedinge out of vvindes, and ven­tosityes, [Page 33] vve then applye them vvithout scari­fications, but vvhen vve are minded to scarifye anye parte, vve first sett the Boxes therone, and havinge agayne removed, and taken the same of, vve thē pricke, or scarify therin, ether vvith a lancet, or vvith the poyncte of a rasor, vvhe­ther it be deepe, or not deep, accordinge as vve suppose, and iudge the bloode, to be grosse, or subtile, but allvvayes vve must note not to sca­rifye deeper then the skinne: touchinge the number of the foresayed scarificatiōs, if soe be vve are not intēded to dravve much blood ther out, vve may not as then make manye scarifi­catiōs: but if vve intend to dravve much blood therout vve must then make many scarificati­ons: vvherō vve must agayn applye the boxes, soe that vvhē vve desire to dravve much blood therout, vve must applye the foresayed boxes tvvo, or three times theron, & everye time sca­rifye the place, & especially vvhen ther is con­tayned in that part anye venoumouse ventosi­tye, or grosse, and corrupt bloode. In delicate, and dayntye persons, vvhich are tender of fles­he, and have an aperte or open skinne, in such persons vve must scarifye but once, notvvith­standinge must apply the boxes tvvo, or three times after other theron: vvhich beinge finis­hed, and havinge vviped, and dryed the parte, vve must then apply one the scarlficatione, the Cerotum Galeni, or els the Vnguentum Rosarum.

THE SEAVENTH TREATISE OF THE OPE­ratione of Chyrurgerye, Contayninge sixe Chapters.

  • Of the Caries, or of the corruptione & rottinge of bones. Chap. 1.
  • Of the fistles of the Privityes or fundamente. Chap. 2.
  • Hovv vve ought to dravve forth Childrene out of their mothers bodye, vvhich of themselves can not be borne. Chap. 3.
  • VVherfore the externalle partes or ioynctes of the bodye, must be extirpatede, as Armes and Legges & vvheraboutes the same must in the fore sayed ioynct be done. Chap. 4.
  • Hovv vve ought to effect, the extirpation, or dissection of any ioynct, & restraynge the bloode after vve shalle have layed dovvne the patient. Chap. 5.
  • Hovv vve ought to extirpate the spoylede, & superflvous fingers, & hovv vve shall separat those fingers vvhich are combinede, & grovven together. Chap. 6.

Of the Caries, and corruptione of the bones. Chap. 1.

Disctip­tion of the natu­rall bones The bo­nes are as vvell sub­iected vn­to all mā ­ner of dis­seases, as is the fleshe. THe bones, not being spoylede & corrupt, are of natur vvhyt smooth, & solide. They are accordinge to the sayinges of aunciente Chyrurgianes and our dayly experience, subiect­ed vnto all evell dispositions, vvhich the flesh is subiected vnto, yea allso vnto apostematiōs. Celsus avouchethe, that all bones vvhich have any impedimēt, are ether hurte, corrodede, corrupted, burst, broken, crushed, plettered, or out of ioyncte. VVe may praeiudice the bones to be altered,To knovv the cor­rupted bones throughe sight. or polluted, throughe our sight feelinge, matter, and impuritye, vvhich ther­out issueth: vvhē vve perceave it to be yellovv or purple, and at the last blacke, & as verye le­arned lye, & discretlye the sayed Author, vvri­teth, first the corrupted bone vvaxeth fattye then blacke,Through feelinge. or putilaginous, that is corroded: vvhen as in touchinge vvith the privet or se­archinge irō, vve feele the bone to be rugged, and not playn, and the privet, entereth therin, as if it vveare a peece of corrupted, & vvorme eaten vvoode, & especially vve knovvinge the same not to have binn bared of his fleshe, ne­ther hath binn of the ayre illuminated: becau­se that sometimes the altered bone, for that it hath a longe vvhile lyen bare, is grovvē to be soe harde, & thicke, thar vvithout greate pay­nes, vve can not fasten therō vvith the grating iron, through the matter, vvhich is thinne,Through the mat­ter. & subtile, cleere, faetide, stinckinge, & blackishe: vvhen as rovvnd aboute the vlceration especi­allye, is regenerated a tender & viscouse flesh vvher through the vlceration can not, be cica­trized, & although shee be cicatrized, therafter redubleth herforces, & breacketh open agay­ne.Occasion of the corruption of the bones Such alteration procedeth of some cōcur­rēt humors, that descēde on the bared bones, as appeareth vvhen they are through soackede vvith any pestiferouse humors, or els because they are of their flesh & pellicle, or mēbrane Periostio, denudatede and barede vvherthrough [Page] they corrupte & vvaxe drye for vvant of blood vvhervvith they shoulde be nourished, or els because they are to full of humiditye, & moy­sture, throughe the purulēt matter, vvhich cō ­tinuallye theron distilleth, & corrodeth: ether because they are to much ānoyncted vvith oy­le, & to much fatty salves therō applyed, vvher­by the vlceration is corrupted, & putrified: Or because she is polluted, vvith the matter of the vlceratione, vvhich supernaturallye, & from a­bove is descēded & theron distilled.

VVhēas therfore for certaynty vve knovve that ther is putrefactiō, & rottēnes in the bone vve must then doe our devoyr to knovv hovv lardge, & profovvnd the same is, because ther­by vve may the surer knovv, hovv vvith moste conveniēce vve shoulde remove & abolishe the same & cause therin a separatione, because it is necessarye that the vivificēt parte, expelle & drive from it the mortified, or els the mor­tifiede allso cause mortificatione in the vivi­ficent partes.

Magni­tude of the pu­trefactiō.Concerninge the magnitude thereof, vve may discerne it through the sight, vnlesse it be operted vvith any viscoufe or slimye flesh, & vve supposing & doubtinge to be more putre­factione of bones, that is patefiede & evidente vnto vs, throughe the circumiacent partes of the vlceraration, vvhich as then are purple co­loured through the spongiouse flesh, through the elevatione of the edges of the vlceratione & throughe the diuturnalle continuāce of the same in one estate:Hippo­crates. For as Hippocrates affirmeth: In the venomouse vlcerations, vvhich for the space of a yeare have continuede, or longer, it can not othervvise be, but necessarilye in the bone vnder the fleshe of the vlceratione, must needes be a corruptione, putrefaction & a cor­rosione, & some peeces therof come out, the Cicatrises also vvill continually be cōcavouse, & hollovve.To cure the pu­trefacted bones. VVe therfore certaynlye knovv­inge this, vve muste as then dilate the vlceratiō denudate the bone, & dilligentlye marck hovv large the foresayede putfactiō is: vvhich muste be effectede vvith causticke medicamentes, by the vvhich the spongiouse fleshe, mvst be cō ­sumede, accordinge as the foresayede vlceratiō reqvireth. Celsus councelleth vs that firste vve make an inscisione in the skīne, to denudate the bone, if so be the putrefaction of the bone, be greater then the vlceratione, discidinge & cuttinge of all the flesh rovvnde aboute, vnto the sovvnde bone: touchinge the depth of the putrefactione of the bone, vve may knovve it throughe the privet or searchinge iron, vvhen as vve feele theron, the vvhich pearcinge deep or not deep in the same, shevveth vnto vs that the foresayede corruptione of bone is great or smalle. But if vv see the bone to be blacke & dry as it happeneth bereft of blood the privet thē vvill not enter therin, vvherfore the depth of such a corruptione, can so certaynly be kno­vven, as through the perforative Trepane, or els through the little groūd dravver, vvhere­vvith vve must perforate the foresayede bone through vvhich perforatione of bone, vve ea­sily shalle perceave, vvhether the bone be bla­cke, vvhyte, or redde, & vvhether ther issuethe bloode out or not if it be so, it is then a signe that the putrefaction, of the bone is not deep. And if so be vve perceave, the perforated bone to be blacke, it is then a token, that the putre­factione is deepe, because the corruptione of the bone, pearceth so deepe, & vvhen vve per­ceave that the bone is vvhyte, & redde, so farre is it then incorruptede.

To the vvhich Caries, or corrupting of bōes vve muste vse the actualle Cauterye, or els allso the potentialle or the Raspatorium: If so be the corruptione of the bone penetrateth not verye deepe,Hovv lōg vve ought to raspe. vve muste then grate the foresayed bone vvith a peculiare Raspatorye, & in raspinge of the same, stifly crush therō, that vve may qvick­lye penetrate through the corruptione, & the operatione, vvih all festinatione be effectede & done. All daūger beinge novv passed, & vve perceavinge the bone to be vvhyte, smooth pu­re, & solide, it is then sufficient: For it is impos­sible, that the foresayede corruptione of bones may have an end, as long as vve doe not liberat, & free the same, by one meās or other, from all daūger, & corruptiō. VVhen vve perceave, in raspinge the bone to give bloode from it, it is then a signe that all corruptione is therout, and that the bone is vvell disposed, because that no corrupte or alterede bones vvill give from thē any bloode. This beinge done, vve as then vse the poulder of Aristolochiae of Mirrha of Ireas & of Aloe to liberate the foresayed bone frō al corruption & praevente the same to be anye more putrefacted and corrupted. If vve suppose, that the Raspatorium, be not sufficient enough, to re­move the foresayed corruption, as vvhē she is deeply corroded invvardes,The fyer is the su­rest remedye to re­pel all corruptions out of the bōes. & vvhen as ther is a peculiare corruptiō imprinted in the bone, the same alsoe being fatt, & oylye, & if so be the pa­tient vveare not timorouse of the fyer, the af­suredest remedye as then is, that vve cauterize the foresayed coruption, vvith an actuall Cau­terye, vvhich conforteth that parte, and consu­meth all venoumouse humors, & vvith all fes­tinatione causeth the corrupted bones to sepa­rate, & causeth little, or noe payn at all, because the foresayed bone is insensible, and doth not communicate his vnhemence vnto the other circumiacent partes.

VVhen as therfore,Māner hovv to apply the Cauterye. vve desire to vse it accor­dinge to the depthe, & greatnes of the corup­tion, or Caries, vve must therin vse a meane, of applyinge the foresayed Cauteriū on the bone, [Page 34] to vvitt vntill through the porositye of the bo­ne ther commeth out, a frothye matter, & noe lōger: for if vve helde it lōger theron, it should through his great callidity, & throughe the ex­siccatinge vertues therof, not onlye consume, the humeditye of the putrefaction of the bone but alsoe the naturall humiditye, & moysture through vvhich occasiō, the fleshe ingendreth & increaseth betvveene the sovvnde & the cor­rupte bones: This doinge, nature in a certayne time therafter, vvill separate the corrupted bo­ne, frō the sovvndebone, engendringe betvveē them bothe, a tenerouse fleshe, vvhich by little & little hardeneth, as if it vveare Pomgranate-kernelles, vvhich foresayed fleshe, vve oftenti­mes may see, grovve cleane throughe the cor­rupted bone, & that in such sorte, as the smalle tender grasse, grovveth through the grovvnde, & as thē is the suppuration, & matter goode & laudable, vvhyte, or reddishe coloured, and vvithout stincke. And vve must heere alsoe far­ther note, that the Chyrurgian, may somtimes gentlely move, the corrupted bone being cau­terized, & stirre it, because nature ther through may be opitulated, vnto the separatione of the cauterised bone, and the foresayed bone lyinge sōvvhat raysed, may be lifted on highe, because as thē it houldeth fast noevvhere, but vve may not vvith any violēce take the same therof, for in soe doing, the sovvnde, bone, before cōplet­lye it be covered vvith fleshe might chaunce of the ayre, to be agayne infected, and corrupted.

The Cau­terization must be reiteratedNether is it sufficiēt, that once vve apply the Cauterye theron, but must divers & sundrye ti­mes doe the same, nether must it be glovvinge or red hott, but reasonable hott, removinge of the forsayed cautery frō one place of the bone to the other, or houldīg of the same in one pla­ce, vntill the place be throughlye vvarmed.

What vve ought to doe in a deep Ca­ries.The corruptiō, therfore or Caries being very deep, vve must them trepane or boare it vvith a perforative Trepane, vnto the sovvnd bone, or vvith the small grounde dravver, make divers hoales therin, the one close to the other, of an aeqvall depth also, as the corruption of the bo­ne is, in vvhich trepaned hoales, vve must as thē apply some little hott actuall cauteryes be­cause the foresayed bone, ther by may be thro­ughlye dryed: By this operation, the corrupted bone vvill separate it selfe frō the sovvnde bo­ne, as heertofore vve have sayed. If soe be that the vvhole substāce of the bone be corrupted, & corroded, vve must then vvholye remove, & take the same a vvay.A historye of Albu­casis. As Albucasis, to this pur­pose, reciteth a memorable history of on vvho­me at three sūdry times he tooke avvay allmost the vvhole shinne bone, dividing also the ope­ration, in thre sundrye & aeqvall times, because the patient vvas not able, to tollerate soe greate payne, because of his great imbicillitye, & alsoe because Albucasis feared least that vnder his hā ­des he should have diede, because through cer­tayne evacuations, he allvvayes fell into great fayntnes, but in the end vvas perfectlye cured: and in place of bone, ther ingendred in the pla­ce, a harde carnositye, vvhich so miraculouslye fortifyed from day to day, that he during some continuance of time therafter, coulde agayne couragiouslye goe one that legge.

VVhē as therfore it is reqvisite, to applye the foresayed actuall Cauterye one anye certayne place, vve must dilligentlye consider, hovv vve might liberate, & defende,The cir­cumiacēt partes of the vlce­ration must be freede. the circumiacēt par­tes of the Vlceratione, least they be touched of the cautery, vvhich vve may vvith most conve­niēce doe, vvith some certayne plasters, becaus nether the fatt nor any other ebullient humi­ditye, vvhich through the calliditye or heate of the cauterye might chaunce to runne therout, one the selfe same circumiacēt partes, of the vl­ceratiō, & that therby they chaunced not to be burned, & seared, vvhich vvould be the cause of greate payne and doloure.

Novv therfore to correct & cure the Caries, or corruptiō of bones, ther are divers Chyrur­gianes of our times & age, in place of the actu­all Cauterye vse the potentialle:Divers re­medyes a­gaynst the Caries. amongest the vvhich the oyle of vitrioll is in the most chee­fest, in like sort alsoe the oyle of franckinsēce, vvhich of divers Chyrurgians is highlye com­mended, and esteemed.

Of the Fistel of the Fundament. Chap. 2.

ANd because vve have not heer intended generally to vvrite of al fistles, & to discours of thei­re matter, & conditions, vvhat partes be therof polluted, of their occasiones, signes, prog­nosticationes, & of the remedyes, of theire cu­res, it seemed expedient vnto me, breefelye to shevve, the meanes, to cure those vvhich reve­ale, & demōstrate thēselves in the Fundament, & that especiallye through a convenient hand­linge,Intention of the Aucthor. or operatione of Chyrurgerye vvhen as shortlye and breeflye I shall have taught, in vvhat sorte vve may best and easyest knovve them.

Those Fistles vvhich are ingēdred in the fun­dament, are of divers & sundry sortes: for some of thē are occulte, others patefyede, the occul­ted are soe called, because vve noe vvher exter­nally espye them, and internally in the foresay­ed fundament,The fistles of the fū ­dament, are ether-hidden or aperte. or excrementall gutt have thei­re apertiō, & issue in the muscle Sphincter, vvhe­ther they be situated vpvvardes or dovvnvvar­des, or any vvher one the syde, adioninge vnto any of the tvvo buttockes. VVhich allthoughe [Page] vve can not evidentlye perceave them, yet may iudge, that the foresayed partes, are hurte or hī ­dered, throughe the payne and throughe the stinckinge matter, and humiditye, vvhich issu­eth out of the foresayed fundament, & through the vvhich commonlye, the shirtes of the pati­ent are polluted, & throughe certayne vlcerati­ons also, vvhich before times in that parte they have hadde, or through certayne internall he­morrhodes, or through any inveterate vvoūd, vvhich vvas badly cured. VVe may also somti­mes see them vvithe our eyes, through the Spe­culum Ani.

The pate­fyed Fist­les of the sudamēt.The patefyed Fistles, are therfore soe called, because immediatlye vvithout any daūger vve may evidentlye see them: Of the vvhich ther a­re some vvhich lye croocked, and curved, & al­though they have but one apertion, vvhich vi­siblye vve may see, yet they have divers vvayes, branches, or cubicles, like Conyeburrovves, vvhich of theire patent Orificium, in the bodye, runne this vvay and that vvay, vvhich vvith the searchinge iron somtimes vve may finde, vvhē as vve thrust it this vvay or that vvay, vvher vve feele it of his ovvne accorde to enter, together also, out of the great qvantity of matter, vvhich daylye issueth therout, vve may easylye iudge, that the foresayed Fistle, must needes have mo­re concavityes, then by the externall fistulouse apertione vve can iudge, vvhich at somtimes is not greate.

Ther are alsoe some Fistles, vvhich external­lye have but one issue, and doe not passe throu­ghe the concavitye of the externall, or arsegutt, or through the muscle Sphincter, as easyly thro­ughe the privet or searchinge vve may percea­ve vvhen vve thrusting the same therin, vve cā not anye vvher perceave it agaynst our fingers, to the vvhich intent vve must thrust the same middle finger of the left hand in the fundamēt, for if it soe be that vve betvveen our finger, and the privet feele anye thinge it is then a signe that it doth not pearce throughe but if vve fee­le it agaynst our finger, it the pearceth throu­ghe.

And novv as concerning the curation of the same,A thre foulde meanes to cure the Fistles of the fundament. vve vvill not heere treate of anye thinges belonging vnto the medicamentes, but onlye speake of the Chyrurgerye to the curing of this dissease: the vvhich on a threefoulde manner is taught vnto vs, as vvell in the curatione of the internalle, as externalle Fistles: to vvitt, ether throughe ligature, inscisione, or through Cau­terye.

Although Avicenna, vvith more others are of opinione, that vvith anye of these foresayed remedyes vve ought in noe sort to meddle ther vvith vnles, they vveare too intollerable, and molestiouse vnto the patiēt, but that vvith cle­ane linnen, vvith Cotten, and vvith decent and convenient lavamentes, vve ought to sustayne them. But for all this not vvithstanding, I vvill heere discribe vnto you, our vse and customes of the auncient Chyrugians.

Novv therfore as vvell to cure the publiqve, and patent Fistles, as the occult and hidden, vve must cause the patient conveniently to lye, na­melye that the patient must lye one his backe, vvith his legges on highe, retayning and houl­dinge the foresayed legges, close vnto his belly, and this is the maner, and customes of ayn­cient Chyrurgians. But vve novve a dayes, cau­se the patiēt to stande on both his legges, vvith his heade, lyinge on a bedde, disioyninge & se­paratīge the foresayed legges vvyde the one frō the other, vvhich alsoe of tvvo servantes or stā ­ders by must soe be helde, least that he agayne might chaunce to shut them. The patient be­ing thus situated, tovvardes the light, vve shall then thrust the middlemost finger of the left hande into the fundamente, havinge vvith so­me certayne oyle anoyncted your finger, and pared close your nayles: and in our right hande vve must have a privet or searchinge irō, in for­me of a needle, in the vvhich at the on end ther of must be a threde, vvhich foresayed needle, or Privet vve must thrust into the Orificium of the Fistle vntill vve sensibly feele the same on our finger, and then vvith our finger recurvate, the end of the foresayed needle, & neatlye, & con­veniently reduce the same vnto the fundamēt, and then dravve the same therout, dilligentlye observinge, that internally vve hurte or vvoū ­de nothinge,Hovv vve must bind a publique, or patent Fistle. and the threde alsoe beinge passed throughe the fundament vve must then cut of the foresayed needle from the threde, & tye the endes of the foresayed threde both together, dravvinge the same reasonable fast, and close together, and vvith a slidinge knott binde the same together, because daylye vve might knitt the same closer, and continuinge this same soe longe in this sorte, vntill such time as vve shall have cutt avvay all the thred vvhich vvas remayninghe betvveene, both the Orificia, and both the apertions become to one, and the threde conseqventlye, vvithout anye mo­re dissectione of the same, shalbe taken there­out.

But vve perceavinge the Fistle to have no issue in the concavitye the arsegutt, and the needle doth not come out agaynst our finger beinge in the foresayed arsegutt, and that ther as yet is some pellicle, or membrane betvveene them both, the needle havinge a reasonable sharpe acuitye or poyncte, vve must thrust the foresayed threded needle, or Privett, bo­uldlye, and audaciouselye therthroughe, into the foresayed concavitye of the Arsegutt, be­cause vve might also dravv the foresayed thred therout, as alreadye above vve have mētioned.

[Page 35]VVe must alsoe heere farther note, that this privet, or needle, must ether be of goulde or sil­ver, because shee may the easyer internallye in the foresayed gutt be recurved. VVe vse heer­vnto a silver plate, vvhich thervnto expressely, vve caused to be made, as this same plate, & the foresayed Privett, or needle, before amōgst the figures of the instrumentes, are also defigured, and sett dovvne vnto vs.

The threde must be of course thred, the same being tvvisted thre or foure times dubble. And because that vnto some, the dissectione of this simple threde, falleth somvvhat tediouse, they annoyncte the same vvith some Causticke me­dicamētes. Gvido, Opinion of Gvido. effecteth this dissection, vvith a rescindent actuall Cauterye, & to praevent the same that it pearce noe deeper, then it ought, he thrusteth in the fiistle a hollovv Privett, on the vvhich concavitye, he vvith the foresayed Cau­terye pearceth the skinne, and in like sort alsoe cutteth throughe the fistle, bringeth, & dirima­teth avvay vvith it the callositye, & praeventeth also the fluxione of bloode.

It is surer to make an inscisi­on in the fistle, thē to tye it.Others vvil not in anye sorte, have the fistle cauterized, nor bovvnde, & tyed, but vvill only have that same to be inscided vvith a croocked lancett, vvhich is betvveene both the Orisicia, to vvitt of the fistle, and the excrementall, or arse­gutt, & that alsoe vvhich internallye is grovven callouse, they vvill have it to be crudifyed and made ravv, or excoriated, as vve are vsed to doe in the haremouthes: yet daylye experience tea­cheth vs, that the ligature is more certayne, thē the inscisione, vvherin vve neede not to take avvaye the callosity, because it oftētimes chaū ­ceth, that vve endevoringe to remove, and take avvay this callositye, vve discide, and cutt of any of the Fibres, of the muscle Spincter, vvhich beinge vvounded, or hurte, the patient ther af­ter can in no sorte restraygne his stooles, or ex­crementes.

It may seeme admiraculouse, & strange vnto some, that I vvrite that, the fistle may be cured throughe the ligature onlye, vvithout remo­vinge the callositye, because it seemeth oppug­nant vnto reason, because all combinatione, & healinge together, is caused throughe the ioy­ninge or touching of vveake thinges together: yet I dare affirme, that all those, vvhich I have seen tyed, have bin perfectlye and sovvnd­lye cured vvithout in any sort to have touched, or removed the callositye.

Novv to come to the operation of the hid­den fistles, havinge situated the patient as be­fore is sayed, vve must then applye therin, the Speculum Ani, opening the fundamēt thervvith, vvith the least payn vve cā, as vvyde as is possi­ble, allvvayes annoynctinge the foresayed Spe­culum vvith oyle, throughe the vvhich sayed a­pertione, the Orisicium, of the vlceratione may appeare & be apparēt vnto vs, be-tvvixt vvhich concavityes or braunches, vve must thrust in a privet, vvhich must be of a reasonable thicke­nes, or crasitude, like vnto a small & little need­le vvherevvith vve are vvonted to make our stit­ches, vvhich must be blunte, & in the one end must vvith a threede be threded, vvhich fore­sayed needle, or privet, vve must thrust vnto the bottome, or grovvnde of the fistle, vvhich penetrateth vnto the skinne, as vve easily may feele vvith our finger, on the vvhich, vvith the croocked lancet vve must make an inscision, & the needle beinge in this sorte passed through, & the Speculū Ani beinge taken avvay, vve must then dravve out the needle, and cutt her from the thred, and tye bothe the endes therof toge­ther.

Other say vve ought besides the privett, in­ternallye to make an inscisione throughe the vvhol Fistle, vnto the other hole, vvhich is ma­de on the other syde: but there is most certayn­tye in the ligatione, to avoyde the effluxion of bloode, vvhenas ther is sufficient flosh enough betvveene.

Ther have binne certayn auntient Chyrur­gianes, vvhich coulde not agree vnto the Specu­lum Ani, but have onlye thrust there finger into the fundament, to dilate the same, and besydes the same a thinne and pusille privett, vvher­vvith they have soe longe felt thervvith this vvay and that vvay & vp, and dovvne, till such time as they have fovvnde the Orificium, of the fistle, vvhich is felt as if it vveare a thinge rent, or torne, and novv hauinge fovvnde the fore­sayed Orificium, An other practice or inven­tione. they then close to ther finger thrust in the privett, conducinge the same a­longe the finger supernallye, or vpvvardes, or thether vvher they suppose the bottome, or ground of the fistle to desiste, and end: vvhich throughe feelinge of the finger of the other hand vve may easylye discerne: and havinge fovvnde the end therof, and perceavinge the skinne or the fleshe not to be verye thicke, in stede of ligatione, vve violentlye thrust the pri­vett ther throughe, vpvvardes, the privett bei­nge passed therthroughe, they then cutt open all that vvhich is situated betvveen the tvvo O­rificia of the Vlceration, or els they thrust a threde ther throughe, and soe binde it thro­ughe.

Amongst those vvhich are of opinione, that vve ought to cure the fistle throughe an actuall Cauterye Albucasis discribeth vnto vs the meanes,Albucasis vvillinge vs to vse a Cauterye of iron thervnto, vvhich must be verye subtile, and glovvinge, or redhott, and that it be pro­portioned accordinge to the greatnes of the fistle, thrustinge the same tvvice, or thrice therin, vntill such time as all the callositye is taken avvay ther from, laudinge the fervent, & [Page] glovvinge Cauterye, above the cuttinge or re­scindent Cauterye, because the glovvinge Cautery, as he sayeth correcteth and amendeth the vntēperatnes of that parte & ther follovv­eth noe effluxione of blood the callosity ther­of is burned avvay, & the superfluouse humidi­ty is exsiccated, vvhich vvas concursed, and as­sembled together vnto that patte.

❧How we ought to extracte, & drawe forthe little infantes out of theire mothers bodye, which of them­selves can not be borne. Chap. 3.

Admoni­tion for the Chy­rurgiane. BEfore vve offer to imploy our hādes, on such on operatione: it seemed expediēt vnto me to admonishe the Chyrurgiane vvhat vvoemē may escape this daūger, because vve should obtayne great blame and discredite, vnto our sel­ves, if so be the vvoman being in childebearth, should chaunce vnder our handes to dye, she supposinge, by our helpe, & councell to be re­leased out of this daunger,The sig­nes vvher throughe the Chy­rurgian is hindered, to dravve forth the child out of his mo­thers bo­dye, vvhic of it selfe cā not be borne. VVherefore those vvhich vve suppose to be in daunger of death, vve must not in any sorte laye hādes on them▪ because the countenance and cheare of those vvoemen vvhich are in laboure, or childebe­arthe and also ther face, administreth sufficient knovvledge vnto vs, vvhat event, or successe the matter shall have: for those vvhich are in any great daūger, of their lives, have a straūge & vvonderfull behaviour over them, to vvitt that shee troubleth, or molesteth her self vvith nothing, hath a fearfull sight, vvhich is cleane contrarye to her naturalle beinge, is debilita­ted, hath hollovve eyes, a sharpe nose, a feeble Puls, vvhich beateth obscurely, and vvithout ti­me: Shee is vvholy cōvicted, as if she hadde the soporiferouse dissease, vvith out all strēgth, cle­ane layed alonge, & although vve speake vnto her, yet vve can not avvakē her, & if vve doe lōg trouble, & plucke her, shee speaketh verye fee­blelye, & vvith noe strength, and then agayne lyeth, as it vveare in a great sleep: the ayre alsoe flyeth out of her throte. Those in the vvhich is anye strength left, they fall into Spasmo, or con­vulsion of synnues. Others after they haye continued a long time in theire labors, as are those vvhich have bin troubled & molested thervvith the space of five, or sixe monethes, they are vvholye decayed, grovvē leane, & vvholy con­sumed, for vvant of foode, & because alsoe that vvhich shee hath eaten, is not chaūged into any nouriture, the vvhol boodye beinge thorough soacked vvith humidity, & especiallye the face, vvherof her svveat most commonlye, is fattye, & axungiouse, and smearye.

But those vvhich can suffer the manuall o­peratione, & are fitt, to have the child dravven out of their bodye, have none of these fore re­hearsed accidentes, vvherfore vvithall festina­tiō alsoe they must be opitulated, & helped, on this māner as heerafter follovveth notvvitstā ­nding vvithout rashlye, or temorously to be­ginne the same, vvithout beinge certifyede, of the Midvvyfe, vvhat the reason or occasione might be, vvhye the vvoman can not be delive­red, or bringe forth her childe,Ther are thre thin­ges vvhich make Childe birth difficulte. beinge certifyed heereof, as vvell of the parturinge vvomā, as of the Midvvyfe, in as much as is possible, dilliggēt­ly considering the same, & having vvell perpē ­ded it, therout to knovve the iust occasione of this heavines & sorrovv, considering, vvhether it taketh his occasion of the parturiēt vvomen, or els out of the childe, because therby vve might knovv hovv to rule, & govern our selves

If so be this daūger consisteth in the mother,The mo­ther. it happeneth then, ether because of her mistru­ste or smalle hope, or because shee is fearfulle, and fayntharted, havinge the vvombe, and the necke or entrance of the sam, small & anguste, because shee is yonge & small of body, tender, and delicate: Or els because the entrance of the foresayed VVombe, lyeth recurved, or is occluded vvith some tumor, or els there is som Apo­stematione vlceration, or any Carnositye ther in, vvhich oppugne themselves agaynst the be­arth of the infant: Ether because that the mo­ther, hath a stone in her Bladder, vvhich therin alsoe beinge oppressed, seeketh by all meanes possible to come therout, and beinge come in­to the mouth, or entrance of the Bladder, crus­heth there the entrance of the VVombe, vvher throughe she is angust, or els because therin is som cicatrice, vvher through she is narrovver, then she ought to be, vvher through she cā not in any sorte stretch forth her selfe.

Childe bearth alsoe in some vvoemē is hin­dered above all these foresayed accidentes, be­cause they ar to fearfull, & are to much affrigh­ted, of the parture, or Childbirth, as yet not beinge vsed vnto the labouring of childe, & doe not yet knovve therafter to governe thēselves, as vveare condecent, and needfulle. Others are grovvne impotent, throughe anye praecedente sicknesses, and having noe strength at all to de­liver the conceptione or fruicte from them.

The childe alsoe may be occasion heerof,The chil­de. be­cause it is to feeble, and cā not helpe it selfe, in the deliverance of his mothers labors, and that especiallye vvhen it is deade, and svvollē: in like sorte also the same beinge to grosse, and greate, ether in any parte of his body, as havinge tvvo heades, four armes, beinge dubble, or els if ther be moe, then one, to vvitt, tvvo, three, or four, vvherof the one might praesent his arme, & an other his legge, or anye other part, all at one time.

Afther the infāt praesenteth himselfe, the [Page 36] childebirth falleth easye, or difficulte: because, that follovvinge the naturall Childebirth, the childe allvvayes praesenteth first his heade, ha­vinge his armes stretched out alōgest both his sydes: or vvhē it praesēteth it selfe vvith both the legges forvvarde, vvherby it may easylye be plucked & dravven out: & vvhen it praesen­teth him one anye other manner, it is as then not naturall, but verye daungerouse, vvherin vve must vse our remedyes as herafter shalbe shevved.

The externall occa­sions.Touchinge the externall occasiones, they are violēt heate, vvherthrough the strengthe & forces of our bodyes are convicted: contra­rilye, ther is great could, vvherthrough, all the conduictes are stopped as allsoe are those per­sons vvhich vve feare, or hate.

The childe alsoe as longe as it lyeth drye, & the vvater as yet is not brokē out, vvherthrou­ghe it can have no passage, because the vvayes & passages are drye, & not slippery, not smoo­the, as in the vvater streames vve may see, that the stones, through the slipperishenesse of the vvater,The ope­ratione. are carryed avvay. In like sort alsoe all sorrovve, & tribulatiō, stoppeth & occludeth the entrance of the vvombe: as cōtrarilye the meane, & reasonable iucunditye, openeth the same.

All these foresayed occasions, must be cōpa­red, vnto ther cōtraryes, as if soe be that thro­ughe the imbicilitye of the mother it be occa­sioned, she must thē be conforted, givinge her a little vvyne, or Hipocras, conforting, & ioy­inge her in her necessitye, as much as is possi­ble: & if soe farr forth as the passage, be to nar­rovve, or anguste, to exsiccate, or dry, or els to much shrūcke, vve must then, endevore vvith decoctiones, vvith vvarme infusions, & vvith pingvefactiōs, to soften, moystē, & make sup­ple the same: If then ther be anye carnositye, vvhich in terrupteth the passage therofe, vve must depose, & detrude the same one the one syde: or if ther be a stone in the entrāce of the bladder, vve must thrust the same on highe: & if soe be the Childe othervvise praesent it selfe thē it should, as first vvith the heade, vve must then turne it in the best sorte vve maye: or if it thrust one arme, or legge out, vve must not thervvith dravve it out, but must gentlelye re­trude it backe agayne, & agayne bringe it into his place: or if ther, be more thē one child, vve must dilligently consider hovve vve ought to take hould therone, notinge that vve doe not take the one by the foote and the other by the foote, & soe both at once plucke thē, vvherfo­re vve must thrust one foote on highe, & dra­vve tovvardes him the foote of that vvhich is next,Hovv vve ought to situate the vvo­man. & most rediest vnto the passage.

But before vve come to the manuall opera­tiō, vve must first of al situate the vvomā con­venientlye: & although ther be divers māners of situationes, (for some sett thē in a stoole, o­thers set thē leanīge, on a table, or one the ed­ge of a bedd, vvith the legges separated the o­ne from the other: others set them one theire knees) yet the best & fittest vvay is one a bed­de, causinge the vvomā to lye one her backe, thvvarte over the bedde, close to the edge ther of, vvith cushēs or pillovves vnder her backe, to rest her heade therō, layinge her heeles clo­se to her buttockes, vvhich must lye alsoe somvvhat exalted, and the hippes spanned the one frō the other, vvhich of tvvo vvoemē must so & in that sorte be helde, least that she doe not chaūce to dravve, & shutt them together: the vvomā lyinge in this sorte, the Chirurgian as then may the easyer obtayn his vvill, and com close vnto her, to drive, & detrud the child to­vvarde the entrance of the vvombe.

