Disciples or as wée may tearme them Schollers and diuerse and sundrie sects and opinions did growe vp amongest them by meanes whereof there was great controuersie contention and disputation of a long time some suppose it was a leauen hundred yéeres but the matter was not concluded indéede till the time of Hyppocrates which after long and manie disputations confuted their fonde and erronious opinions and brought this most excellent arte vnto a most perfect waie and methode of curing which before his time was vnperfect and vsed onelie by Experience without anie methode Some of the same Experimenters affirming that they coulde cure onelie by dyet all manner of diseases and other some affirming that by purging medicines they coulde doe the same and other some were of that opinion that with outward medicines onelie these might bée done vtterlie condemning the other two Many other foolish opinions there were which héere were too long to bée rehearsed Now after all these commeth Hyppocrates that most excellent and noble Philosopher indued by the spirite of God with such excellent wisedome and knowledge in this most worthie arte that his lyke was neuer before or since hée established this art and made it most perfect that before his time was vnperfect He wrote manie worthie Bookes of this arte and speciallie for the curing of Wounds Vlcers Tumours against nature Fractures and Dislocations wherein hée shewed himselfe not onelie to bée excellent in knowledge but also in practise as it may most manifestlie appeare by the Methode therein contained he did diuide the arte of Medicine into diuerse partes that it might be the better learned and vnderstanded declaring which ought first to be learned which second and so to the third and fourth and so to the fifth as it shall héereafter bée set foorth more at large Soranus in the Preface of his booke named Isagogus did saiy that Apollo dyd first finde out the arte of Medicine And Aesculapius dyd inlarge it and constitute it an Arte but that noble man Hyppocrates dyd finish it and make it perfect He sayth that by the excellent knowledge of this arte hée dyd driue awaie the plague out of all Grecia and was rewarded with a crowne of golde of greate value by a Decrée made in the Citie of Athens for his great paines and good deseruing toward the common wealth After his death the Grecians did make in a perpetuall remembrance of his Honourable déedes a most fayre Tombe at Delfus where they did most solempnlie burie his bodie and wrote vppon his Tombe this Epitaph which followeth Hyppocrates of Thesalia and by kinde of the Countrie of Coos doth lie buried in this place begotten of the seede of the immortall God Phoebus leauing in the world manie bookes of Medicine to put awaie sicknesse and to preserue health what shall we neede to saie more of this worthie worthie man there is no mannes cunning that may giue him his condigne praise After his tyme there was manie in the Countrie of Grecia which practised the Arte of Medicine not onelye Kinges but great learned Philosophers Princes Dukes and Lordes and by their worthie déedes in preseruing of mennes liues and putting away of sicknesse they dyd obteine immortall fame I saye such fame did indure longer and was more estemed then the fame of theyr Kingedomes as for their names I let passe for that there be many wryters haue spoken of them at large there was other diuers professers of Medicine before the tyme of Galen that were of worthie fame as you may reade more at large in the first booke of Cornelius Celsus wherefore we lette them passe After all these came that worthie manne Galen who was without any comparison from the beginning of the worlde vnto this daye except Hippocrates not onely for his excellent learning in so many famous Artes which he was perfect in but specially for this Arte of Medicine which he was most excellently séene in both in the Theorike and Practike parte thereof his worthie Commentaries vppon Hippocrates doeth well declare his excellent knowledge wherewith he hath most bountifully garnished the Arte of Medicine as our latter writers doe saye more like vnto a God then a man How excellent be these bookes which he hath written of the method of curing called Methodus Medendi some part whereof wée haue with great trauaile brought into the Englishe tongue and likewise other of his bookes also as hereafter followeth Well I will saye no more of him but what séede so euer were sowen abroad in the vniuersall worlde be the excellent learned men in the Arte of Medicine not onely of Hippocrates who was the Father and fountaine of all Medicine as Galen himselfe doeth witnesse but the séedes of other menne he hathe gathered together sowne in one plaine fielde and watered them with such diligence that they haue so increased that at this daye the vniuersall earth hath receiued nourishment by them perpetuall commoditie and pleasure and he for his great vertue and painefull trauaile hath wonne vnto himselfe immortall fame which shall remaine to the worldes ende After him came Aesius who hath written diuers worthie bookes in the same arte of Medicine Also Oribasius Actuarius and Paulus Aegeneta were worthie writers in the same Arte as you may sée by their workes which they haue written Dioscorides also which was before Galens time I may not forget for his paineful trauaile in knowledge of the simples as it doth apeare by a worthie booke which he hath made thereof All these and many more were worthie men amongst the Grecians and professers of the arte of Medicine and dyd alwaies extoll and take Apollo as the chiefe Captaine and first beginner of the arte of Medicine and Aesculapius his sonne to be a setter forewarde of the same and Hippocrates did make it perfect and finish it What shall I saye for the worthie Arabians as that noble man of Cartage named Aunconius Prince Auisen Auorois Auinsor Rasis Mesuea Albucasius and many other worthie men that spronge emongest the Arabians who hath not a little garnished the Arte of Medicine with a great number of most excellent bookes which are to be séene at this daye All these men I saye toke their beginning of Galen and doeth honour him as their principall head and doeth glory and exalte them selues in his name for that they neuer had perfect method of curing before his time but cured onely by experience as they were taught of their maisters For Hippocrates workes before Galens time were so short and obscure that they were vnto most men not vnderstanded by meanes whereof many doubtes did grow but Galen by most worthie commentaries made vppon the same bookes made those doubtes most plaine and euident vnto all people by meanes whereof not onely many worthie Grecians as I haue sayde before haue taken a courage to write but also many of these moste famous Arabians haue followed their steppes and examples in setting foorth many excellent woorkes in the same Arte
Chirurgerie is not onelie to know the names of sicknesses and diseases but the name of euerie perticular medicament as wel simple as compound And also to know all other strange tearmes appertaining to this arte Wherefore Galen in this booke of Tumours against Nature hath taken greate paines not onelie in setting forth of their names but of theyr true diuisions natures and dispositions with their figures formes and humours by which they doe grow and are maintained without which knowledge no Chirurgion can either rightlie cure either else vnderstand the nature of those things which he doth take in hand Therefore I haue thought it good to set before your eies this most worthie booke which Galen hath writtē of tumors against nature wherein he hath most excellently set forth not onely the most apt names but also the humors that the same tumors doe spring of For like as he hath declared in his methode of curing the diuersitie of wounds and vlcers with their natures formes and properties and also with their accedents symptomata and causes Yea I say not onely with these but also with the knowledge of the temperaments natures and qualities of euery medicament proper for their remedies with their trew deuisions and names to that ende that euery one of them may be exactly and perfectly knowen from other And for the better vnderstanding hereof I haue added in the ende of this booke of Tumors against nature an other booke of Galen of the names of medicines which be proper for diseases which I haue thought very meete and conuenient for you to vnderstand to that ende that you may be accounted men of knowledge in your arte not onely to be accounted so but to be so in deede Thus taking my leaue of you I desire you most hartely to be studious herein and so being you shall incourage me further to procede in other things of this arte which may be much for your profit And thus I commit you to the almightie Lord who illuminate you with knowledge of this most worthy Arte. Your louing brother to the vttermost of my power Thomas Gale maister in Chirurgerie An. Domini 1563. Mense Septembris 25. Claudus Galeni de Tumoribus preter naturam OF those things which chaunceth to mans bodie one thing is that which the Gréekes do call Oncos which we name a tumor or swelling for so doe they tearme that thing which is a swelling or a distention in length breadth and déepnesse Also sometime that bignesse which is aboue natures constitution they do cal Oncos These do not onlie chance vnto them that be sicke but to those that be whole also For corpulent persons and women with childe are more bigger in breadth and thicknesse than according to nature and yet they are not affected against Nature as we haue sayde in other places The other tumor is that which is according to natures constitution or as we may tearme it a naturall tumour in the braunes of our armes and caufe of our legge which is in a meane betwixt those that be according to nature and those against nature For corpulent bodies also leane bodies are not against nature but the one is aboue natures constitution and the other vnder and so both these dispositions are called not naturall But that tumour which cōmeth of the dropsie and leanes in a consumption both these are against nature But now in this presēt booke we doe purpose to intreate of those Tumours which bée against nature which doth not onelie occupie the whole bodie but also may chaunce to anie part thereof so that it bée alwaies determined that the agreuation of this vnnaturall constitution be against nature and the end of the same to be the hurt of the naturall action But we néede not to speake much of these Tumours for that they be commonly knowen vnto all men not onelie to the Phisitions but to all other persons The other tumours which groweth of immeasurable fatnesse and flesh and also women béeing with childe doe make those which are aboue natures constitution And we considering all other Tumours which are according to nature and necessarie for the making of our bodie as in the braunes of the armes and cause of the legges c. All other tumours which doth excéede that which is aboue nature and those which be naturall we account against nature And taking our beginning at the first of them called an inflammation or Phlegmon Of Phlegmon or Inflammation Chap. 2. THe Grecians vse to call that an inflmmation which commeth with great tumor or swelling in the fleshie parte strained and stretched forth resisting with pulsation dolour hot and red The cause of these accidents is not onelie vnknowen to the multitude of the common sort but also vnto manie Phisitions or as we terme them those that vseth the art of Medicine for diuerse of them not séeking out diligentlie doe simplie pronounce that which séemeth good vnto themselues mistaking the thing But consideration must be had héerein if you will procéede in this mattier Therfore there is neuer anie great tumour that chaunceth in anie parte of the bodie against nature except the same parte be affected with one of these two thinges For either it is made flowing increased and stretched forth through ouer much hotnesse either else it taketh some new substance outwardlie And when this fluxe doth happen is stretched out with swelling it is tourned into spirites and béeing refrigerated it doeth easilie tourne againe into his accustomed swelling But we sée no spirits in the inflamed parte neither yet the part inflamed being refrigerated doe not alwaies come againe into their former constitution And it is manifest by incision also that there is no spirites therein contained for if the inflamed part be cutte much bloud will runne out and all the place séemeth euidentlie full of bloud like vnto a wet Spunge But yet you shal sée no spirits come forth either presentlie or yet long after and the coulour of bloud is altogether inseparable There is no part of the bodie that is red but bloud and flesh neither is the multitude of flesh the affect of inflammation for although the multitude of flesh be in the bodie without multitude of bloud yet the tumour trulie shall be bigger than natural and the coulour shall be healthfull and not swarue from his accustomed nature for in anie thing which naturallie increaseth the coulour is not augmented for then should Snow be made more white Pitch more blacke and Golde more yeolowe And the increasing of substance differeth manifestlie from alteration for thinges increase according to their quantitie and altereth according to their qualities but coulour sheweth the qualitie of the substance and not the quantitie Therefore the multitude of flesh differeth from an inflammation and for that cause the bodies which abound with bloud bée most troubled with inflammations Now séeing that sometime in wounds there be greate inflammations and yet there floweth forth thin and watrie humours the place
Medicus that dooth cure vlcers and woundes therefore it séemeth to mée that Mtdicus and Chyrurgus bée indifferent names for those that professeth the arte of curing and for anie thing that I can perceiue either by the wordes of Hyppocrates or Galen or by anie other notorious and famous writers that haue written in this arte The Chirurgions ought not to bée forbidden neither the ministring of purgations nor yet of dyet for as much as they be their chiefe and principall instruments without which they cannot bring to passe their desired scope of health And if we shall speake of the antiquitie of names I suppose the name of Chirurgia to be much more auncient than the name of Phisicke for I suppose Phisicke to be deriued of Phisilogia which worde doth signifie naturall knowledge of mannes bodie and of all the partes and members of the same c. And Chirurgia is deriued of Chiro which is a hand or as we might saie a ministration of Medicamentes done with the hand vnto mannes bodie onelie by experience So that all those that were before the time of Hyppocrates were accounted but as experimenters and to followe an arte without a right methode which that noble man Hyppocrates perceiuing dyd lyke a most famous Philosopher according to reason ioyne together all these vnperfect sects which were in his dayes verie manie and taught them one perfect and true waie methodicallie to worke and also certaine rules howe they shoulde learne the same arte and diuided it into fiue speciall partes as we shall declare héereafter which partes béeing perfectlie vnderstanded is the right waie to procéede to the curation of mannes bodie and without knowledge of these fiue partes no man can methodicallie and rightlie cure anie Vlcers Woundes Apostumes or anie other diseases as wée haue sayde before for whosoeuer taketh vpon them hauing not knowledge of these he may be called a practiser and experimenter or an emperike as the most parte of our Chirurgions may be called that bée not learned in these partes and doth worke onelie by experience without reason but those that vnderstand these partes and followeth a methode in their curing whether they doe cure Wounds Tumours against nature Apostumes Vlcers or what other thinges so euer it bée that doeth appertaine to the arte of curing that same Artist may be called Medicus a Medendo that is to saie of curing for so doeth Galen name him in his third and fourth booke De Methodo Medendi according to the translation of that learned man Linaker And