The vvomā beinge thus setled, or layed, the Chyrurgiā must lay one the knees, & one the belly of the vvomā a cleane linnē clothe, par­tly to be an opercle, or coveringe to the vvo­man, & partlye ther through to be freed from the externall ayre: thē he must gentlely thrust his hande being annoyncted vvith freshe but­ter vvith Sallatoyle, or vvith hogges suct, in to the entrance of the vvombe, first of all cōside­ringe vvhether the childe be alive, or deade, & hovv it is thereī disposed, or turned, vvhether also ther be more thē one, tvvo, or thre child­ren a fore hādes: & hovve soever it be situated,The child must vvith his heade be dravvne out or vvith the feete if it be possi­ble. or disposed, ether alive, or deade, curved, or croocked, if it be possible vve must dravve the heade first out, but if not, vvith both the leg­ges, dravvinge the same aeqvally dovvnevvar­des, & cause, one of the armes, to be stretched out, alōgest the syde of the heade, because ther throughe may be hindered, that the bodye be­inge therout the vvombe doe not chaunce to shutt, & the necke of the Childe be not therin inclosed, vvhich through the arme vvhich ly­eth stretched out by his heade shalbe praeven­ted & hindered. If so be the one foote praesen­teth it selfe, & the other tarrye therī, vve must tye the foresayed foote vvith a ribbon & gen­tlye thrust in agayn the foresayed foote, suffe­ringe the end of the ribbon to hange out, and inqvire, & seeke after the other foot, thrustin­ge the hande, alongst by the foresayed foote, & legge vntill such time, as vve feele the buttoc­ke of the other foote, & then reducinge your hande close to the buttok shall immediatlye finde the other foote, vvhich gētlely you must bring forevvardes, & dravvinge by the ribbō, the other foote, vvil come forth agayn, vvhich having thē both aeqvally together must gētly dravvē thē out vvith, the rest of the vvhole bodye of the child: by this means vve may knovv vvhether they be both the legges of one child, [Page] on this māner dravving out the same, first the one & then the other.

Signes of a deade Childe in his mo­thers bo­dye.But if so be the Childe be deade, it vvill not as then stirre it selfe, & in the feelinge also ther­of it vvill be coulde, vvhenas vve thrust the fī ­ger in the mouth therof, it stirreth nether lip­pes, nor tunge to suck: The mother as then hath a stinckinge breath, hollovve eyes, and a svvollen bellye: vve therfore out of all these foresayed tokens, perceavinge the Childe to be dead, vve must then dravve it out as already vve have sayed vvith the feet forvvardes: As farre forth therfore as if the Childe had one arme or one Legge hanging forth of the vvō ­be & it vveare impossibleto reduce the same agayne into his former sitvation, because that throughe the bodye of the Childe, the entran­ce of the vvombe is stopped, vve must then plucke the foresayed arme or legge & dravve it to the ioyncte of the shoulder, or of the hip­pe:Hovv vve ought to dravve forth a deade Childe. & then discide, & cut of the same in the foresayed ioncte. And if so be the heade did first repraesent it selfe, vve must then thrust both our fingers into the mouth therof in place of a hoocke, tovvardes the roofe, and so as gent­lye as is possible dravve the same tovvardes you. If soe be the belly therof be svvollene, or hath to greate a heade, and the same fulle of vvater, vve must then vvith our finger, a little crush theron, because the aquosity might so­acke therout, and the svvollen partes by this meanes be diminished and vnsvvollen: & if soe be that our handes vveare not sufficient to dravve out the Childe, or to finde the belly, to let out the sayed Aquosity, vvhich ether is re­tayned, in the heade, in the Brest, or in the bel­lye, vve must then gently vvith our right han­de bringe therin, a little curved and croocked knife, vvhich vvithin the curvednes therof is sharpe, and cutttinge, the acuitye or povncte therof being closely inclosed betvvixt his fin­gers,After vvhat fort vve may dravve forth the aquositye out of a deade Childes bodye. vvhich he must houlde verye close toge­ther, vvhervvith vve must make an inscisione ether in the Heade, in the Breste, or els in the Belly, by this meanes to dravve forth the vva­ter vvhich is therin cōtayned: And then vve must take, a hook, vvhich on the same fashon as is afore sayed vve must bring therin, vvher­of vve must fasten the poyncte, ether in the eyes, or in the mouth, or in the Clavicles, vvheron vve must then dravve as violentlye as the cause reqvireth to be done, dilligentlye cōsideringe that the hooke breack not through & let his houlde goe, & through the violente pluckinge of the same doe not chaūce to hāge & take houlde in the VVombe, to the vvhich intēt vve must vvith as much iudgemēt, & cōsideration, dravve the same as is possible, onlye vvith one hande vvhich muste be vvithin the VVombe. Novv if the Childe, be so thick, & so grosse,A mon­struouse Childe. that vvholy to dravv it out is impossible for vs or els if it be a Monster, or tvvo Childrene faste together, vve must as then by parcels dravve them out, cuttinge the Heade thereof in peeces, & then plucke out first the the one peece, & then the other, then the Brest the Armes, and the legges, & allvvayes makin­ge that it be cut in the ioynctes, vvithout brea­kinge any bones: for although they be tender, yet the splinters therof might chaunce to hur­te the vvombe, soe that it is allvvayes the surest vvay vve cutt of the Armes, and legges in their ioynctes.

It chaūceth also sōtimes, that vve dravvinge forthe the Childe by the legges, that onlye the head tarrieth therin vvhich therafter vvithout great difficulty vve cā not get it out, thē vvith extreame daunger, because the same rovv­leth vp and dovvne in the concavitye of the vvōbe: this therfor being happened, ther must as then a servant, or one of the standērs bye vvhich is experimented in such affayers, sittīg one the left syde of the vvoman, crushe vvith both his handes one the bellye of the vvomā, beinge covered vvith a vvarme cloth on this manner to depresse dovvnevvardes the heade of the childe, and ther in that place to contay­ne, and keepe the same.Hovv vve may dra­vve forth the hea­de of the deade childe as yet remayninge in the vvōbe And the Chyrurgiane vvhich sitteth on the right syde of the vvoman must vvith his light hande bringe the hoocke therin, as is already sayed, vvhich he must faf­tē in the heade, ether in the eyes, in the mouth or in the apertione of the heade, & dravve the same by little, & little therout, as if, as yet the vvhole bodye remayend therin: If soe be the foresayed head vveare to great, vve must then in like sorte alsoe cutt the same in peeces, and dravv therout the peeces first the one, & then the other.

The Childe beinge dravven therout, vve must dilligentlye consider, that vve doe not breake a sunder the navell, because it may ser­ve for a conductor, & leader, vvhich vve must allvvayes feelinge the same, and suffering it to glide throughe our right hande must follovve vntill vve be come to the matrice vvhervvith the Childe vvas covered in the foresayed vvō ­be: & hauinge found the same, vve must gent­lye rovvnde about separate her vvher vve fin­de her to befastened, & then dravve her forth vvith al the cōgregrated blood therī, if therbe anye, least that there it might chaunce to pu­trifye: havinge thus finished all this, the vvo­man as then shall ioyne, and shutt her hippes together agayne, and must then circumligate the bellye, as is required, and necessarye.

In this forerehearsed daunger, is oftenti­mes incident vnto the vvoman a farre more lamentable and pitiful accident, to vvitt, a dis­cendinge, and sinckinge do vvnvvardes of the [Page 37] vvombe, vvhich betvveen the hippes sincketh out, throughe the vvhich the vvoman, can not goe.The mā ­ner to ele­vate a­gayn the suncke & discēded Matrice. If soe be therfore this chaunced, vve must gentlye, and easilye by degrees thrust in agayn the same, as vve have sayed of the guttes, or en­tralles being sunck out, vvherof vve must cau­se the disseased and sicke vvoman to keepe her bedde some certayn cōtinuance of time, vvith her buttockes a little exalted, and if soe be the Matrice in her risinge chaunced agayn to sinc­ke out, vve must then agayn, thrust in the same.

And to praevent her that she doe not agayne sincke out of the bodye, vve must thē thrust in the Matrice a Pessarium, like a rovvnde Apple, vvhich must have a hole in the middle therofe, as heer before amongest the instrumentes vve may see it defigured vnto vs vvher vve shall al­soe finde, the forme, the figure, & the manner of vsinge the same.

❧VPpon what occasione, the externall partes as Ar­mes, and legges are, and must be extirpated, or cutt of and in what place it must be do­ne. Chap. 4.

When, & vvhye the externall part, must be saved of. THe externalle membres of mās bodye, as are Armes, & legges, are cutt, or savved of, vvhen as they are sqvised, plettered, and brokē, the Vaynes, Arteryes, & Synues, vvholy be lacerated, & cutt of: Or els vvhen they concerninge any ex­ternalle occasione are hurte, or indammaged, vvherby they sōtimes vvholy come to be mor­tifyed, & that suddaynlye, or els somtimes alsoe by degrees, so that somtimes ther ensueth such a Gangraena, or mortification, that not only the fleshe, & all the other mollifyed partes, of the foresayed ioyncte, doe mortify & corrupte, but alsoe the Bones themselves, soe that ther is noe hope at all, of any health, then onlye throughe the extirpatione of the same, fearinge least that the foresayed Gangraena, shoulde farther infect & pollute all the circumiacent partes, vvhere­throughe the patient might suddaynlye chaūce to dye. Notvvithstandinge the Chyrurgiane may not in anye forte aproch vnto his exstrea­me, & last remedye, before he have tryed all o­ther remedyes, to ease & appease this forsayed mortificatione, & to save the ioyncte: because that such an operatione,Extirpa­tione of any ioync­te, is effec­ted vvith great daunger. can not be done, then throughe extreame daunger, as oftentimes the patientes themselves, doe dye vnder our hādes, because of the great effluxione of bloode, or els some greate fayntnes. Others immediatly after the extirpatione fall into a Phrensye, in extrea­me, & intollerable payne, in Spasmo, in a coulde svveat, vvheron praesentlye, follovveth death. VVherfore first of all vve ought to admonishe the frendes, & kinsfolke of the patient, & certi­fye vnto them that this operatiō is full of daū ­ger, and is as vvell lamentable for the Chyrur­giane as for to patient: and that vve ought not therof the make anye greate matter of vvorth, or estimation, seinge ther is no other hope, nor anye other successe to be expected, & that it see­meth more convenient, and necessarye, to ex­tirpate the mortifyed ioyncte, and soe to avoy­de & flye death, vvhich is more terrible, and fe­arfull, then the losse onlye of one ioyncte.

And before vve beginne this operatione, & that vve must extirpate, the foresayed ioyncte, it is necessary that first of al vve knovv, the pla­ce vvher it must be done,Reason, hovv to make choyse of the place, vvher vve shoulde extirpate the ioyncte. because of divers opi­nions vvhich are hadde therof: for some are of opinione, that in the ioyncte vve ought to doe it, because in this place it vvoulde fall easyer for the Chyrurgiane to execute the same, & is alsoe more tollerable and easyer for the patient, be­because ther it may be done vvith more festina­tione, vvith a simple inscision of a vvell rescin­dent and cuttinge knife, if onlye the Chyrurgi­ane be agile, and experte, in findinge of the ioyncte.

Novv as touchinge those vvhich suppose all vvoūdes of the ioynctes, to be more subiected,Reason for those vvhich extirpate any mē ­bre in the ioyncte. vnto deadly, and dolorouse accidentes, thē tho­se vvhich happē to be thre fingers above, or vnder the same, yet for all that they are noe lesse davngerouse, because of the Tendones, and al other sunnuish partes, vvhich as then are alsoe cutt of, vvhich are rounde more thicker there then in the ioynctes themselves: VVherfor vve neede not to feare, that ther vvill follovve mo­re payne, or convulsione, althoughe the extir­patione vvhich is done, three, or foure fingers belovve, or above the same, because the Tēdo­nes, and the synnues are as vvell in the on place as in the other aequallye cutt of. And vvhich is more, if vve extirpate a membre in the ioyncte, the marrovve, of the pipe as thē is not denu­dated, because of the Epiphysis, vvhervvith it is covered, and contayned: But contrarilye if vve savve throughe the focille, or pipe, the marro­vve as thē is denudated, for the praeservatione of vvhich Nature vvith greate difficultye, must have a longe time, to engēdre a Callum thervn­to, and to cover it, because nature must separa­te that end of the savved bone: And besydes all this, ther follovveth noe superfluous effluxion of bloode, as Hippocrates in his boocke of Hemor­rhoidibus, vvitnesseth vnto vs.

Althoughe that all these foresayed reasons,Reason, for those vvhich extirpate the mem­bre above or belovv the ioyncte. are sufficient enoughe, to persvvade the yonge Chyrurgian, to extirpate the members in their ioynctes and Hippocrates, allsoe commaundeth & councelleth the same, yet al PractisionerS of Chyrurgerye, doe heere in agree, & vnite their [Page] opinions together, that vve ought to extirpate the membre,Reason, for those, vvhich extirpate the mem­bre above or belovv the ioyncte. three, or four fingers vnder, or a­bove the ioyncte, accordinge to the dispositiōe & reqviringe of the mo [...]tified ioynct: For first of all the opratione is done vvith such festina­tion & so certayn, because of the facility ther­of, for vve may righte vvell knovve that the vvhole infectede, & spoylede parte, most com­monlye svvelleth, & the finitimate partes also thervnto lyinge, that vvithout greate daunger & difficultye, vve can not knovve the ioyncte or the place therof in the vvhich vve ought ve­ry vvarily to enscide: Farther allso the ioynctes are most cōmonlye verye difficulte, cleane to cutt them of, or extirpate them, because of the bones, vvhich are placed the one in the orher.

Touchinge therfore the certayntye therof experience teacheth vs, that an inconvenience may as vvell come of the one, as of the other: And such vvoundes, are noe lesse mortalle, then the vvoundes of the ioynctcs. Secondlye, ther much sooner follovveth a cicatrice, because of the greate qvantitye of fleshe, vvhervvith the bone on all sydes is circumcinglede, & co­vered & vvhich in that place is not of such a crassitude, & spongiousnes, as in the ioyncte. And althoughe the Cicatrice can not so soone be effectede, the patient neverthelesse needes not abstayne from going, & that vvithout pay­ne allso, layinge his knee in a stilte, vvhervvith he shall as then abyde the time of his complet sanatione: The vvhich he in that sorte shoulde not be able to doe, before that the cicatrice vve are vvholye curede, & obduratede, if so be his legge hadde binne extirpatede in the ioyncte, because the vvhole body resting theron, throughe the confricatione, or rubbinge together of the same might chaunce to breacke open agay­ne.Experiēce of the Author. As touching my selfe, I have allvvayes foū ­de that the cicatrice hath ever binne very diffi­culte, yea & allmost impossible to be curede & effectede in the ioynct, but īmediatlye therafter is openede agayn, hovv little soever the bodye restede therone.Conclu­sione. VVherfore I also am of the same minde, & opinione, vvith all other com­mon Chyrurgianes that as vvell consideringe the festinatione, & facilitye of the operatione, as allso the brevitye of the generatione of the cicatrice, that vve ought to doe our extirpation or savvinge of, of anye membre, three, or foure fingers breadth above, or vnder the ioynct, to vvitt, of the Legge, if it be vnder the knee: For allthoughe the Gangraena, or mortificatione of the Legge, vveare onlye belovv in the foresay­ed Legge, & the middle of the Legge as yet illaef vnhurt, & sound, vvherfor it is all vvayes better to make the stumpe short, then longe, because vvithe his length, it is associated vvith a certay­ne deformitye, & might cause greate impedi­ment vnto the patiente, vvith thrustinge of the same, heer agaynste this thinge, & ther agaynste somvvhat els. VVhich in the Arme is contrary because ther it is better, that vve suffer him [...]o keepe as longe a parte therof, as is possible to be by any meanes done,

It is right true, if so be the Gangraena, Exceptiō. or morti­ficatione of the Legge, doe end in the ioynct or, close thervnto, & noe higher then to the begin­ninge of the hippe vve must then allvvayes ra­ther doe the extirpatione in the ioyncte, then above the same, & especiallye in the hippe: Be­cause the accidentes might allvvayes be vvorse, consideringe the greate Vaynes, Arteryes, & Synnues, vvhich by hovv much the more vve plucke, & dravve them vpvvardes, so much the greater vve finde them:Nota. And then the cicatrized parte, shoulde be constraynede to reste on the artificiall, fayned legge, as if vve extirpatede the same in the ioyncte: Be it therfore vvhat place you vvill chuse, vve must note, that allvvayes vve rather take avvay some of the sovvnde par­te allso, then leave anye of the corruptede, or mortifiede parte behinde. Because that such a parte of mortificatione, might allso corrupte, & mortify, the finitimate sovvnde part, so that the patient, should have suffered all the davvnger, & payne in vayne, & for nought, & to continue his lyfe, vve shoulde be constrayned to make an other extirpatione.

How we ought to doe the extirpatione, or sawinge of, of a ioyncte and how we may stopp the bloode, after we shall have layed downe the Patient. Chap. 5.

HAvinge noted the place, vvhere vve intende to doe the extirpati­one, vve muste situat the patient as it is reqvirede, not onlye con­sideringe the nature, disposition & qvallitye of the parte, vvhich vve intende to extirpate,Situation of the pa­tient in the extir­pation of a Ioyncte but allso one the Chy­rurgiane his cōmodity, that the patient sitt not agaynst the day, & ligt of the Chyrurgian, not to highe, nor to lovve, nor on a place vvher he mig­ht slippe as it oftentimes hath chaunced, the pati­ent sittinge to farre in the bedde. Some are of minde that vve ought to sett the patient on a stoole because he may sitt the faster, & conveni­enter: Others effect this operation, the patiēt sit­tinge on the edge of a bedde, fearing least he sho­uld grovv faynt, or syncopize, & might thē vvith more ease be gottē into his bedde & restīg place the extirpatione beingedone.. But my vse is, to cause the patiēt to [...]itt in a resonable lovve chay­re, because all beddes are not of one hight, nether are soe readye, and fitt for our purposes nether so vvell tovvardes the day, vvheras vve may set the [Page 38] chayre vvheare vve our selves liste: farther the patient is more surer in such a place, & may al­soe better, & vvith more convenience be held, and better tovvardes the Chyrurgians hande, as vvell to cutt throughe the fleshe, as to sa­vve of the bone and restraygne the bloode: the servantes allsoe shall have more better opor­tvnity to houlde the patient fast & in more sa­fetye.

Hovv vve may vvel & conve­nientlye extirparte a Ioynct.Therfore to effect and finishe this opera­tione, the Chyrurgyne must stande betvveene the legges of the patient, and must cause a ser­vant, or stāder bye as much as is possible vvith both his handes to strippe vp the skinne & the muscles vvhich are situated above the extirpa­tione, after he shall have caused the patient to bende the ioyncte, & that as vvell for the lon­gatione of the skinne, as lengtheninge of the Vaynes, and Arteryes, vvhich after the extirpa­tion of the Ioyncte, the ligature being taken a­vvay, vvill more easyer as then demonstrate them selves, & be more easyer taken houlde of vvithe the Crovvesblil, and they tyen or caute­rized: Then vve must immediatly one the pla­ce, vvher vve intend to make our extirpation, lay a stronge ligatvre of stronge linnen, the sa­me being reasonable closelye dravvne together and that because of divers occasions: First of all because the Ioynct may be praesēted the stedyer and faster to the Operator, and because the fles­he should the better beare, and receave the ins­cione of the croocked, or curved knife: Second­lye, because the sensibilitye of the foresayed Ioynct, in the scissure, might partlye be ther­through benummed, and somvvhat mitigated: Thirdlye, because after the inscision, in sovvin­ge of the bone, the bloode might be soe longe throughe the foresayed ligature restraygned, & kept backe.

Farther more, by this meanes vve keepe the skinn & muscles on highe, vvhich after the o­peratiō, the ligature beinge dissolved, & made loose, sinck agayne dovvnvvardes, and cover the savved bone, by vvhich meanes the Cica­trice the sooner grovveth therover, and serveth the foresayed bone therafter, in steede of a Cushone.

Ther may not be a­nye fleshe one the bone vvhē vve intēde to savve it of.All vvhich beinge finished, vve must then vvith a croocked knife, vvhich is very sharp, cut through the fleshe close vnto the ligature roū ­de abovvte, vnto the bare bone, vvithout leavīg any thinge betvveē the bones vncutt, if ther be tvvo, scrapinge of vvith the backe of the knife the membrane Periostium, vvhervvith the bone is covered, because vve doe not chaunce to tea­re the same, vvith the teeth of the savve, vvhich vvoulde cause an intollerable payne vnto the patient, & also in serratinge, or savvinge might be some hinderance: In like sorte also vve must remove the fleshe as much out of the vvay as is possible, & then vvith a vvell cuttinge savve, savve of the vvhole legge as close to the fleshe as may be, dilligentlye notinge, that vvith the teeth of the savve vve doe not in any sort touch the foresayed fleshe.

The legge novv beinge extirpated,The Ioynct beinge extirpa­ted, vve must thē make loose the li­gature. vve must thē dissolve & make loose the ligamēts, vvhich vveare tyed above the vvound, & strippe dovv­nevvardes the skinne, and the muscles, because the bone of al sydes may be vvel covred: vvhich beinge done, if soe be there be but little bloode issued therout, vve must not then (especiallye vvhere there is a Gangraena,) so soone restraygne the same, but as yet let it a little more bleede, & that as longe, as you suppose it may vvithout a­nye davnger to the Patiēt be done, because that parte there throughe might the better ease her selfe, and be disburthened, and soe much the lesse be subiect vnto anye inflamationes.

The bloode havinge indifferentlye and rea­sonably issued therout according to the strēgth of the Patient, vve must as then stoppe,Instructi­on hovv vve shal koovv vvhe­ther it must be stenched, or let bleede. and re­straygne it, vvhich vve must doe throughe the imposition of the fingers one the mouthes, or apertiōs of the Vaynes, vvhich vve must ether bind or els cauterise the one or the other according as the same shalbe needfull, and requisite, it be ether through binding, or cauterizinge, as the auncient Chyrurgians of former times ha­ve done, & vve have cōmitted it to the memo­ry, of those of our times.

For as in example,Virtves of the actu­all Cau­teryes. if ther be anye member corrupted, and mortified, vvhich must be extir­pated, after vvhich extirpatione, the fluxion of bloode, must be farre more stopped, throughe the applicatione of glovvinge cauteryes, on the appertiō, or mouthes of the vaynes, thē throu­ghe the ligation, or binding of the same, becau­se the glovvinge cauteryes, make one the fore­sayed Orificia of the vaynes an Escara, vvher­through the foresayed Orificia of the vaynes are occluded and the bloode stenched, because it cā noe more issue out, by vvhich meanes it dra­vveth vnto it selfe, & also consumeth al the ve­noumouse evaporations, & dampes, and brin­geth thē to nought, vvhich as yet throughe the foresayed vaynes, have bīne retayned in the su­persituated partes, although, it semeth not that the foresayed parte is in any sorte corrupted, or putrifyed, then onlye soacked throughe vvith some certayne venoumousenes, vvhertroughe sometimes that parte hath binne prepared as it vveare to some mortificatione, or Gangraenati­one: that vve supposing to take houlde one the vaynes vvith the Crovvesbill, and soe to bind them, doe most commonlye chaunce to breake betvveene the Crovvesbill, or els hovv gent­lelye soever vve knit the threde together, one that sorte to tye them, are throughe the tyinge of the threde notvvithastndinge cutt a sunder: [Page] vvherthroughe vve are in the end constrayned to vse the actuall Cauterye.

Galenus.And not vvithout occasione, Galenus testify­eth vnto vs, to be a thinge verye expediente, & necessarye, to stench, and restraygne the bloode throughe actualle Cauteryes, vvhich throughe anye corruptione, hath corroded throughe the vaynes, because they, nether are able to suffer the Crovvesbill, therby to be dravvne out, ne­ther the tyinge, & bindinge. It is also the most surest vvay, to cauterize all that, vvhich throu­ghe the Gangraena is corrupted, or els, that vve applye theron any Causticke medicamentes, as vve are vsed to doe one the originalle of al cor­ruptions.

VVherfore if so soe be the Chyrurgian ha­ve anye suspicione, of anye venoumousenes, vvhich after the extirpation, might be dravven invvardes tovvardes the finitimate partes ther­aboute, it is as then the surest remedye, that to the restraygninge, and stenchinge of the blood, he have in praeparatione, and readines, three, or fovr fervent, & glovvinge cauteryes, vyhich he must applye on the Orificia of the descided vay­nes,Hovv throughe cauterisa­tione vve should restrayg­ne, & stē ­che bloo­de. vvithout houlding, or depressing the same to harde theron, because thus doinge ther may be left behinde a goode Escara: And if it chaun­ced that the bloode throughe the applicatione of one cautery vveare stenched, it is then suffi­ciently cauterized, nether must vve anye more cauterize the same Vayne, prosecutinge of the same, on the other vaynes.

Instructiō hovv to restrayg­ne bloode throughe ligature.Contrarilye, vve beinge constrayned to ex­tirpate anye membre, beinge verye much plet­tered, and broken, & vvhich throughe noe Gan­graena,, or corruptione is putrified, it is as then most conveniēt, to restraygne the blood, throu­ghe takinge hould of the Vaynes, or Arteryes, vvith the Crovvesbill, compraehendinge allsoe some parte of fleshe thervvith, vvhich vvith a good & stronge threede vve must binde toge­ther, as allsoe the fleshe, vvhich vvith the thre­de is tyed, is an occasione, that the ligature must be the more certayner, and surer.

And as Galen findeth it goode, to stench the bloode, throughe actuall cauteryes, vvherby is anye corruptione, or putrefactione, in like sor­te alsoe he commendeth the ligature in the ef­fluxione of bloode, vvherby is noe corruptio­ne,Accorde to agree, the right vvorship­full Mr. Gourme­len, & Mr. Pare. or anye venoumousnes. VVhich right vvel may be an agreemēt betvvixt to great per­sonages of our time, vvher of the on is a Physi­cione, and the other a Chyrurgiane, because of a certayne dispute, vvhich they had, concernin­ge this matter, of the meanes, vvhich vve ought to vse, in the restraygninge of bloode, as they have agitated most inmicisiously this disputa­tione the one agaynst the other vvithout the o­ne, vnderstandinge the other.

The bloode therfore throughe the fore­sayed meanes beinge stenched, & restraygned, vve must as then strovve some restringēt poul­der one that parte, and applye therone divers drye plumaciolles, or flatt tentes, and therone an ordinarye restringent, or defensive plaster, layinge rovvnde about the stumpe, a plaster of Refrigerans Galeni, because that the foresayed de­fensive, shoulde not chaunce to cleave too fast therone, and soe binde the parte, as it requi­reth, and then curinge the same as a simple vvounde, allvvayes dilligentlye consideringe that vve doe not take avvay the Escara, vvhich throughe the foresayed Cauteryes is made, ne­ther the threedes allsoe vvher vvith the Vaynes have binne tyed, if soe be at least ther be anye.

It happeneth allsoe sometimes,Of the dressinge after the bloode is stopped. that the Vaynes after that they have binne cutt of doe dravve themselves invvardes, soe that vvith the Crovvesbill in noe sorte vve can take houlde therone: It might allsoe chaunce, that the tyed Vayne, might chaunce to vntye, vvherthrough the patiente is charged vvith a nevve effluxion, of bloode.

If soe be anye of these accidentes chaunced, and come vnto your handes, and it seemed best vnto you, to Cauterize the Vayne, then to bin­de her, or els rather to binde, then to Cauteri­ze her, and such a mischaunce, or accident hap­pened into your handes vnexpected, and not beinge therone provided, vvithout havinge a­nye Cauteryes in are adines, the right vvorship­full Mr. Pare councelleth vs very fitlye to stench the bloode. The vvhich if in tvvo or thre or four Vaynes it chaunced, or Arteryes, at one ti­me then must the servant, of one of the cir­cumstantes, lay the endes of his fingers, one e­ach vayne one, gentlelye crushinge the same, one the Orificia of the Vaynes, because as Galen sayeth the Chyrurgiane may have time, to re­straygne the bloode: And then take a needle of a fingers length, or longer, and of a reaso­nable crassitude, vvhich is very sharpe, and res­cindent, as heere before is defigured vnto vs, beinge threded vvith a stronge threde, vvher­vvith the vayne after this sort follovvinge must be tyed.

Havinge first of al considered, vvhere the bleeding Vayne is situated,Hovv vve should doe this ligature to stenche the blood you must thē thrust your needle therthroughe, beginninge on the skinne a good fingers bredth higher then the vvounde, one the syde of the Vayne, makinge the same to come contradictorilye out of the vvoūde, to vvitt one the syde, & alsoe somvvhat lovver then the Orificium of the Vayne, because the threde may be thervnder, ther to circumcingle the same, sufferinge the end of the threde to hange one the skinne, vvithout extractinge, or vvholye dravvinge out of the same: Then you must agayne, thrust the same needle inter nal­lye in the vvounde, one the other syde of the [Page 39] vayne, because in soe doinge, the threde, vvhich vvith both his endes is come forth externallye on the skinne may take houlde on the fore­sayed vayne, vvith some certayne portione of fleshe, & soe through both the stitches of the needle, & passages of the threde, may stifflye be bovvnde together, throughe both the endes of the foresayede threde, layinge betvveen the thredes a little compresse of lether, tvvice, or thrice dubbled, as thick as a little finger, becaus ther through the payne might be praeventede, vvhich through the foresayed stiffe bindinge, might be caused, & because the knott, through the continuance of time should not cut throu­ghe the skinne.

A certay­ne ligatu­re.VVhen as this ligature is convenietlye done, shee as then is verye certayne, vvhich allso may be done in all partes of the bodye, vvher ther is anye fluxione of bloode, as in greate vvoundes of the Armes, of the Hippes, or of the Throte. Heere before amongste my Instrumentes of Chyrurgerie, you shall finde them defigurede vnto you.

How we shoulde extirpate, the superfluous, & corrup­tede fingers, & separate those which are growen, & conioynede together Chap. 6.

The hand is an in­strument, of instru­mentes. THe hande, vvhich is an instru­mente, of instrumentes, is divi­dede in five fingers: And it somtimes allso chaunceth, that be­sydes the thumbe, or the little finger, ther grovveth a sixte fin­ger, vvhich is all carnall, or fleshye, or els com­posede of some smalle bones: Yet is nether the one nor the other complet, vvhether ye consi­der ether their figure, or their magnitud, & gre­atnes, as beinge agaynst the course of nature, vvherthroughe they are an impediment to the actiones of the hand. It may allso vvell chaūce, the one finger of the hande to be pletterede, vvithout beinge able to keepe the same from Gangraenatione. Besydes this ther commethe in the endes of the fingers, somtimes a certayn vlceratione,Curation of the Panaris, or Paroni­chia. vvhich is callede Panaris, or Paroni­chia: The vvhich cause such vehemente payne, throughe the venoumouse matter, that ther­throughe the bone corrupteth, & rotteth, yea & the inflammatione allso beginneth moste commonlye in the bone: The vvhich to reme­dye, before that the bone be corruptede, vve muste make an inscision in the end of the fin­ger according to the length therof, begīning at the extreameste end of the ioyncte, vnto the bare bone, because the venoumouse matter, vvhich lyeth inclosede betvvene the bone, and the pellicle, vvhich covereth the same, mighte have some or other issve. The inscisione beīg done, vve muste suffer it to bleede as longe, till it of it selfe restraygneth & stoppeth, thē thrust the finger in good Aqvavitae, vvherin vve must before dissolve a little Treackle: And if so be notvvithstandīge all these remedyes the finger as yet corrupted farther, and must be extirpated, vve may thē verye aptlye effecte the same vvith our rescindent, or cutting pinsers, vvhervvith, vvithout great payne, vve may vvith,Hovv vve may re­move the super­fluous fingers. one nipe clippe it of. Ther are other, vvhich lay the fin­ger on a little blocke of vvoode, & as thē vvith a rasor hevv it of. On this manner also vve may extirpate the superfluouse finger vvherin ther is anye bone.

And soe farre forth as if the fingers, vveare from the nativitye, and birth, or through com­bustione, or els throughe anye vlceratione, he­aled and ioyned together, vve must then vvith a rasor, separate them the one from the other, and accordinge to the length ther of cutt them asunder, and then vvith an exsiccating plaster, being separated cure thē, and soe skinne them, by vvhich meanes every finger vvill separatlye heale. If soe be that there came anye vlceration in the finger, after the vvhich there follovveth a deformed Cicatrice, vvherthroughe the fin­ger, grovveth croocked: VVe must then trye theron some mollifying remedyes, to cause the finger thervvith to rectifye, & grovve straight:

And if soe be by noe meanes it vvilbe soe, as it sometimes chaunceth, vvhen the foresayed Cicatrice is great, and inveterated, & ether the sinnues, tendones or skinne have binne hurt, vve must not therfore proceede vvith the same as a thinge vvhich is incurable, for if soe be vve cutt, ether the one or the other, the finger ther­after should nether be able to bende, nor stret­ch out, yet is it necessary that the bendinge, pro­ceede before the stretchinge out, and the stret­ching out, or rectifying of the same, before the recurvatione, soe that he shoulde allvvayes be right, and verye inconvenient, as beinge better that he be reasonable croocked, then right, be­cause of the inconvenience, vvhich ther throu­ghe vve receave: For vve supposinge to shut, & close the hande, and to fasten on any thing, this finger as then should stand right out: But vvhē it is onlye the skinne vvhich maketh the Cica­trice, throughe the vvhich the finger is recur­ved, vve must then cleane cutt of the same for as it beinge harde, & callouse, can not be throu­ghe the finger erected, and stretched forth.Curation of a croocked fin­ger. Ha­vinge therfor novv rectified this finger, by this meanes, vve as thē make a nve Cicatrice ther­one, & must note that in the generation of the foresayed Cicatrice, the finger doe not chaunce to be agayn recurved, or shrincke vp agayne:A finger-case of lattinne, or of sil­ver. to the praevētīg of the vvhich, I knovve noe better meanes, after he be cured, that ther one vve vve­are a finger case, of lattinne, or of silver, one the plaster, & one the combustion. This fingercase [Page] must be covered vvith Taffatye, or vvith anye other decent substance, & conveniently, vvith a bande, fastened above on the hande, vvhich fingercase shall doe more commoditye, & hel­pe, thē all the splintes vvhich vve might applye theron.

The thū ­be or the finger beinge vvholely lamed.Ther happeneth alsoe a dissease, cleane con­trarye, vnto all other disseases of the fingers, e­speciallye in the thumbe, having receaved the­rone a blovve on the Tendones, vvherby the same is erected, & agayne the foresayed Tendo­nes beinge cutt of, can in noe sort be agayne e­levated, nether stretched forth, vvherthroughe he lyeth in the hande immoveable, and can not be stirred. The same chaunceth alsoe in the hande, havinge receaved anye vvounde in the hande one the Tendones, or alsoe above the hande, vvhere throughe the hande hangethe & falleth dovvnevvardes, as is she vveare parali­ticke, and of her selfe is not able to be lifted vp. As touchīg therfore the thumbe, & the fingers: vve must ether have a thumbcase, or a finger case vvherthroughe they must be heaved vp: And for the hande, a glove, vvherthroughe the hand may be helde vp. VVhich in the boocke of Mr. Pare, are discribed.

THE EIGHT TRE­ATISE OF THE OPERATI­one of Chyrurgerye, wherin is discoursede and handelede of the Cauteryes, and of the Setonne Contayninge five Chapiters.

  • VVhat a Cauterye is, the Species, and differences therof. Chap. 1.
  • Of the inventione & vse of the Cauteryes, & in vvhat disseases, and one vvhat places vve may ap­plye them. Chap. 2.
  • Of the Potentialle Cauteryes, and hovv vve should make them. Chap. 3.
  • On vvhat manner vve ought to applye the Potentialle Cauteryes. Chap. 4.
  • Of the Seton, & hovv vve ought to applye it. Chap. 5.

❧What a Cauterye is, & of the Kindes, & differen­ces therof. Chap. 1.

HAvinge vvith my selfe resolved & purposed, to vvrite sōvvhat, of the Cauteryes, it is first expe­dient and necessarye that vve knovve, vvhat a Cauterye is, & hovve manye kindes, and Spe­cies therbe therof: vvhat theire vse is, on vvhat bodyes, on vvhat disseases vve ought to applye them, and the manner hovve vve shall applye the same.The na­me of a Cauterye may be vnder stoode in tvvo sor­tes. Therfore to vnderstande theire nature, vve must first knovve, vvhat vve by the name Cauterium vnderstande: For it may be vn­derstoode one tvvo sortes or vvayes, Simplely, and not Simplelye: Symplely, consideringe the instrument, & the Causticke matter, vvhich a­dureth in anye parte, as Galen, in his sixt of the simples in his 27 Chap. describeth: Not because of the signe vvhich remayneth in the Cauteri­zed parte, that is because of the little Vlceratio­ne, vvhich remayneth, therin, vvhen as the Es­cara is fallen therout: Soe that this vvorde Caute­rium, in properlye being vnderstoode, can noe othervvise be vnderstoode, then a little Vlcera­tione, in anye externall parte of the bodye, vvhich throughe the art of the Chyrurgiane, is made therin, throughe some comburent, & ad­ustive medicamentes, to give issve, & passage to some certayne matter, of some dissease.

VVherfor the differēces, of these Cauteryes,The differences of the Cau­teryes not properlye taken. or Vlcerationes, are as it vveare dravvne, from their place, & being, vvheron they are applyed, & also from theire efficient cause. The essence, & beinge of these Cauteryes, cōsisteth in theire forme, & figure, vvherfor some ther are vvhich be rovvnde, some contradictorye, others right, great, smalle, deepe, or not deed: All the vvhich have but one onlye apertiō, or sometimes also tvvo, & is thē called a transforatione, or Seton: And also of all other places, vvheron they may be possiblelye applyed, as on the Heade, in the Necke, Armes, Legges, & finally in all partes of the bodye, vvherone they might be applyed, vvhē onlye the agilitye, or actione of the parte can not ther through be hindered, or hurte: Of their efficiēt cause, vvhich is takē out of the di­versitye of the matter, vvhich is applyed one a­nye parte of the bodye, or ingendred in the sa­me. The matter vvhich continuallye is applyed on the bodye, actuallye combureth,Actuall Cauterye or poten­tiallye, vvherfore they are called actuall, or po­tentialle Cauteryes: That vvhich in our body is ingendred, can come through any sharpe, cor­rodent, or bitinge humors, vvherthroughe the skinne is corroded, bitten throughe, & exulce­rated, of vvhich vlceratione, may be effected & [Page 40] made a Cautery, or fontanelle, vvhich may be called actuall Cauterye.

Differen­ces of the cauteryes simply taken.Heere of vve may coniecture and suppose, that the Cauteryes, & fontanelles, vveare in­vented, follovving nature therin, ther throu­ghe to give passage, to that vvhich is contrary, & opposite vnto her, & vvherof she is pertur­bated, & molested, it be ether in quallity, or in qvantitye, as heerafter vve vvill farther speake of. And as touchīg the Cauteryes, vvhich vve call instrumentes, their principalle, & especi­all difference, is taken, of theire substance, for­me, & figure, & of theire tarditye & slovvnes, or festinatione, of adustion, of theire depth, & shallovvnes, & of the manner of theire appli­catione: touching theire matter, or substance, because they actually, & in deede doe combu­re, & burne, or potenciallye, they are therfore called actuall, or potencialle Cauteryes.

The sub­stance of the actual cauteryesThe forme of those vvhich actuallye burne is almost innumerable, vvhich are made hott, & glovvinge. The antique & auncient Chy­rurgians, have commonlye made theire Cau­teryes of mettles, as of gould, of siver, of Iron, & of copper.Archige­nes. Archigenes hath cauterised the la­chrimall fistles vvith liquefacted leade, vvhich through a little pipe he dropped therin. They vveare of opinion, that the cauteryes of gould caused lesse payne,Substāce of the cauteryes vvhich the aun­cient Chyrurgians vsed. & vveare farre more easyer to be suffered, that alsoe the Cauterized place, shoulde not avoyde soe much matter, and the adustiō is not soe daungerouse, because gould amongest all other mettles is the moste tem­perate, vvherfore it burneth not so violently, as Iron, because it is not soe cōdensated of substance: vvherfore in like sorte alsoe the Caute­ryes vvhich are made of Copper, doe not soe closely burne, or cauterize, as those vvhich a­re made of Iron, because the copper, is not so solide of matter, vvherfore vve desiring strō ­gelye, & violentlye to cauterize vve must take such cauteryes, vvhich are made of the condē ­sest,A kinde of spongiouse mat­ter full of dust gro­vvinge on the moū ­taynes vvher­vvith vve vse to stench bloode. & most firmest matter, & substance. Som­times have also the aunciēte professors as Hip­pocrates,, recited, to have cauterized, vvith ten­tes, vvhich they dipped in ebullient, & seethī ­ge oyle, or vvith drye incended puffes as vve call them or vvith the root Aristolochiae, being madefyed in seething oyle, or vvith the rootes of Strutium, as Caelius Aurelianus, Dioscorides, and Attilus, vvhich have cauterized vvith incended Goates dunge. Aetius hath cauterised the cor­rupted gummes,Aurelia­nus, Dios­corides. Attilus. Aetius. Albucasis Guido. vvith ebullient oyle, vvhich he applyed theron vvith vvolle beinge therin madefyed. Albucasis in like sorte, hath cauteri­zed the hollovve, and concavouse teeth vvith seethinge butter. Guido hath cauterised the bo­nes, vvith liquefacted Brimstone, to vvitt of the Caries. Soe that out of all these vve may sufficientlye vnderstande, that vve may make as manye sortes of cauteryes, as there are sub­stances, vvhich may be incended.

The foresayed cauteryes,Differen­ces of the cauteryes cōcernin­ge their figures. & especiallye tho­se, vvhich are made, & composed of any met­tle, are also differinge in their figures the one from the other: For everye cauterye must be proportioned, accordinge to the dissease, and that vvheron vve vvill apply the same: so that some are like heades of great nayles, & trian­gled, others rovvnde, like vnto a buttō, others cutting, some not dislike vnto a halfe moone, and others circlevvyse: As vve may behoul­de, and see, the circles of Albucasis, other in forme of a rapersblade, as Celsus discribeth, ther vvith to cauterize the fissures in the lip­pes.

They are alsoe differinge the one from the other in theire depthe, or shallovvnes: for vve neede somtimes to cauterize the skinn only, as Hippocrates vvilleth vs to doe, in the paynes of the shoulders: VVe must alsoe sometimes cauterize the fleshe, as in the Sciatica:Cautery­es to cau­terize deepelye. Some ti­mes also to the bone, and crushe the same rea­sonable close thervnto as vve must doe, vvhen as vve must cauterise above on the heade, vve must sometimes cauterize, into the concavity of the bodye, as vvhen vve must cauterise in­to the brest, to let ther out any matter, & som­times vve doe but only scorche or singe abo­ve one the place.

And because that amongest the cauteryes,Differen­ces of the cauteryes taken out of theire actione. (considering the matter vvherof they are composed) ther be some vvhich are quicly heated) and some vvhich continue longer hott, then others even soe ther are some, vvhich consi­deringe theire pōderousnes, or levitye, tardi­tye, or festinatiō, ether in violence, or payn of theire operation, are differinge the one from the other.

The Cauteryes are alsoe differing,Differen­ce in numbre. in theire numbre, for at somtimes vve applye but one, somtimes tvvo, thre, four, yea alsoe fifteen at one time, as Aetius cōmandeth vs, to the curing of the vlcerations of the Brest.

They differ alsoe in theire manner of appli­catione, for some are applyed alone,Differēce taken out of the manner of the ap­plycation others in little pipes, vvhich at one ende are aperte, and opē, or have any appertiōs, or vvindovves in the sydes therof.

Of the Invention, and of the vse of the Cauteryes, and to what disseases, and one what places, they must be applyed. Chap. 2.

IT may rightvvell be sayed that nature hath shevved vnto vs,The invē tiō of the cauteryes is dimon­strated vnto vs through nature. the inventione, of the Caute­ryes, & fōtanelles: For as sōti­mes the partes being overladē vvith to manye humors ether [Page] theire tartnes, or venoumousnes are troubled, they in the end, discharge, & vnburthen them­selves, in some parte of the body, of that vvhich molesteth thē, as in one of the Armes, or leg­ges, causinge ther to ther solace, and ease, some excoriatione, or apertione. So that the Physiti­ones, & Chyrurgianes, to helpe heerin the na­ture, have there throughe fovvnde out the vse of the Cauteryes, & Fontanelles, effectinge by their arte, that vvhich nature oftentimes, thro­ughe her ovvne commotione thervnto ende­voreth to doe, vvherfore vve alsoe vse the Cau­teryes, as oftentimes as vve desire to make any derivatione, revulsione, interceptione, or eva­cuatione, of anye matter, the vvhich ether con­sideringe her qvantitye, or qvallitye, or vvith both of them together, might in anye sorte be occasione of any harme. VVe alsoe vse them, not onlye vvhen as vve desire, to transpire, and cause to evaporate any venoumouse vapours, but also, vvhen vve vvould cause anye concur­rent matter to exsiccate, & consume, endevo­ringe to dravve the same from vvithine exter­nally, as vvell through the extractione, vvhich it heer maketh, as through the vlceratiō, vvhich therafter remayneth, as throughe certayn little open fistles, or small rūninge issues vvhervvith vve dravv the matter from invvardes, outvvar­des, ther to evacuate the same, and cause to di­gresse from the one place to the other.

Cauteryes are profitable sayeth Galen, & Hip­pocrates, in all corrosive, & ambulative vlcera­tiones, agaynst fluxions of the eyes, in the tu­mor Aegylops, Vtilitye of the cauteryes vvhen as the fore arme, is suncke and discended vnder the Armepittes: In the Sciatica, & payne of the hippes, for they retracte & dravve backe the humors, vvhich trouble & in that place hinder those partes: In the Gangrae­na: in the extirpatione of the mēbres, to stench, & stoppe the bloode, & soe forth in all fluxions of blood, & in all other internal disseases vvhat soever, as in the Consumptione, in vlcerations of the Breste,Albucasis and in the Dropsye. Abucasis avou­cheth the Cauteryes generallye, to be profita­ble, in all disseases, and sicknesses, vvhich take their originall, of any matter, or vvithout mat­ter. They are also profitable, and commodiou­se, for all bitinges, & stinginges of anye venou­mouse creature, in the Carbuncles and Venus botches, becaus through theire heat, they con­sume the venoumousnes of the humors, & an­nihilate them and out of the depth dravve thē vpvvardes. They are alsoe verye profitable, in al criticke Apostemations, vvhich are could, & vvaterye, and vvhich are verye slovve in matu­ratione because that throughe theire caliditye, they opitulate, and helpe to ripen, the could, & toughe humors, vvhich are in that parte. They are alsoe goode, agaynst all corruptione of bo­nes, because they exsiccate the venoumous­nes of the same, and consume it, and cause the corrupted bones to separate from the sovvnde.

VVe may applye thē on all partes of our bo­dye, and especiallye, beinge needfulle, to make anye apertione, to give issue and passage, to a­ny matter, or vapoure, vvhich therine is assem­bled.

Ther are some vvhich have applyed the cau­teryes one the vpper part of the head,In vvhat partes the Cauterye must be applyed. about the sagittal suture, vvher she ioyneth her self vvith the Coronalle suture: VVhich vvith great and good successe I have seē to be done of Mr. Pare,Mr. Pare. agaynst the Hemicraniam, or payn of the one sy­de of the heade, and agaynst manye other sortes of inveterated paynes of the heade, because that through such an apeatione, manye and divers humours, & vapours, vvhich are congregated in the heade, by this meanes are exhalated: allso agaynst the fallinge sicknes, to give transpirati­one to some venoumouse humor, & vapoure, vvhich are often times the occasion of this dis­sease: Agaynst shortnes of breath, and difficul­tye of breathinge, vvhich have takē their origi­nall, of the superfluitye of humors, and descen­de out of the heade dovvnevvardes to the brest & ther hinder & molest the partes of the brest, and bringe vvith them the shortnes of breath, and oftentimes allsoe are cause of vlceratiōs in the brest through corruptiō, and putrifyinge of some pituitous humours: & also in the Ophthal­mia, or inflammation of the eyes, vvhich is ther throughe caused, through any fluxiō, vvhich is sēt through the vaynes, vvhich lye scattered in the Pericranio, & soe runne to the externall tu­nickle of the Eye: Agaynst reddnes of the face: Agaynst payne in the teeth, of the Eyes, in the Sqvinancie, & in manye other disseases, vvhich come in the mouth, and in the throte.

VVe Cauterize alsoe the Eyeliddes, vvhich a­re relaxated, in like sorte also the Cilia vvhich sticke in the Eyes, and allso in those vvhich in number are to manye: Alsoe in the Arteryes of the temples of the Heade: The tumefactiō Aegy­lops, the Polipus, and Ozena, the cleaved lippes, the Ranula, the Teeth, and the pallate of the mouth vvhen it hangeth to lōge, & also the Almōdes: The Thorax, or Brest, on divers places, somtimes shallovvly, & sōtimes to the cōcavity of the fo­res. yed Brest: the inferior parte of the Belly: the Scrotum, or genitalles, & especiallye the hippe a­gaynst the Sciatica: & the bone, vnder the knees, on the insyde of the legge.

Some ther are vvhich sett five cauteryes one the heade of those vvhich vve suppose to be in­fected vvith the lazarye.Caute­ryes for such as a­re troub­led vvith the lazary VVherof vve must set the first cautery, one the Coniunctiō, of the sa­gitalle suture vvith the Coronalle: The secōde above the forheade, vvheare the hayre ceaseth: The third in the Necke: The other tvvo the Os­sa Petrosa above the eares, somvvhate aftervvar­de, [Page 41] tovvarde the end of the Lamdoidalle Suture, to avoyde the end of the temporalle muscle: to vvitt one, one the right syde; & an other, on the left syde: All vvhich Cauteryes are applyed, to separate those humors, vvhich cause the nose to exulcerate, and the internalle part of the mouth, in those vvhich have the lazarye, and vvhich externallye have theire face corroded, & deformed, & fearfull to behoulde. These Cauteryes are applyed one some, because vve shoulde not see that they have binne cauteri­yed, onlye behinde in the necke, and one both the Armes.

❧Of the Potentialle Cauteryes, & how we ought to make them. Chap. 3.

The potē tiall Cau­terye, and the mat­ter therof THe potētiall Cauteryes are tho­se, vvhich through theire intollerable, & extream heate, being vvith their forces set to vvorke together vvith the benefites of our naturall caliditye, burne as it vveare a fyer in that parte, vvherone they are applyed, leavinge behinde them an Escara, or crust: Of the vvhich the matter of the Corrosi­ve is in great number, and hot, vnto the fourth degree: Amōgst the vvhich ther ar som, vvhich are extreame hott, & a little gentler, accordinge as their operatione is tardive. Amongst them are numbred, the Cantharides, the Tartre, the common Vitrioll, or the calcined, the vnslissed lims, the Auripigment, the Arsenicvm, the su­blimate, the Aqvafortis, the Oyle of Vitriolle vvith more others) the vvhich vve novvadayes, doe seldome vse, in such sorte as they are, vvith out praeparinge, or mixinge of them, to make any Fontanelles, because that experience, hath taught vs some, vvhich are farre more conve­nient, & lesse daungerouse.

The vse of the ac­tuall Cau­terye.The actuall Cauterye, is much conveniēter▪ then the Potentiall, vvhether it be vve consider on the nature & substāce, on the healthfullnes festinatione, and certayntye, in operatione: for the fyer, is a simple element, havinge noe other forces then by the heate therof, & exsiccation, vvithout havīge associated vnto it anye venou­mousnes, vvherfore the operatione therof is festivous, certayne, & healthfull, pearcing dee­per therine vvhen vve please, vvithout causing anye accidentes in the circumiacent partes, al­thoughe, that thervvith vve chaunce to touch them, & that because of the subtilenes therof, and consideringe the virtues of his substance. It is an enimye vnto all corruption, vvherfor, it freethe alsoe from all covruptione, & putre­factione, yea it consumeth all venoumouse matter, & qvallityes, vvhich in that parte might lye occulted, and hidden, consumeth also all su­perfluouse humidityes, and correcteth alsoe all vntemperate coulde, and moysture.

VVher on the contrarye, the matter,The vse of the potentiall Cauterye the mat­ter, & vir­tues ther­of, and vvherone vve ought to consi­der. vvherof the Potentiall cauteryes are made, are oftenti­mes venoumouse: And hovv soever they be praepared, yet ther operatione, & actione, is vn­certayne, retardate, and slovve, and sometimes alsoe daūgerouse, vvithout simplye knovvinge the vittues therofe, & hovve to limite his ope­ratione: Because somtimes it spreadeth it selfe broader, then our meaninge is it shoulde, and causeth more detriment, and harme in corrosi­one, then vvillinglye vve vvoulde, it shoulde, because it doth not only combure & burne the place vvhereone it is applyed: But beinge vni­ted, vvith our naturalle caliditye, it extendeth, and pearceth alsoe deeper in the fleshe then is necessarye it shovlde, vvherthroughe that par­te beinge by little, and little calefyed, and vvar­med, it imprinteth not onlye one that place his venoumouse nature, but extendeth it self far­ther, throughe the circumiacent vaynes, & Ar­teryes, & Synnues, in the vvorthye partes, spoy­linge, & oftentimes burninge, the good, & vvel disposed complexion of that parte, out of the vvhich commonlye follovve verye badde acci­dentes, and vlcerations, vvhich therafter verye difficultlye vvilbe cured, yea also some times a Gangraena.

Notvvithstandinge althoughe the Chyrur­gians novveadayes, are boulde enoughe in the application of actuall Cauteryes, novvithstan­dinge most commōlye they vse the potentialle consideringe the feare, & affrightednes, vvhich the Patientes conceave therofe, soe that the ac­tuall Cauteryes are allmost therthroughe re­lapsede into oblivione: It is right true,Velvet Caute­ryes. that the Potentiall Cauteryes vvhich novve adayes vve vse are indeede of velvet, & verye excellēt, & vvhere of I never as yet knevve anye badde accident to follovve, throughe the longe vse vvherof, vve have learned the certayntye hovve to make them.

VVe must note, that in the Potentiall Caute­ryes, or Ruptoryes, vve adde nothinge, vvhich hath any venoumouse nature or qvallitye: Be­cause they, cōsidering their virtues, are through our naturall calliditye compelled to doe their operation, vvhich by little, & little suscitateth, the redormitinge, & soporiferouse forces ther­of, soe that it is not possible, but that of necessi­tye, this venoumouse nature, must imprint so­me parcell of her venoumousnes in that parte, if soe be at the least ther be any venoumousnes mixed thervvith: vvherfore most commonlye one this sorte vve praepare it, that immediatlye it might shevve forth his operatione.

VVe make novve adayes Cauteryes in form of Trociskes, of divers kīdes of Ashes, Saultes,The mat­ter of the potentiall Cauteries vvhich novv a­dayes are in vse. & limes. The ashes are made of Oackē vvood, [Page] of Figgetreevvoode, of VineBranches, of Bea­nestravve, of Cabbage stalkes, and of Titimallo: The saultes are Alcali, Salpeter, Armoniac, Sault of glasse, Vitrioll, Tartare, or Pottashes, vvher­of vve, ether of anye partes of the same make lye, out of the vvhich vve extracte a Corrosive sault, vvhich may be made strong, debile, or ex­treame stronge, and acute, accordinge vvith all that vvhich commeth in the foresayed lye.

Mr. Pare.Amōgst all Cauteryes vvhich are made that is one of the best, vvhich Mr. Paré, calleth the Cauterye of Velvet, vvhen it is only sodden, & made, as it reqvireth to be done: notvvithstan­dinge it seemed convenient vnto me, heere to discribe certayn other Cauteryes, vvherof I my selfe have seene divers goode operations.Receipte, of the Velvet Cauterye Take sault of glasse, Potashes, vnflist lime, of each a povvnde, ashes vvhich are burned of the inve­terate sydes of a vvynepipe, tvvo povvnde: Put all these together in a great earthen pott, & in­fuse theron 18, or 20, povvnd of cleere vvater, and let it so stande soackinge 8. or 10 dayes, or as longe, till one your tunge you feele, the lye to be verye sharpe, and tarte, or vntill that ther may drive an egge theron, vvith a sticke daylye stirringe of the same, and then vve must lett it to clarifye, & sincke, vvherof you must defu­se the vppermost therof, and ether straygne it throughe a thicke close cloute, or els throughe a Felt, vvithout stirringe of the bottom or foe­ces therof, of vvhich aeqvall parte, you must make Trociskes, as heer after vve vvill demonstra­te.

An other Cauterye, of the disceased Monsr. Cheval, Chyrurgiane.

Of Monsr Cheval.Take sault of glasse halfe a povvnd, Sal gem­mae six ovvnces, Sublimate vvhich is smally perfricated, halfe an ovvnce, Ashes of Vinebran­ches halfe a povvnde, 10 povvnde of common vvater, let all this stande and soacke, as is abo­ve sayed, and therof make trociskes, addinge in the end thervnto tvvo dragmes of Opiū, vvhich is liqvefacted in Aqvavitae.

An other of Monsr. Rasse Desneux.

An other of Rasse desneux.Take tvvo povvnde of potashes, Saul [...] [...]f glass and Sal alcali, of each halfe a povvnd [...] [...] povvnde of common vvater, & heerof make a Lixivye, as is above rehearsed, and alsoe make therof Trociskes,

An other of Mr. Iaqves de Vile neufve, a great practisioner at Mompeliers, as I have in the same cittye seene him make.

An other of Iaqves de Ville­neufve.Take Sopemakers lye tvvo pounde, Vitriol three ovvnces, Sublimate one ovvnce, make heerof Trociskes addinge in the end thervnto tvvo dragmes of Opium.

An other of Monsr. de Iovine.

VVe may also make goode Lixivye, onlye of Oackē ashes, or of Ashes of Vinebranches, vvhē as the same is vvel soddē, vvith potashes, and of Beanestravve, addinge thervnto a little vnslissed lime, vvherof vve may make verye ex­cellent goode Cauteryes.

An other vvhich qvicklye can be made.

VVe may in one day make verye goode Cauteries taking therto a povvnde of vnslissed lime, halfe a povvnde of Potashes,An other vvhich vvith all expeditiō can be made. Sal alcali pulverizated very smalle, foure ovvnces, com­mone ashes of vvoode tvvo povvnde, infuse heer in 15 povvnde of common vvater, let it stande & soacke three or foure hovvres, & then seeth it a little, if you take it to be convenient, and then let it stande & purifye, or sincke, and then let is straygne throughe a Felte, & heerof you may make goode Cauteryes.

Allthoughe that vve have all these foresayed thinges in a readines,An obser­vatione in seethinge of the saulte to the Cau­terye. therof to make a lye or lixivye, vnles that you ebulliate your sault, ve­rye short, & drye, it vvill as then have noe great forces, & vvill qvicklye be liqvefacted, & agayn dissolved. Therfor to seeth a right your lye you shall infuse it in a Basen, & let her there seethe, and ebulliat, or evaporate, till such time as shee be verye thicke, like vnto honye, mixe, & stirre it vvell together, vvith an iron Spatula, and then the foresayed sault, vvill somtimes present di­vers colours, as blevve, & by little & little, vvill grovv thicker, yet not vvithstandinge, vve must yet make greater fyer thervnder,Liqvefactinge fyer vvith violente flames, as if it vvear a liqvefactīge fyer, because the foresayed sault might be melted and liqve­facted, as Butter, & chaunged into vvater, of the vvhich you must take a little on your Spatula, & lay it on a stone, & if soe be it immediatly vvex harde, it is thē a signe that it is sufficientlye sod­den: For if soe be as then you keepe it longer one the fyer it vvill as then burne, & agayne be chaunged into ashes, as beinge needfull that there be some humiditye therby to keepe it in his vvonted thicknes: vvhich beinge done, you must then remove your Basen from the fyer, & vvith the Spatula, take out the sault, or your Cauterye therout, vvhilest as yet it be hott, least that it cleave therone to harde, vvherof yon must then make great or little Trociskes, vvhich im­mediatly you must put, into divers little glasses violles, least that through the ayre they chaun­ce to be altered, and chaunged, and stoppe the [Page 42] same very close,Hovv vve must prae­serve the cauteryes & vse thē vvhensoever it shall please you.

And to praevent, that the Escara, of the caute­ryes, or ruptoryes, be not to harde, a certayne frende of mine for certayntye imparted vnto me, that in the end of the ebullitione of your lixivye, vvhen shee is aboute the thicknes of hony, vve infuse thervnto a little Aquavitae, or spanishe vvyne, or els anye other stronge vvy­ne, as Malmasye. And to make them soe, that they shoulde not cause anye great payne, vve must as thē adde vnto it a little Opium, vvhich is liqvefacted in Aquavitae, but I never tryed it.

The manner howe we ought to applye these Cau­teryes. Chap. 4.

NOvv therefore condecentlye to applye all cauteryes as vvell ac­tuall,VVheron vve ought to consi­der in the appli­cation of the Cau­teryes. as Potentiall, vvithout ex­pectinge therin anye reproche, vve must first of all cōsider, one those, vvhich are able to tolle­rate them: In vvhat places they may be best sett, and applyed: & one vvhat manner vve may ap­plye them: for commonlye, the vvithered, & le­ane personnes, can not tollerate them, vnles it vveare one the heade, because their bodyes, are nothing els then Membranes, Vaynes, & Syn­nues, vvherthrough sōtimes greate payn might be caused, or anye vayn, or Artery might chaū ­ce to be through corroded, one al vvhich thin­ges vve must note, vvhen as vve must applye a­nye Cauteryes: vve must also consider, one the nature of the Patient:Divers conside­rations. for a strong grosse bodye as a Labourers, or countrye clovvne, may farre more easyer tollerate, & suffer a Cauterye, then a tender delicate bodye, or of a vvoman: nether can anye obdurate parte, as is the skinne of the heade, soe easylye be corroded through, as anye other soft or tender parte, vvherfore vve must houlde the Cauterye longer one the one place, then one the other. A little actuall Cautery, or a little parcell of a potētiall Cautery, vvil vvor­ke as forciblye, one a tender, & softe bodye, as a great cauterye vvould doe, one a strong grosse, and obdurate bodye.

If soe be, it be a replete, & corpulēt bodye, or an vnhealthsame bodye, vve must then first of al Phlebotomize, or purge the same, because in the cauterized partes ther chaūce not to come, anye concursione of humors. VVhen vve desi­re to applye anye Cauteryes, or make any Fon­tanelles, vve must consider that vve apply them not one any synnuishe parte, nether on the en­des, or beginninges, of any muscles, nether any greate Vayne, Arterye, or Synnue.

Places vvheron vve apply the Cau­teryes.VVe applye them most commonlye on the Heade, one the Armes, and one the legges, & betvvixte all corners of the heade, for the curinge of divers disseases, vvhich heere before vve ha­ve recited, the aunciente Chyrurgiās have ma­de theire choyse of that place, vvhere the Sagit­talle suture, ioyneth and vniteth her selfe vvith the Coronalle, vvhich place is like vnto a thre­fould vvay of the heade: the vvhich plase becau­se vve should not misse of the same, is shevved vnto vs, of Albucasis: To vvitt, that vve cause the Patient, to put forth the one of his handes,Hovv vve shall fin­de in the heade the place vvheron vve must applye the Cau­terye. and lay the end therof, (vvhich is the vvriste, or bē ­dinge of the hande) one the originall, & begin­ninge of his Nose, betvveene both his Eyes, and thē stretch forth his middlemost, or longest fin­ger, tovvardes the crovvne, or superior parte of his heade, & one that place vvhere as the fore­sayed finger shall have his endīg, ther vve must apply the Cautery, because that ther is the pla­ce vvhere the sagitall suture vniteth her selfe vvith the Coronall suture: & if so be throughe the applicatiō of this cauterye, vve desire to doe anye vtilitye, & profite, vve must thē suffer the same to penetrate vnto the bone: for by this meanes the bone being denudated, it vvill exfoli­ate, & peele, through the vvhich, the apertione continueth the longer open.

VVherfore, divers, after they have applyed the potēciall cautery, & the next day follovvin­ge have cutt of the Escara, doe applye theron an actuall cautery, vvithout any daunger, as often­times I have seene to be done of Mr. Paré.

VVe may applye alsoe cauteryes, of corrosi­ves, in the posterior partes of the Heade, in the end of the suture lambdoide, behind vnder the Eare, therthroughe to avoyde the muscle Crota­phite: To the surer findinge of the vvhich place therfore, vve must cause the patiente to opē, & shut his mouth, and soe to feele the motion of the sayed muscle. Monsr. Martel chosen, & ordi­narye Chyrurgian to the kinge, vvhich vvas an experte man, he applyed cauteryes behinde the Eares, in the cōcavity vvhich is situated behin­de the little flappe of the Eare, called Fibra, Cauterye in the Fi­bra. and that agaynst all inveterate disseases of the Eyes, vvherof he certifyed me, to have allvvayes had ominouse and happye successe, vve allsoe so­metimes applye the Cauteryes in the Necke, in the hollovvnes, or concavousnes therof, but vve must consider that they doe not penetrate to deep least that vve chaunce to adust, or cor­rode, the eight small musckles, of the Heade, vvhich are in this place situated, vvhich might cause daungerouse accidentes, as I oftentimes have knovvne to chaunce.

The most commonest novve in vse,Meanes hovv fit­tlye to ap­plye the Cauterye on the Arme. is to ap­ply the Cauteryes, one the armes, vvhere most curiouslye, & vvith greate care vve must make electione of the place: the most fittest place is in the middest of the arm, tovvardes the inner sy­de therof, right betvveē the brachialle musckle, & the musckle Biceps close to the syde of the he­ade vayne. And convenientlye to make choyse [Page] of this place, vve must lay the first finger one that place, stiffelye crushinge the same, & vvith the other hande, foulde & shutt the elbovve, & agayne strech him out, & allso lift vp the Arme, because through this motione of the Arme vve might perceave, vvhether there be noe synnue or Tendone situated thervnder, to vvitt vnder your finger, & vvhether you finde in that place noe concavity, or interstitiū of muscles, vvhich is verye fitt, for a Pease or little pellet to be the­rine, to keepe open, & apert the foresayed Cau­terye: havinge novv vvith your finger fovvnde out the most fittest place vve must there applye the Cauterye.Meanes hovv to apply the cauteryes conveni­entlye on the legge. And touchinge the same vvhich vve desire to apply one the legges, the most cō ­veniētest place ther vnto is tvvo, or thre fingers breadth belovve the knees, vvhere vve are vsed to tye our garters, vvhether it be internallye, or externallye one the legge: But those that are much vsed to ride on horsebacke, & also to cau­se better abscessione of humors, vvherthrough the Sciatica is caused, for thē it is better to apply them in the externall partes of the legges, in li­ke sorte alsoe for vvoemen.

Admoni­tione in the applycation of the actu­all Caute­ryes. Havinge therfore vvell, & dilligentlye consi­dered on the fittest places, and those vvhich are also the surest, you must thē first race avvay the hayre, if at the least ther be any. VVhich being finished, vve must then situate the Patient on a convenient place, beinge helde of some other persone, if soe be it be needfull, & thē you shall take your Cautery, vvhich must be proportio­ned, & fashoned according alsoe vnto that par­te vvhich you intende to cauterise, and must be glovvinge, & redd hott, or at the least as hott as is required, because your operatione may at one time be finished, if it by anye meanes be possible, vvhich accordinge as shalbe required, you must imprint the same deepe, or shallo­vve in that parte, consideringe, & taking heede, that in noe sorte you chaunce to hurte the cir­cumiacent, or finitimate parte thervnto, to the praeventing vvherof, ther are invented, & foun­de out divers defensions for the foresayed Cau­tery, as certayn pipes, & little cases being com­posed, and made of Iron, least that vve shoulde chaūce to combure, the finitimate, & approxi­mate partes, vvhether it vveare throughe the faulte of the patient, or els throughe temerous­nes, & timorousnes of the Chyrurgian, as in o­ther places vve more at large have spokē of, & alsoe therby have placed the discriptione of the foresayed Cauteryes.