forasmuch as ye shall the better credit the worthinesse of this arte of Chirurgerie as well for the antiquitie thereof as for the Instruments appertaining to the Artist I haue héere set forth before your eies an Epistle made by Franciscus Valleriolus in the commendations of the arte of Chirurgerie which Valleriolus is one of the most notable learned men in the arte of medicine that is nowe liuing whose wordes héereafter followeth The office of a Chirurgion and the Instruments appertaining vnto the same Art set forth by Franciscus Valleriolus Medicus Anno Domini 1562. IT is commonlie knowen I haue shewed it before that the other part of the Arte of Medicine is that which cureth with the hand which also the Gréekes doe call Kyrurgicon for the manner of working wée kéeping that name doe call it Chirurgia This part as it is counted among the olde writers the ancientest so trulie both for the magnitude and for the profite of the effects it is counted the chiesect Moreouer Podalirius and Machaon being the first authors of that art as it is supposed and the lawfull issue of Aesculapius the father of the art of Medicine doe declare the ancientnesse thereof whom as Homer writeth followed Agamemnon their Captaine in the Troyan warres and to haue bene no small helpe to his souldiers in curing of them not by the helpe of inward medicines onlie but in curing diligentlie of their wounds with yron instruments and with other fit medicines therevnto appertaining whereby it doeth appeare this parte of Medicine to be onelie proued of them and the same to bée auncientest Furthermore the profit and vtilitie thereof doeth of it selfe manifestlie appeare by the curations of greate Apostumes of wounds of vlcers of luxations and of Fractures all the which this part of Medicine doeth intreate of exactlie And of this part we will intreate in this Chapter and of the same we will shew forth these things what that art is and what be the parts of it what is the end thereof who be the authors what the office and dutie of a Chirurgion is what be his instruments which he hath accustomed to vse in healing what a one he ought for to be and to conclude who ought to be accounted the best Chirurgion and thus we will finish our Chapter Chirurgerie is defined of Galen to be a certaine order of curing which is accomplished by accustomed incisions and adustions and other thinges which are done by the hande Moreouer the author of the Introductorie whosoeuer hée hath bene hath defined the same after this manner as they doe properlie call it a taking awaie of things hurtfull by incisions and concinations by a certaine methode reason In like manner it is the curation of wounds and vlcers which is administred to mans bodie But if anie man will set forth the order of it more curiouslie and expreslie he wil call it the third part of the methode Therapeutichon which doth cure diseases by the artificialnesse of the hand by adustions and incisions and by curing luxations and by putting broken bones into their places and such like Guido of Caliacensia hath so defined that it maye be a science which may both teach the order and qualitie of operation chiefelie by adglutination and incisions and other operations of that kinde which bée done by the vse of the hand restoring men to their health as much as is possible Also it behoueth vs to vse this name of Science more largelie in this place and applie it vnto that parte of Chirurgerie which doth profit by meditation of preceptes and giuing of Methode and not by curing with the hand For it is manifest that Chirurgerie is an Arte and not a Science properlie whose end is the bringing to effect and not the contemplation of the veritie onelie and for that cause Aristotle would haue the same worthelie to be an arte and also hath thought it good to place it amongest those artes which do pertaine to the vse of the hand But other things being put in the definition doe kéepe their place of difference in like manner this parte is not put vnaduisedlie to the definition that men be restored to their health as much as is possible for although that health is counted to a Chirurgion for a perpetual scope yet that same cannot alwaies be obteined by arte because there be many diseases vncurable which doe chaunce eyther because they are such by their owne nature as Elephantiasis
Thomas Gale vnto the friendlie Reader Salutations MY friendlie and welbeloued brethren when I did consider with my selfe the great defect and imbecilitie which doth remain amongst our Companie for lacke of learning in the speculatiue part of this worthie art of Chirurgerie which chieflie doth appertaine vnto the same And considering with my selfe what great ignorance and infamie hath growen to our Companie thereby I haue not bene a little carefull to remoue the same thinges from vs. And considering with my selfe also that these things cannot be remoued but by knowledge and that knowledge cannot come but by reading and hearing and reading is vnprofitable except it be vnderstood Therefore I haue with great diligence collected and gathered together these foure bookes of Galen called Therapeuticon being trāslated into the English tongue I haue dedicated the same vnto you to that end that you may with the like diligēce studie receiue pleasure profit great commoditie by these bookes which I heere deliuer vnto you with painfull trauaile great cares charges But when I did consider these diuine most excellent bookes how profitable cōmodious the same should be vnto you I saie not onelie to you but to the whole common wealth of our Countrie what great honor shuld grow vnto mine owne natural Country men hereby also what furtherance increase of knowledge it shal be vnto those that professe this art I neither regarded monie nor profit nor passed for anie paines but yeelded my carefull studie to serue your turne in this most diuine worke And moreouer I thought it my bounden dutie to helpe to raise vp that most famous mā Galen who hath lien so long buried with that foule monster Obliuion from the knowledge of our natural tongue so that worthelie he hath deserued immortall fame Now my brethren there are three speciall points that are to be considered The first is to whom you do minister and to what end your ministration serueth The second is with what thinges you doe minister and what methode you ought to keepe in the time of your ministration The third is what manner of knowledge ye ought to haue that will cure methodicallie and rightlie by his ministration To whom this Artist doth minister it is easilie knowen for he doth minister to mans body which is subiect vnto the art of Medicine and the end and affect of his ministration is to cure mans bodie of such hurts and diseases as the same bodie is anoyed and troubled with The second doth consist in those things that you cure withall and they be three that is to saie conuenient diet or as wee may tearme it conuenient gouernment of the sicke patient and conuenient medicaments apt and meete for the disease and also an apt and conuenient person methodicallie rightlie to vse these two The third is what manner of knowledge this person ought to haue Galen doth verie well describe his knowledge in these bookes against that foolish bragging Thesalus how he would take vpon him in sixe moneths to make a man perfect in this arte and yet he himselfe but a Woolman or as we may tearme him a Spinner and carder of wooll whose foolish stupiditie was such that he would compare with Hyppocrates and Galen and therfore Galen hath written against him in all these bookes not onelie condemning him but condemning all other ignorant persons which vnderstand not the principles of this arte and speciallie other Artists as Carpenters Smiths Cookes Weauers and women which doth leaue their owne honest occupations wherein they haue bene brought vp and dooth arrogantlie and presumptuouslie take vpon them this most worthie arte wherein they be vtterlie ignorant and if they cure anie thing it is by chaunce and not by methode as you may perceiue in his first booke There is also another thing to be noted that Galen doth not make such diuisions betwixt wounds and vlcers as wee commonlie doe for hee dooth name all those that commeth with solution or separation of the skinne Elkos in Greeke that is to saie an vlcer But if you doe diligentlie consider Galens method as in the curation you shall finde it most excellent and which is to bee vnderstoode an vlcer and which a wound c. Now there resteth no more but your painfull trauaile and studie heerein and euerie one of you brotherlie and friendlie to haue conference herein one with another by meanes wherof the true meaning shal be the better vnderstood you your selues shal receiue it the better into your perpetual memory Thus I take my leaue of you requiring of you no rewards but true and faithfull good will louing words with friendlie furtherance desiring the almightie Lord to preserue and keepe you and send you the knowledge in this worthie Arte to the profit of the common wealth FINIS THE THIRD BOOKE of Galen called in Greeke 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 in Latine Methodus Medendi The effect of the same 1 First he sheweth the curation of Vlcers that bee not malignant and stubburne 2 Secondlie he sheweth what manner of Medicines the Emperikes haue found out to ingender flesh 3 Thirdlie he sheweth the curation of a hollow vlcer 4 Fourthlie he sheweth that the Indications ought to be taken of the temperament of the affected part 5 Fiftlie he sheweth that the curation of the similer parts consisteth in the iust temperamēt of the foure qualities 6 Sixtlie hee sheweth that all bodies require not lyke medicines but that weake and tender bodies require most gentle medicines and that drie and strong bodies require most strongest medicines The first Chapter IF therefore Hiero the indication which first springeth of the nature of the thing doth find out what is to be done then the beginning of finding out remedies must of necessitie be takē of the nature of diseases thēselues For truly it is against all reason that one thing should shew the waie of curing and another that is cured for each thing can better shew of himselfe than of another but this shall be made more euident héereafter And for because all men do graunt the first indications to be taken of the affects we shall not néede further trauaile héerein to proue that héereof we must take our beginning nay rather let vs goe about to shew that it is neither the whole neither any great portion as the Methodicians doe iudge but rather the least part and onely the beginning Therefore they themselues doe affirme that the stone in the bladder because that it is altogether against nature doth shew that it must be taken awaie In like sort Acrochordonas Mirmicias Atheromata Steatomata Meliceridas and other of like kind Also the intestine that is now fallen into the purse of the testicles and all that are dislocated because they are in a place against nature they shewe that they must be reposed and put in their naturall seate And all these trulie are so farre from anie cunning that they are manifest euen to euerie
many wayes friuolous and foolish For our bodies doe not consist of little bodies called Atomes and of little passages or pores but if this were true it should not be possible to shewe in what maner musterd might change or alter the state of the same pores if any of them should shew the truth yet we would not agrée vnto their sect because they promisse that they wil be content with their apparent communities therefore lette them not vse these names neither let them hinder vs no more in our matters For it is lawfull without the name Metasincrisis to say in other wordes the curation of inueterate vlcers as the Emperickes doe Also we haue declared in the second booke how they talke of this woord Atonias that is to say imbecilitie yet know not what it meaneth For if they vse this name as the Emperickes do then it should signifie nothing else but that the actions are not kept for if they say that certaine faculties doe gouerne liuing creatures which we all the auncient writers doe affirme but yet notwithstāding they repugne against the precepts of Asclepiades also they propound vncertaine things to the which the authors doe not agrée they touch the truth a little yet they commaund to eschew it But tell me true Thessalus what meaneth this worde Metasincrisis if thou saie that it betokeneth to change the pores thou art deceiued and supposest vncertaine thinges But if thou saist that it is a great matter to cure the particle grieued of the bodie as the man thou saist no more thā the Emperikes except the name For they doe knowe that men are made whole by medicines but they know not the cause or reason by what meanes the remedies restoreth health For none of the Emperikes can tell if the facultie of the medicaments chaungeth the pores or if it maketh a Simitrie or if it altereth the qualitie of the Patients particle that is grieued Howbeit the Emperikes are discréete men if they saie that they know onelie one thing that is to saie if they haue noted and obserued the times how vtilitie hath followed when the medicament of mustard hath ben ministred to such vlcers and in what time Neuerthelesse they speake not of method neither yet repugne against it neither be displeased with the notise thereof nor dispraise the ancient writers neither Hyppocrates but rather praise him and affirme that he hath said all thinges well But Thessalus doth not onlie despise Hyppocrates but all the other auncient Phisitions neither doth he vnderstand that he hath written all the precepts of rebellious vlcers without reason emperiklie For if he had written them well then it should haue bene counted a worke most profitable But it appeareth not that he hath done so séeing that he peruerteth the right order of remedies and vseth his remedies to the grieued part before he hath prepared the bodie For this is an argument of great ignorance séeing that almost it is a principle in Chirurgerie that all the bodie must be purged of the euill excrementes before anie strong medicine be applyed vnto the affected parte For who is he that will iudge either by reason or experience for there is no other third thing to iudge by in what art so euer it be nor in anie part of life he shal finde that it is agréeable to reason for a man to minister strong hot medicines to anie particle of the bodie before he hath purged the bodie of all anoiance prepared the same to health for the said medicine draweth the excrements and superfluities from all the bodie like as boxing or Ventosis doth it doth so fasten to the affected part that it may be scarcelie remoued Therefore it must be asked of these Thessalions frō whence this opinion cōmeth to Thessalus to write fables as cōcerning the curatiō of rebellious vlcers séeing that none of the Emperiks nor yet Rationals haue written so before this time For neither Thessalus himselfe neither anie other of his sect dare affirme that the order of such remedies either doth agrée with experience or reason For neither can they giue Indication of time neither yet of the affect of the disease Yet for all that Thessalus is not all together ignorant because he iudgeth that the cause the hindereth the ciccatrise must be considered and taken awaie because also that he iudgeth that this must be done not onelie in vlcers but also in all other diseases as the ancient writers do admonish But they answere nothing to the purpose for they saie alwaies that we do not vnderstand them as if they knew perfectly the thought of Hyppocrates and of all the ancients And they affirme the Thessalus hath a good opinion when he saith that there is a communitie of inueterate vlcers that Hyppocrates vnderstood it so in his booke of Vlcers which writeth in this maner It is profitable that the bloud doe flowe continually from the inueterate vlcer when so euer it séemeth néedfull It were not farre from my purpose if I should speak of the iudgement and opinion of Hyppocrates though I haue not promised that I would so do in this place But that which I will saie shall be of the interpretation of the wit knowledge of the auncient Phisitions the which truelie as yet haue giuen no sect but studying with simple pure minde to inuent some thing profitable to mans health It is well perceiued therfore that they haue found some thing by reason and some thing by vse and experience Then dyd they write their inuentions many times without giuing reason thereto and sometime they did and if they did giue anie reason it was to profit the readers For if they intended to be profitable to their successors and when as they knew reason of inuēting things then diligentlie they set it forth and where they thought it obscure they thought it superfluous to rehearse and therefore let it passe Now it is well knowen vnto all men though I hold my peace that the ancients haue loued no verbositie For that cause afore recited not only Hippocrates but also all the other ancient Phisitions sometime not making mention of the middlemost speaketh of the third thing For if the first be a signe of the second the third of necessitie must followe after the second And thus oftentimes omitting the first and second they spake of the third I haue oftentimes declared how the ancients and chieflie Hyppocrates haue written after this manner But he that will know and perfectlie vnderstand the maner of curing ought to be exercised in their stile and manner of interpreting For this I will intreate of that which I haue purposed The fift Chapter FOr those Vlcers which after medicines to them ministred be not cured those the Phisitions cal in Gréeke Cachoethae but we cal them maligne and rebellious to cure But we haue spoken in the booke aforesaid what the curation of vlcers is Therefore in these kindes of vlcers that be