For the reitera­ted Cau­teryes.Beinge therfore necessary, oftentimes to rei­terate the Cauterye, as in any great Gangraena, or in any Carie of legges, vve must then cover, the approximate places thervnto vvher vve intend to Cauterize, vvith Compresses, beinge made­fyed in Plantine-vvater, or anye other humidi­tye, yea & also vestite the edges of the vlceratio­nes, vvith plasters of Infrigidans Galeni, or els vvith some linnen cloutes, beinge madefyed, and dipped in anye distilled Aquosityes, or vva­ters.

Novv beinge sufficientlye Cauterized, vve must then by all meanes indevoure to qualifye & ease the payne, and doloure therof, & to cau­se the Escara to separate:To ease the payn, and Sepa­rate the Escara. vvhich must be effected throughe anye vvarme, and moyst remedyes, vvhich is aequallye proportioned vvith our hu­miditye, & calidity, because through the humi­ditye, or moyster therof it may soacke through the Escara, and also the finitimate partes therof, vvhich are obdurated, & drye, & because throu­ghe the caliditye therof, it might suscitate, and dravve vnto him, the naturalle caliditye, out of the internall partes of the body into the exter­nall partes of the same, & by this meanes expel that frō him vvhich is mortifyed & combured. Amongst all remedyes there is none better, thē that vvhich is made of Oyle of Egges, of insul­sed, and freshe Butter, & of Venetiane Terebe­bentine, addīg in the end thervnto a little poul­der of Ireas, Aristolochiae, and a little Beanemeale, vvherthroughe alsoe all the purulente matter, vvhich hangeth therone as lime, and an Escara is purifyed. Some vse a Digestive made of yolc­kes of Egges, of oyle of Roses, & of Terebītine: But that is not soe necessary, as the formest, be­cause it doth not soe califye, coagulating as the yolcke of an Egge is vvonted to doe, and alsoe immediatlye vvaxeth drye, and exsiccated.

The potentiall Cauterye,Hovv vve must ap­plye the potential Cauterye vvhich maketh an Escara, or scabbe, being as it vveare a Vicarius, of the actvall, is in this manner follovvinge ap­plyed. VVe must first of all make a playster, of Diacalcitheos, or some such like, as greate as a lar­ge peece of tvvelve pence, in the middest vvher of vve must cut a little hole, as great as the nay­le of ones little finger, or a little greater, accor­dinge to the bignes as vve desire to have the a­pertione: and if you desire to have the apertion somvvhat longe you must then alsoe make the hole in the plaster somvvhat longe, & then lay the same on that place vvhich vve desire to o­pen: And in the hole of the foresayed plaster, vvherthroughe vve perceave the skinn denu­dated, lay your potenciall Cauterye, or Corro­sive, vvhether it be greate, or smalle accordinge as you desire to make the apertion great, or lit­tle deepe, or shallovv: VVhich being done, vve must lay therō, a smalle dubbled clovte, vvhich must be sōvvhat greater thē the Cautery,The cau­terye ma­keth a farre gre­ater Esca­ra then the hole of the Plaster. ther­vvith to cover the same, and theron as yet an o­ther playster, vvhich must be a little broader then the firste, and one this plaster an other cō ­presse, vvhich must be of tvvo fingers breadthe and agayn theron an other vvhich must be yet greather, and then tyinge the same vvith a liga­ture, acordīg as the parte shal thē be requiring.

[Page 43]The Cauterye therfore having done his ope­ratiō, vvhich most commonlye in the space of tvvo hovvres is finished, if so be the sayed cau­terye be stronge, & violent enoughe, vve must as then take it of: and presently to cause the Es­cara to separate, vve must make a crossevvise in scisione therin: Other suffer her, of her selfe to separate, vvithout inscisioue: Some inscide her rovvnde, and then lift her vp, & so cut her loose from vnder. But vve desiringe through the ap­plication of a Cauterye, to make an apertiō, for the evacuating of any matter, vve must not on­lye thē inscide the foresayed Escara, but also pe­arce somvvhat deeper therin, vntil such time as vve have sovvnded the matter, to give her pas­sage.

Divers meanes to keepe, open a Fontanel, vvhich throughe a poten­tiall cau­terye is made.If soe be the Cauterye be applyed to make a fōtanelle, vve must then cause the Escara throu­ghe the sayed remedves to separate, and keep o­pen the hole, or the foresayed vlceratiō, as grea­te as the rotunditye of a bullet: to the effectua­tinge of vvhich, some vse a great Pease, vvhich throughe the great humiditye vvhervvith shee is soacked svvelleth as thick & as bigge agayn, as she vvas before, by the vvhich meanes vve may keep open the apertione, as longe as plea­seth vs: others make little pellets of elder pithe, of Rhabarber, of Agarico, of the blacke neesinge roote, of a Gallenut, of Gētian, & some of goul­de, or of sylver beinge hollovve, & concavoyse, but the most convenient, & fittest vvhich I ha­ve experimēted, are made of vvhyte vvaxe, am­ongst the vvhich is mixed, verdegriece, Cantha­rides, hermodactilles, & a little auripigment, ad­ding thervnto a little pirosin. This kinde of lit­tle Balles, vveare invented of Monsr. Hubert, Chyrurgiane to the kinge, one of the most ex­pert Chyrurgians of our times.

What cō ­tinuance vve may keepe opē the vlce­ration.Touchinge the time, of keepinge open these Fōtanelles: Celsus teacheth vs, in his fourth bo­ocke and 22. Chap. that it is oftentimes necessa­rye for the Chyrurgiane, to exvlcerate the par­tes of the bodye, vvith a glovvinge Cautery be­inge, as it vveare, an aeternall prohibitione, that vve should not suffer such vlceratiōs so quick­lye to close agayn, as of themselves they vvoul­de, but that vve must sustayn and keepe them a­pert & opē, till such time as the dissease, vvhich throughe this apertione vve intend to cure, be vvholye finished, and cured.

Of the transforation, or seton, and of the manner how we ought to apply it. Chap. 5.

Setō Pro­perlye ta­ken. THe transforation, or the Seton, may in tvvo sortes be vnder­stoode, properlye, and impro­perly, vve simplely vnderstand it, cōsidering the threde vvhich vve dravve cleane through the skinne, vvith the needle, vvhich threde in aun­ciēt time, vvas made of, course hayre, as of hor­sehayre, or any other such like, vvhich of the la­tinistes is called Seta: But vve novv a dayes ma­ke our threde of silcke, of Cotten,Setō im­properlee vnder­stoode. or of Course yarne. Improperly, vve vnderstand by the Setō, a logestretchinge vlceration, in anye externall parte of the body, vvhich is clean thrust throu­ghe the dubble skinne, and that throughe agi­litye, and dexteritye vvith a glovvinge Cau­terye.

VVe apply especiallye the transforatiō,In vvhat partes vve ought to apply the Seton. or the Seton, in thre partes of the body: to vvitt be­hinde cleane through the Necke, although so­me to follovv, the direct concurrence of the fi­bers, applye the same in the length therofe: In the Navle, and in the Scrotum, vvhen as it is full of matter, & ventosity, as it oftentimes is vvon­te to happen in the Dropsye.

This transforatione, is vsed, ether for any re­gressione of humoures, or for an evacuation,The vse of the Seton. or expulsione of the same: For vve applyinge the foresayed transforatione behinde in the necke, it then revelleth, and dravve the backe agayne those humors vvhich concurre tovvardes the Eyes vvith those allsoe vvhich runne tovvarde the Mouth, and the Brest, and retayneth allsoe those humours, vvhich descende, and sinck, be­hinde in the Backebone, and in the Hippes: He beinge dravven through the Navle, or Scrotum, he then dravveth ther throughe all the Aquo­sitye, and ventositye vvhich is therin contay­ned.

It is novve adayes also applyed on tvvo man­ner of vvayes, namelye vvith Pinsers,Tvvo sor­tes of ap­plycation of the transfora­tion. and vvith an actuall Cauterye, or through the Needle on­lye. The transforation vvhich onlye is layed in the Necke, must be applyed betvvixt the secon­de & the third Vertebram. VVhich convenient­ly to effecte, vve must cause the patient to sit on a little stoole, and least that the transforatione should cōpraehend more one the one syde then one the other vve must denotate a line vvith Inck in the middle of his neck, or els on the sa­me parte vvher vve vvill apply the tranforatiō,Hovv vve ought to apply the transfora­tion be­hinde throughe the nec­ke. causing the patiēt to hould his heade on highe, and leene backevvardes over, because therby, the skinne might be the looser, and stretch the farther commaunding then one of the servan­tes, or standers by, that vvith one of his handes he take hould one the skinn, close by the hay­re, as deep as he cā, ether according the lengthe, or thvvarte over the skinn, follovving the line vvhich therī is made, liftīg the same in the mid­dle on highe, vvhich thē the Chyrurgian, vvith his lefte hand shall take hould one in the mid­dest of the same, and elevate it, because that he vvith his right hande, & vvith a rounde, & vvell cuttinge threded needle vvhich must be thre­ded vvith a thicke threde, may thrust cleane [Page] throughe the same, the foresayed thred beinge in this sorte thrust therthroughe vve must cutt him of close to the Needle.The transforation vvith an actuall Cautery. But if rather you desired, to effecte the foresayed transforatione vvith a hott Iron, the skinne beinge lift vp on both sydes, through some servant, or through the Chyrurgiane vvith his Pinsers, vvhich he must houlde fast in his left hande, dilligentlye consideringe least he take houlde thervvith of anye Muscles of the Necke, vvhich are situated vnder the foresayed skinne, as to that purpose, & intent he must cause the Patient to bende his necke, hould his heade vp, or on highe, & right by this meanes to knovve, vvhether anye of the foresayed, Muscles are compraehended of the Pinsers or not. VVhich beinge done the Chy­rurgyane must nipe, & shut close together the foresayed pinsers theron applyed, therby to be­numme & dissipate the senses & feelīg vvhich through the hott iron might be caused, & as thē vvith a triāgled glovving cautery thrust throu­ghe the hole of the pinsers & soe throughe the elevated skinne alsoe: The vvhich foresayed skinne being in this sorte perforated, & imme­diatlye agayn being dravven therout, vvithout suffering the skinn to fal, vve must thrust thro­ughe the perforatione, a needle vvith a thicke dubble threede vvhich threde must be soacked in the remedyes above rehearsed for the Caute­ryes, or els at the leaste being made fatt in some Digestive, & then the sayed threde being dissec­ted, and cutt of, vve must suffer him to remayne therin, as is above rehearsed, & applye therone a Playster of Refrigerans Galeni, for the first or se­conde daye, and then a Playster of Betonica.

This foresayed threde, or Seton, vve must suf­fer it to continue therin, as longe as it shalbe needfull, as vve have sayed of the Fontanelles.

As concerninge the transforation,A transforation ap­plyed in the Scro­tum. vvhich in the navle, or in the Scrotū may be applyed it vvil be sufficient vvhen vve take the Scrotum, & the extreamest end of the navle, & so perforate the skinn being doubled, vvith a reasonable greate or grosse needle, vvhich must be threded vvith a vvoollen, cotten, or silcke thred, and applyinge therone, the selfe same remedyes, of the vvhich vve have in the transforatione of the necke re­hearsed.

THE NINTHE TRE­ATISE OF THE OPERATI­one of Chyrurgerye, wherin is discoursede and handelede of the Ligatures, or vvindinges, & circumvolutions, & of the conve­nience or the situation of the partes, Contayning sixe Chapiters.

  • VVhat the Ligamentes, or Circumvolutiones are, theire matter, qualitye, forme, and quanti­tye. Chapit. 1.
  • The Kindes, and differences of the Ligamentes. Chap. 2.
  • Rules, and generall instructions, vvherone vve must consider, in all circumvolutiones, and Liga­mentes. Chap. 3.
  • Hovve vve ought to tye the Ligament, and agayne make loose the same. Chap. 4.
  • Hovve vve must ligate, and tye, the broken Armes, Legges, and Hippes. Chap. 5.
  • Of the placinge, and situatione of those partes, one the vvhich the operatione, is set one vvorke. and imployed. Chap. 6.

❧ What the Ligamentes or Circumvolutiones are their matter, quallitye, forme, and quanti­tye. Chap. 1.

HAvinge therfor spoken, & trea­ated of the combinationes, and sutures, vvherthrough al vvoū ­des, & divisione, or separatiō of the vvhole is inserted & com­bined together agayne, and the lippes or edges of the foresayed vvoundes are kept close together & shutt, vve vvil novve tre­acte, and handle of the Ligamentes, or bindin­ges, of the vvounded partes vvherin vve ought to consider, vvhat their matter, theire qualitye, forme, quantitye, & differences are,What Li­gamen­tes are. hovve vve ought to vvind, and agayne vnvvinde the same.

The vvindinge therfore, or dressinge of a vvounde is nothing els, then a vvindinge abou­te, or circumvolution, of the Ligatures, vvhich is as much to say, vvith a broade and longe liga­mēt, vvhervvith not onlye, the vvounded par­te, butt allsoe the fin itimate, and circumia­cent partes, are involved, and circumvestede [Page 44] by this meanes to restore them to theire For­mer estate, and naturall beinge.

Matter of the Liga­mentes.Those Ligamētes accordinge to the affirma­tions of aunciēt Chyrurgiās, are of divers mat­ter, as of Linnen, vvoolle, or Lether: the linnen Ligamentes are the most commonest of all the other, vvhich at that time they vsed, vvhen as they vvoulde stifflye compresse, & bringe close together anye parte: they vsed vvoollen rovv­lers, in the fractures vvith vvoundes, gentlye in that sort to retayne together the broken bones, & to cause noe payne, or inflammatione at all. Hippocrates vsed the Ligamentes of lether,Hippocra­tes. in the fractures of the Nose, & the nethermost chavv bone: But of vvhat matter soever vve make thē they must not be too much vvorne out, becau­se that they may be strōge enough, to be dravvn close together, & stretche stifflye out: Farther more they must be even and smoothe, nether must they have any silvages, nether must it ha­ve anye harde seames, & must be cut aright the threde, accordinge the length of the linnen, & not cōtradictorily: because they may tye smoo­the and evenlye, vvithout the one syde beinge hardre tyed then the other, as oftentimes it chaunceth, vvhen the rovvler is cutt contradi­ctorryelye: It is right trevve, that the ligature vvhervvithe after Phlebotomye vve tye the ar­me, yeeldeth it selfe better beinge so cutt, but it chaunceth heerin, because in that place it yeel­deth it selfe better for the bending of the arme.

Touching their qvallity, they must be cleane & vvhyte, leaste that throughe their impuritye they be a hinderance, or interruption vnto the parte, & because by that meanes they may the better receave the humidityes, as Oxicrate, & vvyne, or any such like, vvherin vve chaunce to madifye, & vvett them. They must allso be fine & light because throughe their ponderousnes, they doe not overburthen the parte, suscitate, & provoke payne, & cause inflāmation. Third­ly they must be softe, & flexible because throu­gh the obduratnes therof, they might chaunce to hurte that parte. Fourthlye, of līnen, vvhich must be verye vvhyte, & not to closely vveaved because so they ar more better to be placede, & the matter, & the evaporationes might the easier therthroughe transpire, vvhich being therin occluded, cause inflāmatione, & itchinge.

Forme & figure of the Liga­mentes.Concerning their forme, & figure, vve muste knovve, that these foresaede Ligamentes, or rovvlers, are ether rovvled vp, or involved, sī ­plelye, or dubblelye, vnto the middest of the foresayed ligature & of an aeqvalle latitude in all places, as are those vvhich vve vse in the fractures of the Armes, Hippes, & Legges: In like sorte allso in the vvoundes, & vlcerations of the same partes. The dubble ligament or rovv­ler is ether of on peece of linnen, on the endes beinge diverselye cutte, or on an other place, in other endes, as are the ligamēts of the Head, vvhich are cutte into foure, or sixe endes: And in foure endes for the Scrotum: Or in the liga­ment, vvhich is sovved together, & made of di­vers peeces, as are those vvhich are vsed for the flancks, for the Brestes, for the Testicles, & for the Fundament, & that especiallye vve desirīge to spare, & be chairye of the linnen. And as much as concerneth their longitude, & latitud that cosisteth on the consideratione, & iudge­ment of the Chyrurgiane, vvhich before hand must see the figure, & knovve it, & must therby allso be able to knovve, the conformatione, & sitvatione of the parte, & the diversitye of the dissease: for vvhen as vve are vrgede to make a greate circumvolutione, vve must then consi­der on the length, & make it as long as is reqvi­red: cōsideringe the breadth, vve must make thē accordinge to the longitude, & latitude of the dissease,The Ligamēt must bē broa­der then the dissea­se. so that the foresayde ligament must be greater thē the dissease, because vvith on circū ­volutione doe not onlye involve the vvounde but allso both the endes therof as vvell on the one syde as the other: for if so be the ligamente vveare smalle, he must thē crushe the dissease, vvherthrough greate payne, and inflammati­one might becausede.

And to speake of the qvantitye of the fore­sayed ligamentes,Quanti­tye of the Ligamē ­tes. that is nothinge els then the meane, and measure vvhich vve must vse and observe ether in stifly or loosely bynding, as in respect, of the persone. For as the one man is grosser & more corpulent then the other, so ther are also disseases, vvherof the one is more paynfull then the other, vvherfore vve muste consider, that the ligament be nether too stifly nor loosely tyed, for all ligatures vvhich are too stiflye bovvnde, cause payne, & concursione of humors, vvith inflāmations, yea & somtimes allso a Gangraena: And those ligamentes vvhich are too loose, they are profitable for nothinge, & cause that the restauratede partes, vvhich are sitvatede, move therout, as the broken Legges & the dislocatede membres, yea & allso the lip­pes of the vvoundes vvhich are insertede, and brought together throughe the loose ligature doe agayne separate the one from the other. And finallye in one vvorde to conclude, the mediocritye of ligatione, is a greate solace, and comforte to the Patient, as he vvill then vvith his ovvne mouth testifye.

VVe must note that all ligatures muste not in a vvoūd so faste be ligatede,Wherone in Ligati­one vve ought to consider. as in a Fract­ure & lesse in a Fracture vvhich is vvithout a vvounde, then in a simple vvounde: VVe must allso harder, & more violenter binde & ligate on the vulneratede parte, & one the fracture, thē on any of the approximate, & nexte adioy­nīg partes, therby to repell, & drive back agayn the humors, vvhich doe theron sinck and allso [Page] crushe out, those vvhich are suncke into the finitimate partes, vvhich is leaste shutte: for in so doinge, vve keepe those partes occludede, & li­berate, & free from all inflammations. Farther more in the end of the ligatione vve espye a tē ­der tumefactione, out of vvhich vve may iudge that the parte is reasonablye shutte: if so be the tumor be harde, & obduratede, & blackishe, it is then a signe that the parte is too stiflye tyed. And vvheras at all vve perceave anye tumefac­tion, it is a signe that the ligament is too loose­lye tyede.

❧Of the kindes, & differences of the ligamentes. Chap. 2.

Tvvo sortes of ligaments in generall. HIppocrates gennerally hath made tvvo sortes of Ligamēts: vvher of the firste is, that vvhich of it selfe, & by his virtues did pros­per,First kind of ligatu­re. & opitulate the curinge of the disseases, and vvithout the vvhich they can not be cured becaus that vvith out the same, the parte can not be contaynede in his statione, or forme, vvherin shee must be contayned, to be cured, & to be praevented that ther happen noe fluxione vnto the parte, ne­ther the matter beinge therin congregatede, vvithout the sayede ligature coulde not be dri­ven, & expellede therout. As vve may note on the ligamentes, vvhich in the vvoundes of the Heade vve vse, vvhich allso in all concavouse vlcerations vve vse, in Fractures, in dislocatiōs, recurvatione of Ioynctes, in the separatinge of those partes, vvhich agaynst nature lye the one above the other, in the reductione of the sepa­ratede partes, in the apertione of the partes, vvhich are to closelye occludede, & shutte & a­gaynste the minde of the Chyrurgiane, vvill combine themselves together.

The se­cōd sorte of Liga­ment.The seconde ligament, is that vvhich is or­daynede, not onlye because of it selfe it is com­modiouse, & profitable, but Per accidens, & bye chaunce, & it is but onlye vsed, to contayne, & keepe the remedyes, & compresses, on the diss­easede parte, as on a great, & dolorouse inflam­matione, on a greate Apostematione, or on any other dolorouse parte.

Redivisiō of the first kind of Liga­ture.And touchinge the ligature vvhich of it selfe is profitable, & commodiouse, ther of ther are tvvo kindes, vvhich of the vse, vvher vnto they are ordaynede, are taken: vvhich is ether to cō ­tayne the partes as close in their naturall being because therthroughe they may be combinede & vnitede, vvherfore this ligatione is called, the agglutinative, or incarnative ligatione: Or els to praevente, the fluxione vvhich might chaūce to come to that parte, & expell the same ther­out, vvhich is molestiouse, & troublesom vnto him, vvherfore he is called the expulsive, or re­pellinge ligature.

The incarnative or conglutinating ligation,Icarnati­ve Liga­ment. is commōly vsed in this form on the vvounds. To vvitt, that vve roule vp the rovvler, or liga­ture on both his endes, vnto the middest ther­of, vvherof in each hāde vve must take the one end beinge rovvled vp: laying that parte of the ligamēt vvhich is not rovvled vp, on the other syde of the vvounde, reducinge both the endes of the ligatione, vvhich vve have in our hands above on the vvounde, that ther throughe, vve might adioyne, & bringe together, the separa­ted partes, & lippes of the vvounde, crossinge the foresayed ligature, in forme of a Burgundi­ane crosse, or in forme as in the margine is set dovvne vnto you: Then vve must reduce both the endes to the parte, bringinge one end, to­vvardes the superiour parte of the membre, because therby the fluxione may be praevented, & the other end, on the inferior parte, that the bloode therthrough, vvhich is suncke, and dis­cended into that parte, might be depressed, and crushed out: and the fore sayed Ligature must be of such a breadthe, that vvhen as he is rovv­led vp, & applyed on the vvounded parte, may not onlye compraehende the vvounde but al­soe both the endes, of the same.

If soe be the vvoūde vveare ample, & greate, and the ligature, cōsidering his latitude,Nota. coulde not be accommodated, vve must as then com­praehende but the one halfe of the vvounde, & the other halfe therafter.

Such a Ligament therfore must be reasona­ble closelye vvounde, but allvvayes a little stif­fer one the vvounded parte,Hippocrates. as Hippocrates vvil­leth vs to doe, yea also, in the vvoundes vvith Fracture, because there throughe might be ex­pressed, and crushed out, the bloode, vvhich in that parte is suncke, least that there shoulde happen anye inflammatione thervnto, & then an Apostematione.

The expulsive, or repellinge ligamente,Expulsive Ligamēt. is ve­rye much vsed in Fistles, & in concavouse vlce­rations, thervvith to expell the matter, vvhich is discending to the grovvnde or bottome of the same, & vvhich throughe the longe retenti­one, internallye corrodeth that part.Admoni­tione. This liga­ture is allso verye commoeiouse in the Varices or bursten vaynes, & in tumefacted Legges, but vve may not vse it in Fistles, nor in any conca­vouse vlcerationes, vnlesse first of all they be putrifyede, & their callositye taken therout, ne­ther in inflammationes:

This ligamente is imposed,Hovv vve may ma­ke the expulsive ligament. vvith the one end being revolvede, & rovvled vp, begīning vvith the sovvnde part, vvhich is sitvated close to the bottome of the Sinus, vvhere he muste be som­vvhat more dravven together, & shutt, & then is reduced agayne tovvard the vvounded parte, [Page 45] & tovvarde the mouth, or apertion of the con­cavitye, vvith out bindinge the same to stiffe, & consideratione, of the inferiour parte.

As if the Sinus be in the legge, & the bottome of the same vnder the Knees, & is alsoe higher, & hath his issu in the crassitude of the calfe, vve must them beginne to binde, one the Knees, & finishe in the inferiore partes therof. Contra­rilye if soe be the inferior parte of the Legge, & the issue therof be by the Knees, vve must thē beginn the ligatiō by the foote, & end the same close to the Knees. But if vve desire to vse this Ligature in greate Armes, and great Legges, vvhich are Varicouse, vve must then beginne from belovv the legge, or Arme, vpvvardes, vvhich is the most farthest, from the originall of the Vaynes and supernallye end the same, to vvitt, about the Harte, & the Liver, vvhich are the originalls of all Vaynes, & Arteryes, heerby to repell the humors vvhich are in that parte, & to praevent that there concurre noe more vnto that place.

As farre forth therfore, as if that parte be rugged, and vnsmoothe, as is that Legge, vvhich is farre more thicker in the Calfe therof, then in the lovvermost partes therof, vve must thē frō palme, to Palmebreadthe, a little more thē half throughe cutt the same, and fovvlde both sydes cōtradictorilye the one to the other, & soe loos­lye sovve the same, by vvhich meanes the sayed Ligament, is made to be recurvated, and crooc­kedlye vvounde, like a Bovve. Having therfore stifflye rovvled op this foresayed ligature, or rovvler,An at­tractive Ligature. vve may thervvith as smoothlye vvind & involve a Legge, vvithout makinge, therin a­nye inaeqvalitye, or furrovves causing that syde vvhich vvas cut of, & thē agayn sovved, aeqval­lye to agree vvith the thīnest parte: & the vvhol parte vvhich is the longest, to agree vvith the greatest parte. Above these tvvo foresayed Kin­des, & differēces of Ligamentes, vve may as yet adde thervnto a thirde Kinde: The vvhich vve call an attractive Ligamēt, vvhich vve may vse vvhen vve desire to retracte, anye bloode, nou­rishment, or anye other vitall Spirites into that parte, the vvhich, the parte of it selfe can not dravve, & attracte vnto it, because her attracti­ve forces are debilitated, & very much feebled.

The secō ­de kinde of Liga­ment above re­hearsed.VVe vvill somvvhat alsoe speake of that liga­ment, vvhich of it selfe is for noe vse profitable but accidentallye cureth, throughe his conti­nuāce of the remedyes, vvhich are applyed vn­to the dissease, vvherfore vve may call it the re­tentive Ligament: vvherin vve must consider thre especiall thinges. First in vvhat disseases it is commodious: Secondly on hovve manye fashones, it may be composed, & made: Third­ly,Ligamēt for the dissease. & lastelye, hovve vve ought to vse the same.

Touchinge the first, vve ether vse the same, consideringe the parte, or the Dissease, vvhich can tollerate noe other: Consideringe the Dis­sease, as anye vvounde, or vlceratione, accom­panied & associated, vvith anye great payne, or inflammatione, or vvhen vve disire an Aposte­matione to be matured: Consideringe the par­te, as vvhen a vvounde is in the Heade, in the Necke, in the Bellye, or in the Testicles, vvhich partes cā not indur to be stiffly tyed, or bovvnd, & therfore neede noe ligatione, but only to re­tayne the remedyes therone, because that the other stiffe ligatures, bringe vvith them great discommoditye.

Concerninge the seconde poyncte:Ligamēt for the parte. The re­tentive Ligamēt, must have tvvo, three, or four endes, accordinge to the forme, & situatione of the parte vvhich vve vvoulde dresse. Touching the thirde poyncte, that must be begunne in the dissease, & ended on the other syde of the same.

❧ Of the Rules, & generall Instructions, wheron we must consider, in all Rowles, & Ligatures Chap. 3.

THerfore convenientlye,Tvvo thinges to be considered, vvhen as decentlye vve desi­re to vvinde anye parte. & de­centlye to vvinde, or involve anye parte, or mēbre, vve must note, & cōsider on tvvo espe­ciall thinges, vvherof the first is, the vvounded parte, vvhich vve vvill vvinde: the seconde is the aegritude, or dissease. Touching therfore the disseased parte, vve take this for a generall Rule, that shee must be tyed, & that in such a forme, & figure, as vve vvil have her to cōtinue, & lye: For if soe be vve vvind a foulded, & curvated parte, vvhich ther­after must be situated right, and extented, ther vvill as then conseqventlye insue such or the like Accidentes: to vvitt, that the Ligature vvill dissolve, & loosen, that ther vvilbe caused great payn, & doloure in the parte, because the Mus­cles, Vaynes, Arteryes & Synnues, & the verye bones alsoe have an other situatione, beinge erected, & extended, then vvhen as they are re­curved, and croocked.

As in exāple: If soe be a broken Legge,Example. being recurved, & soe on that manner be circumliga­ted, & vvounde vvhich ought othervvyse to be tyed, beinge stretched & extended right forthe, vvithout doubte all the Ligature vvill goe loo­se, vvhen as vve desire to extende the same, out of the vvhich vvill follovve great payn, because the brockē Bones, Vaynes, Arteryes, Synnues, & Muscles, doe not as thē keepe the same place, as they have done, the parte beinge bovvnde, & tyed.

Contrarilye, vve desiringe to dresse a fracture in an Arme, he must then be shutt, & foulded together, for if soe be vve dresse him beinge ex­tended, vvhē as therafter he shalbe recurved & bended, then the Bones in therre lyinge, vvith the other partes, be turned into some other fas­hone, [Page] vvherthroughe the Ligature, vvil in one place be loosened, & in another spāned, vvhich also suscitateth payne in that parte: For it must necessarilye follovve, that vvhen as a tyed parte be chaunged, and then ether shutt & bended, or extended, thē there are some of the Muscles ex­tended, & crushed, as in the rotunditye, in the abbreviatione, & others vveackened, & vnited: And vvhē they are exrected, they must needes then be crushed throughe the Ligature, out of the vvhich must necessarily follovve intollera­ble payne, because of the Compresse, vvhich in ferreth vvith it in that parte great fluxiones, & other accidentes, & mischaunces.

The dis­sease.Novv for as much as cōcerneth the dissease, vve must circumligate, & involve an Arme or a broken Legge vvith a vvounde, on an other manner, and fashon, then a Fracture vvith out vvoūde: & on an other fashon a Legge, vvhich hath but a simple Vlceratione, then a Legge, vvhich hath a concavouse, or Fistulouse vlce­ratione: And a Ioyncte vvhich is full of payne, must one an other manner be tyed, then that vvherin is noe payne.

Decētlye to vvind.Therfore cōvenientlye, & decentlye to ligate or vvinde, the Ligature must be right, & close­ly rovvled vp, because vve may houlde him the faster, & stedyer in the hāde, vvithout stirring, or glidinge this vvay or that vvaye, as he might chaunce to doe the same not being stiffly rovv­led vp, because that throughe his hardenes he may the better be handled, & conduced, so that all ligationes, farre cōvenienter, & more decēt & to more contentment of the Patient, and the circumstantes, or standers by may be effected, then other vvyse, vvhē as the Ligature is layed dubble, croocked, curved, & vneven.

❧Howe we ought to tye the Ligament & agayne make loose the same. Chap. 4.

Wherone vve ought to, consider in the fa­steninge of the li­gature. THe Chyrurgiane must cōsider, & note, that ther be no seames knottes, or anye vnevennes, in the Ligament, vvhich might chaūce to crushe the vvound: and the Ligatione alsoe being finished, consideringe that the end of the Liga­ture, be not fastened, one the vvounde, nether one anye place vvher ther is any payne, for vn­les vvith a pinne, vve fasten it, or els vvith a Needle sovve it, it allvvayes inferreth payne vvith it: vvherfore vve must fastē the sayed Li­gature, ether higher, or lovver, or one the syde of the same, one the end of the rovvler, & one such a place of the Ligature, vvherone the Pa­tient doth not lye, as behinde one the Heade, in the Temples of the Heade, one the Backe, & on the Buttockes, nether one the Flanckes, or Ar­mepittes,

And concerninge the dissolutione, or vn­tyinge, therine vve must cōsider tvvo thinges:Tvvo thinges vvherone vve must consider in the dressinge of a vvounde Namelye one the time, vvhen the Patient must be dressed, & one the cōvenience of doinge the same: and heerin disagreethe the practise of the aunciente Chyrurgianes, from vs: For touching the dressinge of vvoundes (Celsus vvilleth) that vve ought not to dresse the vvoūde, but in thre dayes once, suffering it tvvo dayes▪ Celsus. to continue vvithout dressing: And then vvilleth he vs, that vve dresse it but once in five dayes. And as tou­chinge the simple fractures,Hippocrates. Hippocrates coun­celleth vs, that in thre dayes once vve dresse thē But novve adayes, vve doe not observe this mā ­nes, for vve dresse the Patiēt after the first dres­singe 24, hovvres, vnles vve feared anye greate fluxione of bloode, vvherfore vve suffered the Patient to lye lōger vvith out dressing, to vvitt, tvvo, three, foure, or five dayes longe: It is right true, that vve sometimes make loose the liga­mēt in tvvo, or three dayes once, vvithout tou­chinge of the playster, onlye to give ayre to the parte, & to note, vvhether there be nether In­flāmatione, nor any other Accident come ther vnto: But vvhen as the vvounde is come to ve­rye great suppuratiō, & that ther is much mat­ter, payne, or Inflammatione at hande, vve as then dresse the vvounde tvvo, or three times in the space of 24 houres, to vvitt, all eight hovve­res once, if it be possible.

And touching the simple Fractures,For sim­ple frac­tures. vve keep thē sometimes, sixe, or seaven dayes vndressed, vnles that ther vveare anye Accidentes, at hād, but allvvayes vve tarrye as longe as is possible: for hovv little soever vve touch a brokē legge, the endes of the bones, of the fracture are ne­verthelesse, stirred, & dislocated, & the on rub­bed agaynst the other, vvherthroughe is caused payne, and the combinatione, or together hea­linge is hindered, because that all conglutina­tione, can not be vvith out cōtinuall coniunc­tione of the one parte vvith the other.

The redressinge, or dressinge,Hovv vve may gēt­lelye take of the Li­gament. must be done one this manner: to vvitt, that vve easilye make loose the bande, or rovvler, novv vvith the one hande and then vvith the other looseninge of the same, alvvayes houldinge the vvhole Liga­ment in the hande. But because most commō ­lye the first dressinge of the vvounde, cleaveth soe fast, as if vvith glevve it vveare theron faste­ned, because of the bloode & matter, vvhich is therone dryed, and baked, vve must first of all therfore, madefye, & moysten the same vvith a little vvarmed vvyne, and thervvith soacke the same because the ligament may be taken, & re­volved therof vvithout payne, yea or els also in the vvindinge of, of the same comming on the vvounde, vve might ther everye time cutt it of, because in soe doing, vve might by peecemeale take avvay the same, vvithout in any sorte hur­tinge [Page 46] of the Patient.

❧How we shall dresse the broken Armes, hippes, and legges. Chap. 5.

Our mā ­ner of dressinge of al bro­kē legges may be assimila­ted, and compa­ted, vvith the man­ner of the auncient Chyrur­gianes. AL thoughe that our common practise, of the dressinge of all broken Legges, seemeth to be alienate, and to differ, from the manner of doinge, of the anti­que, & auncient professors, & Chyrurgiās, it is notvvithstanding in such sor­te, that vve easyly can compare them together. All the auncient physitions, & Chyrurgianes, have binne of opiniō that in the Fractures vve ought to vse a dubble kinde of Ligament: Na­melye inferiore ligamentes, vvhich they called Hypodesmidas, & superior ligatures, vvhich they called Hypodesmous: they have these names be­cause of their situatione, because some of them are tyed, and bovvnd vnder & some agayn abo­ve. And as touchinge the inferioure ligamētes, Hippocrates maketh mention of tvvo sortes.

Tvvo sor­tes of in­ferior, or vnderligamētes.VVherof the first, & the shortest, beginneth one the fracture, layinge alvvayes the one end contradictorilye therone because it should not vvholy lye, on the place of the payn, vvhich li­gament must be tyed round about the fracture, & then be reduced vpvvardes, vvhere he as thē endeth: This ligament must closelye be vvoun­de together, because so the fluxiō, vvhich might chaūce to sincke into the disseased parte, might the better be kept therout. The seconde liga­ment, vvhich allmost, must be as longe agayne as the first, is allso begunne one the same man­ner, to vvitt, on the fracture, layinge onlye ther­one, a turne, or tvvo, vvinding dovvnevvardes, to crushe therout the bloode vvhich might chaunce to sincke into the fracture, vvith cir­cumvolutiōs, vvhich must be layed a little mo­re a parte the one frō the other, then in the first ligament they vveare: for vve must take heede of makinge to greate expressiones of bloode, in the endes of the Armes, or legges, that vvithout imflammatiō they can not receave much ther­of, and the ligament being come dovvne, must vvinde the same vpvvardes agayne, to come a­gayn to that place vvher vve did beginn, becau­se both these ligamentes might hould fast, and the muscles be brought into theire naturall si­tuation, vvhich through the tvvo formost liga­tiones might be brought therout.

Subdivi­siō of the seconde inferior ligature.Other auncient Chyrurgianes make of this nethermost ligature, tvvo ligationes, vvherof the one is the surest the seconde for the fractu­res, vvhich beginneth one the brokē parte: ha­ving therafter, made one, or tvvo circumvolu­tiones, then is the foresaved ligature reduced dovvnevvardes. The other vvhich may be the thirde for the fractures, must be begunne, on the beginning of the parte, endinge supernally vvher the first ligatiō is ended passing over the Fracture: Soe that they impose therone thre li­gationes all vvhich three vve may call inferior ligamētes. The first vvhich ascendeth from the fracture one highe, as from the middle of the legge tovvarde the knee. The seconde vvhich descēdeth from the fracture dovvnevvardes, as from the middle of the legg tovvardes the foo­te. The third, vvhich from the extreameste part of the Ioyncte, ascendeth superiorlye as frō the the soule of the foote tovvardes the knees.

But novveadayes & folovving our common practise,An astrin­gent pla­ster on the frac­ture. vvhich vve vse before these three liga­mentes, vve applye first of all, one the place of the fracture an astringent Plaster, vvhich is ma­de of Bolus, of flovver, or volatill meale, of vvhy­tes of Egges, of Oyle of Roses & of a little Tere­bentine, (in steade of Cerotū Galeni, vvhich the aunciēt Chyrurgians vsed:) After the first dres­sing vve vse the Plaster of Diacalcitheos, or of Di­apalma, liquefacted in oyle of Roses, vvith vi­neger. The ligature novv being decētly vvoūd, because the legges, the hippes & the Armes, are thinner belovve then above they are, vve must therfore one such slendernes apply some certayn cōpresses because the foresayed ioync­te may be in all places of an aequall crassitude, & thickenes, & the splinter, vvhich must be ma­de of stiffe paper, of lattinn, or of any other sub­stance, be verye evenlye, & smoothlye applyed therone, & tyed vnder the inferior ligatures, or rovvlers.

These splinters must be three in numbre, vvhich must be excavated like a gutter, vvherof the first must be a little broader, then the other to by applyed vnder the fracture, & to comprae­hende all that, vvhich is belovve the fracture, & be as it vveare a fundament, or foundatiō ther­vnto. The other tvvo one both the sydes of the fracture, being somvvhat separated the one frō the other, least that in the ligatiō they chaūced to glide the one over the other. They must also be of such a longitude, as the broken parte re­quireth.

These thre foresayed splintes being thus im­posed, one the inferior rovvlers,Applyca­tione of the infe­rior Li­gatures. vve must then tye the fracture that it may lye fast and steadye & the part be cōtayned in a goode quallitye & disposione. VVith the first of these tvvo ligatu­res, vve must beginn, at the extreamest parte of the membre, frō vnder vpvvardes. The seconde must beginn frō above & end belovv: vve must allsoe note that the one of those rovvlers, must take his beginninge internally in the membre, & must proceed from the left to the right syde, becaus they may crosse the one over the other, in such a forme as in the margine you may see, or in forme of a St. Andrevves Crosse, because it may be involved verye closelye theron.

[Page]It seemeth that Hippocrates hath vsed noe o­ther ligature, in the Fractures vvith vvounde, but that he rovvled the same somvvhat loose.

Ligamē ­tes for shott vvoūdes, vvith crushing of bones.But in those fractures vvhich vveare shott, or vvith anye other such like instrument, or engi­ne, be done, vvherin is great crushinge of bo­nes, because vve should little neede to handle this parte, vvhich is thus broken, and crushed, least the acute, and sharpe ossicles, or bones, & frustles, the vvhich in the pertractatione of the same, might chaunce to pricke the Flo [...]he, Tē ­dones, Synnues & the Peritoneum, vve must ther fore vse heervnto great Cōpresses, beinge foul­ded three, or foure on the other, and soe sovved together in the midle, beinge in tvvo places cut throughe, the compresse beinge of the bredth of a palme, of ones hāde, or theraboute, vvhich vve revolve the one tovvardes the other parte, as if vve desired to circumligate the parte. The­se, or such like Compresses, vve must by little & little shove vnder the crushed parte, or mē ­bre: & the same being immūdifyed, & impure, and vve desire to lay an other thervnder, vve as then sovve a cleane vvhite Compresse, one the impured Compresse, & as then vve dravv avvay the impure compresse from vnder the Fracture & then subseqvētly follovveth the mundifyed, & cleane compresse thervnder, in the steade of the immundifyed. I have constituted the defi­guratione, of these Compresses, heere before a­mongest the figures of the Instrumentes, in the table of the Glossocomium, vvhich of Hippocratis is called Ambi, on vvhich place, & in the forsay­ed leafe, is defigured vnto you, a broken legge, vvith the Ligamentes of the same.

Of the situation, and of the constitutione or collocatione of those partes, one the which the forsayed Opera­tione must be effected. Chap. 5.

NOe man is ignorāt, hovv neces­sarye, & requisite these operati­ones are, to the resanatiō, of the disseases, vvhervvith mās body is daylye, & continually oppug­ned & opressed: and indeed, this operation shoulde in vayn be vsed, if so be that not onlye the vvhole body, but also the forsay­ed disseased partes, vvherō vve effecte our Ope­ration, vveare not therafter, constituted & situ­ated, and vvith most convenience colloca­ted.

Therfore decentlye, & vvith most couveni­ence to collocate the same,Vitilitye in consti­tution of the parte. the Patiēt must first of all lye on his bedde, (if soe be at the least the magnitude, and largenes of the dissease require the same,) & that in such a form, that the vvoū ­ded, or vulnerated parte; may be vvith most ea­se, & cōveniēce collocated, as it is reqvisite, for they are not al together situated in one fashō, & manner: It is right true, that there are some cer­tayne rules, as are in the ligatures, vvhich must only be vsed one disseases.

First of al therfore, & generally,Thre thinges to be cōsidered in the collocatiō of a parte, or membre. to collocate & rightlye situate al vvounded partes, vve must consider thre especiall thinges: to vvitt, that the situation, be Softe, Smooth & Highe: Softe, be­cause a hard situatiō, somtimes might chaunce to disturbe, and irrequiate, not only the vulne­rated part, but also the approximate partes ther vnto, by the vvhich meanes great payn, inflam­mation, & consequentlye also an attractione, & a fluxion must necessarily follovve in that par­te: & vvhich is more, the Patient is constrayned not being able to tollerate the obdurate collo­catiō, to ease and yeelde solace to that parte, by oftentimes turninge, and revertinge of himsel­fe, vvhich is very vnprofitable for him, because that parte, requireth nothinge els then quietu­de, vvithout beinge much disturbed, and mole­sted.

Even, and smooth, becavse that the vnevē,Playn, & smoothe situation. & implanitude collocation, inferreth payn & re­curvatiō in the Ioyncte, to vvitt, the one parte resting on somvvhat, & the other parte, depen­dinge vvithout restinge one anye thinge.

On Highe, because that therbye,Highe si­tuatione. al concursi­one of humors is praevented, vvhich othervvise through the lovv situatiō of the Iovncte, might be therthervvardes dravvne.

Considering this occasion, have the Chyrur­gians alvvayes caused the broken or vvounded Arme to be dependently vvorne one the breste & the legg to be collocated on highe, to vvit sō ­vvhat higher then the bodye, the Patient lyinge on bedde, because he may nether be erected, nor sitt.

Nether is it onlye necessarye that the mem­bre, or parte be collocated softlye, smoothly,The aper­on of a vvound must all vvayes be recurva­ted dovv­nevvar­des if it be possi­ble. & highlye, but it is also requisite, (if soe be ther be anye vvounde, or vlceration, vvhich especially is fistulouse) that the apertiō therof, if so be it is possible, recurvate it selfe dovvnevvardes, be­cause that the matter, might have the liberater a passage, to enter forth at, vvithout makinge a­ny greater cōcavityes, & doe not chaunce to in­cēce, or inflame the approximate partes, nether to corrode them, vvhich vvould bringe vvith it divers, & sundry accidentes: & praeposterate the resanatione of the same.

Secondarilye,The situ­atione of the Ioyncte must be natu­rall, & ac­custo­med. the Ioyncte must be situated in such a forme, and fashone, vvhich is agreinge vvith the naturalle disposione of the Ioyncte, and alienated from all payne: vvhich tvvo ob­servationes, are vvell agreinge the one vvith the other: For all fashons vvhich cause noe payne, that is the naturalle, and accustomed figure, and collocatione therof: Euen as the [Page 47] paynefull, and vnnaccustomed figure is agaynst nature, so that the naturall, and accustomed fi­gure, or fashō, is vvholy vvithout payn: vvhich happeninge, the Patient must a longe continu­ance keepe his Ioyncte in that beinge, because soe he shall feele noe, or at the least verye small payne at all vvhich is verye cōmodiouse, to the resanation of all vvoundes, vlceratiōs, Fractures & also for all dislocatiōs, as it is in like sort pro­fitable for all other disseases vvhatsoever,

The aunciente Chyrurgians, have called, this forme of situatione, the right and true colloca­tione, because all the Vaynes, Arteryes, Synnu­es, & muscles, as then are right, nether are they extended, nether lye they recurved.

The na­tural situatiō vvhich of the aū ­cient pro­fessors, is called the right si­tuation.And althoughe that the Arme have binn an­glevvyse collocated, notvvithstāding vve estee­me it as then to lye right, because that all the fo­resayed partes, are accounted to lye right, & not extended, nether recurved, & that this colloca­tion of the Arme is naturalle, as heere after vve vvill more largelye speake of.

An exam­ple of the situatiō of any disse­ased part.And by degrees to specifye, the situatione of each, & sundry parte, vve vvil heere discribe so­me of them for an example: vvhē as ther is any vvounde, Apostemation, or dislocation in any Ioyncte, vve must then vvith all dilligence note the situation there of: for through a badde situ­atione, not onlye immediatly are caused many accidentes, but after the sanatione therof, the Ioynct sometimes tarryeth right out extended, vvhich ought to have binne croocked, or els a­bideth croocked vvher it oughte to be extēded or els combineth it selfe, & ioyneth vvith some other thinge, vvhich ought to have binn sepa­rated, & seioyncte.An excel­lent ob­servation VVherfore if the vvoun­de be in the vppermost parte of the shoulder, vve must then impose vnder the Armepites of the Patient, a great linnē balle, & hange the ar­me one the Brest, & somvvhat beare, out his el­bovve, because that the heade of the arme, may be somvvhat elevated, & the separated partes, may agayne be inserted the one vvith the other and so much the better be cured together agay­ne: The contrarye vvherof must be observed, if soe be that in the inferior parte be anye vvoun­de, as vnder the Armepittes: for the vvound be­inge cured, & vve doe not lift vp somtimes, the Arme & let him fall dovvne agayn, & stirre him othervvayes, vvithout causinge any payne, and that the Arme is not helde from the Breste, the Patient therafter, because of the Cicatrice shall not be able to lift vp his Arme because through the same the Arme is grovven stiffe. As therof vve have an example, exemplifyed vnto vs of the throte, & in the Necke also of many and di­vers, vvhich beinge vvounded, or burned, the cicatrice hath remayned so obdurated, that they ther through have ether helde their Heades, to much on high or to much stoupinge, or hāging backvvarde, or to much dependinge ether on the right, or one the Leftsyde.

If so be that ther be an Apostemation,The an­glevvyse figure, is the natu­rall forme of the Arme. in the Elbovve, or els that the same be dislocated, or vvounded, vve must thē situat the Elbovve an­gle, or cornervvyse: for such aforme is very ne­cessarye for the same, & natural, & accustomed vnto hī: & although, the cornervvyse figure is that vvhich maketh an accute corner, notvvithstāding vve meane therby through the anguled figure▪ vvith the auncient Chyrurgians, that vvhich hath his corner right but yet not so cle­ane, and vvholy erected, but that vvhich attayg­neth somvvhat tovvard the rectitude, so that it commeth somvvhat bluntlye, and such a figure is not as yet truelye the meane, betvveene the inflexione, and the extensione, but is the same vvhich yeeldeth her selfe, tovvarde the extensi­one: If soe be the Arme be inserted and combi­ned, vvith being able to be recurved, or extēded vve may yet as then better, and vvith more faci­litye helpe him selfe, then if he vveare vvholye recurved, or vvholye extended.

VVe may alsoe observe the same in the han­de,The hand must be shutt. for vve must keepe the fingers shutt, & halfe bended, and if soe be the dissease vveare in one finger only, it vveare then better that the same continued ether inflected, or incurved, thē that he vveare strayght, for the property of the han­de is to gripe and take houlde, the vvhich shee can not effecte, and bringe to passe, then throu­ghe the recurvatione of the same.

If soe be above in the Hippe ther chaunce to come, an Apostemation, or vvovnde,The hip­pe must be stirred. vve must then in the consolidatinge of the same, observe that vvhich in the shoulder vve have seene, as beinge necessarye to stirre the foresayed parte, on divers fashons, because the heade of the bo­ne, doe not insert it selfe, and grovve fast in the panne.

VVe observe in the Ioyncture of the knees the contrarye, for if so be,The leg­ge must be kept right. that ther be a vvoun­de, or an Apostemation, or els in the finitimate parte, the Patiēt must thē hould his legge right, vvithout havinge the heeles dravven in tovvar­des his buttockes, as it in divers persons happe­neth, and that to the hinderance of the Patien­tes, vvhen they are cured.

And vve must dilligentlye note, that the leg­ge be collocated as right, as is possible, and if so be by chaunce it laye recurved, vve must then as gentlelye, as is possible stretche and exten­de the same agayne, othervvyse the patient be­inge cured, might chaunce to be mutilate, and vvithout greate indecorū, or deformity should not be able to goe, as vve have knovvene the same to happē vnto tvvo great personages, of our times.

Novv as concerninge the foote, & the Toes, they must allsoe be extended, and not recur­ved, [Page] or inflected, as vve have spoken of the hād, & fingers:Discom­moditye of having the Legge croocked For if soe be they cōtinued soe croocked, the bodye as then shoulde not be able to rest, or stayede theron: Soe that the situation of the Arme, is cōtrarye to the Hande, to the Leg­ge, and to the Foote: because the one must be recurvede, or croocked, and the other extended right out.

The end of the Frenche Chyrurgerye, contayninge the manuall O­perations.

Methodicalle discourse, or rehear­sall, of the Originalles, & occasiones, Signes, & Tokens, Accidentes, & chaunces, Prognosticationes, and Remedyes, agaynst the Bloodyeflixe, or Dysenterye.

BY all other miserable and piti­fulle disseases vvhich doe commonlye vexe, and trouble the Entralles, and runne through the same, as is the Cholicke, the restrictione, or constipati­one, Ileus, Lyenteria, Diarrhea, Tenasmus, the vvor­mes, & many other such like yet me thincketh the Dysenteria, or the Bloodye flixe, of all these to be most intollerable,Bloodye­flixe. and most mortall: And also amongst the Commonaltye, amongst our Frenche Martiallistes or vvorriours, amongst the Svvitsers, Countryemen, Englishemen, & farther amongst all sortes, and Kindes of vvar­riours, it is soe commō, that it seemeth this dis­sease, as soon as they are gone out of their hou­ses, that there nothinge els follovveth them, thē the shaddovv of their body, vvherthrough in all leagers throughe this dessease at someti­mes ther are more poeple deprived of their li­ves, then throughe all the inqvietude, through all povertye, throughe the Plague, yea & more alsoe then of the enimye are Killede: And tou­chinge my opinione heerein, I take this sicke­nes to be a pestilentialle spirit, and a certayne essence of the Plague: Soe that necessarilye ther vnder must be occulted, & hidden, a secreate, & ineffable venoume, or poyson, vvhich through defilinge, and infectione, spreadeth it selfe from the one bodye into the other, Because the inte­stines or entralles, of a sovvnde, and vvelfaring man, throughe some inclinatione, or Sympa­thye, are made partakers of such venoumouse vapours, of him vvhose guttes are polluted vvith this dissease, and by that meanes also are imparted vvith the bloodyeflixe: As in the cō ­sumptione vve may see, vvhich proceedeth out of some vlceratione of the Lunges, and also in the Ophthalmye of the Eyes, the same to be as infectiouse, that the on body, may obtayne the same of an other: VVhich commeth to passe,Reason of Aristo­tle. as Aristotle sayeth, because that the Lunges, & the Eyes, are continuallye contayned in a perpetu­alle motion, vvherthrough the venoumousnes is the easyer imparted to an other body: Health beinge, as it vveare a continuall rest, and an assured estate.

And as the entralles, have also their perpe­tualle motione, the vvhich in Greeke vve call Peristaltica, in like sorte alsoe may they imparte theire dissease vnto other entralles, as the eyes vnto the eyes and the Lunges doe vnto the lun­ges.

Of the Causes, Signes, Accidentes, prognosti­cationes, and remedyes, I vvill somvvhat dis­course, consideringe more the necessitye ther­of, therby to instructe the yonge Chyrvrgian, thē because of any pleasure, vvhich I take ther­in, or anye ostentatione.

The Dysenteria, or bloodyeflixe,Discripti­on of the Bloodyeflixe. is a sangvi­nolent excrement of the Bellye, vvith greate doloure, and as it vveare scissure vvhich the La­tinistes, call Tormina: And this dissease may be taken properlye, or improperlye.

The improper Dysenteria, or Bloodyeflixe,Dysente­ria Improperlye ta­ken. is a fluxione of bloode, vvith out any greate pay­nes, or travayle, vvherof ther are tvvo sortes, or Kindes, ether vvhen vve avoyde pure, & cleane blood, vvhich vve call Sangvinolenta, & Cruenta or els vvhen vve avoyde vncleane bloode, and impure.

The pure cleare bloode issveth forth of the Mesenterium, vvheare a longe time it hath lyen occulted, & cōgregated, as it oftentimes chaun­ced, in those vvhich are grosse of Belly. And sometimes alsoe it procedeth out of the Liver, of the Milte, of the Hemorrhodes, and someti­mes also out of some great vaynes, and out of other partes, yea and also out of the vvhole ha­bitude of the bodye: All vvhich differēces, must throughe their ovvne signes be knovvne, be­cause the resanatione of the same may be the surer.

As for example it happeneth commonlye,Those vvhich are depri­ved of a­nye Ioyn­cte, are very sub­iecte vn­to the Bloodyflixe. throughe anye greate superfluitye of bleeding, in those vvhich have lost an Arme, or a legge, that on certayne times they have the bloodyeflixe▪ In vvhich kinde of Mysenteria, vve neede not much to feare, nether neede vve to vse tho­se remedyes heervnder discribed: But must restraygne such Patientes, from great comesti­ones, and superfluouse drinckinge of VVyne, and cause him to be vvell phlebotomised: vvherof vve in this place endevoure to adver­tice, [Page 48] and instructe the yonge Chyrurgiane, be­cause that vvithout making any great delaye, he might be adiuvable & helpefull to the patient vvith these remedyes vvhich consequently fol­lovve: the vvhich in passinge by, it seemed con­venient vnto me to rehearse: Because it is not my intent, in this place, onlye to speake, of the improper Dysenteria, & curatione therof, but of the true, & proper bloodyeflixe, or Dysenteria, vvhich in all Leagers is common, & familiare, and infectiouse.

The impure Bloodyeflixe, is the truest, & as­suredst, and is assimilated vnto vvater, vvherin nue slaughtered fleshe, hath binn vvashed: the vvaterye Bloodyeflixe,Fluxus Hepaticus. is called Fluxus Hepaticus, the Liver laske, vvhich is caused, throughe the imbicillitye, of the retentive forces of the liver, through the vvhich the vitall spirites & the na­turalle calliditye doe exhalate, & the personne, is vvholye bereft of all his forces & therthrou­ghe also the stomacke is feebled, that it can not any more compraehend, any meate, or drincke, to feede one, nether digest the same, soe that by this meanes the vvhole bodye consumeth and vvithereth.

The black, heavye, & thick bloodyeflixe, pro­ceedeth especially out of the Milte, vvhich is, as it vveare a Poole, or receptacte, of al melancho­licke, thicke, and blackebloode.

Dysente­ria pro­perlye ta­ken.But that vvhich properly, or vprightly is cal­led Dysenteria, or Bloodyeflixe, that is a commō vlceration of the entralles, out of vvhich first of all the viscositye of the same is driven, & expel­led out, then the Axvngiousenes therofe, vvith a little redde blood intermingled: Thirdly, the internalle membrane of the intestines, of the vvhich the pellicles, and the little fibres are in the stooles seen, thervnder to be mixed: finallye the vlcerrtiō as yet proceeding, & more, & mo­re grovving vvorse, as thē consequently follo­vveth the carnositye, & the verye substance, of the corroded, & corrupted guttes: all vvhich kī ­des, are accōpanied, & associated vvith those cō ­mon accidentes, to vvitt, vvith bitinge, or mor­dicante payn, vvith continuall punctiōs, vvith continualle concupiscence of goinge to stoole, vvith intollerabilitye, & vvith a continuall cō ­motiō. VVhich foresayed Dysenteria, or Bloo­dyeflixe, ether happeneth to the small entralles or to the great intestines, the vvhich vve first es­pye out of the situatione of the payne, & out of the diversitye, and mixture of the matter,

VVhen as therfore the vpright Bloodyeflixe is in the smalle guttes,Signes vvhē the small guttes ate hurte. as then vve see blood, & certayne membranouse pellicles, intermixed vvith the excrementes, ther is also great payn a­bove on the Navle the time betvvixte the payn & the deiection is slovve, and ther associateth it most commonlye a vomitinge, and a greate oppressione of the harte, and the Hick coughe, in the entrance of the stomacke, through com­munity vvhich the forsayed entralles have thervvith: For as Galen sayeth, the Harmony, & con­iunctione, vvhich the partes of the bodye have the one vvith the other, is vvonderfull, & to be admired, because as soone as the actione of one parte is hindered, or suffereth any thinge, al the other partes of the body doe thervvithe cōspi­re, and sympathise.

If soe be the sayed vlceratiō be in the greate guttes, or entralles,Signes of the great▪ intestines ther as thē driveth one the deiectiones, or excrementes certayne droppes of bloode, and some little parcels of fleshe, and the dolour of the vvounded, or hurte entralies, not so pungent and sharp, but somvvhat more surde, and benumde.

The occasione of the bloodyeflixe is the ve­noumouse puissance and force,Occasion & cause of the Dysenteria. Dynamis of the acute, saulte, and mordicant humoures, vvhich beinge as it vveare on the iournye, to descende right to the guttes, but they come recurvared, & in form of this lettre S. as in the situatione, they must passe by manye recurvationes, & cō ­cavityes▪ vvher they cleaving fast, first of al cru­difye, and excoriate the foresayed guttes, & in the end throughe theire acuitye corrode the sa­me: as is the cholericke humiditye, the melan­cholycke humors, and the saulte Petuita, the vvhich is ether ingēdred internally in the gut­tes, or els congregate together in other place & are soe driven that vvay, as it happeneth com­monlye in the Pestilentialle agues, in Causo col­liqvanti, Phthisi, Athrophia, in the Cacochimia, in the inflammatione, and in the colliquation, of the vvorthyest partes. The humors are also ir­ritated, and provoacked, through causticke and venoumouse medicamentes, as throughe the Coloquintida Scammonia, or throughe the Subli­mated poulder of a Diamante.Ravve fruicte causeth the Bloo­dyflixe. Also through anye viciouse, acute grosse cibaryes and those vvhich are apte vnto corruptione, or els is not sufficientlye dressed: Alsoe throughe any frui­cte, as by cherryes, Blackecherryes, Plumbes, Peatches, Coucoumbres, Milions, & such like, vvhich vve call Hotatij Fructus, vvhich more, throughe the constitutione of the ayre, vvhich ether is to moyste, and pluviouse, or raynye, to coulde, or to hott, in others through intempe­rature, and other inordinate victitatione, or de­bacchatione, by the vvhich it inseparablelye happeneth as vvell in the VVinter, as in the Summer, that this dissease of the bloodyeflixe, afflicteth man kinde.

It is right true, that this dissease,Indicati [...] hovv vve may easi­lye, or difficult­lye attayn to the Bloodye­flixe. oftentimes reagneth in the Prime, or vernall time of the yeare, and especially in the Harvest, or Autum­ne, in the vvhich time the humors, doe most impeach, & hurt vs vvith the qvallityes. Ha­vinge observed all these thinges, vve must con­sider one the quantitye and quallitye of the [Page] dissease, as on the greatnes of the vlceratiō, and the superfluitye of bloode, and one the greate corrosione, and one the violence of the dissea­se, therbye to iudge, vvhether the dissease vvith anye facilitye, difficulty, or impossibilitye may be repelled, and cured.

VVe esteeme the cure of the Dysenterya to be of more facilitye, the same beinge in the great guttes, or intestines Caecum, Colon, & Rectum, thē it being in the smalle entralles, Duodenum, Ieiu­num and Ileum.

VVe take also the same to be lesse daunger­ouse, in yonge persons, and in the men, then in yonge children, and vvoemen.

In a longevalle, or longe continuing Dysen­terye, it is a badde signe vvhē the appetite is de­parted, & yet a farre more vvorse signe, vvhē as ther are associated vnto the same Agues, or Im­flammationes.

They vvhich a­re of most experiēce may iud­ge of this poyncte.As is that vvhich is caused, out of anye Apo­stemation, beinge burst out of the Liver, or of the Milte, vvhich verye rarelye happeneth, and yet more rare out of the pulmonicalle Aposte­mationes, vvherof the matter disgorgeth it sel­fe in the left ventricle of the Harte, and soe into the Artery called Aorta, the truncke, or body of all other Arteryes, frō thence into the Vaynes of the Mesentery, vvhich are extēded to the en­tralles, the vvhich passage or vvay vve can not then throughe imagination compraehend, and vvhich is very obscure. And if soe be ther follo­vved any peculiare thinge therout, besides the causticke, and venoumouse matter it might thē inferre fearefull, & daungerouse accidentes, to the hart of the Patiēt, (vvhich is the vvelspring of lyfe) & the onlye originall, of vitall spirites, vvhich are diffused over the vvhole body, & are occasione of the actione, motione, & also all o­ther agilityes of the bodye.

The evomitiō of the choloricke humors, in the beginning of the dissease, doe beare vvitnes alsoe of the daunger follovvinge.

The bloody flixe, vvhich is caused out of any melācholicke humors, is esteemed to be vvith­out anye hope.

The convulsiō of synnues, the Hickough, & the parbraking, are forerunners, & as it vveare, embassadoures of death.

In like sorte allsoe vvhen vve espye, a blac­ke spott behinde the left eare, as bigge as a Vetche, vvherbye is great alteratione, that allso is a signe of Death, as Hippocrates vvithnesseth vnto vs. If soe be this dissease, through negligē ­ce, or through malice, or aulteration, or by any other meanes, came to be inveterated, the Pati­ent as then vvill vvholye consume, & vvexe so feeble, that vvithout great difficultye he shall not be victor therof.

This therfor is the cause, or occasiō, the spe­cies, & kindes of this dissease, & the afflicted, & opressed parte beinge aperte, and knovvne, vve must novv proceede to the resanatione of the same.

The finall end of the curatione, is ether ge­neralle, or specialle.

The generall end is to be noted, ether on the dissease, or on the Physitione, as on both the es­peciallist, & most principall personages, vvhich acte and sett forth the Historye of this dissease. In all the kindes of Dysenteria, Cure of the Dy­senteria. the patient must keepe himselfe reposed, and quiet, because all vlcerationes, desire to be quietlye kepte, and in ease: Notvvithstandinge, Hippocrates in his third boocke de Diaeta councelleth, that vve shoulde cause the Patient vvhich hath the bloodye flixe to vvalke, & alsoe cause him to stirre his bodye, vvherby he meaneth, that vve ought to doe the same, before the foresayed Dysenteria become, & because of the Prophylactica, therthroughe to prevent, the procreatiō of all badde humors, & to defend the same out of the intestines, & cau­se them to vvithdravve themselves into other externall partes of the bodye.

Farthermore the patient must allvvayes re­tayne his stooles as longe as he possibly may or can, vvithout constraygninge himselfe ther­vnto,

The Chyrurgian must first of al consider on the vse of the astringent medicamentes,What as­tringent medica­mētes the Patient must vse. vvhich before repast, or comestion are vsed: for he cō ­tayninge the viandes, or cibaryes, they helpe al­so to the digestiō of the same: but by the astrin­gent thinges I vnderstande, & meane, vvhich a­re reasonablelye fortifyinge, and confortative, and those vvhich are helpefulle to the concoc­tione: For it vveare the greatest, & absurdest er­ror of the vvorlde, if soe be in the first, & especi­allye in an vnhealthfulle bodye, to vse violent stopping & astringent medicamētes, for it vve­are nothinge els, thē to shutt & keepe our eni­mye or theefe vvithin doores.

VVherfore his viandes, or meate & drincke,What his meates, & drinc­kes must be. must onlye be Diureticke, & astringent & cau­singe to voyde vrine, because through the vrine especially, all aquositye of the blood is evacua­ted: but if so be you perceave, that the great tou­ghenes of the acute & sharp adusted Pituita, or aquosity, vvhich is verye retardatelye expelled & conglutinateth vvith the guttes, or entralles, is a cause of the bloody flixe, vvith payn & vvith corrosiō, you must thē vvith discretiō vse the u­rine expulsors, or vrine provokīg remedyes be­cause through the vse therof, it expelleth the a­aquosity throgh the vvhich othervvyse the for­sayed viscouse & tough Pituita, might by chaū ­ce have binne driven out, so that thervvith it is made more viscouse and tougher, then befo­re for by hovv much the lesse any thick viscou­se matter, hath adioyned vnto it anye thinne humiditye, by soe much it is the vvorse. VVe [Page 49] permit some consideringe the imbicillitye of their stomackes, to vse & drincke a little astrin­gent vvyne.

Medica­mentes vvhich vve must eschevve.Farthermore vve must bevvare, and take heede, of all sharpe, & mordicant medicamen­tes, as Arsenicum, Auripigmentum, Antimonium Sal Gemmae, & manie other such like thinges, & that because of their, to great, & suddayne evacuati­ones, & because they irritate & provoacke the dissease.

Thirdlye vve must consider on the Liver, & especiallye on the stomacke, because all those vvhich are afflicted vvith the bloodye flixe, can digest noe viandes. The specialle end must be the fluxione, or the dissease it selfe.

The Scopus of the fluxione is, to stoppe, & to diverte the concurrent humors, but vve must in the first gentlely, & easilye reserate the same, & vvith such, consideration, as before vve have sayed, least that in reseratinge of the same you increase the ague, the vvhich vvith reason, and experience may chaunce.

Remedy­es vvhich may be taken out of the re­ason.The remedyes vvhich may be taken out of the reason, are ether externall, or internalle.

The internall are, ether simple, or cōpovvn­de. Simple, as Covvemilcke, nue Egges, vvith Masticke, or vvith Ambergreece, Poulder of sovver Mulberryes, flovvers of Peatches, fine Bolus, Terra sigillata, confited Nuttes, Nuttmeg­ges, beinge thervvith intermixed: Rhabarbarum so acked in Plātine-vvater is alsoe hadde in gre­ate estimatione, or in the decoctione of Miro­balanes, Syrope of dryed Roses, & Iulep, of Ro­ses.

Amongst the compounde Remedyes are the Trociskes of Diacorallum, Dialectrum, De Spodio, vvith the iuyce of Endive, of Cicorye, & more other.

VVe must alsoe content our selves, in this dissease vvith sudoriferouse medicaments, and vvith easye vomites: because throughe diversi­tyes, vve may reserate, & retayne the fluxione.

This subseqvent poulder, is oftentimes vvith great successe administred, & vsed, the vvayght of a Crovvne, vvith the yolcke of an Egge.

(rum) Boli Armeni, terrae sigillatae, lapidis Haematites, ana drachmas duas, picis navalis vnciam semis, Coral­li rub. Margaritarum elect. cornu Cervi vsti & loti in aqva Plantaginis, ana scrup. duas, Sacchari rosati vn­cias duas, fiat omniū pulvis subtilis: capiat drachmam semis, vel scrupulos duos mane.