maligne we may vse these names indifferentlie that is to saie we call them Cachoethae inueterate or Diuturnus In like manner the affect of the disease called Cachoethae that is to saie stubburne and rebellious to be cured that maketh some thing for our purpose to know neuerthelesse the saide diuturnitie of the saide vlcers because they come againe or be of long continuance waxe olde haue no conuenient indication of curing but that must hée considered because the vlcerate part is ill affected that ill affect béeing once knowen the cure is manifest But thou wilt aske how can this be done trulie if thou wilt heale the vlcerate part affected thou must first take awaie the abundance and corrupt vicious humors from all the bodie for in cleansing awaie the same the diuturnitie is taken awaie but the finding out which is profitable to vs commeth not first of the diuturnitie but of the ill disposition malignitie of the humour by meanes whereof these thrée things following must chiefly be considered that is the signe the affect and curation The signe is the diuturnitie or continuance of the vlcer the affect is the vicious humours repairing to the vlcer and the curation is the taking awaie of the saide humours By this meanes you shall finde that the auncient Phisitions manie times after the first made mention of the third leauing the middlemost as Hyppocrates did whē he said it is vtill to cause the bloud to flowe out often of inueterate vlcers But it is inutill that the indication curatiue should be taken of the diuturnitie of the vlcer but of the ill disposition of the bloud For a little after he saith thus the vice and euill bloud hindereth greatlie the cure of the said vlcers Also putrefaction of the bloud all things that commeth by transmutation of the bloud letteth also the curation of the sayd vlcers And afterward he speaketh of vlcers that come not to a cicatrise The vlcers trulie saith he may not be closed together if the lips and partes that are rounde about be swart or blacke with rotten bloud or Varises that causeth the fluxe if you cure not the sayd partes that bée about it they will not come together And afterward hée writeth of the cure of Varises and then maketh mention of the purging of all the bodie as well in woundes as in Vlcers where feare of daunger or putrefaction in Gréeke called Sphaselos doth remaine and besides in Vlcers called Herpes and Esthioninus that is to saie which doe erode and eate the skinne And thus Hyppocrates is wont to call those vlcers after this sorte wherein anie ill humour doth cause erosin And thus when he speaketh of them that ensueth he saith in such wordes In euerie Vlcer whereas chanceth Erisipelas all the bodie must be purged And finallie if you reade diligentlie the booke of vlcers you shall finde that he taketh Indication alwaies of the affect of the disease if he haue anie consideration of time it is onelie to knowe the affect And that it is so you may know it in the beginning of the said booke which concludeth thus You may not minister anie moist thing to Vlcers what vlcers so euer they be but wine Then sheweth hée the cause and saith Drie vlcers are néerest to health and moist the contrarie then after he saith it is an vlcer for that it is moist but if it be dry it is whole Therfore in all his cure in as much as he hath constituted the end of al the cure of vlcers to be drinesse it ought to be considered Then he findeth out the perticular thinges admonishing vs manie times of the same end writing in this manner Euerie wound that is diuided with a cutting Instrument receiueth medicines in the beginning that ought to be applied to rawe and bloudie wounds the which Medicamentes in Greeke is called Enaimon which is drying and letteth the wound to come to suppuration for it is more drier by the reason of the bloud which floweth out of it And agayne Hyppocrates sayth All vlcers that are well purged they come sooner to drynesse and ciccatrize but if anie superfluous flesh do grow it is by the reason of some contusion And againe he saith if that anie of the wound cannot consode together the moistnesse is the cause thereof In all these sayings Hyppocrates admonisheth vs of the first Indication curatiue of all Vlcers for of a truth the curation of an Vlcer for as much as it is an vlcer is moderate drynesse whereof the demonstration hath bene giuen in the booke going before For the curation of an vlcer that is coniunct with another affect whereof the cure ought to procéede is not like to a simple vlcer for the first curation of such a one as is coniunct with anie other affect shall begin first of the same affect and then at the vlcer For if there be either Phlegmon or swart coulour or Ecchymosis or Erysipilas or Oedema in the vlcerate part first you must begin the curation at one of the sayde affectes Neuerthelesse all men knowe well that sometimes these Vlcers are not well cured but are made greater for that the partes round about the Vlcer is affected either with Phlegmon either by brusing either with some other tumour which should haue ben first taken awaie before you had procéeded to the cure of the vlcer And for a certaintie it is not possible to heale the vlcer if the place where these be be not first cured And therefore Hyppocrates putteth vs in memorie of those things which he hath spoken of in the beginning of his booke and also of those things before especified and of those that be present he writeth thus Euerie wound that is diuided with a cutting Instrument or sharpe pointed receiueth Medicament called Enaemon and also a medicament desiccatiue that may let the filthie mattier But if the flesh be contused or cut with a blunt weapon remedie must be giuen in such wise that it come soone to suppuratiō For in so doing it shal be the lesse molested and grieued with Phlegmon And also it is necessarie that the putrified flesh which hath bene contused incised come first to suppuration and afterward new flesh to be engendered By these wordes Hyppocrates sheweth manifestlie that all the affects of the vlcerate partes ought to be desiccated except those where Pus will sodainelye bréede And so he going forward saith that Pus commeth through some putrefaction Furthermore that all putrefaction commeth through moistures and heate and therefore the Cataplasmes made of Barlie meale séeing that they are hot and moist we will minister it to all diseases where it is expedient to engender Pus for the Barlie meale with water and oyle and likewise bread with oyle or a fomentation of much hot water or the Malagma called Tetrapharmice and to conclude all things that moist and heat ingender Pus And if in the parts where Phlegmon is there ariseth pulsation in such wise that there is no
CERTAINE VVorkes of Galens called METHODVS MEDENDI with a briefe Declaration of the worthie Art of Medicine the Office of a Chirurgion and an Epitome of the third booke of Galen of Naturall Faculties all translated into English by Thomas Gale Maister in Chirurgerie AT LONDON Printed by Thomas East dwelling betweene Paules Wharfe and Baynards Castle 1586. TO THE RIGHT Honourable Sir Henrie Neuell Knight Lord a Burgauene and his singuler good Lord c. FOrsmuch my singuler good Lord as I haue perceiued you to be naturallie inclined to the art of Medicine and chiefelie to haue vnderstanding in that part which is commonlie called Chirurgerie I haue not beene a little carefull since my acquaintance with your Lordship to further you in the same studie euen to the vttermost of my power and forasmuch as you haue so profited not onelie in the Theorike part but also in the practike I haue thought all my paines labors well bestowed And although I should holde my peace and saie nothing heerein yet a great number of poore men and others which haue bene cured of your Lordship of many sundrie griefes and diseases will set abroade and bewraie your notorious and charitable deedes And forasmuch as your Honour hath better vnderstanding in this worthie arte than a greate manie of those which take vpon them the name of Chirurgions I might verie well saie the most parte And forasmuch as your Lordship beareth such a singuler loue vnto the same arte I am therefore moued to dedicate these my simple trauailes vnto your Honour to bee the patrone and defender thereof for I doe perceiue that now in our time no good enterprise can be gone about but false detraction and enuie is like to ouerthrowe the same which hath mooued mee for as much as you are a noble man the rather to dedicate my trauailes vnto your Honour to bee my aide and succour in the defending of this my small trauaile which I protest I haue not taken in hand neither for vaine glorie neither yet for anie worldlie profit or gaine for since the first time that I beganne to sette out anie parte of this arte in our English tongue I haue both susteined great displeasure and also lost manie profites of those which were in times past my speciall friendes and the greatest matter that they haue to saie against mee is onelie that I goe about to make euerie bodie cunning in the arte of medicine with setting foorth of these my workes in the English tongue but if it shall please your good Lordshippe to vnderstand my bounden dutie first to almightie God of whom I haue receiued the talent and also my dutie to my naturall Countrie whom I ought to profite with my talent according to the saying of our sauiour Iesus Christ which saith He that hideth his talent in the ground and vseth it not to the profit of his neighbour it shall be taken from him againe Wherefore my good Lord I thinke it my dutie to set foorth these thinges for the commoditie of the common wealth of my Countrie What greater profite may come vnto any in the time of neede than to cure his grieuous woundes without which hee should presentlie die to cure his grieuous sores which dooth not onelie eate the flesh but fretteth and rotteth in sunder the great bones with most vehement griefe and paine and also great inflammations and tumours against Nature which taketh awaie the naturall actions of the bodie and molesteth it with most vehement and continuall paine and also curing of broken bones and bones beeing out of ioynt to restore them into their naturall places againe with many other griefes appertaining to the same arte which were heere to long to bee recited And for as much as manie haue taken vppon them the curation of these diseases aboue sayde and haue committed many great errors for lacke of knowledge to no small daunger of Gods people no lesse hurt of the cōmō wealth I haue thought it therefore my bounden dutie to set foorth my onelie one talent in furthering of knowledge euen as the poore widow did which had but onelie one farthing and put the same into the Lords treasure like as that same was accepted with almightie God so I trust he wil accept this my good will according to the knowledge which he hath giuen me so that at the last daie I trust he shall not saie vnto mee thou hast hidde thy talent in the ground and not profited therewith as thou shouldest haue done And also I trust that good men of my Countrie shal haue no cause to haue an euill opinion in mee either through negligence or idlenesse for that they may well perceiue that these trauailes do both require studie and time of setting foorth Now my singuler good Lord if they shall saie it is not good because it is in the English tongue then I must alleadge vnto them the famous men which were the chiefe setters forth of the same art as Hippocrates and Galen amongst the Grecians whatsoeuer they might vnderstand by foreine languages either else gather by reason or by experience or obseruation of time all these whatsoeuer they were they did write them in Greeke which was their owne language tongue to that end they might the better bee vnderstanded and sooner bee learned Also in like manner the worthie Arabians as that noble king Auicen Auerois Albucasis Mesue a great sort more of worthie men which did collect and translate manie noble workes of Medicine out of the Greeke tongue the Ebrue tongue and many other languages into their owne naturall tongue which was then the Arabian tongue In lyke manner the Latinists were no lesse diligent to collect and gather both out of the Greeke and Arabian tongue wrote it in their owne tongue as you may reade in the workes of those famous men Plinius and Cornelius Celsus with manie other more whose workes are manifest at this present daie If these worthie men haue beene moued with good conscience for knowledge sake and for the better maintenance of their common wealth in setting foorth of this art for the reliefe comfort succour helpe and health of those that be sicke and diseased or other waies wounded or hurt in warre or by mischaunce c. Why should not I then without blame or reproch for the furtherance of knowledge and other necessarie things aboue rehearsed set foorth in our English tongue some part of this good and necessarie arte for the instruction and further knowledge of those young students which are desirous to learne the same and to vse the same to the profite of the common wealth in the time of necessitie I doe not meane that honest Artists as Tailers Shoomakers Weauers or anie other handie occupations that they should leaue their artes wherein they are perfect and fal to this art of Medicine for I doe wish with all my heart that politike lawes might be made to constraine euerie man to follow that art in