Admoni­tione.But to commit noe error at all, vve must be­fore the reseratione, or before the vse of this poulder, administer an ounce of Cassie, by it sel­fe, or vvith halfe a dragme of Rabarber: or vvith an ovvnce of the double Catholicon, vvith a de­coctione of Plantine, of Agrimonye, Flovvers of Nenufarre,Infusiō of Rubarbe. vvith Tamariscus, to the refrena­tione, or bridlinge, of this furiouse humoure. Or els vve must take, a gentle infusione, or ex­pressione of Rubarbe, made vvith Rosevvater, addinge thervnto sixe dragmes, or an ounce, of Catholicon. But besydes all this, vve may not re­serate, & restraygne this laske at the first, as the common poeple suppose.

But amongst the externall remedyes, Phle­botomye is verye commodiouse for the same, but must alvvayes be effected vvith Knovvled­ge of the cause, for that sometimes is more ne­cessarye then all the other remedyes, & especi­lye, vvhen as the intemperature beinge caused out of the Liver, vrgeth vs thervnto but not heerby to debilitate the forces & strēgth of the Patient, vvhich in this dissease reqvire to be fir­med, & cōforted,Phlebotomye must be done vvith dis­cretione. the sayed phlebotomye must vvith all discretione be done, because the Pa­tient, throughe the deprivatione of to greate a qvantitye of Bloode at one time, might chaūce to be vvholye superated, & overcome, and fall dovvne deade vnder his packe, or burthen: For it is knovvn vnto all men, that the blood is the treasure of lyfe or the domicille, & habitatione of the soule: Secondly vve may not in Phlebo­tomizatione be to timorouse & fearfull, for in place of Phlebotomye, & yeeldinge ayre to the Vaynes, the ague chaunceth sometimes to cō ­tinue, & increase alsoe, the bloode also gettinge noe ayre, is thē polluted vvith some sharpenes, or venoumousnes, vvhich therafter corrodeth, & consumeth the entralles.

The Patient is praeserved by his strengthe, throughe goode nouriture, & feedinge, vvhich is easye of digestione, & throughe the Cordialle corroboratinge medicamentes.

Amongst the astringent Medicamētes,Astringē ­tia. ther are the oyles of Quinces, of Roses, of Masticke, & oyle of Mirtles, beinge intermingled vvith a little astringent poulder, in like sorte ther are also confortative Playsters, amongst the rest, is the cōfortative Plaster of Vigo, vvhich vvith cō ­sideratione, must be vsed, as before vve have sayed.

VVe may in this dissease alsoe vse some cer­tayne fumigationes, & exsiccating Lavamētes.

Those thinges vvhich are most belonginge, to the dissease, are the mundificationes, and the cōsolidationes of the vlcerationes: For the mū ­difyinge of all vlcerationes is nothinge els, thē to cure, to exsic [...]te, & to cōsolidate thē. VVher fore first of all vve must elavate the vlceratione vvith a clisterye, and if the same be profovvnde, & deepe, a little absterge the same, mixinge thervnder some confortative thinges, to forti­fye, & strengthen the intestines.

VVhervnto as thē vve may vse, mellifyed, or Honyed-vvater, Barlye-vvater, vvith the yolkes of Egges, Suger, Honye of Roses, & vvith many other such like thinges beinge mixed thervn­der: and if soe be vve as yet desire more to mun­difye the same, vve must then vse the decoctio­ne [Page] of vvheaten branne, & of Vetches: and if soe be ther be calidity adioyned therūto, vve must thē adde thervnto Sap of Roses, of Plantine, or iuyce of Night shade, or Solatri.

Reme­dyes to consolidate the vl­ceratiōs.Touchinge the cōsolidatione, that is effected throughe the providence of nature, or vvith a­ny incarnatinge medicamētes, vvhich vve call Sarcotica. Vnto cōsolidatione are foure thinges necessarye, to vvitt, the clisteryes of Plantine, of Hogges grasse, and of VVillovvleaves, vnto the vvhich vve adde Goates suet, Butter, oyle of Roses, or oyle of svveet Almondes, vvhervvith the vlceratiōs be internally annoyneted, the pun­ctione, & acuitye of the vlceration is somvvhat diminished, vvhich cōtinually soacketh therī.

VVe may also verye fitlye mixe theramōgst, the sealed earth, Franckinsence, Sangvis Draco­nis, & amongst manye other this one incarna­teth very much, to vvitt the Lachrima Thuris, but vve must note that all these Poulders, be verye diminutlye pulverisated, least that in the vlce­rationes of the entralles, they chaunce to cor­rode, & bite.

Clisteryes made on divers fashones.As touchinge the Clisteryes, vve must at the first vse, payne assvvaginge clisteryes, as ther are those, vvhich are made of freshe milcke, vvher in vve must contunde some yolckes of Egges, oftentimes reiteratinge of the same: and thē v­singe the absterginge clisteryes, vvhich gentle­lye vvil purifye the intestines. VVe make also divers other of divers fashons, & formes: vvher vnto this shall serve, for an example of one.

(rum) Rosar. rub. Tapsibarbati, Furfuris Hordei, ana P.j. fiat decoctio in Lacte, in colatura, ad lib. j. vel, ad quartastres, dissolve oleiras. colati, Sacchari albi a­na ℥ ij. Syrupirosar. siccarū ℥ ij. fiat Clyster, additis duobus ovorum vitellis.

VVe may vse this clister, & reiterate the same as often as vve perceave it to be necessarye: but vvhen vve must vse some astringent Clisterye, vvhich vve may not doe, vnles that the repeccating humors, be cleanlye purged out, and then vve may vse this subseqvent clisterye, or anye other such like.

(rum) Furfuris macri, paleae Hordei, tapsi Barbati, Cen­tinodiae, Chamemillae, & summitatū Anethi, ana M j. fiat decoctio in aqva Chalibeata, velin Lacte vstula­to, in colatura, ad lb j. vel ad quartes tres, dissolve syr: rosar. siccarum, vel mirtillorum ℥ ij. Vitellorum ovorū iij. pulveris Mastiches, & sang. draconis, ana ℥ iij. fiat Clyster.

VVe may also cōstitute, & exordinate, to this end divers & Sundrye potiones, & Electuaryes, also the Kindes of Diacorallum, nature of a Harte fine Bolus, sealed earth, iuyce of Berberis, Ribes, conserve of Roses.

The Empiricke medicamētes, vvhich the Methodicall Physiciones, doe so disdayne, & estee­me of little vvorth, are those vvhich vve throu­ghe experience, & throughe the divturnall vse have fovvnde to be most excellēt, vvhich being vsed vvith iudgemēt, are not vvholye to be dis­dayned, seinge that Galen testifyeth, that the Physition, must be established one tvvo fundamē ­tes or foundations, to vvitt, on the reason, & on the experiēce, vvherof the Reason is, as it vvea­re the Soule of the same, vvhich measureth, & ponderateth all thinges: and the Experience the body, as a providēt, tutor & Schoolmaster.

Experiēce teacheth vs, that the Rubarbe, on vvhat manner soever vve administre the same, (but especiallye the infusione therof) is verye commodious & profitable in this dissease, as in like sorte also is the Spiritus Vitrioli, vvith Rose­vvater, & vvithe Plantinevvater, & also beinge administred vvith Cynamomevvater. Ther is a sugerye dulcor, or svveetnes, extracted out of Leade, vvhich never deceaved the hope of the right vvorshipfull Mr. Duion,Monsr. Duion an expert Phisition vvhich is a verye experte, & learned Physition, & vvherof I have attayned the best, of this discours. The Tincture of Coralle, and of yellovve Ambre, extractede vvith Aquavitae is in his operation admirable, also Crocus Martis, Flos sulfuris being administred vvith cōserves of the betryes of the Cornus, Cō ­serve of Roses, Marmalade, Citronpeelinges, vvith manye other such like thinges, are all to­gether verye commodiouse. Because amongst naturall thinges, I knovv nothing that exsicca­teth more, & oppugneth it selfe more agaynst all corruptiones: And to conclude ther are an innumerable sortes of remedyes, vvhich vve must so compounde, that they may have one similitude, or one Analogye vvith the dissease.

Finallye, vve must in an extreame Dysenteria, for the last remedye, endevoure to mitigate the payne, vvith Narcoticall thinges, as is the Oleum Iusqviami, Mandragora, the could seedes, the Phi­lounium. Reqvies Nicolai, & manye othes such like compositiones, vvhich are vnto this dissease v­sed, & vvhich may not be administred thē vvith great iudgment and advice had therone.

The end of this Treatise of the Dysenteria, or Bloodyeflixe.

An Apologye, for the Chirurgians, wher throughe is apparantlye, & evidentlye demon­strated, & shewed, which be the occasions, or causes of death, in divers & sundry, wounded Persons, although notwithstandinge, their woundes weare smalle: wher by the Chyrurgians may be liberated, & excused, from all calumnes, & sclaunders wher with falsely they are accused, & reproched.

THe common discourses of Chyrurgery, are novve adayes farre more meane, & idle, more fabulouse, & vncertayne, thē the Nativityes of the Goddes, the Historyes of [Page 50] the Giantes or the doctrines of the Philosophi­call stone yea & a thousand other phantasticall sommationes,Ther is but one experte Chyrur­giancinal Fraunce- & dreames.

There is novvadayes in all Fraunce, but one expert Chyrurgiane, vvhome everye poten­tate and great Lorde, endevoureth to retayn by them, vvherthrough they are vvont to say I ha­ve the best & expertest Chyrurgian vvhich is li­ving, vvherfore they also laude, & extoll him, to have a million of knackes vvhich vveare never before herde, or knovvne. The one boasteth that his Chyrurgiā, in a verye shorte time, hath cured one vvhich hath binn shott clean throu­ghe his head althoughe the very substāce of the Braynes,Divers fictions, & Lyes. issued therout: the other stedfastlye af­firmeth, that his Chyrurgiane, hath agayn im­posed the Eye of a man, vvhich frō the earth he tooke vp, vvithout beinge deprived of his sight in that Eye, or els that he cut of a peece of ones Liver, or Milte, & yet hath praeserved the life of the man. Farthermore an other vvill bouldlye periure himselfe, & say, that they are but nuga­tiones, & Childrens play for his Chyrurgian to cure, a harqueboushed, or shotten vvounde of the Harte, the Liver, the Milte, the Blather, and the stomacke, and the Intestins and of the great vaynes, yea & is noe more molested ther­vvith, thē vveare the Sould lours of Iulius Cae­sar, vvhich never interrogated hovv forcible, & strong theire enimies vveare, but vvheare they vveare: nether one vvhat place of the Citye the breach vvas bartered but vvhether īdeed it vve are shott or not.Compa­rasion. So that novvadayes, the Chy­rurgianes also doe not anye more aske, nether doe any more endevoure, to knovv the nature, the conditiō, the necessity, the vse, or the vvor­thines, or excellencye of the vvounded partes, but aske only vvhether the man be vvouded, & althoughe all the ossicles of his Legge, vveare crushed, yet vvithī the space of 14. dayes, at the farthest, vvith theire vvater of shottē vvoundes they are able to cure them, although I my selfe doe not disdayne the same, the same beinge administred, & vsed vvith discretton. And breefly to cōclude each lord supposeth that he hath by him an Hippocrates, an Aesculapius, a Podalirus, a Machaon.

Out of vvhich ignorāce, & persuasion, as not to knovve, vvhat vvoundes are mortalle or cu­rable, vvhat vvoūdes are little, or greate, vvhich are of an easy, or difficulte resanation, ther must then necessarilye heerout follovve, that vvhēas any body seemeth to be little hurt & dyeth vn­der the hādes of a most expert Chyrurgiā ether because of the greatnes of the vvound, through any vnhealthfullnes of the bodye, through any concursione of humours, or els because of any vnexpected accidentes, he is then vvithout all compassione, blamed, disdayned and diffamed, notvvithstandinge all his greate paynes or dil­ligence, accordinge to the arte he in curinge of the foresayed Patient hath done & that, because they are ignorant of the causes of his deathe, & allvvayes persuade themselves,A foolish persuasiō that if the Patiēt had binne in handes of theire Chyrurgiane, he vvithout al doubte had not dyed, although that theire Chyrurgian, have experimented & tried little or nothinge at all and is vvholy inexper­te so that by continuance of time vve finde thē to doe, or vvorck noe more miracles thē a common or lay man, and also vvith noe more cer­tayntye, doctrine, nor experience and oftenti­mes in their practise, beinge at theire vvittes, or councels end, are constrayned to sue for succoure, & ayde of their companions, or partakers. Because therfore that in conseqvente times heerafter, these fellovves, should not vndeser­vedlye reape such honoure, & the aunciente Chyrurgianes might liberate, & free thēselves from all calumnes, & of beinge ignorāt vvhich is layed to their charge, and to reqvite, and re­solve the opinions of those mighty, and potē ­tat Lordes vvith reason, because therafter they doe no more blame, and sclaunder the Chyrurgianes, I vvill heere breeflye recite,Some vvoundes are estee­med to be small, vvhich indeede are great and daunger­ous. the occasi­ons of Death, causinge them playnlye, and evi­dently, to vnderstāde that ther are some vvhich of a vvoūd, vvhich vve esteeme to be but small, and of little regarde, doe notvvithstanding dye, & yet of expert, & learnede men the same vvas esteemed, and accounted for a perillouse vvo­unde. And contrarilye, some are cured of great vvoundes, vvhich indeede vve esteeme to be but smalle, and of little regarde, and vvhich vvith all facilitye may be cured.They can not cure all men. Notvvith­standinge beinge impossible for the Chyrur­giane, hovv erudite, & experte, soever he be, to cure all men, althoughe at sometimes they be vvoundede vvith verye smalle vvoundes.

Novv therfore to returne to our discourse,What is required to the re­sanatione of vvoun­des. vve must first of all knovve, that to cure a vvoundede parte, & to restore agayne that person- into his former, & accustomed estate of health thervnto are many thinges reqvired, vvhich I heere normallye, & rightlye vvill prosecute. First of all ther is the integrity, force, & vigore of the vulneratede, & hurte parte, or membre: As evidentlye doe demonstrat vnto vs, the auc­thoritye, reasone, and experience: For accordīg to the opinione, and sentence, of divine Hippo­crates, It is nature vvhich cureth all sicknesses, and disseases sect. 5. Epid. 6.

The vvounded partes are infeebled, ether cō ­sidering the nature of their first conformation or throughe any accidentes, chauncinge to the dissease, or els because of any hurtes, or shottes vvhich happen vnto the same: vve may throu­ghe their nature knovve thē vvhen as the head is to little, for as then it is vvhole inconveniēt: Or els to grosse and so vaste, and ponderouse, [Page] that becaus of the dissease, the patiēt is not able to beare vp the same right on his shoulders: If so be it be perfectlye, and completly rounde for in such a Heade is ether vvanting, the ante­rioure,A Heade noughti­ly formed or the posterioure future, or both of thē together vvhich are the suspiracles, through the vvhich nature disburseth her selfe, of all super­fluityes, vvhich beinge therin contaynede, they retardate the curatione of the vvounde. And if it soe chaunced, that the Heade of your vvoun­ded, vveare indecently formed, the vvound see­minge to be small, (allthough indeede noe Ca­pitalle vvoundes are to be esteemed smalle) and the curation therof be tardife, and the Patiente chaunce to dye therof, vve ought not as then in anye sorte to attribute the faulte vnto the Chy­rurgiane but to the badde formatione of that parte vvhich is hurte, or vvounded.

VVe must alsoe vnderstande the same of the Breaste, vvhich being anguste, & stricte, suffici­ently demonstrateth vnto vs, that the harte and the naturall calor of the same are very feeble be cause the domicille of the harte, & the Lūges is to angustlye formed: vvhich might be the cause that if any body, being vvounded in such an an­gust & stricte breaste, shall vvith great difficul­ty receave agayn his health, because the natural caliditye, being in these partes feeble, & lāguide shall not be able to surmount the Accidentes vvhich ordinarilye happen vnto such partes, as difficulty of respiratiō, through the oppression of the effuded blood in that part, vvhich cā not be digested, nor expelled, ether by the Mouthe, or through the vvoūd, & that for vvante of na­turall caloure, vvhich cōmonly in such a stricte & anguste Breast is very smalle.Abadde formed Backe, or Backebo­ne. The like may also be sayed of the Back, & of the Spina Dorsi or Backebone, vvhich being sōvvhat to lōg as tho­se vvhich cōtumeliouslye, & diridingly vve call Elevenribbes, because they have such huge and vaste long sydes vvherof vve neede not doubt, but that such a Back or Backcbone, is farre mo­re debile then others, & therfore more apte, and prone to receave anye vnnaturall humiditye, vvherfor also in such vvoūdes there happē gre­at fluxiōs betvveen the Muscles, & the skinn & betvvixte the distāces of the same, becaus of the great quātity of excremētes, vvhich have theire accourse out of the Braynes, & other partes of the body, vvherby, betvveē the Muscles & the distāces of the same, there sincke manye superflu­ous humors, vvhich by consequēce of time are chaūged into some venoumouse humiditye, & matter, through the vvhich vve are sōtimes cō ­strayned, to make some great apertione, vvhich require a long continuance of time to the mū ­difyinge therof, & vvholy to be cured, yea & sō ­times also aulter & chaūg into fistles, becaus of the tendernes & softenes of the part, vvhich cā not be shut, nether through ligamentes resera­ted, or cōpressede, as an arme or legg. Hippocrates hath observed, & noted that betvvixte feeble,A nota­ble sen­tence. & diseased fleshe ther alvvayes descēdeth & sīcketh a vvaterishe humudity, vvhich easily can cor­rupt. The small, thinne,Hippes vvhich a­re baddly formede & Hern fashoned hip­pes & legges, vvherof vve commonlye say they goe one VVayghtes, & are vnder, and above all most of aequall crassititude and thicknes, cōtra­ry to those vvhich vve saye, to be hipped, & leg­ged, or have a payere of goode, & stedfast stiltes vnder thē, vvhich are vvel proportioned, vvher of daylye experience teacheth vs, & that to our greate greefe, and sorrovve, that such persons, ether being vvoūded in hippes, in the legges or in the feete, are subiecte vnto many, and divers accidentes, & the vvoundes alsoe difficult to be cured & mūdifyed,Legges vvhich a­re of a difficulte resanatiō. in the vvhich oftētimes above the ordinary fluxiōs therin engēdreth prou­de fleshe: & novve being as it vveare almost re­adye to be Cicatrizede, can very difficultely be brought thervnto, & being cicatrized, through anye small occasion bursteth open agayn. And if so be the bones be offended, or brokē, as then the Ioyncte most commonlye consumeth, and vvithereth & the health very retardately can be agayne restored.

Novv all this vvhich hath binn sayed,The most truest, & assuredst signe of the imbi­cilitye of any part is suffi­cientlye knovvne, vvith all the diseases of all o­ther partes. But vve must generallye note, that the most assuredst signe, of the imbicilitye of a­nye parte, chaunceth through, the vntemperat­nes, and badde formatiō of the same: for if so be that the Temperamente, had binne goode, and by consequence, the formative virtue had binn stronge, she should as then exactlye have for­med that parte: for by the operation is the ope­rator therof knovvne. VVherfofe Aristotle is of opinion, that the incomplete creation, hath her deformity, through the vvante of the frigide, & could nature, and the imbicillity of the Sperma:Similitu­de. for even as vve see, that the Mechanicall opera­tours, or handyecraftes men, can not make any peece of vvorke so perfect, & so neate, of a badd peece of stuffe as, they might vvell & easily doe, of a good, and apt and tractable peece of stuffe, vvhich is not spoyled, nor corrupted.

All vvhich is before approvede by the thirde rule, sect. 1. of the sixte Epidemiorū Hippocratis, & founded, on an excellēt Axioma in the commē ­taries of Galē, vvhere be sayeth, Imbicilla membra multum pravumque excrementum colligere consueve­runt.

Such a congregatiō, & excrescence of venoū ­ous excrementes vvhich chaunce to congrega­te themselves together in such deformed partes doe drounde, choacke,Suffoca­tiō of the naturall calidity. & oftentimes corrupte the naturalle caloure, first of all of the diseased parte, and then of the vvhole bodye, after the vvhich must necessarilye follovve death, vvith­out the Chyrurgiane being able to remedy the [Page 51] same or vvith any aequitye might therof be bla­med although notvvithstanding oftētimes the Princes & great Lordes, vvhich of these matters have smalle knovvledge, vvithout occasiō doe blame, & reproache theire Chyrurgians: yea & some times also accuse them, & require of the magistrate to have punished, & themselves also vndeservedlye punishe theire Chyrurgians.Acciden­tal imbi­cillity.

Touching the accidētalle imbicillity, vvhich hath binne from the beginning of the first cre­ation, it is certayn, that as vve have sayed of the momorsions, or Bittes, even so in like sorte vve may saye of the diseases, that the first are verye nocent, vnto the last: For Quae non possunt singula, multa nocent: & a little therafter, Gutta cavat lapi­dem, non vi, sed saepe cadendo. VVe doe not throu­ghe sicknes a mende, & the pitcher goeth so of­ten to the vvell, till that in the end he returne broken home agayne. For all diseases are of so venoumous a nature that although they are cleane cured, yet they relinquishe some badde re­liques in the parte, vvherthrough they may the easyer returne agayne, vvherfore of our Divine Hippocrates it is called Philostrophes, The one disease follovvinge the o­ther is ve­ry troublesome. vvhich signi­fyeth, noe return agayn or at the least, such par­tes are as then most subiected to receave some nue disease: also the sayed Hippocrates sayeth far­ther, in his Booke of internall diseases, that all aegritudes, vvhich follovv any other disease, are allvvayes most cōmonlye mortall: because shee findeth the naturall forces debilitated: vvhich vve allsoe must vnderstande of the vvoundes, vvhich are receaved in anye partes of the body, vvhich before have once binn vvounded.An ague being cu­red com­monlye leaveth an Empire­ma after her. The­se dispositiones are of oure Physiciones called Diatheses and are esteemed to have great forces, for the generatione of diseases or for an incura­ble confirmation of the same: In like sorte allso relinquesheth an Empirema after her, vvher by that Personne is made more subicte to receave more agues, & that in such a sorte as a hott ovē, vvhich hath once binne heated, is more apte a­gayn to receave the heat: as in exāple, ther be a­ny on vvhich hath once binn vvounded, agayn being vvounded, & especiallye in the same pla­ce, vvher before he vvas vvoūded it is impossi­ble that the sayed parte shoulde have, the same force, virtue, or vigour, to repugme and to resi­ste for the curatiō vvhich before shee hath had­de, before ever shee vvas vvounded: and that in such sorte as in a Corselet or harnas, vvherone hath binne a shott, and having gotten a crushe, or bendinge in, allthoughe the same be beaten, and malleated smothe agayne, yet it vvill never be beatē so smoothe, nether so playne & strong as it vvas before it hadde the shott. Nether can can I heer praetermit, to recite those vvhich ha­ve itenerated, and travelled throughe the Suda­torye regione, and passede, throughe the driveling, or sputaminouse climate, & beinge agayn ready to travell the same vvay, being grevous­lye vvounded, vvher there is one vvhich is safe­lye returned from the iournye vvith good for­tune, there are three, yea & foure vvhich by the vvay doe faynte and so dye: vvherfor as thē vve admire, vvhy they are not cured, or vvhye their resanation is so tardife, not considering that the vvounded vvas halfe before corrupted,The vvoū ded vvhich have binn in the drivelinge climate can verye difficult­ly be cu­red. & that his humors have vvholy binne aultered throu­ghe the venoumousnes of the foresayed disea­se: or havinge binne cured therof, have as yet retayned any aulteratione in the Liver, or in a­nye other internalle partes, vvhich gathereth continuallye many venoumous excrementes, vvhich the foresayed parte vvithout anye ces­sation, dischargeth into the vvounded parte.

And soe most commonlye the occasione of death commeth throughe the inordinate state of life, in eatinge,Gluttony is the oc­casion of much evel. and drinckinge vvithout ob­servinge anye rule of victitation, hauntinge al­so of vvoemen, and not suffering themselves to be handled, of the handes of the Chyrurgian, as the cause requireth, it be ether in tenting of the vvounde, by inscisione, by cauterisatian, & by keepinge himselfe quiet vvhich all aunciente Chyrurgians so highly and exactlye commaū ­de,Ease is goode for al vvoun­des. to the furtherāce of the curatiō of the vvoū ­de, follovvinge the sayinges of Celsus, that Opti­mum Medicamentum, quies, & abstinentia, is: Soe that I am intended, as of a thinge that is of all men knovvne, not much in this place to speake therof althoughe notvvithstanding, it is often­times the occasione of death, hovv lightly soe­ver they be vvounded: yea allsoe and of greate vvoundes, being cleane out of daunger throu­ghe theire inordinate manner of lyfe, especial­lye in eatinge, and drinckinge, doe agayne fall therin, and come to a farre more vvorse estate then ever before they vveare, yea and someti­mes allsoe dye therof: for it is most certayne that.

More ther are which of Gluttonye dye heere,
Then of blowes, or shottes to death come neere.

So that vve vvill novve, handle, or treacte,Conside­ration on the time of the yeare. of the times of the yeare. There is nothīg more manifest, then that many vvounded personnes might of theire vvoundes be cured, if soe be the time of the year, vveare such, as it vveare requi­site it should, that is, if soe be the foure seasons of the yeare, reserved their naturall temperatu­re & quallity: It is also apparent that the intem­perature of the ayr, the disordre of the time, the astrolicalle venoume, & other funestall influ­ences, doe make the vvoundes incurable, or els verye difficulte to be cured, and chaungeth the habitude, and complexione of men, throu­ghe the chaunginge of the time, & through the Astronomicall constellation, vvhich over vs is [Page] praedominating. As if so be the vvinter, vvhich ought indeede to be coulde,The irre­gulatede season of the yeare aultereth our bo­dyes. vveare vvarme, & the summer vvhich ought to be vvarm, is coul­de: Also vvhen it is novv hott, thē could, novv drye, thē moyste, vvithout the time of the yeare requiringe the same to be othervvyse then he ought to be: vvhoe cā doubte therof but the sa­me must be preiudiciall, to the vvoūded patiēt? because our bodyes, heere bye receave mervay­louse, & suddayne alterations & chaunginges, vvherthrough out vitall spirites, & humors, are vvondrouslye, & vvith great daunger aultered, observinge the sayinge of Hippocrates, vvhich a­voucheth that all repentine & subite permuta­tiō, hovv soever the same may be are vnto our bodyes very preiudicialle.All repentine, & suddayne chaunge is daun­gerouse. The divrnalle expe­rience demōstrateth the same vnto vs, for if so be in the vvinter, in stede of a drye coulde vvin­de, there respire a southvvest vvind, vvith vvar­mishe shovvres of rayne, ther then cōmonlye follovve greate corruptiones in our humors, vvherthroughe the vvoundes doe putrifye, and gangraenize. The infected ayre, may also be an occasion, of the death of manye vvounded per­sons, hovv little soever they sōtimes are vvoun­ded: because vvithout ayre vve can not Live, vvhich allvvayes such as it is vve must receave,We can not live vvithout ayre. & that not ōly through the mouth, & through all the conductes of our bodye, & poro [...]tyes of our skinne, & through our Arteryes, vvhich a­re situated vnder the porosityes of our skinne, frō vvhence the foresayed ayre doth dravve to­vvardes our Lunges, sōvvhat to cool the harte, & refreshe it & be as it vveare a nouriture vnto the same, frō vvhence the sayed ayer is farther spreade & devided throughe our vvhole bodye, vvherby it thē chaunceth, that if so be the same be corrupted, & infected, consequently also the foresayed Harte, vvith some other of the noble & vvorthiest partes are polluted, in steade of beinge praeserved, & mayntayned, in theire forme & virtue.The ma­lignante ayre pol­luteth the harte. Galen in the ninth of his Methodes, at­tributeth so much to the ayr, that he sayeth that the especiallist, & principalist demonstratiō to cure anye dissease, must be observed out of the ayre: because vve cā in noe sorte, be vvanting or missinge the communitye, and vse therof.

Besydes al these occasiones, there are yet cer­tayne times of the yeare, vvhich are irreprehē ­dable, & yet cleane contrarye to certayn dissea­ses: for vvhoe is he that doubteth that the starre Canicula doth not disturbe the vvynes,Virtves of the doggeda­yes. & cause­the the same to boyle, vvhere he lyeth in the fellers? as by experiēce vve finde & in Plinio vve may reade, that the same also causeth our blood to boyle vvithin our vaynes,Lib. 14. Chap. 18. that sōtimes there follovveth such a superfluous sangvinatiō, that by noe meanes it can be restaygned, by the vvhich meanes the same also flovveth tovvard the vvounded parte, vvhich before vvas tormē ­ted vvith sufficient payne enoughe. In like sor­te also vve perceave the Autumne,The Au­tumne is enimye to all pul­monicall vvoundes or Hurvest to be an enimye to all vvoundes of the Lunges, as is apparēt by the 10. rule, the 3. of the Apho­rismes, becavse they oftentimes chaunge into fistles or into pectorall Apostemationes. The penetrable coulde is allsoe a sore enimye to all vvoūdes in the Heade, Aphor. 3. lib. 5. Farther­more Hippocrates dissuadeth vs, Lib. de aere, VVe must not purge in the dogg dayes. aquis & locis to administer any physicke vnto the pa­tientes in the greate constellation of the starres vnder the Solsticium, nor vnder the Aequinocti­alles, because of the greate perturbations, & al­terations, vvhich as then are in our bodyes, by the vvhich meanes the vvoundes as thē are far­re more molestious & mortalle: vvhich must al so be vnderstode of the greate vvyndes & thun­deringes, the effectes vvherof are so admirable, & tirrible, in inanimate thinges, vvherbye vve may the lesse admire at the greate alterationes, vvhich they doe cause in the vvoundes, & disse­ases of mens bodyes, vvhich bodye is the most sensiblest, and the most dilicatest, amongst all the animate bodyes.

Besydes this vve have spoken of the times & saysons of the yeare,An excel­lent observation. vve may also adde heerūto that the Carpenters, & the Architectors, doe al­soe observe a choyse of the fellede, & cut dovv­ne vvoode, vvhich at this time, or at that sayso­ne of the moone hath binne felled: esteeminge the vvoode, to be more moyste, & replete vvith vvormes, & more subiecte to corruptiō, vvhich is felled in the ful Moone, & that more durable yea & all most incorruptible,The ina­nimate thinges doe feele the effec­tes of the Moone. vvhich is felled in the decreace of the Moone, as in Palladio vve may reade, in his Treatise of Ianuary, & Novē ­bre, Caesar also sayeth the same, in his commen­taryes, on Arat: that the Moone hath not onlye povver over that vvhich hath receaved sēsibili­tye, but that alsoe the stones, the bones, and the VVoode doe perceave the effectes of the Moo­ne, vvhich being of the Moōinfected, vvexeth full of vvormes: vvherfor the common phraise of the Lavvyers, or Iuristes is as yet observed, de Lignis sua Luna caesis:: vvhich being soe vvherfo­re shoulde not vve also esteeme a vvounde, to be more moyste in a fulle Moone, & more sub­iected to putrefactione, then in the decreace of the Moone, seinge that man is tender of fleshe & farre more subiected vnder the domination, & subiectione of the Moone, & the influences therof, then those thinges,Man is subiecte vnto all inflven­ces. vvhich are inanima­te & have nether life, nor sensation: Above all these praecedente, reasons, and experiences it is manifest, & a commō axiome, that all terrestri­alle corps, are ruled, & governed by the caelesti­all, or supernall influences.

Through all vvhich foresayed occasions, the humors oftentimes being so corrupted, & pol­luted, after death ther are certayn apostematiōs [Page 50] foure in divers places of the body, yea & somti­mes allso, in some of the vvorthyest partes of the body, as in the Liver, in the Braynes, in the Milte, in the Lunges, or in any ioynctes, accor­dinge vnto the imbicillitye of any of the partes of the body, vvhich have binne debile, & apt to receave such impurity of the bodye, vvhich be­inge thervvith, out of all measure charged, ex­pellethe frō him the forsayed impure humors, in anye of the sayed feeble partes, vvhich ther­after is chaūged into purulēt matter, the vvhich there possessinge more place, & makinge more concavitye, thē is requisite, doe expell frō them certayne faetide & venoumous vapours, & par­ticipate the same vnto all the other vvorthiest partes, out of the vvhich insueth, Inquietude, Agues, Convulsiōs, or Spasmus, Phrenesye & in the end necessarily must follovve death perce­aving the vvoūdes to vvaxe blacke & dry, vvith­out being able to iudge therof, or to knovve the occasiō, vvherof this might proceed, notvvith­stāding hovv erudite,Corrodinge matter causeth manye acciden­tes. & experte soever the Chyrurgiā be, nether being possible for him hovve small soever the vvounde be to save the Patiēt, havīg noe signe vvherbye he may knovv, vvhe­ther that venoumouse matter, hath implanted it selfe in any of the sayed vvorthyest partes, or not. Nether.

Can the physicione cure all those,
Which are incurable, and without repose.

Cōstitu­tiō of the vvoūded.Let vs therfore novv consider, & serche out the pecvliare, cōstitutiōs of the vvounded: so­me ther are vvhich have little blood, tovvardes the resanatiō of their vvoundes: others have to much vvhich notvvithstāding, is nether to the curation goode enoughe, nor pure enoughe.

Hippocrates speakinge of those vvhich have to little bloode, in the 24. rule of the fourthe secti­on, in the sixt Epid: sayeth that those vvhich ha­ve theire entralls hott, & as it vveare burninge, theire fleshe could & have binn badlye nouris­hed,Which a­re vnhe­alth same poeple. vvhich commonly vve call vnhealthsame poeple, vvho having receaved in theire bodyes some great vvoūd, are most cōmonly alvvayes very difficulte to be cured, for vvant of materi­alles: vvhich also vve may see to be in aged per­sons, vvhē as they are any vvhear vvounded, or by chaunce breake their legges. VVe have also an excellent rule in Hippocrate vvhich is, the 6. Aphorisme, of the sixte sectione vvhere he say­eth Hydropicorum, A nota­table sen­tence. & lentiginorum on other pla­ces he addethe therūto Vlcera non facile sanantur: of those vvhich are troubled vvith the Dropsy, because theire bloode is to cleere, & vvaterishe: of the lentiginouse, because theire bloode is to sharpe, or tarte, & for that occasione can make noe goode combinatione, or healinge: & vvhe­reby this might be occasion, to vvit, vvhether it be through nature, or by the inordinate māner of life, of eating, or drincking, it becaused, as by the drincking of stronge vvynes, or by eatinge of garlick, of Onions, of Porrhy, of pouldred, or saulted meate, or of spices, as the suldiours vve­are vvonte to doe, that is little belōging to our purpose. Nether can I heer praetermit to spe­ke,Perturba­tion of minde. of the perturbāce of the minde vvherthrou­ghe most commonlye the Martialistes are very much afflicted, vvhich through the generosity of their courage, if so be that in any assault, bat­tayle or skirmishe, they have not valiāte enou­ghe born thēselves, or at the least not to the cō ­tentatiō of their Capitayne, & have not as Cae­saristes behaved thēselves, & fought & are ther­fore blamed, of those vvhich are their, enviours & such as hate thē, vvherī they doe so vehemē ­tlye vexe, & greeve themselves, that it ircketh thē, & doe so melancholize themselves therin, that they doe vvholy neglect thēselves, desiring & vociferatinge for death rather thē to live soe miserablelye in dishonoure. VVherfore also it may happen in the same, (beinge greevouslye vvoūded) that vvhich happened to the Lord of Aussun, vvhich vvas one of the most valiant, & most magnanimouse, gentlemen of all Fraūce, of vvhome it vvas cōmonly for a proverbe say­ed,Hardines of Assun. the hardines, and valoure d'Aussun, causeth vs to adhibite credite thervnto, vvho, throughe I knovve not vvhat mischaunce, & suddayn a­stonishmēt in the first charge of the battayle at dreux, ther arrived & as it vvear overvvhelmed him such a disgrace, for the vvhich he so gree­ved him selfe, and sorrovved that vvithin fevv dayes therafter vvith sorrovve he died: havinge solemlye svvorne, that he vvould never anye more eate, or drincke, vvith vvhich resolution hedyed. Contrarily the souldiors sōtimes, doe so valiauntly cōbate, by the vvhich they vvexe so couragious, & doe so ioy thēselves therin, & therby doe so exalt thēselves, that their harte of tētimes is inflamed, & puffed vp vvith pride of their victory, & honoure vvhich they reape, & enioy. VVhich causeth great alteratiō, & chaū ­ge as vvel in the body of the one as of the other.

And to speake truth,The per­turba [...] are of g [...]ate effect & forces in our bodyes. such motiōs & turbatiō of the minde, are of great forces, in the body of man, they cause therin ether great aegritudes & disseases, or els death: for if to be the motions, and perturbations of the minde, have pover to increace the naturall caloure, or to diminis he the same, of causing the same to dravve in vvar­des, or to expell the same outvvardes & to spre­ade it selfe by the vvhole bodye: & such motiōs of the naturall calour, vvhich doe reduce vvith thē the vitall spirites, & the blood, is an occasiō of all disseases, & of health: ther must then cer­taynlye subseqvute, that the sayed motions, and perturbationes of the soule, and minde, have all povver in their handes of our healthe.

So that it is even as Aristotle, Lib. de motu ani­malis [Page] Chap. 5. sayeth, that the motions, and tur­bations of the minde, doe cause such a remotiō and alteration of the naturall caloure: as Hip­pocrates also testifieth the same vnto vs sect. 5. of the 6. Epidemiorum, & Galenus Cap. 5. secundae de Symptomatum causis and Chap. 5. of the seconde of Methodes;Through pertuba­tions of the min­de, a man may dye. vvhere he demōstrateth, that ther are manye vvhich throughe motione, and per­turbatione of the mindes have died: VVherfo­re Galen also, on the 14. rule, of the 4. section, of the sixt Epidemiorum, those vvhich internallye, have a sharpe corrodent caloure, (vvherfore by by soe much the more vve must prohibite the vvounded) to abstayn from ire, and choler, and from all turbations of the minde, vvherbye the humors might be moved. The sayed Galen in his booke de sanitate tuenda demonstrateth, that all turbations of the soule & all motions of the minde, do ingendre greate quantitye of Cholera vvherby are caused great inflāmatiōs & fluxions in the vvounded parte and per conseqvence a Gangraena, and somtimes in the end a suddayne death.

Amongst all other turbations of the spirites, Ioy is that vvhich ought to cause the least acci­dentes vnto our bodyes, notvvithstanding vvas the same so immoderate, and violent in Chilo­nio lacedemonico, Sudday­ne death of Ioy. & in Diagero Rhodiano, both the vvhich soe ioyed themselves, perceavinge their children victoriouslye to returne over theire e­nimies, that of ioy they both immediatlye, and suddaynlye died: for through such immodera­te ioy, the bloode and the vitall spirites of the Harte, are vvith such vehemēcy reverted from the Harte, and diffused and disperced, throughe the vniversall bodye that the Harte, is vvholye destitute of his naturall caloure, & the persone must necessarilye fall into syncopizatione, or fayntnes, out of vvhich commonly follovveth death:Virtues of mode­rate ioy. But if the ioy be moderate, it fortifyeth, and strengtheneth the animale, & the naturalle virtues, stirreth vp the vitall spirites, & sugge­rateth the digestione, and is consequently com­modious for all the constitutione of mans bo­dye, vvherthrough the Ioynctes, are throughe­ly soacked, & moystened, because of the humi­ditye vvhich is disperced throughe the vvhole massa of the bloode, soe that by this meanes, the vvoundes are better mundified, and incarnated and those partes doe increace, and pingvifye.

Effects of Cholera.In like sort alsoe doth Cholera, or anger, and yet also more, then the immoderate ioy: becau­se heerby, besydes all this that in the spirites & humors of the bodye is caused greate corrvpti­one and they throughe theire greate heat, & ca­loure chaunce to inflame, and by this meanes consequently, the vvhole habitvde of the body is replete vvith putride agues, hovv little sicke soever the persone be, vvhich foresayed agues, if they chaunce to afflict the patient vnto death as it oftentimes happeneth, vve most commō ­lye then attribute the same vnto his vvound,Acciden­tes of sor­rovve. as if of the Chyrurgiane he had not binne vvell handled, and not to the ague. Is it not evidente enoughe vnto vs, vvhat accidentes are caused throughe sorrovv, and greefe, hovv healthfull, & sovnd soever the personne be vvhich is ther­vvith intrapped? for she soe reserateth, and as it vveare strictly occludeth the Harte, that by noe meanes there can engendre anye vitall spirites, and hovv fevv soever ther are, yet they may not be dispercede vvith the bloode throughe the vvhole body, because the same is grosse, and te­nebrous, by the vvhich the vitall virtues, and al theire accōplices, are debilitated: so that in the end a man is in his minde vexed, & hebede,The me­lācholic­ke doe hate thē ­selves. the Harte omitteth all ioy, & pleasure, he odiously hateth himselfe, fallinge into desperatione, and raginge, havinge lost his livelye coloure in his face, consuming the body, vvherby oftentimes must follovv death.

It vvill not also be alienate vnto our purpo­se, to the a poroving of my sayinges, that I heere recite that vvhich the father of eloquence hath vvrittē ad Atticum, the vvordes vvherof are the­se: It vveare an excellent matter my good frend Atticus, that man could live, vvithout meate, or drincke: but yet a farre more excellellēter mat­ter if so be vvithout anye envie, and hate vve coulde Live: because those viandes vvhich vve eate, doe corrupt nothīg els thē our humours, but the trayterous envie, and sorrovv, doe consume vs evē vnto the bones: Envye, & ma­lice consume the bones, & corrode the entralls, as vve playnlye may behoulde: for man sicke­neth, through some certayne envye, & malice, of the vvhich he by continuance of time dieth. Doest thou not knovv by experience, that tvvo torturors, vvhich vvill deprive a mā of life, that the torturer of greefe, and sorrovve is the most cruellest, yea then of the Gluttonye?Effectes of stupe­factione.

Nether may vve heere omitt to recense, and speake of the obstupescēce, & feare, vvhervvith the covvardes, & faynte harted are oftentimes touched, and taken: This stupor causeth in vs, the same accidētes vvhich the sorrovve causeth but somvvhat greater for the time: for this fore sayed stupefactione, and feare, expulseth from him, & retracteth tovvarde the harte (but vvith more festination, & more raptnes, then the sor­rovv) the bloode & the vitall spirites, vvherfor vve may perceave, that the face in the time of stupefactione, & feare, vvaxeth pale, and the ex­ternall partes coulde, vvith tremblinge of the vvhole body: the Belly relaxateth, & the speech fayleth, vvith a greate reverberation of the har­te, because that throughe the greate quantity of bloode, & of the spirites, vvhich suddaynly doe retire thethervvardes, being allmost suffocated can verye difficultlye move it selfe, but greatly [Page 53] desireth to be refreshed, and discharged of such a sarcinatione, so that oftentimes ther follo­vveth death, because the bloode being dravvne tovvardes the Harte, suffocateth it selfe there, & by that meanes the naturall calor and the vitall spirites beīg extingvished,Error of the vulgare, & cō ­mon poe­ple. vvithout the vvhich the life of man can not be preserved.

If so be that anye bodye beinge vvounded, through perturbatiōs of the mind doe chaūce to dye, the vulgare & commō poeple, vvill not attribute the occasiō of death vnto chose prae­cedent, or praenominated occasions, but farre more to the negligence, and ignorance, of the Chyrurgian, vvhich hath not intreacted him, as it vveare convenient he had done,Feare and nicenes doe im­peach he­alth. although that those vvhich have a more sovvnder iudge­ment of such occasions, vvill iudge clane con­trarye thervnto, and others. The like also may be sayed of those, vvhich vvill not allovv of the vvill, and intente of the Chyrurgian, nether of anye other remedyes vvhich vveare commodi­ous, and proffitable for his health, beinge ether to timorous, or delicate, to suffer any apertion, vvhich for his disease had binne necessarye, to administre issue, & passage to some corrodent matter, or parcells of bones, that lye there prae­pared & readye to be taken out, vvhich by thei­re remansione in that place, doe also corrupte the finitimate partes, doe alter & permutate the remanent part of bone, and corrupt the Mar­rovve, vvherby the health, can not suddaynlye follovve, as the Chyrurgiane is exoptatinge, & vvishinge for the same, yea also & by this mea­nes oftentimes remayne incurable, by vvhich occasione the Chyrurgiane,The Hi­storye of Duke d'Aumal­le after­vvardes Duke of Guyse. vvith his Patient must hope for that vvhich his Patient vvill not suffer, and yet notvvithstandinge is required of his disease. And to this end Du Bellay, reciteth in his memoryes, that the Duke d'Aumall, son­ne to the Duke a Gvyse, being mortally vvoū ­ded, vvith a splīter of a laūce, vvhich pearced his Eye, sayed to the Chyrurgians, intreate, or han­dle not my sonne as a Prince, or mightye Lord, but as a Pioner, or servant: vvhich vvas alsoe an occasione of his resanation, because he suffe­red,Contem­plation of instru­mentes. that the tronchone of the Launce, vvhich stucke clean through his heade, to be vvith for­ce, and violence dravvne therout.

And if therfore vve desire to enter into the contēplatiō of the diversityes of instrumemē ­tes vvhervvith the vvoūdes are made, vve shall then finde sufficient occasion, to establishe the vnexspected death considering onlye the mat­ter vvherof the vvoundes are receaved, as vvell of the small, as greate vvoundes. Those vvhich have vvritten of Agriculture,Wher­vvith the vvounde is made must be cōsidered or tillage, & Gar­dening, as Cato Plinius, & Columella say, that the­ris greate difference, vvhether a tree be vvith an Iron knife engraffed, or vvith a knife of Bone. And vve make little or noe differēce, vvhether our bodyes are vvounded vvith Leade, Iron or Brasse, seing that brasse being mixed vvithe the matter of our vvoundes resolveth it selfe into viriditye, vvhich corrodeth the fleshe, and cau­seth somtimes such an inflammatiō, that death therafter follovveth. Nether is it sufficiēt, that in shorte time, vve have accommodated this mettle vnto our ruine, but novv by little and little vve make it four cornerde, vvhich is farre more daungerouse, thē if it vveare rounde, be­cause throughe the quadrangulatenes therof, it rescindeth, cutteth & breaketh in peeces al that vvherō it glaunceth, vvithout any smalle hope of resanatione: as also somtimes the bullets are fastened together vvith coppervvyer by vvhich meanes they cutt a sundre all fleshe, vaynes, ar­teryes and Synnues, vvhich are in that parte.

And becaus that those men, vvhich cōmon­lye vve must give account of our cures,A notable Historye of the daughter of Nerio. ar farre more stirred vp through exāples thē vvith any reason, vvhat example is it of the daughter of Nerio vvhich is discribed in the fifte booke of E­pidem: Hippocratis, vvhich being but of the age of 20. yeares, and beinge smitten iestingly, of one of her playfellovves, and frendes, vvith the pal­me of the hand, on her forehead,Note the circūstan­ces of the blovve & the death vvill see­me more admira­ble. is therof gro­vven mute, asthmaticke, or shorte of respiratiō and fallen into a convulsione, and tremblinge, and so the ninthe day therafter died. True vvill the backbiter or sclaunderer say that chaunced throughe the commotiō of the braynes: vvhat ansvver? of such a little blovv, vvhich vvith the palme of the hand vvas done, and of a mayden, frende and playfellovve, iestinglye strikinge a mayde of tvventye yeares? VVhye shoulde not then the same commotione of a varice, or bur­sted vayne, not onlye in the Braynes, but in the Breste also, vvhich happeneth to a souldioure, vvho hath ridden the space of ten, or tvvelve hovvres longe on a harde trottinge Horse, and vvho before hath taken greate paynes, and tra­vayle, & hath led an inordinate manner of vic­titatione, the vaynes of the Lunges, & the Har­te spanned, & extended, or svvollen, vvith vvy­ne vvhich is as it vveare a corselet vnto them,Wine is necessary for soul­diors, and combata­tes. vvhervvithe they adorne, & arme themselves, vvhen as they assault their enimies, and especi­ally in Battayle, vvher they doe straygne them­selves vvith lovvde clamors and scritchinges, & vvith fightinge, and furiouslye assaultinge, not dallyinge, or playinge vvith their enimyes, but bouldlye incountring them vvith Launces, on theire bodyes, and thvvacking the on the other vvith courtelasses, and vvith Pistolls, and Mus­kettes, shootinge each, at other, by that meanes to murdre on another, yea and they also vvhich are completelye harnassed, beinge lifted out of theire saddles lye one the earthe for the other Horses,Discom­modityes of vvarres to trample one vvhich not only one or tvvo dayes have binn in greate trouble but the [Page] vvhole before vvinter have suffered in tollera­ble coulde, and marched through, rayne, vvind hayle, and Snovve, or els have travayled the vvhole sommer, through extreame heat of the sunne, and have received all the iniuryes of ti­me have bin hardlye lodged yea and sometimes vnder the resplendēt starres, living on his pray vvhich he hath gotten, somtimes halfe dressed, or ravve, hott or coulde not tarryinge the time, of the meales sometimes beinge replete vvith, filthye, stinckinge and corrupt viandes, and for his drinck harshe, noughty & tappīges of vvy­ne, or els foule and impure puddle, yea & stinc­kinge vvater, havinge consumed most of his ti­me vvith nocturnall vigilations, laboure, feare, stupor, anger, & melancholye.

Manye ther are vvhich for vvant of succoure doe dye.Others dye because in time they are not dres­sed and succoured, vvhich as yet not long a goe is happened, vnto our great sorrovv, & lamen­tatione, to Capitayne Roux, vvho vvas shott in his cheeke, & rising, to avoyde a clistery, vvhich vvas administred vnto him, had such a fluxione of bloode out of his vvounde, during the space of eight hovvres, vvithout finding any Chyrur­giane vvhich coulde restraygne the bloode, soe that in the end he vvas cōstrayned to yealde his spirite, my partakers, or compagnions, Ponget, le Gendre, and Hubert, and I, beinge charged to tarry vvith the King that night in the trenches: therfore the Chyrurgians ought noe more to be blamed, then vvhen the disease is so deeplye rooted, that ther is noe more remedye or cure for the same, for as vve say by the commō pro­verbe, or oulde adagye.

To serotine doth Doctour then beginne,
When the disease to deepe is rooted in.

Manye thinges are often­times vvātinge vnto the vvoūded.Ther are othervvyse many thinges vvanting by the vvoūded, vvhervvith vve might succou­re thē, & solace thē as it is requisite vve should. VVe see oftentimes greate Lordes lodged in an aperte place vvher the vvyndes blovve on al sy­des, beinge destitute of oulde linnen to dresse them vvith, & have very small store of victual­les, and drinck, I heere omitt the poore souldi­ours, vvho being vvounded must lodge on the earth.

Obiectiō.Therto may novve be ansvvered: I confesse that sometimes of the yeare are intemperate, & vnordinate, that the ayre also is infected, & cor­rupted & that the vvounded also have vvant, & are destitute of manye thinges, & breefly to cō ­clude, that manye of the above rehearsed thin­ges doe fayle: notvvithstandinge ther are many cured vvithout anye accidentes chauncinge to theire vvoundes, and for vvhose sake take little paynes, & have noe great expenses, althoughe they are verye sorelye vvounded & contrarily, other of little & shallovv vvoūdes doe dye.Ansvver. To this obiect I ansvvere, that all vvoundes vvhich seeme to be larg & ample, are not therfor mor­tall or perillous, as are the great carnall or fles­hye dissolutions or vvoundes, vvherin none of the vvorthiest partes are touched vvhich are necessarye to the life of man, vvherin are nether hurte great Vaynes, Arteryes or synnues, but vvhich are onlye greate, & cutt in the fleshe, as in the Buttocke, in the calfe of the Legges or in an Arme and yet notvvithstandinge be called a great vvounde, not being so daungerous, as the least punctiō of a synnue is, or the hurt of a gre­ate Vayne or Arterye, or els a little fissure of the Cranium, or any small thrust in the Brest, or the inferior parte of the Bellye, percinge into the concavitye of the same.Daun­gerouse vvoundes And if so be there vve­are any vvhich of such vvoundes vveare cured, beinge great vvoundes, not consideringe the a­pertione, but because of the vvoūded parte they ought to be vvell disposed, to buste & strong, to resiste such an evell, & impeach the accidentes vvhich happen thervnto, that they must also be rightlye disposed& tempered vvithout anye of the vvorthye partes, or those vvhich are neces­sary vnto life being thervvithe polluted or cor­rupted, and such may easilye be cured:Necessary thinges a good cu­ratione. Soe that those vvhich are not vvholye sovvnde of body havinge receaved such a vvounde, are in great daunger of death, as others considering the dif­ference of the time and of the difference of the bodye, and body, and of partes therof: there are some, vvhich are of so good a temperature, that they vvith great facility are cured of such vvoū ­des, the vvhich in others bodyes vvear mortal: Contrarily ther are some persons, vvhich have receaved a vvound in some abiecte and not ne­cessarye parte or Ioyncte, vvithout profoundly penetrating the same, vvherof notvvithstāding they died, ether through the constitutiō of the time or throughe the disposition of the bodye, the humours vvher of have their defluēces to­vvards the vvounded parte or els through any other occasions, heere before alleged: but the vulgare poeple, can not compraehend all these circumstances, and considirations, as the Chy­rurgians doe in such persons.

For to speake truth vve looke on the time,The vul­gare, and common poeple, cā not soe deeplye iudge & consider any thing as the Chyrur­giane. one the yeare, & daye, numbre of poeple, all vvhich have binne the one as sorelye hurte, or vvoundede as the other, yet for all that, those vvhich vve esteeme most daungerously vvoū ­dede, & vve iudge to be out of all hope, are sō ­times first of all cured: VVher of vve doe not so muche admire, after vve have after death a­notomizede the deade corpes: for besydes ther vvounde vve finde, an other apparente occasi­one of death.

As it is as yet in freshe memory happened to the Lorde of Bellay Barron of Tovarce,Historye of my lorde of of Bellay. King at d'Ivetot, vvho having receaved a shott [Page 54] before Rovē, or Roane in his left Arme, vvher of the focille of the Elbovve vvas broken & the vvounde beinge in good suppu [...]atiō, & yelding goode matter, and the fleshe verye rubicund, & grayned as vve vvoulde desire, & the Arme re­mayninge in his naturall dispositione, as vvell above, as beneathe, vvithout anye payne, or in­flammatione, verye fevv, or noe agues at all ad­ioyninge thervnto, notvvithstanding al vvhich beinge brought to his house, tvventy dayes af­ter his vvound receaved, is he fallen into a hot, venoumous, or furious ague, vvhich accompa­gniede him vnto the thirtith day, in vvhich day he died, hovv greate paynes, and laboure soever the expertest Doctors of Physicke, & Chyrurgi­ans and amongst other the right vvorshipfull Mr. Amboyse Dr. of Physicke, an ordinary Phy­sicione to the Kinge, have therin taken, vvhose experience is sufficientlye knovvē, the foresay­ed Arme vvith the vvoūd allvvayes remaynin­ge is his former estate,The occasions of the death of the Kinge of d'Iveror. & disposition. Novv the corps beinge Anotomized, vve perceaved his Lunges to be cleane corrupt, and replete vvith obdurate schirrouse vlcerations, his right Kid­ney also vvholy polluted & much matter in his blather: vvhich vvas the occasione of his death, & not the vvounde it is a thinge therfore most certayne, that if so be his entralls had binn soū ­de vvithout doubte he might have binne cured of his vvounde, because the same nether of it selfe, nor of anye other accidentes vvas mor­tall.

An other Historye of my Lord of Gyuri.The contrarye heerof chaunced, to the great contentation of all the Nobility, to my Lord of Gyuri vvho having receaved, a terrible shot, in his sinistre shoulder, the entrāce vvherof vvas right in the ioyncture, the bullet havinge tou­ched a great parte of the apophysis of the bone of the Arme, pearcinge a longe the Omoplate, & remayning, in the inferiore angle of the fore­sayed Omoplate, vvhich bullet vvas happely ex­tracted & dravvne out by Mr. Lavenot, svvoren Chyrurgiane to the Kinge, vvhich verye excel­lently hath dressed him the first time: notvvith­standinge, he is of this greate vvound (I say gre­ate vvounde consideringe that parte of the bo­dye) vvholy cured, vvithout perceaving therin any bad accidents.

Nature cureth all diseases.The vvhich vve must attribute, partely to the good Temperature compositione, and nature, (vvhich must cure all diseases,) vvhen as shee is evel intreated of experte, and learnede Physici­ons, and Chyrurgians, and therof ayded, as ve­rye excellentlye hath done amongst others, the right vvorshipfull Mr. Portaile, Counceller, & chiefe Chyrurgian to the King, vvhich as novv is chiefe amōgst vs: & of Mr. Gillis des Rus, his Chyrurgiane, vvhich dressed him: and vve are heer farther to note, and observe, that ther may be an other vvhich being vvoūded in the same place of his body,& shalbe treacted of the sel­fe same Chyrurgians, and shall yet for all that dye.

And for the confirmatione, of al that vvhich is before rehearced, I vvill conclude this my A­pologie, throughe my Lordes heerevnder no­minated, beginning vvith my Lorde de Hallot de Montmorency, vvho beinge on Horsbacke by the Citye of Rovan, receaved a shott of a ca­non, of the vvhich his Horse died, & he beinge prostrated on the earthe, his Legge being in di­ves peeces brokē right vnder the Ioyncte of the Knee, notvvithstandinge all vvhich, vvith his good dispositiō & nature hath cōbated agaynst all the malice of time, & magnitude of the vvo­unde, beinge verye successivelye cured of the right vvorshipfull Mr. Martel, Chyrurgiane to the Kinge,A [...]o the History. vvho is verye experte in all the ope­rations of Chyrurgerye. Contrarilye, my Lord the Baron of Salignac, beinge vvounded onlye vvith a simple shott of a handgunn, vvithout a­nye fracture of bones, in the end dyed therof, al thoughe notvvithstandinge he vvas assisted by the right vvorshipfull Mr. Pouget, alsoe one of the Kinges Chyrurgians and chieffe in Mont­pelliers havinge seene the houre, in the vvhich the Gangraena chaunced to his vvounde, manye fluxions oppressed him, by vvhich meanes he verye difficultlye coulde be cured: VVhich vve must only attribute ūto his tēperature, vvhich vvas not soe good as in deede it vveare to be exoptated it had.

The most happye cure vvhich Mr. des Hayes hath effected,A nother History. one also of the Kinges Chyrurgi­ans, vvhich is a verye vvyse man in the arte of Chyrurgerye on my Lorde de Vic, gouvernou­re for the Kinge in St. Denis, vvho vvith divers vvoundes vvas vvounded, & especiallye in his heade by the crovvne of the heade, and one the sagittalle suture vvhich vvas rescided cleane o­verthvvarte, & is therof very ominously cured vvherby is demōstrated vnto vs, vvhat the goo­de dispositione of the body can doe, vvhich cō ­bated agaynst the iniuryes, and malice of time, and many other more, inquietudes, vveare cle­ane contrarye vnto him: vvherin the foresayed Mr. des Hayes, hath vsed great consideration, to his perfecte resanatione.

The same allsoe happened, in my Lorde the Duke of espernō,An other History. vvho beinge vvounded vvith a greateshott, vvhich dilaniated a parte of his inferiour lippe, had deprived him of certayn of his teeth, and a part of his chavvbone, penetra­tinge, & takinge his issue close by the vayne Iu­gularis, vvas cured of Monst. le Gendre, & Sur­lin, Chyrurgians to the foresayed Duke: out of the vvhich vve may playnly note, that not on­lye the iunioritye, or youth and good tempera­ture, are not onlye profitable vnto the resana­tione of vvoundes, but alsoe the goode consti­tutione [Page] of the time: For a little before (vvhich vvas about the besieging of Chartres) thē died most of all the vvoūded,The con­stitutione of the ti­me is cō ­modious to resa­natione hovv sound notvvith­standing soever they vveare, & hovv little soe­ver they vveare vvounded: vvhich partlye vve must attribute to the badde constitution of the time, as in deede at that time it vvas a disordred vveather: because in a shorte time therafter, all the vvounded vveare of their vvoundes cured: & amongst others my Lorde the Earle of Flex,An other History. vvhoe in the end of the besieginge, receaved a short of a Canon in the inferiour parte of his Bellye, vvherof it vvas vvholye plettered e­ven vnto the Peritoneum, the vvound being all­most the length of a foote, in longitude, of hal­fe a foot, in latitude, as Mr. Portayle & Samboy­se can vvitnes, vvhich a longe time administred helpe vnto them.An other History. On the same time, my Lorde of Favolle vvas cured, of a shott, vvhich brake bothe the focilles of his Legg, a little above the anckle, vvhich allsoe vvas cured of the right vvorshipfulle Mr. Portaile, & d'Amboyse, & of the most ominouse, & dextrous hād of Mr. Bil­larde, ordinarye Chyrurgiane to the King, and of Mr. Biron.

And for an inventiō, or practice, vvhich vve might say to be vvholy agaynst reason, amōgst manye others more vvhich chaunced at Char­tres: ther vvas the Chamberlayne of my Lord the Earle of Chiverny,An other History. called the Pietmontois, vvho vvas vvoūded, on his heade vvith a raper, vvherby his Parietale vvas cleā rescided throu­ghe, yea & clean through the Dura, & Pia mater also, pearcing the depth of ones finger into the substāce of the Braynes: vvherof in the second dressinge, cleane throughe the dissolutione of the Craniū, ther issued out as much of his Bray­nes, as the quātity of the little finger in lōgitu­de, & crassitude therof: notvvithstanding al this is he in the presence of the right vvorshipfull Mr. Le Febure, & Duret, svvorne Physicions to the Kinge, & other Doctours of this profession out of Paris, vvhich are verye experte in Chy­rurgerye, vvhich vveare alsoe assistantes in this disease, & vvas of me completelye cured, vvith­out havinge retayned any accidente, or impedi­mente therof: Divers Chyrurgians of the citye of Chartres stoode heerby, & amongst the rest vvas Mr. Fransoys Cheaureau, & Michel Fauve­au.

At the same time trepanede M Gabriell du Tertre,An other History. a verye experte Chyrurgiane in all his operationes, a certayne vvomane vvhich vvas threescore yeare of age, or more, vvhoe hadde a fracture in her occipitalle partes of the heade: he hadde besides her a little page, or lackye in handes, vvhoe hadde his Os Petrosum brokene & splitte, and some parte of the Parietale. In like sorte also trepaned Mr. Gillis Pillier, a most ex­pert Chyrurgiane, a Tripeseller, called Mr. Lau­rence, vvho had his membrane Dura matter cleft a sunder: all vvhich foresayed patientes have re­ceaved theire complete resanatione: vve must heer also farther note, that vvithin the space of tvvo moneths therbefore all those vvhich vve­are vvounded in the Heade died, notvvithstan­dinge all the secourse vve coulde doe them yet for all that they dyed suddaynlye.

All vvhich beinge noted, vve must attribute the deaths of soe manye valiant Capitaynes,Conclu­sione of the Apo­logye. & vvorthy Lordes, and brave souldiours, on such occasions, and disorders, and not on the fault as if they vveare inconvenientlye treacted, & sol­licited, vvhether ether it vveare throughe yon­ge, or oulde Chyrurgians. Or els vve vvill con­clude it rightlye, vvith the Aphorisme, & com­mō proverbe, it is allvvayes good Lucke, as lō ­ge as a man falleth not and breaketh his Necke.

As Hesiodus sayed, sometimes is the day our mother, and sometims our stepmother.

End of the Apologye for the Chyrurgians.

THE INDEX OF THE MOST ESPECIALL, and notablest thinges contayned in this worcke of Chyrurgerye, vvherin the F denotateth the lease.