which he hath bene well instructed and brought vp in But my meaning is onelie to instruct those that be brought vp in the art of Surgerie vnder some experimenters who hath little learning in the tongues yet desirous to attaine knowledge and forasmuch as these experimenters are permitted by lawes to occupie the art of Surgerie I thought it my bounden dutie both for the furtheraunce of their knowledge and also for the reliefe of these that be diseased to set foorth this in the English tongue which I haue done I doo not goe about to instruct those which be great learned men and vnderstandeth the tongues neither yet doe I goe about to satisfie the minde of those that be contentious and captious that will rather finde fault with other mens dooings than to further those that be willing to learne with their good dooings My intent is onelie to further those that be willing to learne which with humble and gentle heart doo accept and take in good part other mens great paine and trauailes and forasmuch as Prentises and young men which haue not beene trained vp in schooles neither yet can vnderstand the Greeke or Latine tongue and yet can vnderstand and reade English verie well and be of readie wit and good memorie to carrie awaie that they reade heare It hath mooued me therfore the rather to write these bookes in the English tongue forasmuch as the foundation of art doth consist onelie in reason experience neither can ther be anie third thing added thervnto as Galē affirmeth in his 3. booke named Therapeuticon It semeth to me therefore that he which vnderstandeth any tongue whether it be Greke Latin or English it serueth him no more but for the further vnderstāding of that thing which he doth reade for it doth not follow that euery one which can speake Greke Latin or Ebru by and by to be a good diuine or perfectlie to vnderstand the Arte of Medicine for the common people amongst the Gretians spake the Greke tongue and so in other countries which speaketh their language and yet neither Diuines neither yet Phisitions therefore it doth manifestly apeare by Galen that the tongues maketh not an Artist but reasonable knowledge being ioyned with experience maketh the Artist so that in what tongue soeuer a man may gather knowledge whether it be Greke Ebru Latin English or what other language soeuer it be that same knowledge being ioyned with reason and experience maketh a perfect Artist yet my good Lord I would wish that he that should be a Chirurgion should vnderstand the tongues for as much as in times past they haue bene more diligent careful to further their common welthes in those countries then they be in ours by meanes whereof they haue brought many noble Artes into their owne tongues which we haue not so largely set forth in our English tongue Therefore if the professors of Chirurgerie were learned in these tongues they might more easely vnderstand the principles of their Arte with their true diuisions and definitions which should the more readier instruct them to follow a true methode and this hath bene one cause which hath moued me to take this matter in hande Thus most humbly beseeching your Lordship to take these bookes the fruites of my painefull trauailes into your noble protection defend both them and me your poore suppliant from the mallice of busie detracters and I shall not onely be the better incouraged to set forth other things according to my knowledge for the furtheraunce of the common wealth but also as my duetie requireth to pray vnto the almightie Lord for your Lordships long life perfect health and dayly increase of honour At my poore house in London the .vij. of Nouemb. 1566. Your honors alwayes to commaund during his life Thomas Gale Chirurgion GO forth my painefull booke Thou art no longer mine Eache man may on thee looke The shame or praise is thine Thou mightst with me remaine And so eschew all blame But since thou wouldst so fayne Go foorth in Gods name And seeke thou for no praise No thanke nor yet reward Nor eache man for to please Haue thou no great regard For as to pleasure many I haue bene euer glad Right so to displease any I would be loth and sad The labour hath bene myne The trauaile and the paine Reproches shall be thine To beare we must be faine But if thou please the best And such as be of skill I passe not for the rest Good men except good will FINIS Thomas Gale Maister in Chirurgerie vnto those young men which are desirous of knowledge and are studious in the Art of Chirurgerie IN the name of the blessed Trinitie I for the health of mankinde haue with great paines and trauaile collected and gathered together certaine parts of the Arte of Medicine and haue put the same into sūdry bookes for that ende they might be the better vnderstanded and for as much as there be many young men desirous of knowledge in this Arte and fewe of them learned in the Latine or Gréeke tongue Therefore I with the help of my friends haue set foorth these bookes in English This part which I haue set foorth is commonly called Chirurgerie for that it doth cure by the ministring of conuenient medicines with the hand And for as much as diuers and sundry persons taketh vpon them to vse the same Arte hauing little skill in the principles or right vse thereof and some of the same doe dwell farre from Cities and good Townes wherefore they cannot haue such counsaile as is needefull to be had when great and daungerous cures chaunceth into their hands Therefore I haue set forth and published abroade both for your better vnderstanding and also safegard of Gods people these woorks desiring you most hartely to giue God the praise and thanks therefore and as for my part I haue done but my dutie in furthering of the common welth in this my profession and Arte requiring you in the name of Almightie God that when great daungerous cures happeneth into your hands not onely to be circumspect to trust in your owne doinges but also to take counsaile of other auncient and graue men that haue had good experience for in so doing it shall not be onely a helpe vnto the Patient but also vnto your owne selues for in seeing of other cunning mens woorkes you shall learne and sée those thinges which you did neuer know nor sée before further more the common people shal haue a good opinion in you for that you disdaine not to take counsaile of other expert men Thus I leaue to trouble you any further committing this my doing vnto your iudgement desiring you to take it in as good part as I offer it vnto you and diligently to reade all these bookes often times ouer and then I trust you shal finde such commoditie and profit thereby as shall redound vnto your perpetuall good name and fame and to the safegard of
he sawe such vertue in herbes and other things as is aforesaid and how profitable they were for mankinde in helping of diseases woundes pestilence and many other things wherewith many people in that countrey were afflicted he hauing compassion vpon them and minding to leaue a perpetuall remembrance in writing of the natures and properties of those herbes and other things aforesaide and what diseases they serued for He called vpon the eternall Gods to strengthen assist him in his enterprise with wisdome and cunning with length of time that he might set forth these things to their euerlasting praise to the vniuersall profit and commoditie of mankinde And so he began to wryte and wrote foure bookes in tables of wood as Strabus doth affirme and some saith that those tables indured to the time of Ptolome the great who did dedicate them vnto the gods and deliuered them vnto the Priestes of the Temple where afterwarde they were destroyed by the meanes of warre Some hold opinion that Chiron Sentaurus hearing of this excellent man Mercurie went forth of Grecia into Egipt to learne of him and became excellent in diuers artes and specially in the arte of medicine and in knowledge of the simples and afterwards he returned againe into Grecia his owne countrie and in that time there reigned in Grecia a noble Prince named Apollo who was of excellent wisedome and diligent in studie to further the common welth of his countrie with knowledge and he hearing of this excellent man Chiron Sentaurus sent for him and gaue him great rewards and so he learned of Chiron Sentaurus as some writers affirme to know the natures of herbes and other thinges appertaining to the Arte of Medicine hauing knowledge of them and their natures he put the same in vse to the great comfort reliefe and helpe of the diseased and sicke people and to his owne immortall fame for that he did help such diseases and sicknesses which before that time coulde neuer be holpen wherefore the people did honour him as a God and supposed that he was a counsaile with the Gods in that that he did knowe the nature and propertie of these hearbes and other thinges which they did affirme no man might know except he learned it of the Gods themselues and after the death of their king Apollo they lamented and mourned throughout all the Countrie thinking the art had bene vtterlie lost but hée béeing carefull for his Countrie had taught the same vnto Aesculapius his sonne which when the people vnderstoode and for the worthinesse of his owne good déedes they gathered great summes of money throughout all the lande of Grecia and builded therewithall a rich Temple and buried his bodie in a meruailous rich Sepulcher within the same and called it the Temple of Apollo and dyd honour him as a God for his most vertuous life and painfull trauaile as concerning the common wealth of his Countrie and speciallie for that hée dyd not disdaine to cure the most miserable diseased people which before his time perished without remedie And now that wée are entered in amongest the Grecians and for that some affirmeth Apollo to bée the first inuentour of Medicine wée will procéede foorth to the noble men of that Countrie which had this arte in so great honour and estimation that they most diligentlie aboue all other artes studyed it and in time dyd growe so excellent therein that they excelled all other Nations in the world as it doth most manifestlie appeare by their most worthie Bookes lefte vnto their posteritie for a perpetuall memorie of their most vertuous and painefull trauaile which redoundeth vnto our greate commoditie and to the helpe and succour of those that be diseased The most auncient of all the Grecians I supposed to bée Apollo who dyd cure many great and wonderfull diseases by the helpe of the forenamed Chiron Centaurus and some suppose for that that the same Chiron dyd cure manie grieuous malignant and virulent vlcers amongst other diseases that the name of the Arte of Chirurgia was first deriued from Chiron for that hée dyd minister medicamentes with his hands and so cured the people and being the first that practised with medicines by the vse of the hande it is supposed that hée gaue it that name Then after Apollo came Aesculapius his son who was no lesse diligent and studious in the same arte than his Father and calling vnto him diuerse Philosophers and other noble men of his Countrie and by their aduice and consent hée dyd constitute it an Arte and made it lawfull for his subiectes that had studied the same and béeing brought vp with men of greate experience and practise to vse the same arte amongest his people to the restoring of their health in curing of their diseases and infirmities By meanes whereof Aesculapius got vnto himselfe immortall fame and was called the sonne of the Gods and first constituter and founder of the arte of Medicine as you maye reade in the Historie of Tragus Homer and manie more of the Gréeke writers and the same Tragus doeth saie that those men which vsed the arte of Medicine were named Iatroes for that they dyd cure all manner of griefes woundes and sores and in our auncient English tongue they were called Léeches and in the Latine tongue Medicus which names doeth signifie no other thing but curing and healing of mennes bodies with conuenient medicines Then next after were Aesculapius two sonnes called Machaon and Podalirius who béeing well instructed in the foresayde arte by their Father Aesculapius became wonderfull excellent as it may appeare more at large in the Storie of the Troyan warres by their cures which they dyd vppon the wounded sore and sicke men These two noble Princes as Tragus sayth had manie Disciples which they taught this arte vnto and they and their Disples by continuall practise in proouing experiments found out manie meruailous remedies against poisons of vncleane meates and drinkes and against the poyson of Hearbes Serpents and many other things and against the poisoning of Swoordes Dartes Arrowe heades and Speares as it is sayd by Demosthenes and other writers Then of their Disciples did growe a greate number which were dispearsed into diuerse partes of the worlde some were sent for into Aegypt some into Persia some to the Romanes and some to the Scithians whereas they were had in great estimation with the Princes and noble men of those Countries for that they did cure and helpe their wounded and hurt Souldiers in the time of warres and also did reléeue and cure their people in the time of pestilence and other grieuous infections to the great safegard helpe and comfort of their people and to the great securitie and staie of the Realme which if their people had dyed of these contagious infections that were saued by them their Country should haue lien open to haue ben taken and possessed of their enimies Now of these men vsing this arte in diuerse Countries hauing many
or else that as the curation is taken in hand doeth bring more discommoditie and also a more grieuous sicknesse than that which is taken in hand to be cured As when we goe about to cure Vitiliginem Antiquam Lichenas Hemorroidas Sinuosa vlcera and the old Fistulas Cancers and to conclude when as we haue a stubburne patient which doth giue no regard to the Surgions that gouerneth him these are the causes why that all cannot be brought to their health by arte In like manner Chirurgerie is diuided into two partes generallie the one is which doth declare what things belong to the art doth set forth the precepts wherwith the workman being furnished may worke rightly This part the Gréeks do call Theoreticon we do cal it Theorica that is to saie the learned or speculatiue part the other doth folow that doth perform in effect that precepts of the former it is called in Gréek Practica or rather Poetica that is to say a bringer of things to passe for it wholy doth consist in doing and bringing to effect and séeing that the whole Arte doth depend of these we maye with good cause thinke Chirurgerie worthie to be called an arte as whose ende is affection and woork For she doth exercise all her properties either in soft mēbers or in harde parts The soft parts are those which haue their beginning of bloud and are called fleshie and the hard parts do spring of séede And chirurgerie doth exercise her facultie in those partes by incision by cutting or by taking away by reposition and adustion And truely of this arte there are certaine other more speciall partes as those about the which the arte it selfe is speciallye occupied that is to saye Tumors against nature wounds vlcers fractures and Luxacions Therefore as there be fiue parts which the art doth intreate of so there be fiue partes of Chirurgerie in the whole as which doe teache vs to cure tumours which woundes and which vlcers and which can put fractures and luxacions in their proper place But the ende wherevnto Chirurgerie directed all his actions and prouisions is the ablation and taking away of those sicknesses which maye be cured by ministracion of conuenient medicines with the hande to restore the sicke vnto his health which ende truely the workeman cannot alwayes obtaine vnto For those causes which we declared before séeing that it is not in his power to cure euery sicknesse And this long arte vaunteth hir selfe vnto the famous companie of excellent and noble authors worthie of great renowne In whose register that diuine man Hippocrates the patron and defender of the noble arte of Medicine doth of very right challenge to him selfe the chiefest place by whose meane this parte of medicine is better declared then it was before his time the which thing the deuine monuments which he left to his posteritie doe witnesse I doe meane his bookes wherein he doth speake of the woundes of the head of fractures of the lyms of vlcers of fistules of the emorodes and of the furniture of Chirurgerie and of cutting out of the Anathomies Furthermore Chirurgerie béeinge as it were deuided at length from the other hath chosen vnto hir selfe a proper place and beganne to haue hir proper professors for in the time of olde writers in the florishing age of Hippocrates Chirurgia was not deuided from the other parts of medicine for they were then both Phisitions and Chirurgions And Philoxenus declareth it to haue florished in Egipt which hath set foorth and garnished this Arte in many volumes And after him Gorgias Sostratus Hieron and the two Apollonij Amomus Alexandrinus and many other excellent men and it is certaine that there was no meane professors of the same arte at Rome as the auncient Fathers Tryphon Euelpistus and Meges the most excellent of all as Celsus writeth But how much Galen excelled in restoring and enriching this parte of medicine his learned Commentaries vpon the bookes of Hippocrates wherein he doth declare of the Arte of Medicine and vpon his booke De articulis de fracturis And moreouer his sixe bookes of the first methode of curing called Therapeuticon and the last two of the same the two also De arte curatiua ad Glauconem his booke De tumoribus preter naturam his booke De compositione medicamentorum secundum genera doe testifie abūdantly Moreouer Paulus oegeneta ought greatly to be commended who in a method compendious but yet most exact hath comprehended all Chirurgerie both in his fourth booke and also in his sixt Furthermore Auicenna Rasius Albucasis and Haliabbas being of the schoole of the Arabians haue intreated most diligently of the Arte of Chirurgerie as Auicenna in his fourth Canon and the third fourth and fifte féen Also Rasus in his seuenth booke to Almanser the King Albucasis in a whole volume Haliabbas in his ninth booke of practise of the regall disposition neither hath she lacked hir honour of Latines Celsus and Plinius Captaines who with great beautie and like dignitie haue intreated briefly of this parte Why should I passe ouer Guydo de Gauliaco who onely among the French we haue knowne to haue intreated very well of Chirurgerie if ye regard the reason of the arte We may trulie gather by his rude spéech that he wanted onelie such happie time wherein he coulde not come to the knowledge of the Gréeke tongue nor to the pure eloquence of the Latine tongue whilest at that time ignorance and barbarousnesse exercised tyrannie ouer good learning which was the cause that in rehearsing the place of Galen the truth of the author was much desired But if God graunt me life I will diuide those places of the Arte of Medicine from the common place I trust that I shall helpe Guido and I will of a barbarous and impure writer make him a fine and eloquent Latinist restore him to his beutie which our friēd Siluius hath performed in correctīg Mesueus the same doe I faithfullie promise to the studious to multiplie in repairing of Guido if God prosper our indeuours although perhaps without méete or equal thanks yet shall I doe it with due labour and good will But now I will returne to my purpose for manie famous men and authors most worthie of fauourable commendations haue set forth this arte among the which Guido Vigonius and among the men of this age Tagaltius being my fellowe in office and my companion in my studies haue done greate things and worthie of praise in amplifying and garnishing this part whereby it may be gathered how much is vnto this art to be attributed which so many renowmed haue each one in his workes and monuments set forth increased and enriched that men might know it to be most profible and in effects most euident among all the partes of medicine Now must we show what are the duties and office of a Chirurgion and howe he should enterprise the same for there be thrée chiefe points
these sixe things not naturall Therefore it may be saide Necessitas non legem habet therefore there ought no lawe to bée made against that thing that must be of necessitie As for example of necessitie we must eate drinke that we may liue Therefore it were tyrannicall to forbidde vs to eate and drinke for they be proper things for vs whereby we doe liue But yet the abusing of meate and drinke may be spoken against and good and iust lawes made for the reformation thereof In like manner for abusing the arte of Phisicke or Chirurgerie there hath béene good and wholesome lawes made héertofore and I trust in our Lord God shall be hereafter againe But to commaund from them the knowledge of their arte or anie parte thereof or other necessarie instruments or medicaments wherewith they should cure their grieued and wounded Patients which other wayes must of necessitie perish or else not bée cured at all Such commaundements or lawes were tyrannicall and not to be well thought of for that they should let the workes of mercie in this most excellent arte of curing to be ministred vnto the people orderlie for their safegard curing of their diseases There were much to be spoken of these sixe vnnaturall things which maketh nothing for my purpose héere in this place for that I intend nothing but to proue that these bée necessarie instruments for the Arte of Chyrurgerie by certaine examples as you haue heard for these things are spoken of at large not onelie in many worthie bookes which are set forth by Hyppocrates and Galen but also in all other worthie mens bookes that haue written of this art at large as it may appeare at this present daie Some men might héere aske a question why these are called not naturall things for it is to be thought that sléepe meate and drinke moouing c. should be naturall But forasmuch as both health and sicknesse doth come by these things therfore they be called not naturall They bée not called against nature for sicknesse the cause of sicknesse and the accidents that follow sicknesse those be called Praeter naturam against nature Neither may they bée called naturall for the that sicknesses cōmeth by thē But they are indifferētly called not natural These things are so necessary for our bodies as I haue said before that we do not onlie liue by them but the matter substanticall of our bodies after generation is increased and mainteined by them and also all the humours and temperaments with the spirits and other things contained in the same bodie should vtterlie cease if it were not but for those sixe thinges Thus I conclude with these examples aforesaid to proue this part to be necessarie for the art of Chirurgerie doubting nothing but those that be learned men and men of reason will so iudge for so haue the auncient fathers before our daies appointed it to be Now that you may the better come to the perfect knowledge of these things I thinke it good to declare vnto you some of the bookes which both Hyppocrates and Galen haue written Hyppocrates de elementis Hyppo de Aqua Aere regionibus Hyppo de flatibus Hyppo de vrinarum differentijs Hyppo de ratione victus salubris Hyppo de ratione victus prauatorū Galen de sanitate tuenda Galen de imperica dieta sub figuratione Galen de aqua Gal. de ptissana Galen de Euchimia Caccochimia Galen de attenuante crassante victu with many more bookes written by most excellent men sence their times which were superfluous here to be rehersed for as much as these are most necessary to be vnderstoode and sufficient for the profe hereof And thus I commit this part vnto your friendly iudgement procéeding vnto the fourth part called Semiotica Semiotica is an other part perteining to the arte of Chirurgerie which part doth iudge by signes and tokēs what the diseases are and what be their natures and what humors or other things be the cause therof and whether they may be cured easely and in short time or whether they be hard to be cured must be cured in longer time or if they cannot be cured at all Or else whether it is not necessarie that it be not cured at all least worse diseases should come by the curation of them and specially this part is necessarie about the curatiō of wounds to know which are deadly and which are not deadly and also which are maymed and which are not maymed and to foresée daungerous and perillous accidents which might chaunce vnto the woūded man as paralisis conuulsions gangrena spasalus and manie other more daungerous diseases which the Chirurgiō ought not onely to foresée by meanes whereof he might resist the same But also when any of the greuous accidēts doe happen he might make a good and a true prognosticatiō what might happen after these greuous and perilous sicknesses and also in wounds that chaunceth in daungerous places to prognosticate and declare the great perill thereof vnto the sicke and gréeued pacient or else vnto his friendes as it shall be thought most conuenient for except he make a true and a iust prognostication he shall get vnto him selfe dishonestie and cause the worthie arte to be euil spoken of This parte of the Arte can not be attained vnto without great knowledge and long experience and also a most excellent wit For Hyppocrates sayth in his Aphorismus that this part is the most hardest he saith that the lyfe of man is short the arte of medicine long the occasions to minister medicines many prouing of experiments perillous but iudgement and prognostication of sicknesse to be most difficult and hard Wherefore Hippocrates and Galen did will all men that would auoyde slander and euill name to beware wise in prognosticating and not to be rashe and quicke How many men haue gotten dishonestie for lacke of knowledge of this parte of the Arte and by mistaking of the Symptomata and accidents it were wonderfull to number them And also how many sick men haue béene ouerthrowen and vndone for lake of knowledge of the same parte it is not to be spoken Wherefore this part is most necessarie and requireth most diligent and exacte studie as it doth appeare both by Galen and Hippo in Galen where he hath written vi bookes de differentiis causis morborum Symptomatum which doth chiefely perteine to this parte of the Arte. And also that most excellēt and worthie man Hippocrates hath written two diuine workes wherein is conteined diuers bookes the one called his Aphorismus and the other his prognostications which are the most worthiest bookes that euer were written for him that shall practise in this Arte for therein may he learne the diuine iudgement of Hippo. And also how to prognosticate rightly which two thinges doe most chiefely and principally appertaine to the Art of Chirurgery Thus I haue declared vnto you the foure principall parts or as we may tearme
them the foure principal pillers or foundaments of this art without the knowledge of which foure no man may rightly or methodically work in the same arte I dare not say no man ought to worke in this Arte that vnderstandeth not these least I should condempne a great sort but I will say as Hippocrates Galen Guido Valleriolus Tagaltius and many other worthy men doe say that these are the principles of the Arte and they ought first to be learned and trained vp in the knowledge of these before they be permitted to woorke in the Arte for in the olde time they did first learne their principles and had them by heart and then they were brought vp vnder some cunning maister where they might sée the same put in practise and so trained vp in most exact and perfect experiēce And thus being brought vp they were able to iudge in their art so they did cōstitute builded vpō these foure principles a most excellent art which Galen calleth Therapeuticon that is to saie the art of curing which part those that are disposed to reade their works may plainlie vnderstand and specially in a booke called Introductio seu medicus Thus I haue proued these foure parts as I haue said before to be the Theorike part of Chirurgerie and we intend to proue Therapeuticon to be the practike part for that it doth cure diseases griefes of mans bodie Guido Tagaltius other did not make these fiue diuisions of parts as I haue done but diuided the art into two parts that is into the Theorike and Practike for Guido saith that he which woulde vse the arte of Chirurgerie must be learned in the Theorike part as wel as in the Practike part but Guido vnderstandeth the Theorike part to be Phisicke and the Practike part to be Chirurgerie as it may appeare by his words héereafter Conditiones quae requiruntur in Chirurgo sunt quatuor prima est quod sit literatus secunda quod sit expertus tertia quod sit ingeniosus quarta quod sit morigeratus Riquiritur quod sit Chirurgus literatus non tantū in principijs Chirurgiae sed etiam Phisicae tam in Theorica quam in Practica In Theorica oportet quod ipse cognoscat res naturales non naturales contra naturam precipue Anathomiam nam sine ipsa factum est nihil in Chirurgia The English is this There be foure conditions speciallie required in a Chyrurgion first that he be learned second that he be expert third that he be ingenious and fourth that he be well mannered It is further requisite that the Chyrurgion be not onelie learned in the principles of Chirurgerie but also in Phisick as well in Theorike as in Practike In Theorike it behooueth him to knowe thinges naturall not naturall and things against nature Thus it maye manifestlie appeare by the wordes of Guido that he vnderstoode the Theorike part to be Philick and the Practike part to be Chirurgerie for other diuisions made he none but vsed the art indifferently together that is to saie diet purging medicaments and all other things appertaining to the art of Chirurgerie These foure partes that we haue spoken off before were accounted to be Physicke as Guido and all other later writers doe make mention and euerie one of them supposeth that a Chyrurgion ought to know these partes either else he cannot rightlie and methodicallie worke in his arte But when he dooth vnderstand these parts and is well brought vp in experience in the same and hath also good vnderstanding knowledge both in the simples and compounds whereof he maketh his medicaments and hath séene long experience and vse of the same I thinke him then a man méete and worthie to be allowed to vse the practike parte of Chirurgerie or else not for otherwise he should be ignorant in the curation of many grieuous diseases which doth appertaine vnto this art that cannot be cured other waies but by the administration of the hand for this parte called Chirurgia is the last remedie in the arte of medicine and cureth those things which are most hard and difficult to be cured and therefore it is accounted amongst the auncient writers as both Galen and Hyppocrates doe affirme to be most profitable and most worthie as we shall declare more héereafter in the Treatise of the methode of curing called Therapeuticon And thus wée end this fourth parte called Semiotica Now it doth behoue vs to speake of the last part called Therapeutica and although it be last in number yet it is chiefe in effect and most profitable in the common wealth For Therapeu is no other thing to be vnderstoode than Curatio and Curatio is nothing else but to helpe mans bodie of wounds sicknesse and other infirmities as I haue sayd before Therefore Guido doth saie that this arte doth restore mans bodie vnto health by the curation of wounds vlcers tumours against nature fractures dislocations and all other infirmities wherewith the same bodie is grieued And he addeth and saith further as much as lyeth in the Chirurgion to doe For he saith that it lieth not alwayes in the Artist to restore his sicke patient to health for that that manie diseases be incurable which the Artists ought to vnderstād and know and to make true and right prognostication thereof least he should get vnto himselfe great shame and bring infamy and slaunder to the noble arte Therefore one Vego a Spaniard who hath made a worthie commentarie vpon the prognostikes of Hippo. sayth that it doth behoue the artist chiefely to prognosticate rightly and truely of those things which are to come which being knowen neither could the daunger thereof be auoided if it were possible neither yet should the artist auoyd a slanderous pernicious name And therefore he deuideth this arte into thrée parts that is into agnostica prognostica and curatiua Agnostica he vnderstandeth to be the knowledge of naturall things of things not naturall and of things against nature Prognostica he vnderstandeth to be a right iudgement in the foresaide thinges which he doth gather by the Symptomata of the bodie other excrements which nature doth auoyde Curatiua is that part which followeth both these and with knowledge and right iudgement truely and rightly prognosticating the same he doth take vpon him perfectly to cure mans bodie of those griefes and diseases wherewith it is hurt either else if the same may not be cured to preserue the same from further vncōuenience as much as is possible for this arte to doe Thus it séemeth to mée by the woords of this great learned man as well as by the woords of Guido c. That this part of the arte called Therapeutica or curatio consisteth in two speciall points that is to say in the curing of mans bodie perfectly and in the preseruation of the same bodie when the diseases are incurable as in Cancers c. as wée haue saide before There be other learned men that