A

  • A Bullet somtimes, carrieth somethinges vvith it into the bodye. Fol. 7.
  • A bullet sometimes pearceth through the gris­sles. Fol. 8
  • A bullet through his ponderousnes sincketh dovvne­vvardes. Fol. 8
  • A Chyrurgian may easilye in searching a broken scull be deceaved. Fol. 9
  • A certayne Ligature. Fol. 39
  • A Chyrurgiane is the servant of Nature. Fol. 8
  • A dubble inscisione in a dubble Hernia. Fol. 22
  • A dissease beinge cured, most commonlye leaveth so­me relique behinde it. Fol. 51
  • A fingercase of Lattinne. Fol. 39
  • A greate vvounde is taken thre manner of vvayes. Fol. 2
  • A historye of the daughter of Nerius. Fol. 20
  • A heade noughtilye formede. Fol. 50. & 53
  • A monstruose Childe. Fol. 36
  • A notable historye. Fol. 7
  • A notable sentence. Fol. 50
  • A remedye agaynste the corruptinge of the gūmes. Fol. 24
  • A suture, or commissure vvhat they be. Fol. 9
  • A thumbe beinge vvholye mutilate. Fol. 39
  • A tryede remedye, for sinckinge of the palate. Fol. 25
  • A true signe of the imbicillitye of anye parte. Fol. 50
  • Accidentes of a departed svvellinge. Fol. 2
  • Accidentes of the Dropsye. Fol. 20
  • Accidentes vvhich may ensue through cutting to hi­ghe of the pallate. Fol. 25
  • Accidentes proceeding out of badde phlebotomy. Fol. 27
  • Accidentalle imbicillitye. Fol. 51
  • Accidentes of sorrovve. Fol. 52
  • Actualle Cauterye. Fol. 39
  • Admonitiō concerninge all greate Apostematiōs. Fol. 18
  • Admonitione for the lettinge of vvater or matter goe from the Breste. Fol. 29
  • Admonitione for the Chyrurgiane concerninge the Polipum. Fol. 22
  • Admonitione for the Chyrurgiane, concerninge the extraction of yonge Children out of their mothers bodye. Fol. 35
  • Admonitione in the applicatione of the actuall Cau­teryes. Fol. 42
  • Admonitione concerninge the bloodye flixe. Fol. 49
  • Advice of Celsus. Fol. 5
  • After vvhat sorte vve ought to list out the trepanede bone. Fol. 12
  • After vvhat manner vve must in sovving collocate the patiente. Fol. 16
  • After vvhat sorte vve must thrust in agayn the Net. Fol. 16
  • After vvhat sorte vve ought to tye the teeth. Fol. 27
  • Agaynste rotten, hollovve, and stinckinge teethe. Fol. 26
  • Agreement of Mr. Gourmelin and Mr. Pare. Fol. 38
  • All greate vvoundes are daungerous. Fol. 51
  • An excellent similitude. Fol. 5
  • An other fashon of sovving of the bellye, accordinge to some mens sayinges. Fol. 17
  • An other conditiō, vvheron vve must consider, in the openinge of a svvellinge. Fol. 18
  • An exellent consideration to be had of the Paracente­se. (20
  • An other meanes to cure the Polipum. Fol. 22
  • An instrument called Staphilagres. Fol. 25
  • Antiades. Fol. 25
  • Aneurisma is daungerous. Fol. 30
  • An artery vvhich of the Aucthor vvas tyed above the Aneurisma. Fol. 30
  • An other practise concerning the Fistles of the Fun­dament. Fol. 35
  • An astringent plaster on a fracture. Fol. 46
  • An excellent observatione. Fol. 47
  • Anglevvyse figure the naturall situation of the arme. (47
  • An ague beinge cured, commonlye leaveth and Em­piema after her. Fol. 51
  • Applicatione of divers corrosives. Fol. 20
  • Applicatione of Boxes. Fol. 32
  • Applicatione of the superioure Ligature, in a broken Legge. Fol. 46
  • Apertione in the Scrotum, by the thrusting through of a silke threde. Fol. 22
  • Apertione in the Vaynes, and arteryes, of the temples of the heade. Fol. 29
  • Apostemations founde in the vvorthyeste partes of the bodye. Fol. 52
  • Archigenes. Fol. 20
  • Ascites is subiecte to Paracentese. Fol. 20
  • Astringentia. Fol. 49
  • [Page]Attractive ligature. Fol. 45
  • Auncient Chyrurgians cauterized the Varices. Fol. 31
  • Autumne enimye to all pulmonicalle vvoundes. Fol. 51
B
  • Backe badlye formede. Fol. 50
  • Badde signes. Fol. 3
  • Basilica. Fol. 29
  • Basilica is daungerous to be phlebotomized. Fol. 30
  • Blacke vayne. Fol. 29
  • Bloodyeflixe. Fol. 47
  • Bones of yonge Childrene are bent invvardlye. Fol. 12
  • Bones subiected to all manner of disseases. Fol. 33
  • Boxes may be applyede on all places of the bodye. Fol. 32
  • Brest baddelye formede. Fol. 50
  • Broade, and narrovve lancets. Fol. 28
C
  • Canckerous almōdes, may not be tyede, nor cut of. Fol. 26
  • Cauterizatione of the Caries must be reiterated. Fol. 34
  • Cauteryes to cauterize deepelye. Fol. 40
  • Cauteryes for those vvhich are troublede vvith the la­zarye. Fol. 40
  • Cauteryes of Mr. Cheval. Fol. 41
  • Cauterye of Mr. Iaqves de Ville neufue. ibidem
  • Cauterye of Mr. Rasse d'esneux ibidem.
  • Cauterye vvhich in all haest can be made. Fol. 41
  • Cauterye in the Fibra. Fol. 42
  • Celsus. 9 his manner of sovvinge of the Bellye. Fol. 17
  • Cephalica. 29 openede vvithout daunger. Fol. 30
  • Chirurgerye is auncienter then Physicke. Fol. 1
  • Chyrurgerye must not rashlye be effectede. Fol. 8
  • Choyce of the place vvhere vve shoulde extirpate any ioyncte. Fol. 37
  • Circumiacent parte in all vlcerations in cauterizinge must be freede. Fol. 34
  • Cleavinge of the Eares, and nostrelles. Fol. 23
  • Clisteryes made in divers fashons. Fol. 49
  • Coloboma, curtum. Fol. 23
  • Columella. Fol. 24
  • Comparison. Fol. 50
  • Conclusione of the Apologye. Fol. 54
  • Consideratione for the vvoundes of the heade. Fol. 3
  • Consideration to be had before the givinge of repor­te. Fol. 4
  • Consideration, of Bullets. Fol. 6
  • Consideratione in fasteninge of the Ligature. Fol. 45
  • Consideratione on the time of the yeare. Fol. 51
  • Constitutione of the vvounde. Fol. 52
  • Constitutione of the time, is commodious to resana­tione. Fol. 54
  • Contemplatione of instrumentes. Fol. 53
  • Continuāce of the māner rightly to phlebotomise. Fol. 28
  • Continuance of raspinge of the Caries of bones. Fol. 33
  • Continuance of keepinge open an vlceration. Fol. 43
  • Convulsione in vvoundes is verye daungerous. Fol. 2
  • Corrosive vvith an inscisione in an Escara. Fol. 20
  • Councell of Hippocrates to dravve of the vvater. Fol. 21
  • Councell of aunciente professors, for the curinge of the Varices. Fol. 31
  • Corrodinge matter causeth manye badde accidētes. Fol. 52
  • Cure of the tunge tyinge. Fol. 24
  • Cure of Ranula, and reversione therof. Fol. 24
  • Cure of Aneurisma. Fol. 30
  • Cure of a Varice. Fol. 31
  • Cure of the putrefacted bones. Fol. 33
  • Cure of the Panaris. Fol. 39
  • Cure of a croockede finger. ibidem
  • Cure of the Dysenteria. Fol. 48
D
  • Daungerouse vvoundes. Fol. 52
  • Descriptione of Physicke. Fol. 1
  • Descriptione of the signes, of a dilaniated Cranium. Fol. 8
  • Descriptione of sovvinge. Fol. 23
  • Descriptione of the Dropsye. Fol. 20
  • Descriptione of Aneurisma. Fol. 30
  • Descriptione of a Varice. Fol. 31
  • Descriptione of Horseleches. Fol. 31
  • Descriptione of horne boxes. Fol. 32
  • Descriptione of naturalle bones. Fol. 33
  • Decentlye to vvinde. Fol. 45
  • Descriptione of the bloodyeflixe. Fol. 47
  • Difference betvveene these thre vlcerations Ateroma, Steatoma, and Meliceres. Fol. 18
  • Difference of Boxes. Fol. 32
  • Differences of the Cauteryes not properly taken. Fol. 93
  • Differences of the Cauteryes simpletye taken. Fol. 40
  • Differences of Cauteryes concerninge their figure. 40 concerninge their actione. ibidem
  • Numbre. ibid. & manner of applicatione. ibidem
  • Divers miscostruinges of this vvorde Chyrurgerye. Fol. 1
  • Divers accidentes of the vvoundes of the heade. Fol. 9
  • Diploe vvhat it is. Fol. 12 & 10
  • Divers formes of future accordinge to the diversitye of the vvounde. Fol. 14
  • Discommoditye of havinge the legge croockede. Fol. 47
  • Discommodityes of vvars. Fol. 53
  • Divers Chyrurgicall operations. Fol. 26
  • Divers considerations of cauteryes. Fol. 42
  • Divers fictions. Fol. 50
  • Dressinge of an extirpated membre the blood beinge stenchede. Fol. 38
  • Dropsye of the brest and her tokens. Fol. 19
  • Dubble bande in phlebotomye. Fol. 28
  • Dysenteria improperlye taken. Fol. 47
  • Dysenteria properlye taken. Fol. 48
E
  • Eare vayne. Fol. 29
  • Ease goode for all vvoundes. Fol. 51
  • Effectes of Cholera. Fol. 52
  • Effectes of stupefactione. Fol. 52
  • Elevatorium. Fol. 7
  • Elevatorium vvhat it is. Fol. 13
  • Entrance of the stomacke beinge hurte. Fol. 4
  • Entralls beinge out of the Bellye, must everye one be agayne restorede into his former place, and naturall statione, if it be possible. Fol. 16
  • Error of common poeple Fol. 53
  • Example. Fol. 8
  • Example of Hippocrates. Fol. 8
  • [Page]Example of Albucrasis. Fol. 8
  • Example of the situatione of any disseasede parte. Fol. 47
  • Excellentie of Chyrurgerye. Fol. 5
  • Experience of the Aucthor in extirpatione. Fol. 37
  • Expulsive ligament. Fol. 44
  • Extirpation of a ioyncte is verye daungerouse. Fol. 37
  • Eye vayne. Fol. 29
  • Eye vayne in the hande. Fol. 29
F
  • Feare and nicenes doe impeach health. Fol. 53
  • Fifth incarnative suture. Fol. 15
  • First vvay to cure the sinckinge of the pallate. Fol. 25
  • First kinde of ligament. Fol. 44
  • Fissures recollect themselves sometimes. Fol. 10
  • Fistles of the fundament are ether occult, or aperte. Fol. 24
  • Fitlye to applye the Cauterye on the arme. Fol. 42
  • Fleshe, vvith fleshe vniteth farre sooner thē skinne, vvith skinne. Fol. 14
  • Fluxus Hepaticus. Fol. 48
  • Foolishe persuasione. Fol. 52
  • For vvhat occasione vve ought to trepane. Fol. 10
  • For greate payn, and doloure in the teeth. Fol. 27
  • For simple fractures. Fol. 45
  • For reiterated cauteryes. Fol. 42
  • Fourth incarnative suture. Fol. 15
  • Foure especialle conditions, vvhich the Chyrurgiane must consider, before he open anye tumor. Fol. 18
  • Forme and figure of ligamentes. Fol. 44
  • From vvhence vve must take our indicatione of the greatenes of a vvounde. Fol. 18
  • Furriers suture. Fol. 16
  • Fyer, the sureste remedy for corruptiō of bones, (33
G
  • Gastroraphia. Fol. 16
  • Gluttonye the occasione of much evell. Fol. 51
  • Grosse bloode in phlebotomy doth nothinge els then droppe. Fol. 40
  • Good doctrine for a Chyrurgiane. Fol. 8
  • Gurgulio. Fol. 2

H

  • Hande, an instrumente of instrumentes, Fol. 39
  • Hardines of Aussun. Fol. 52
  • Hepatica. Fol. 29
  • Hemorrhoidalle vayne. Fol. 30
  • Highe situatione of a broken membre. Fol. 46
  • Hinderance of the sanatione of the tunge tyinge. Fol. 24
  • Hippocrates in his Porthet. Fol. 2
  • Hippocrates hath binne deceaved. Fol. 9
  • Hippocrates in prognosticis, and thirde booke of dise­ases. Fol. 19
  • Hippocrates concerninge the caries of bones. Fol. 33
  • Hippes baddelye formede. Fol. 50
  • Historye of Albucasis. Fol. 26
  • Historye of Messalinus. Fol. 31
  • Historye of Albucasis concerninge the corruption of bones. Fol. 34
  • Historye of Duke d'Aumalle, aftervvardes Duke of Guise. Fol. 53
  • Historye of my lorde of Bellay. Fol. 34
  • Historye of my lorde Gyuri. ibidem.
  • Horseleeches are enimyes to all pingueditye. Fol. 32
  • Hovv vve shall espye the hayrye fissure. Fol. 9
  • Hovv greate the apertione must be for trepanatiō. Fol. 11
  • Hovv to sovve a vvounde convenientlye. Fol. 14
  • Hovv vve ought to make the apertione in the Empie­ma, vvith a lancet, or vvith a corrosive, Fol. 19
  • Hovv vve ought to effecte the openinge of the Drop­sye. Fol. 20
  • Hovv vve ought to make the apertiō in the Hernia. Fol. 21
  • Hovv vve ought to cure the Polypum. Fol. 22
  • Hovv vve ought to cure the cloven lippes. Fol. 23
  • Hovv vve ought to cut the tunge tying in yonge Chil­drene. Fol. 24
  • Hovv vve ought to dravve a tooth. Fol. 27
  • Hovv vve should conveniently phlebotomize. Fol. 28
  • Hovv vve shoulde stench bloode. Fol. 29
  • Hovv vve shoulde open the vaynes of the handes. and feete. Fol. 29
  • Hovv vve shoulde open an Arterye. Fol. 30
  • Hovv to cut avvay a bursten vayne. Fol. 31
  • Hovv vve shoulde cause a horseleech to fall of. Fol. 32
  • Hovv vve shoulde restraygne the blood after the hor­seleech hath sucked. Fol. 32
  • Hovv vve shoulde binde a patent fistle of the funda­ment. Fol. 34
  • Hovv vve shoulde situate the vvoman in dravinge a childe out of her bodye. Fol. 36
  • Hovv vve shoulde convenientlye extirpate a ioyncte. (38
  • Hovv vve should tye the ligature to stoppe blood. Fol. 28
  • Hovv vve shoulde gentlelye take of a ligament from a fracture. Fol. 45
  • Hurtes of the blather. Fol. 4
  • Hydrocele. Fol. 22
I
  • Inanimate thinges feele effectes of the moone. Fol. 51
  • Incarnative suture and her fiye manner of vvayes. Fol. 15
  • Incarnative ligature. Fol. 44
  • Indication hovv vve may easilye, or difficultlye attay­ne to the bloodye flixe. Fol. 48
  • Infusione of Rhubarbe. Fol. 49
  • Inscisione must be done, before inflammatione. Fol. 11
  • Instructione hovv to vvorke vvyselye. Fol. 7
  • Inscision of the Scrotum. Fol. 21
  • Instructione to knovve vvhether the extirpatede mē ­bre must be stenchede or lett bleede. Fol. 38
  • Intent of the Aucthor. Fol. 5
  • Intentione of the Aucthor concerninge the fistles of the fundament. Fol. 24
  • Intent of the Aucthor of Phlebotomye. Fol. 27
  • Inventione of sciences. Fol. 1
  • Inventione of the Cauteryes is throughe nature she­vvede vnto vs. Fol. 40
  • In phlebotomising of those vvhich are phrensye, vve ought to make but a smalle apertione. Fol. 28
  • In vvhat persons the dravving of vvater must be vsed, and in vvhat it must be left. Fol. 20
  • [Page]In vvhat places the scarifications may be made. Fol. 21
  • In vvhat persons the operatione of the haremouthes is daungerous. Fol. 23
  • In vvhat partes the Cauteryes must be applyede. Fol. 40
  • In vvhat partes vve ought to applye the Seton. Fol. 43
  • Irregulated seasō of the yeare, aultereth our bodyes. Fol. 51
  • It is surer to make an inscision, in the fistles of the fun­dament then to tye them. Fol. 35
  • Iudgement must be providentlye given. Fol. 4
  • Iugularis vena. Fol. 29
K
  • Knovvledge by sight of a corrupted bone. Fol. 33
  • Knovvledge throughe tacture. ibidem
  • Knovvledge by the matter. Fol. 33
L
  • Legges of a difficult resanatione. Fol. 50
  • Ligament must be broader then the dissease. Fol. 44
  • Ligament for the dissease. Fol. 44
  • Ligament for the parte. Fol. 45
  • Ligamentes for shot vvoundes, vvith crushinge of bones. Fol. 46
  • Ligatione of Epoulis, is more certayne thē inscisiō. Fol. 23
  • Ligature, or inscisione in the Almondes. Fol. 26
  • Ligatione of the Elbovve, after Phlebotomye. Fol. 29
  • Lippes vvhich are cleft in tvvo places. Fol. 23
  • Lippe vayne. Fol. 29
  • Liqvefactinge fyer. Fol. 41
  • Liver beinge hurte. Fol. 3
M
  • Magnitude of the putrefactione in bones. Fol. 33
  • Malignant ayre polluteth the harte. Fol. 51
  • Man is subiect to all influences. Fol. 51
  • Manner to cure Epoulis. Fol. 23
  • Manner hovv to trepane vnto the membrane. Fol. 13
  • Manner of applicatione of the Cauterye on the cor­rupted bone. Fol. 35
  • Manner to dravve forth a deade Childe. Fol. 36
  • Māner to dravve out the aqvosity out of a deade Chil­des bodye. ibidem.
  • Manner to elevate agayne the suncke, and descendede Matrice. Fol. 37
  • Manner to praeserve the Cauteryes. Fol. 42
  • Manner to applye the transforatione in the necke. Fol. 43
  • Manner of dressinge of all broken legges, vvhich may be comparede, vvith the māner of all auncient Chyrurgians. Fol. 46
  • Manye men praeserve their lives agaynst the opinione of the Chyrurgiane. Fol. 6
  • Manye ther are vvhich for vvant of succoure doe dye. (53
  • Manye thinges are oftentimes vvantinge vnto the vvoundede. ibidem
  • Master Dvione an experte Physitione. Fol. 49
  • Matter of the Vlceratione Ateroma lyeth inclosed in a little blather. Fol. 19
  • Matter of the Potentialle Cauteryes vvhich are novv adayes in vse. Fol. 41
  • Master Paré of Cauteryes, ibidem
  • Matter of the Ligamentes. Fol. 44
  • Meanes hovv to knovve vvhether the bullet have takē any thinge vvith him. Fol. 7
  • Meanes to dravve out the heade of a deade childe, as yet remayninge in the vvombe. Fol. 36
  • Meanes to finde the place in the heade to cauterize. Fol. 42
  • Meanes to keepe open a Fontanelle. Fol. 43
  • Meanes to make the expulsive Ligamente. Fol. 44
  • Mediana. Fol. 29
  • Medicamētes to be eschuede in the bloodyflixe. Fol. 49
  • Membranouse Ligament, or tungeryinge. Fol. 24
  • Methode hovv to trepane. Fol. 12
  • Mideler eefe beinge hurte. Fol. 4
  • Milte beinge hurt. Ibidem
N
  • Naturall situation, vvhich of the aunciente professors is called the right situatione. Fol. 47
  • Nature cureth all disseases. Fol. 54
  • Nayle vvhich heaveth vp it selfe may be pricked throu­ghe. Fol. 21
  • Necessarye thinges to a goode curatione. Fol. 53
  • Noe Polypus can throughe Chyrurgery be curede. Fol. 22
  • Nose vayne. Fol. 29
  • Note your forme of your trepane in the sculle. Fol. 12
  • Note the circumstances of the blovve, and the death vvill seeme more admitable. Fol. 53
  • Nue inventede trepanes. Fol. 13
O
  • Observatione of the Aucthor. Fol. 9
  • Observatione in seethinge of the saulte to the Caute­rye. Fol. 41
  • Occasione of corruptione of Bones. Fol. 33
  • Occasione of the death of the kinge d'Ivetot. Fol. 54
  • Occasiōe of the Dysenteria. Fol. 28
  • On vvhat manner in dravving forth a bullet vve must collocate the patient. Fol. 6
  • On vvhat sorte vve must dravve a bullet out of a ioyn­cte. Fol. 7
  • On vvhat sorte the Aucthor tyed the arterye on the A­neurisma. Fol. 31
  • One dissease follovvinge an other is very daungerou­se. Fol. 51
  • Opinione of Paulus Aegineta. Fol. 5
  • Opinione of aunciēt professors touching inscision. Fol. 9
  • Opinione of Hippoc. touchinge the curing of fractu­res. Fol. 10
  • Opinione of Hippoc. concerninge trepanatione. Fol. 10
  • Opinione of Avicenna touchinge trepanatione. Fol. 11
  • Opinione of Celsus concreninge the apertioue of a­postemations. Fol. 17
  • Opinione of Hippocrates concerninge Empiema. Fol. 29
  • Opinione of Gvido concerninge the fistles of the fun­dament. Fol. 35
  • Organicke partes vvhich are cut of can not be cured agayne. Fol. 2
  • Other considerations to be had in prognosticatione. Fol. 3
P
  • Paroulis and the meanes hovv to cure it. Fol. 23
  • Partes of Physicke. Fol. 1
  • Partes of Therapeutica. ibidem
  • [Page]Patesyede fistles of the fundament. Fol. 34
  • Patient lyinge on his backe can verye vvel suffer phle­botomve. Fol. 29
  • Paulus Aegineta. Fol. 8
  • Penned suture. Fol. 15
  • Perturbations of minde. Fol. 52
  • Perturbationes are of greate effecte in our bodyes ibi­dem.
  • Phlebotomye vvhye it is difficulte. Fol. 27
  • Phlebotomye must be done vvith discretion in the bloodyeflixe. Fol. 49
  • Place of the apertione in the vlceration Empiema. Fol. 19
  • Place vvher vve may cut the Varices. Fol. 31
  • Places vvheron vve applye the Cauteryes. Fol. 42
  • Playne, and smooth situation of a brokē membre. Fol. 45
  • Potentiall Cauteryes and matter therof. Fol. 41
  • Practise of the Aucthor. Fol. 13
  • Practise of the Mr. Floris Philips. Fol. 20
  • Practise, of the Aucthor concerninge teeth. Fol. 26
Q
  • Qvantitye of Ligamentes. Fol. 44
R
  • Ranularis vena. Fol. 29
  • Ravv fruicte causeth the bloodyeflixe. Fol. 48
  • Reason vvhy a membre must be extirpatede in the ioyncte. Fol. 37
  • Reason for those vvhich extirpate a membre, above, or belovve the ioyncte. ibidem.
  • Reason of Aristot: concerninge the bloodyeflixe. Fol. 47
  • Receipte of the Velvet Cauterye. Fol. 41
  • Redivisione of the first kinde of Ligament. Fol. 44
  • Remedyes agaynst the bleedinge of the descidede pal­late. Fol. 25
  • Remedyes agaynst the tumefactione Antiades. Fol. 25
  • Remedyes for a vvounded arterye. Fol. 30
  • Remedyes agaynst putrefaction in an Aneurisma. Fol. 31
  • Remedyes agaynst the Caries. Fol. 24
  • Remedyes to consolidate the vlcerations. Fol. 49
  • Renuinge of Phlebotomye. Fol. 29
  • Roote, and originall of the Polypus. Fol. 22
S
  • Salvatella. Fol. 29
  • Saphena. Fol. 30
  • Sciatica vena. ibidem
  • Seconde incarnative suture. Fol. 15
  • Seconde genetalle suture. ibidem
  • Secōde meanes to cure the sinckinge of the pallate. Fol. 25
  • Seconde Kinde of Ligamente. Fol. 44
  • Seconde kinde of attractive Ligament. Fol. 45
  • Seton properlye taken. Fol. 43
  • Seton improperlye taken. ibidem
  • Seton vvith the vse therof ibidem. ibidem
  • Signes contrarye to prognosticatione. Fol. 3
  • Signes of a deadlye fracture of the sculle. Fol. 3
  • Signes vvhen the braynes are hurte. ibidem
  • Signes vvhen the backbone is hurte. Fol. 3
  • Signes vvhen the harte is vvounded. ibidem
  • Signes to knovve vvhen the Trepane is enterede into the Diploe. Fol. 12
  • Signes vvhen matter is fullye ripened. Fol. 17
  • Signes to knovve the vlcerations Ateromata, Steato­mata, and Melicerides. Fol. 18
  • Signes of the matter vvhich is retayned in the Breste. (19
  • Signes of a vvaterburste. Fol. 21
  • Signes of a venoumouse Polypus. Fol. 22
  • Signes of a tractable Polypus. ibidem
  • Signes of a counterfissure. Fol. 9
  • Signes to knovve vvhen the svvollen almondes exvl­cerate, vvith their remedyes. Fol. 26
  • Signes of an Aneurisma. Fol. 30
  • Signes of a venoumouse horseleech. Fol. 31
  • Signes of a goode horseleech. ibidem.
  • Signes vvherbye the Chyrurgian is hindered, to dravv forth the Childe out of his mothers bodye. Fol. 35
  • Signes of a deade Childe in his mothers bodye. Fol. 36
  • Signes of suppuratione. Fol. 17
  • Signes vvhen the small guttes are hurt. Fol. 48
  • Signes vvhen the greate intestines are hurte. Fol. 48
  • Similitude. Fol. 50
  • Situatione of the patient, in the extirpation of a ioyn­cte. Fol. 37
  • Situatione of a ioyncte must be naturalle, & accusto­mede. Fol. 46
  • Sixe thinges vvhich in sovvinge must be cōsidered. Fol. 13
  • Smalle gutts being cut a sunder, are incurable. Fol. 16
  • Some men dye of a smalle vvounde. Fol. 4
  • Some men are cured contayninge the bullet in their bodye. Fol. 5
  • Some vvoundes are esteemed smalle, vvhich indeede are greate, and daungerouse. Fol. 51
  • Sovvinge may not vvith anye violence be done in the lippes of a vvounde. Fol. 14
  • Sovvinge of the haremouth. Fol. 15
  • Sovvinge of the bellye must not be done as the other sutures. Fol. 16
  • Staphilocauston vvhat it is. Fol. 25
  • Stomacke, and guttes beinge hurte. Fol. 4
  • Subdivisione of the secōde inferiour ligature in a bro­ken legge. Fol. 46
  • Substance of actuall Cauteryes. Fol. 46
  • Substance of the Cauteryes vvhich the auncient pro­fessors vsed. ibidem
  • Suddayne death proceedinge of ioy. Fol. 52
  • Suffocatione of the naturall caliditye. Fol. 50
  • Superfluouse comestione, & bibacitye, are not so op­pugnant vnto vs, as is Melancholye, or sorrovve. Fol. 52
  • Supernaturalle teeth. Fol. 27
  • Sutures of the heade variable. Fol. 9
  • Suture in a separatede place is needelesse. Fol. 13
T
  • Teethe vvhich grovve forth vvith an acuitye. Fol. 27
  • Teeth vvhich stande forth out of their ordre, are bro­ken, and vvherin as yet remayneth some little peece ibidem.
  • Temporall vayne. Fol. 29
  • Tendones are daungerouse to sovve, and vvhye. Fol. 13
  • [Page]The apertione of a vvounde must allvvayes be recur­vatede dovvnvvardes, if it be possible. Fol. 46
  • The apertione in the Hernia, is better to be done abo­ve then vnder. Fol. 22
  • The Cauterye maketh a greater escara, thē the hole of the plaster. Fol. 42
  • The Childe must vvith the heade be dravvē out of his mothers bodye, if it be possible. Fol. 36
  • The Chyrurgiane can not cure all men. Fol. 50
  • The Chyrurgiane is sometimes to late sent for. Fol. 10
  • The dissease of a shortened tunge. Fol. 24
  • The dissease of the tunge after a callouse vlceratione. ibidem.
  • The figure, or forme of vvoundes. Fol. 2
  • The formes of inscisione in phlebotomye. Fol. 28
  • The hande must be shut. Fol. 47
  • The heade may not to strictlye be bovvnde, and the reason vvhy. Fol. 20
  • The hippe must be stirrede. ibidem
  • The ioyncte beinge extirpatede, vve must dissolve the ligature. Fol. 38
  • The legge must be kept right. Fol. 47
  • The manner of makinge an apertione. Fol. 29
  • The meanes to dravv out the Polypus. Fol. 22
  • The meanes to cure the pallate. Fol. 24
  • The Melancholicke doe hate themselves. Fol. 52
  • The operatione to cure these thre vlcerations, Atero­ma, Steatoma, and Meliceres is nothing differēt. Fol. 19
  • The place vvher, in the Paracentese the apertion must be made. Fol. 20
  • The scull is the naturall opercle to the braynes. Fol. 22
  • The seconde instruction in dravving out of bullets. Fol. 6
  • The seconde kinde of Dropsye. Fol. 20
  • The sutures, & temples of the heade may sometimes be trepaned. Fol. 11
  • The thirde instructione. Fol. 6
  • The tumor Empiema externally sometimes demon­strateth it selfe. Fol. 19
  • The vayne in Phlebotomye must be inscided in her middle. Fol. 28
  • The vayne beinge vvel openede, yet throughe the af­frightednes of the patient she droppeth. Fol. 29
  • The vvounded feeleth not his vvounde at the first dressinge. Fol. 6
  • The vvoūded vvhich have binne in the drivelinge cli­mate, can verye difficultlye be curede. Fol. 51
  • Ther may not be anye fleshe on the bone vvhen vve intende to savve it of. Fol. 38
  • Ther is but one expette Chyrurgian in all Fraunce. Fol. 50
  • They vvhich are of most experience may iudge of the poynctes, concerninge the bloodyflixe. Fol. 48
  • Thirde incarnative suture. Fol. 15
  • Thirde generalle stitchinge. Fol. 15
  • Those bullets vvhich sticke fast in the bones, are verye difficult to be dravven out. Fol. 7
  • Those vvhoe are deprived of anye ioyncte are verye subiecte vnto the bloodyeflixe. Fol. 47
  • Thre sortes of sovving by the auncient professors. Fol. 15
  • Thre sortes of Dropsye. Fol. 20
  • Thre thinges to be considerede in the collocatione of a broken membre. Fol. 46
  • Threfoulde meanes to cure the fistles of the funda­ment. Fol. 34
  • Thre thinges vvhich make Childebirthe difficulte. Fol. 35
  • Throughe perturbatione of minde a man may dye. Fol. 52
  • Thrustes in the synnues are daungerouse. Fol. 2
  • To applye the Cauteryes on the Legges. Fol. 42
  • To applye the potentiall Cauteryes. Fol. 42
  • To make a horseleech violentlye to sucke. Fol. 32
  • To knovv vvhether the Hernia be on both sydes. Fol. 21
  • To knovve an imbicille parte. Fol. 52
  • To mollifye the skinne in Phlebotomye. Fol. 28
  • To restrayne bloode throughe ligature. Fol. 38
  • To remove superfluouse fingers. Fol. 39
  • To regenerate anye substance is the vvorcke of Natu­re and not of the Chyrurgiane. Fol. 23
  • To stenche bloode by Cauteryes. Fol. 38
  • Tractatione of the returnede Epoulis. Fol. 23
  • Transforaiion vvith an actuall Cauterye. Fol. 43
  • Transforatione in the Scrotum. Fol. 43
  • Trepaninge of the Brest bone. Fol. 29
  • Tvvo sortes of applicatione of the Seton. Fol. 43
  • Tvvo sortes of Ligamentes in generalie. Fol. 44
  • Tvvo thinges to be cōsiderede in dressiinge of a vvoū ­de. Fol. 45
  • Tvvo sortes of inferiour ligamentes. Fol. 46
  • Tyinge, and thirde meanes to cure the pallate. Fol. 25
V
  • Vaynes vvhich burst vvithin the braynes. Fol. 9
  • Vayne of the foreheade. Fol. 29
  • Vena pupis. Fol. 29
  • Vena illiaca. Fol. 30
  • Vena poplitis ibidem
  • Velvet Cauteryes. Fol. 41
  • Virtues of the actuall Cauterye. Fol. 38
  • Virtues of the doggedayes. Fol. 51
  • Virtues of moderate ioy. Fol. 52
  • Vlceratione Ranula, and originall therof. Fol. 24
  • Vnhealthsame poeple. Fol. 52
  • Vse of iudgemente. Fol. 1
  • Vse, and inventione of sovvinge. Fol. 12
  • Vse of the pipe in the Dropsye. Fol. 20
  • Vse of the Pallate. Fol. 25
  • Vse, situatione, & compositione of the Almondes. Fol. 25
  • Vse of these times concerninge the Varices. Fol. 31
  • Vse of the horselaeches. Fol. 32
  • Vse of smal Boxes. Fol. 32
  • Vse of the actuall Cauteryes. Fol. 41
  • Vse of the potentiall Cauteryes. Fol. 41
  • Vtilitye of Inscione. Fol. 7
  • Vtilitye of the Cauteryes. Fol. 40
  • Vtilitye in constitutione of a broken parte. Fol. 46
  • Vva. Fol. 24
  • Vulgare, & cōmon poeple, can not soe deeply iudge, & consider of any thinge, as the Chyrurgiane. Fol. 53
W
  • VVe can not live vvithout ayre. Fol. 51
  • VVe may not trepane that bone above the Eyebro­vves: Fol. 11
  • [Page]vve may not sovve the lippes of an inflamed vvoūd. Fol. 14
  • vve may not provoacke the cāckerouse excrescēce of the gummes, Fol. 23
  • vve may not trepane the sydes of the heade. Fol. 11
  • vve may right vvel trepane, on the sydes of the sutu­res. ibidem
  • vve must endevoure to dravve forth the bullet at the first dressinge. Fol. 6
  • vve must not at anye time leave our patientes. Fol. 6
  • vve must dilate the vvounde if the bone be dilacera­tede. Fol. 7
  • vve must in operatione dilligently consider, that vve doe not chaunce to breake anye Vaynes, Synnues, Arteryes, or Tendones. Fol. 19 & 2
  • vve must let the cloven Lippe, after the operatione is done somvvhat bleede. Fol. 23
  • vve must nipe of the Needles endes stickinge in the cloven Lippes. Fol. 23
  • vve must not purge in the doggedayes. Fol. 51
  • vve oftentimes finde harde matter in the Vlcerations Ateromata, Steatomata, and Melicerides. Fol. 19
  • vve ought not all times to trepane. Fol. 20
  • vvhat a Chyrurgiane ought to knovve, in givinge of his iudgemente. Fol. 2
  • vvhat astringent medicamentes, the patient must vse in the bloodye flixe. Fol. 48
  • vvhat Apostemations vvilbe openede before their complete ripenes. Fol. 17
  • vvhat forme the searchinge iron must be of. Fol. 9
  • vvhat forme a Needle must have. Fol. 14
  • vvhat forme the threde in sovving of a vvounde must have. ibidem
  • vvhat his meates, & drinckes must be. Fol. 48
  • vvhat manner of threed and nedle vve must have in sovvinge of the bellye. Fol. 17
  • vvhat Ligamentes are. Fol. 43
  • vvhat is reqvired to the resanatione of vvoundes. Fol. 52
  • vvhat is to be vnderstoode by the left lippe of a vvoū ­de. Fol. 17
  • vvhat places may beare trepanatione. Fol. 11
  • vvhat qvantitye of bone vve ought to trepane. Fol. 12
  • vvhat sometimes deceaveth the Chyrurgiane. Fol. 7
  • vvhat this vvorde operatione signifieth. Fol. 1
  • vvhat vve ought to iudge out of the accidētes of vvoū ­des. Fol. 2
  • vvhat vve ought to doe the Dura mater beinge crus­hede. Fol. 13
  • vvhat vve ought to doe vvhē the discendede & svvol­len gutt cā not be agayn restored into his place. Fol. 16
  • vvhat vve ought to consider before vve make the apertione in an Apostematione. Fol. 17
  • vvhat vve ought to esteeme of the bleedinge of the gummes. Fol. 27
  • vvhat vve ought to doe vvhen vve perceave the fayn­tinge to approche the phlebotomised patient. Fol. 29
  • vvhat vve ought to doe before vve vse the horse lee­ches. Fol. 32
  • vvhat vvhe ought to doe in a deepe Carie. Fol. 34
  • vvhat vvoundes of the hippe are. Fol. 2
  • vvhen, and vvhye the externall parts must be extirpa­tede. Fol. 37
  • vvhen that the reporte must be done. Fol. 4
  • vvhē the Apostemation must be opened vvith a Cau­terye. Fol. 17
  • vvhē vve ought only to vse the exfoli [...]tive trepane. Fol. 12
  • vvhen vve ought to open an Apostematione. Fol. 17
  • vvhen vve ought to cut avvay the pallate. Fol. 24
  • vvherby vve may knovv the vvindy-hernia. Fol. 21
  • vvherin consisteth the daunger of dravvinge forth of bullets, Fol. 5
  • vvheron vve ought to cōsider before phlebotomy. Fol. 27
  • vvheron vve ought to consider in the applicatione of the Cauteryes. Fol. 42
  • vvheron in ligatione vve ought to consider. Fol. 44
  • vvhervvith the vvoūde is made must be cōsidered. Fol. 53
  • vvhich are strange thinges. Fol. 5
  • vvhye the vvounde in extractinge of a bullet mus [...] be dilated. Fol. 6
  • vvhye vve may not in the resovving of a vvounde dra­vve the lippes close together.
  • vvhye the threde in sovving of a vvounde may not be dyede. Fol. 14
  • vvhye vve file teeth. Fol. 2 [...]
  • vvhye vve must give a staffe to them in their handes vvhich vve Phlebotomize. Fol. 28
  • vvine is necessarye for all combattantes. Fol. 53
  • vvombe beinge hurte. Fol. 4 [...]
  • vvoundes of the Lunges. Fol. 3
  • vvoundes of the Kidnyes. Fol. [...]
  • vvoundes that are daungerouse. Fol. 2
  • vvoundes that be difficult to cure. ibidem
  • vvoundes vvhich are esteemed incurable. ibidem
FINIS.

IMPRINTED At Dort by Isaac Canin. M.D.xcviij.

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