curteouslie to amend the same or else to giue mée knowledge and I shall be as willing to amend them as I haue bene diligent in setting it forth praying you to leaue off slaunderous wordes and euill iudgement by meanes whereof I haue bene greatlie impaired not onelie in my good name but also in the profite and commoditie of my arte which is to my great hinderaunce and this hath partlie risen by a booke of Chirurgerie which I haue latelie set forth to my great cost and charge and some men haue not let to saie that it was onelie Doctor Cuninghams dooing and none of mine Vnto whom I answere That Cuningham was the writer thereof and put the same booke in order as you may now sée for I my selfe hauing not perfect vnderstanding of the tongues required him for the more perfection thereof to put in the Gréeke Latine words in such sort as he thought good And for the matter in the most part therein contained you may verie well perceiue that it was mine owne practise as the stories therin contained for the curation of diuerse people doth declare which I my self did cure as it may more at large appeare in the same booke And for the medicines that be written in the same booke their names which deuised the same medicines are put vnto theÌ„ so that this is but a slaunderous vntrue malitious reporte onlie to deface me of my good name without any deseruing or cause reasonable For it is well knowen that Maister Cuningham neuer did anie such cures as there is mention made of neither yet is Maister Cuningham anie Chyrurgion as yée may perceiue farther in his own Epistle written vnto the same booke wherein he doeth not onelie declare my paines and trauaile in collecting certaine partes of Chyrurgerie but also my great expenses and painfull labours in collecting and setting forth of the same These slaunderous and euill wordes haue caused me to set pen to booke my selfe to auoide that foule and euill fauoured monster false detraction and also to spare my expenses which I before did lâ—…se amongest vnthankfull and ingrate persons And I haue taken paines now mine owne selfe without anie other helpe of liuing men at this present daie but of mine owne trauaile and collected them out of these famous authors which I haue before rehearsed vnto you and although it be not in so good forme and eloquent stile as it might haue bene if a better learned man had taken it in hand yet the truth is not to be reiected because of the barbarousnesse of the stile or words Thus I leaue off least I should be tedious vnto you Now I will speake of the â—…d of this noble art or as you will saie to what ende this art doeth serue The end of this art of Medicine is to restore mans bodie to health as much as lieth in this Artist to do so that the end of this art consisteth in the curation of diseases or as we may tearme it restoring of health For man at his birth was cast into this world naked and vncouered requiring the helpe of other things to couer his nakednesse withall neuer leauing crying and wéeping till such time as reason and nature had prouided for him such necessarie thinges as dyd growe vppon the earth either else vpon some other creatures by meanes whereof hée was both nourished and also clothed and also by the vertue of other thinges that the Earth brought forth restored to health in the time of his grieuous infirmities But how was he restored to health Truelie by Arte. And by what Arte euen by the art of Medicine which doth comprehend both Phisick and Chirurgerie with the knowledge of all simple Medicines and compound medicaments and all other things whatsoeuer doe appertaine vnto the same And therfore I will saie as that worthie man Hippocrates did That this art is most honourable and worthy for that it doth intend to kéepe mans bodie in health and to remoue sicknesse Therefore it is said that the end of Chirurgia is the restoring of mans health Now let vs consider whether this art be like vnto other artes or not In some thinges wée saie it is like vnto other arts and in some things it is not It is like vnto other arts in that it doth consist in a multitude of principles whose affectes are rightlie to bring to passe or finish some thing which we intend to doe for Aristotle in his .6 Ethic. cap. 4. doth define Art to be a certaine order of doing placed with habit and vnderstanding working vppon some subiect to bring to passe and finish some thing that he doth intend by the same art so that what thing so euer is brought to passe or done it must néeds be done by some one art In this the art of medicine is like vnto all other artes for that it consisteth in doing and bringing to passe or as we may tearme it in restoring health or curing mans bodie being subiect therevnto But other waies it doth differ and doth require a further knowledge than the common Artist doth It is requisite that this Artist which intendeth to vse the arte of Medicine should be verie well learned in the speculatiue part of his arte as well as in practise It is vnpossible to carrie in minde so many considerations so many obseruations and so many inuentions as this art doth require and therefore it is requisite that he be not onelie well learned in the principles of his arte but also that he be studious in the workes of other excellent men wherein he may learne their wittie and ingenious deuises to helpe this Artist the sooner to bring to passe his desired end In this it doth much differ from other artes which worketh onlie by experience in wittie bringing of things to passe without anie further consideration neither doe they néed anie such excellent learning for that theirs doth consist chieflie vppon experience and practise and hath not so much regard vnto the life and health of man For this art doth onelie intend to saue mans life in the time of necessitie also to remooue awaie such grieuous sicknesses as might anoie and disquiet both bodie and minde Wherefore this Artist is chieflie to be considered and looked vnto not onelie to be rewarded for his excellent cunning in restoring mannes bodie to health but to bée seene vnto and throughlie examined whether he bée learned in this arte or not if he be not learned neither vnderstandeth the principles of this arte then he is to be forbidden this art for the worthinesse thereof for this worthy art worketh vpon mans bodie for whome all this worlde was made and all things therin contained and the almightie Lord had so great care for man that he did not onelie make these things for him but also made him Lord of theÌ„ and gaue vnto him straight lawes that he shoulde foresée that one man should not kill and destroie another neither wilfullie neither yet willinglie Then I
shall not take an Indication of it after foure â—…neths but that which we haue taken at the verie beginning And for a truth that I may not permit such an vlcer to abide so long time but at the first I will take awaie the cause thereof But I cannot coniecture what may shewe the time more than the number of daies except Thessalus will saie that to haue knowledge of such an vlcer we must tarrie the time but in such a case he sheweth himselfe altogether foolish That is to saie if he confesse openlie that hée knoweth not the first affect which hath inueterated the vlcer Furthermore he must plainlie also confesse the Indication curatiue to be taken of the disease and the knowledge of the disease to be taken of other things But bée it so that time serueth somewhat to the disease neuerthelesse the Indication curatiue is not taken of time But to what purpose serueth it if any Vlcer bée inueterate to do away that which letteth the coition to renue the place which is pained For thou foolish fellow if for the maligne fluxe which the Gréekes call Cachoethae the lippes be affected in such sort what shalt thou profit if thou doe cut them before thou hast prouided to stop the fluxe Trulie thou shalt but make the Vlcer wider than it is as some doe that cure vlcers after the same manner as thou doest For the cause remaining which before made the vlcer harde and flintie thou shalt doe no other thing in cutting awaie the lips but enlarge the vlcer For those which thou cuttest shall be made hard come again as they were before Although that prudent Thessalus hath not added this thing that the partes of the vlcer which are hard stonie and discouloured ought to be cut awaie but commandeth by an absolute sentence that those thinges which hinder the closing of the vlcer ought to be cut awaie and to be renued But if trulie hée had counsailed to take awaie the causes that hinder the adglutination of the vlcer and that this reason were auncient and olde I would not accuse him for it is commanded almost of all the auncient Phisitions which doe write of the curation of vlcers by a certaine reason and Method that those causes which doe excite the vlcers ought to be cut awaie euen trulie as of all other diseases For trulie I do thinke it expedient that the efficient cause remaining which exciteth the vlcers ought first to be taken awaie In other diseases it is not expedient but chieflie there the curation must be taken in hand where the efficient cause remaineth And if the sayd Thessalus hath not spoken of the causes that let the conglutination and hath onelie spoken of the lips as he hath said afterward it appereth that he is ignorant of more than he knoweth of those things which appertaineth to the curation of vlcers But it is possible that this alone is the cause which hindereth the cure of the vlcer And it may as it is aforesaid be the cause that intemperauncie which is without a tumour against nature be in the vlcerate partes and also that it be ioyned with a tomour the which doth not require that the lips should be altogether cut awaie It maye also bée the cause that Varix which is aboue it or that the milt which augmenteth it or some disease in the liuer and beside this the weaknesse of the affected part be nothing else but a manifest intemperancie And besides this a vicious humour in the bodie which the Gréekes call Cacochimia and the chiefest of all the causes which may be to the vlcers an incommoditie Truelie great abundance of humours which the Gréekes call Phlethora resorting vnto the vlcer doeth hinder the curation But if Thessalus be of that opinion that the lippes onelie must be taken awaie I saie that of many things he knoweth but one alone which is so euident that the shepheards are not ignorant thereof for if a shepheard sawe the lips of an vlcer hard flintie wan blacke or a leadie coulour hée would not doubt to cut it awaie Then for to cut awaie is an easie thing but for to cure by medicines is a greater matter and that requireth a true methode Neuerthelesse Thessalus neuer knew howe the lips might be cured by medicines for all men confesse that he hath swarued from this part of the art and as he himselfe hath shewed it séemeth that he had neither experience nor rationall knowledge of medicines which is a manifest thing by the booke that he hath made of medicines before rehearsed But of this one worke consequent wée shall entreate of those things which hée hath not writâ—…n well And now we doe intend with deliberation to speake of the curation of inueterate vlcers of the which he hath before intreated Certainlie it had bene better to haue called them Cachoethae and not inueterate theÌ„ to declare their nature disposition and cause of their generation and the curation of either of them And first to know the common curation of all vlcers for as much as they be vlcers of the which I haue written in the third booke next after the perticular and proper cure of either of them afterward the kinde of the efficient cause as I haue spoken of in this present booke And although Thessalus hath done nothing of all these things yet he doth thinke that the vlcerate place must be renued when it is made like vnto a new wound to cure it as a bloudie vlcer what is he that is exercised in the workes of the Arte that vnderstandeth not euidentlie that such a doctrine hath bene written by him that neuer cured vlcer Is it possible that a man may cure an inueterate vlcer as you may cure a bloudie wound and after he hath made it lyke vnto a fresh wound shall it be in drawing of the vlcer together by rollers or ioyning them by stitches or neither by the one or by the other but by conuenient medicines What is he that knoweth not that an vlcer called Cachoethae is caued or hollow séeing that it is made by corrosion Is it possible O foole and impudent Thessalus that a caued vlcer may grow together and be adglutinated before the cauitie be filled with flesh is not that to cure an vlcer as a gréene wound then hast thou thy selfe written in vaine that hath taken indication to cure caued vlcers not with closing but with the filling of the cauitie But if euery vlcer called Cachoethae were not hollowe of it selfe yet when it is made bloudie in cutting the lips awaie as thou commaundest then of necessitie it is made hollow and requireth great space betwixt the lips euen in such manner that I cannot sée how thou maist make them conglutinate together as a bloudie wound for if thou assaie by force and violence the lippes that are so farre a sonder of necessitie there commeth Phlegmon which letteth the sayde lyppes to close together The which thing I suppose that
manifestly that they haue no regarde of other things that appeare in the affected part for to come to such euacuation But I doe not say thus that purgation is euacuation the which is no indication of the course of the bloud but for bicause wée must sometime haue consideration to the letting forth of bloud although there be no course of bloud present which may flow to the greued part for when the disease is very strong there is none which vnderstandeth the arte of medicine but will let bloud And truely the Emperickes themselues let bloud when any is fallen from an high place or when there is any part sore brused hurt with any wound though the pacient were whole and sound before and without superfluitie of bloud By the which it appeareth that it is not the flowing of the bloud to the affected parte which giueth indication but the magnitude and vehemēcie of the disease the force of the strēgthes excepting yet from our talke children As for example If a man be whole and sound and without any maner of hurt and hauing abundance of bloud it is not necessarie because of his abundance to take his bloud from him For there is no indication to be taken of the bloud for because the man is whole for to such men fasting doth profit small eating and sometime Purgation or bathing and Frications may suffise Letting of bloud is not necessary to such as the Emperickes say Likewise Purgation is not good in the onely abundāce of humours for euen as letting of bloud is done either for abundance of bloud or for the magnitude of the disease so is purgation giuen either for the abundaunce of ill humours or for the force of the disease As touching letting of bloud we haue spoken of in another booke and shall doe againe hereafter But in this present booke I will speake of purgatiōs for they that be diseased require them not onely because it doth euacuate the noysome and superfluous humours with the which the bodie is grieued but also putteth foorth and clenseth the excrements within the bodie And for this cause Hyppocates as well in his other works as in that he hath written of Vlcers considereth the vehemencie and strength of the disease whereof he taketh Indication of purging and sayth thus Purgations of the bellie is profitable to many Vlcers and also to woundes of the head of the bellie and of the ioynts and where there is daunger of the rottennesse of the bones or where stitching behoueth in woundes or where erosions bée or where Herpis other affects be which hindereth the curation of Vlcers and also where rolling must be vsed By these words it is apparant truelie that Purgations are profitable both to wounds and Vlcers at all times when they be great and grieuous For not onelie the sayd affects but other bée made great and grieuous thrée manner of waies that is either through the excellencie of the afflicted part either else through the greatnesse of the affect or else because the said affects are Cacoethae that is to saie hard to be cured Hyppocrates hath made mention of all these thinges perticularlie when he dyd intreate of woundes of the head and bellie and of the excellencie and dignitie of hurt parts I thinke it is manifest to all men that he must bée vnderstoode not onelie the lower bellie but also the superiour for in diuiding the Trunke of mannes bodie which is betwixt the necke and the legges is two greate capacities The first is contained vnder the Thorax and aboue Diaphragma and the second vnder Diaphragma vnto Os Pubi or to Peritoneum which couereth the inwarde parte of the bellie And for certaine those woundes which hath pearced within the Thorax or within Peritoneum is verie dangerous chiefelie if anie of the inward parts bée wounded Likewise there are verie fewe but they doe know that the woundes of the ioyntes are Cachoethae and are harde to bée cured Which thinges the Emperikes vnderstand onelie by experience and they that haue studied and haue attained to the knowledge of mannes bodie vnderstand these thinges by the nature of the hurt parte For in tendonie and sinnowie parts where bones are void of flesh there is great daunger of paine waking and priuation of rest and also of conuulsion Such woundes as these be and such as be stitched that is to saie those that are so great that they néed stitching or at the lest of binding or rolling requireth purgation We haue declared in the last booke that all the greater wounds ought to be ioyned together either by stitching or by binding Likewise the vlcers where there is daunger of corruptiō of the bones are oftentimes ioyned with great inflamations Also they that procéede of ill humours bée Cachoethae and with erosion Also Herpetes come of cholerike humours and all other olde vlcers come of such like cause Wherefore in all the vlcers before especified Hyppocrates commandeth to purge by the bellie and afterward he addeth these wordes In all vlcers whereto Erisipel as is come the bodie must be purged in that part most profitable for the vlcer so that the purgation be made either by the vpper partes or else by the lower which difference hée hath set forth in the booke of Humours where he commandeth to tourne awaie the humour to the contrarie parte As for example There is a great flux that commeth to one part of the bodie where there is an vlcer it behoueth to make another in the contrarie parts and thereof he speaketh in the said booke Wherefore if there be as yet a great fluxe which dooth runue to the sore part we shall make reuulsion to the contrarie part that is to saie if the vlcer be in the vpper parts by purging downward and if it be in the neather partes by purging the vpper ventricle But if the fluxe bée newe stopped in such sorte that is fixed in the member it is expedient to driue it out by the next partes séeing that the passages be the next places séeing that the accesse and attraction of purging medicines is more easie and prompt to remoue those things that be néere rather than those thinges that be farre of the which reason belongeth to another part of the art which entreateth of purging medicines therfore hereafter it shall be declared and made perfect Now I will shew the force or if you will call it the magnitude of the disease to be appointed for a certaine indication of taking away bloud or giuing purgation And also that Hippocrates was the first inuenter of the sayd indication I will speake in the bookes following of diseases and in this booke I will speake of vlcers I haue alreadie spoken of Purgations For séeing that euery disease is greuous thrée maner of wayes it is either for the excellencie and noblenesse of the part or for the magnitude of the affect or for the frowardnesse of the same affect called in Gréeke Cacoethia Hippocrates hath made
mencion of all these things where he speaketh of Purgations But some perchaunce will say How then doth not Hippocrates councell vs to take away the bloud for these causes aboue especified By my iudgement he commaundeth them thus but in few wordes and that not without demonstration as he and all the auncients were accustomed to doe Thou shalt vnderstand that it is so if that thou wilt reade againe his words that are these In euery fresh wound except it be in the belly it is expedient to let bloud flow out of it more or lesse For by that meanes the wound shall be lesse grieuous the inflamation lesse and all the places about it But if thou shalt remember hereafter those wordes that he writ when he did entreate if vlcers and also those thinges that he hath propounded in all his other bookes that is to say how that a Phisition ought to be an imitator and follower not onely of nature but also of those things which shal be profitable when they come to their naturall state Then thou shalt plainly vnderstād the minde of Hippocrates and also how that bloud ought to be drawen when wounds be great but if out of such wounds bloud doth not flow especially when as it is a thing most conuenient then thou must adde and supply those thinges that be néedefull and necessarie The matter that followeth he conioyneth it with that which is abouesayde Also it is profitable that from inueterate vlcers bloud doe flow and also from the parts which are about them But forasmuch as he hath said before that bloud should flow from euery gréene wound except that he made mencion now of inueterate vlcers it would séeme to some that he dyd entreate onely of greene and fresh wounds Therefore he did well adde this that is to say how that it is a thing most méete to draw bloud from inueterate vlcers Wherefore now seeing that the doctrine which we haue taken of him is true and firme that is to say how a flux beginning at the contrary parts ought to be drawen how that which is alreadie fixed in the partie ought to be purged either from the payned part or from the part next vnto it therefore it is now easie for vs to conclude of the detraction of bloud how that in the beginning it ought to be done in the part farre of and then in the vlcerate parts Furthermore if you doe adde vnto these which I haue before spoken how that Hippocrates coūselleth to euacuate the superfluous humour and that detraction of bloud ought to be vsed when it surmounteth and that a medicament ought to be giuen which hath vertue to purge humours Chollerike Melancholicke and Phlegmatike Yet haue in remembraunce all these woords how that none of them is the curation of vlcers no not so much as of an vlcer but rather of Cacochimia that is coniunct with the vlcer or of Plethor or of Phlegmon or of Herpis or other like dispositions Neither yet be not forgetfull of this thing that is to say that none of the accidents of the vlcer giueth such proper indication as magnitude In the booke precedent we haue intreated of vlcers wherein we haue declared all the differences of vlcers how many and what they be what is the indication of either of thē Howbeit I haue not sppken in the saide booke how the indication of purging is taken of the vehemencie of the disease bicause it should not be to much prolixitie demonstration Neither in the saide booke I haue connixed the curation of all the bodie with the vlcers but yet I haue declared in this present booke in as much as it was agréeable and vtill for my purpose The seauenth Chapter BVt the firme and perfect demonstration of this kinde of Indication which is taken of the vehemencie of the disease shal be shewed héereafter In like maner the indication which is takē of the age that which is takē of purging humours Likewise the Indication which is taken of the afflicted parts shal be declared in the bookes which follow But as yet we haue onlie made mention of the curatiue Indication that may be taken of the nature of the said parts that is to saie of temperance substance But trulie we haue nothing touched the Indication which is taken of the scituation figure of the partes Therefore we will speake of the indications that be profitable for the curation of Vlcers The part trulie that hath sharpe and quicke senses ought as much as is possible to be cured without dolour or paine But the Anodinon of such remedies is spoken of in the Booke which entreateth of the simple medicaments But he that hath but small senses and those that be not quicke may if the disease require suffer strong medicines But we must haue regard and consideration to the strength of the principall member whereof we will more copiouslie héereafter declare when as we shall haue occasion to speake of Phlegmon But if it be not a principall member surelie without daunger you may minister vnto it such medicines as mittigate and asswage the Gréeks call them Calasticke whereof we will plainlie and more at large declare héereafter At this present we will declare the indication which is taken of the scituation and figure of the partes and then we wil finish and conclude this fourth booke For this cause haue we excogitated and inuented certaine medicines that must be giuen to him that hath his ventricle vlcerate the which medicines must be dronken at once but to him that hath his throate vlcerate they must be ministered at sundry times by little and little because of the passing which bringeth great vtilitie to the vlcer neither they must be ministred so in such case as to him that hath his ventricle vlcerate Likewise we haue declared by the situation and figure of the said part that such medicines ought to be made grosser and thick more clammy than the other because that the throte is a passage of things that is eaten and dronken And for that cause remedies which may conioyne cleane on euerie side of it is most conuenient and not such as are thinne and easie to slide away For the thicke are alwaies about the parts and the clammy doe cleaue vnto it Likewise vlcers that are in the thick intestines haue more néede of medicines which are cast out by the fundament in asmuch as they be next vnto it But the vlcers that are in the thin intestines because they be fardest from the fundament require both medicines that is to say those that are receued by the mouth and those that are cast in by the fundament Now truly the cōmon indication of all the interior parts is that we ought to choose things that be most familiar to the nature of man be they meates or medicaments and to eschew those things which be contrarie vnto it Although to Vlcers which bée in the outwarde partes the vse of such medicaments be
not hurtfull as Aerugo aes Vstum aeris Squāma Cadmia Pomphilix Litarge Cerussa Yet they ought not to be ministred to the vlcers of the inward parts of whose nature we haue written in the booke of temperaments and in the booke of simple medicines But if we go about to glutinate the vlcer and bring it to a ciccatrise we must choose glutinatiue medicines such as will not cause erosion But if we will clense the vlcer we must vse things abstersiue and such as wil absterge it moderately as raw Honey which of al things for this purpose is the chiefest But as touching adstingent potions called Austerae and other such like alimentes they be knowen vnto all men This woord Auster is called Stiphos in Gréeke that is to say little astringent and that which is lower or bitter is called in Gréeke Striphnon But the medicines which may be taken without danger are spoken of in the booke of Medicaments Neuerthelesse I wil shew some forme of wholsome Medicaments for the inward vlcers which are these namelie Hipocystis Balaustium Cytini Punicorum Galla Malicorium Terra Samia Lemnium Sigillum Rosarum Succus Acacia other or like kinde which be profitable for inward vlcers and you must minister the said medicaments with some decoction of adstringent things as of Quinces Lentiske or the tops of Rubus or of Vines or gréene mirtills or with adstringent Wine It is now manifest and I thinke none is so ignorant but will iudge that hée must eschue drinking of wine if there be Phlegmon or else there is no daunger In like maner it is euident that the said Medicaments must be prepared receiued with decoction of moist things Also you must mixe gumme Tragacanthen in those medicines which are for the vlcers in Gula you must vse Gargarises in the Vlcers that are in the partes called Fauces and Paristhmia but if the vlcer bée in Aspera Arteria called Trachia then the Patient must be layed vpright and kéepe the medicine long time in his mouth in loosing all the muscles that be in that place for in so dooing some part of medicament will flow by little and little to the grieued parte For when the sayde Aspera Arteria is in his naturall state or in good health then we may easilie know when anie potion passeth through it For like as we must take heede when as it is in good health least anie fluxe fall that waie which maye hurt it so in like manner we must beware when it is grieued least anie thing doe fall that waie which may prouoke the cough then it séemeth that the Indications of it are taken of the scituation and forme of the part Also Honie must be mingled in all Medicaments which are ordained for the Vlcer in the Thorax and Lungs Therefore if we vse astringent medicines they will remaine in the bellie Then the instrument which is profitable for the digestion and distribution of the said medicamēts ouer all the bodie shal be honie Also it being mingled with the said medicines shall be occasion of their quicke passage ouer the bodie neither shall it anie thing anoie or hurt the vlcer In like manner if there be an vlcer in the bladder in the raines honie and such as prouoketh vrine must bée mingled with the said medicines But I thinke that it is apparant to all men though they take not me the author of the same how that the vlcerate partes may be discerned or knowen by their substance action vtilitie scituation and figure The which things trulie haue ben amplie declared in the booke which entreateth of the signes of the affected parts but now there is no time to talke of them therefore I will returne to the method of curation Also I saie and affirme that not onelie these aboue rehearsed but also many other be the indications of the figure and scituation of the partes For you cannot well and exactlie binde the affected part before ye take indication either of the figure or scituation or of them both Neither can you set the pipe of a clister well before ye take such Indication What should I make mention of Argalia speciallie when as you cannot minister it before you perfectlie knowe the scituation and figure of the bladder Then trulie by these things it dooth manifestlie appeare that the affected part giueth indication to the curation But in ruptures truelie which the Gréekes call Regmata many Indications may be taken to one purpose and principallie the indication that is taken of the scituation ought to be considered For the ruptions that be hid in the deapth of the bodie require other curations than the woundes which appeare outwardlie and for because they be such as be with Ecchimosis or contusion about the broken flesh therefore they declare diuerse Indications curatiue For alwaies the Indications curatiue do answere to the number of the affects wherof we wil shew more copiouslie heereafter when we shall speake of Phlegmon how that the affects that are in the déepe places of the bodie requireth stronger medicines than those in the vpper parts Then at the least I iudge it to be manifest that it is necessarie that the strength of the medicamentes that are ministred outwardlie ought to be resolued when the affected part which should be cured by those is hid in the deapth and profunditie of the bodie Therefore it behoueth to augment the vertue of the same medicaments so that by the passage thereof it may be staked Certainlie Ecchimosis doth indicate euacuation for the remedie of the cure Wherefore medicamentes that will moderatlie heate and drie be most conuenient for it For they that do vehementlie drie trulie do resolue and digest more at the beginning than they which drie but simplie But I will speake héereafter somewhat of this disease which is difficill and serious to cure But of that which did pertaine to the matter wee haue largelie spoken of Truelie those medicamentes that moisteth and heateth more than they which the Gréekes call Calasticke Also those which doe somewhat to drinesse which the Gréekes call Suntatica be the chiefe and principall remedies for all Ecchimosis But we must take héede the medicines do cleaue to the ruptions that are in the deepnesse of the bodie and also that they be of strong vertue that they be sharpe and such as will digest and to speake brieflie such medicines ought to be of great force inasmuch as Ecchimosis is in the déepnesse of the bodie and far from the skin In such affects the vse of a cucurbite is profitable which is an instrument inuented of Phisitions to cause vlcerate attraction And when Ecchimosis is digested by the vse of a cucurbit then you may minister those things which may drie the broken flesh and conioyne it with ligature adde that which may coagulate and ioyne the wounde together for Ecchimosis being resolued and digested the broken flesh shall coagulate together But if it be resolued then
corruption bréedeth in it and occupieth the space that is betwéene the lippes of the wounde so that the ruption cannot close Wherefore these aboue rehearsed declare vnto vs all causes howe small so euer they bée For although some hath had rigour or though the bodie hath béene ouerthrowen by some Feauer so that there bath not bene good concoction or that it hath béene defatigated and wearied then immediatlie there shall bée paine in the part where the ruption and wound is because that the said ruption hath bene latelie ioyned together but not so substantiallie because of time Wherfore it followeth that a little thing may easilie part them fil the place againe with superfluous humours But what engendereth in such wounds or ruptions nothing but new Ecchimosis and much like vnto the first That is to saie when the flesh was first broken except that this Ecchimosis that is new of more and corrupter mattier than that which was at the beginning which came of bloud and therefore now this is more easilie digested and resolued than that which was at the beginning And thus the which we haue spoken hetherto shall suffice for the disputation of Vlcers thus we conclude this fourth Booke of our Therapeutike methode called Methodus Medendi FINIS THE FIFT BOOKE of Galen called in Greeke 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 and in Latine Methodus Medendi The effect of the same 1 The curation of vlcers which chaunce in the fleshie partes and then the curation of Vlcers in the Instrumentall partes 2 Of the ruption of a veine or Arterie 3 How a fluxe of bloud may staie by deriuation 4 The Medicaments that wil make a crust which doth much to the stopping of a flux of bloud 5 Of spitting and distillation of bloud 6 The curation of Vlcers in the pudend places 7 The curation of a veine or diuided Arterie 8 The reiecting of bloud both from other parts also from the lungs The first Chapter SEeing that in the two last bookes we haue taught how anie shall rightlie cure Vlcers we will by the waie shew that all other Phisitions which vse the arte not searching out the Elementes of those simple particulars in vs cannot cure anie thing onelie by reason but yet least of all other those which professe Thessalus doctrine The rest which are by méere experience onelie taught suppose that at the least those Vlcers which are in diuerse partes are to bée cured by diuerse reasons But those that followe Thessalus as their Captaine for his excellent wisedome thinke that euerie Vlcer in what parte of the bodie so euer it bée requireth like curation for if it bée hollowe they saie it must bée filled with flesh if it bée equall then to bée ciccatrized if there bée supercrescent flesh then that flesh must bée diminished if it bée bloudie and new then it must bée adglutinated As though he that knew this must of force cure rightlie or that this reason were vnknowen to the common people when as there is none that is héerein ignoraunt But they vnderstand not howe the hollownesse is to bée filled with flesh neither howe that which is filled ought to bée ciccatrized or to take awaie that is ouermuch encreased or to ioyne together that which is pure and bloudie without hollownesse such workes trulie are properlie appertaining to the art of Medicine found out by the helpe either of Reason or Experience or both Therefore repeating againe let vs briefelie ouer-runne those things wherby the beginning of these which are to be spoken may be ioyned with the aid of those which we haue alreadie set out Wée haue declared that euerie Vlcer requireth desiccatiue medicines but that which hath hollownesse beside that it needeth desiccatiues it also doeth require abstersiues that which requireth to haue the lippes ioyned together such is a gréene wound called in Gréeke Enema doth aske both more drying medicines and also that be gentle astringent without anie abstersion Furthermore those vlcers which néede to bée ciccatrized require not onelie yet more drying medicines but also strong astringent remedies and whereas there is supercrescent flesh against nature there are required sharpe and abating medicines such of necessitie bée hot and drie If anie accident bée ioyned with the Vlcer the Indication of curation must bée taken of the nature thereof and of this all the faculties of medicines also to bée had If there should superfluous mattier growe in the Vlcer it behooueth to haue medicines which should take it awaie and such haue a greate deale more abstersiue vertue than some incarnatiue medicines haue Also if there bée séene more copious moisture there is néede of a medicine more desiccatiue but yet not to exceede his kinde and if the medicine shoulde be glutinatiue it ought to bée drying and astringent if it shall incarnate it must be desiccatiue and some thing abstersiue and so in all other as is alreadie declared Also if the flesh subiect should be intemperate first truelie we must cure this intemperatnesse that which is drier by medicines humectiue the moist by desiccatiues Also that which is hot by refrigeratiues the colde by medicines that are hot And if by coniunction of two qualities the flesh bée intemperate it must be cured by ministring a contrarie medicine which hath double qualities for this one thing is common to all affects against nature that they cannot come againe to their owne nature without such medicines as haue contrarie qualitie Furthermore at this time the causes of these intemperatiues are to be considered whether these be common to all the whole bodie or else proper of some partes which should infest the vlcerate member by societie the Gréekes call it Simpathia First of all trulie the cause that nourisheth this intemperatnesse is to be cured and after that the intemperatnesse it selfe which is now made for this indication is common to all such as spring of anie cause We haue also declared that there are diuerse indications taken of the differences of vlcers and also those which are taken of the temparament of the sicke bodie haue a contrarie reason for those Indications séeing they are taken of those things which are against nature declare that all contrarie things must be applied these Indications because they are taken of natures selfe shew that like things must be vsed for if how much the part is drier so much the more it requireth to be dried that which is lesse drie is lesse to bée dried In like sort trulie it is declared in making hot or colde Neither haue we let passe that of the excellencie of the member or contrarie state Also to the sharpnesse or dulnesse of féeling there is to bée had a contrarie scope of curing The second Chapter THerefore we will now consider that which remaineth of the curation of this kinde of infirmities we call this kinde for more euident doctrines sake solution of vnitie neither is it anie matter if thou call it solution of continuitie This kinde doth not onelie
bloud came gushing out and much in quantitie being red and hot manifestly shewing that it came not farre of Surely the transsumption of the bloud from the brest into Aspera Arteria bringeth a great doubt but of those Phisitions who suppose that it cannot be sent out by the cote which inuesteth the lunges And peraduenture they would haue affirmed that the bloud could neuer be voyded by the mouth out of the brest Many of those that were affected felt present dolour other hauing an inflammation which after dyd supperate shewed a manifest token that the affect was in the brest But now being confounded by these signes they graunt that it commeth from the brest But while they séeke another way yea by the cote of the lungs they are constrained to bring out many and that absurde things although as I suppose they sée most euidently in them whome the Gréekes call Empios the mattier it selfe which they confesse to be in the middest space betwixt the lungs the brest to be spyt out from the lungs We verely haue vsed to them Melicratum which was iniected into the brest to be spyt out from the lungs in those where was so great an Apostume that part of the bones was putrified Surely at Rome we haue séene such affects amongst the Romans to haue after remained in the brest so that of force we were faine to cut out the affected bone and in many also the Pannickle which within is ioyning to the ribbes This being found putrified with the corrupt ribbes we are accustomed in this cure to vse Melicratum to be put in by the vlcer the paciēt inclining himselfe on the affected part to cough and sometime hastely to blow his nose and in the meane time with an instrument that draweth out matter the Gréekes call it Pyulcon to bring out the Melicratum that remained this being done when as we trusted that we had voyded out both all the mattier and also the Sanies by by wée iniected Medicines so that in these affects if thou leauest in the cured space betwene the breast the lungs any moisture thou shalt presently cause the same to be cast out with coughing Truely wée doe maruaile of those that doubt of the waye by the lungs why they doe not rather doubt how grosse bloud issueth out of the Callus of a fractured bone for the bloud which issueth is more grosser thā that which is natural and the substance of the skinne is a great deale thicker than the pannickle inuesting the bones Therefore as we saide when as any vessell of the lungs is broken either with falling or with loude crying and that without griefe there gusheth out much bloud hot and fresh by coughing you may vnderstand that the wound is in the lungs the cure must be taken in hande after the manner that we often haue done and that many tymes with good successe Therefore we must commaund the pacient that he vse not great respiration and furthermore that he alwayes vse silence Furthermore the inwarde veine of the Cubite must be opened from which twice or thrise afterwarde thou shalt take bloud because we may diuert it then rub and binde all the the ioyntes as we are wont These thinges being done thou shalt first giue him to drink Oxicratum delayed and bloud warme that if in the inward part there be any congeled bloud being resolued it may be spit out and thus doe twice or thrice in thrée houres then giue him some medicine which both hath an Emplastique vertue and is also astringent and that first with delayed Oxicratum or with the decoction of Myrtiles or such lyke astringent Againe at night giue him this medicine in like sorte suffering him not to eate any thing if the affect be vehement but else giue him of some supping that shal be sufficient and it shall chiefely profit if the pacient be strong if that the next day a little bloud be taken out of the deuided veine and so to continue in diet and medicines as is aforesaid vnto the fourth daie the breast in the meane time if it be in Summer being moistned with oyle of Roses in Winter with Vnguento Nardino And if thou wilt vse an Emplastique medicine thou hast an excellent one of our making which boldly thou maist also vse to other wounds it is made of Aspaltum and Vineger and other which are accustomablie mixed to those medicines which Phisitions call Enaema Barbara But if thou cure a woman with childe or him that hath soft flesh the medicine that is called Diachalciteos is verie conuenient whose vertues I haue declared in the first booke of Composition of medicines And by this waie we haue cured many vnto whome wée came presentlie as they felte paine for this is the greatest thing vnto which it behooueth thée to be greatlie attendant whether presentlie vpon the rupture of the vessell thou beginnest the curation that thou dost adglutinate the gréene wounde before there that bée inflamation for if inflamation flowe there is after small hope of adglutination but yet you may prolong the time And the cause that such vlcers can hardlie or not at all bée cured is that when the inflamation is cured the mattier and Sanies of the vlcer are to be taken awaie but in the matrix or bladder they are voide of their owne accorde when as the Patient lyeth groueling and also we maye cleanse them But in the lungs neither of these are to be done Therefore in all vlcers which are in it all the purging that is made is onelie by coughing But if we commaund all quietnesse and small respiration and to speake little that the wound maye adglutinate what hope can there be of curation to thē that cough but the cure is to be dispaired of for that through respiration this member doeth continuallie moue and those that haue bene before our time do iudge it so by the vacuation of the mattier and Sanies But if anie is presentlie cured by this waie the wound wil close and if inflamation do come the cure is both hard and vncertaine when as the mattier Sanies cannot be expelled out of the places of the lungs and that the cough doe stretch the parts affected But those that are brought out of the breast haue a triple aduantage more than that which is euacuated out of the lungs For the substance of Aspera Arteria which is altogether drie voide of flesh is not found in anie parte of a liuing creature These that falleth in the like are wont to be broken if anie other veine or arterie be ruptured the Aspera Arteria remaining sound the translation of the bloud is by opening of the mouths called in Gréeke Sunanastomasis so that in such the bloud which commeth out is neither hot nor red nor yet much and these affectes at the first séeme small not inducing feare through the great euacuation but trulie they are héereby the more perilous for the bloud coniealed about the
and maketh an vlcer but when it is not so sharpe it maketh a Cancer without vlceration And we haue declared before how that the veines swell more in this tumour than with an inflamation and what manner of coulour it maketh There are not onelie Cancers engendered of this tumour but many other tumours consist of the same humour All these bodies which are vexed with these affectes are nourished with the euill iuyte either of cholerik or melancholik things either else of some virulent and naughtie humours comming of great putrefaction or corruption Of Phagedena Scabie and Lepra Chap. 13. THose vlcers which cateth and deuoureth the founde partes about them are called Phagedena for they name Phagedena compound of two things that is to saie of the vlcer it selfe and of the tumour ioyned with it For Herpis also eateth that which is about it but it is onelie an vlceration of the skinne and Phagedena doth not onelie eate the skinne but the flesh also which is ioyned to it Now to name other Vlcers as Telephia and Chironia c. it were superfluous for it is sufficient for vs to call all Vlcers commonlie Cacoethae that is to saie malignant Also Scabies and Leprosse be melancholie affectes of the skinne euen like as the same humour maketh a Cancer when it is in the veines and fleshie partes Of Elephas named Elephantiasis Chap. 14. ALso Elephas is a melancholike affect and hath his generation of melancholie bloud and in time the bloud is made more blacke and manie of these are full of vlcers which are of euill smell and grieuous to beholde and when this affect springeth first it is named Satyriasmon because they are like Satyres in countenance And we doo call them so when there appeareth risings of the bones in the temples and other parts of the bodie Also there are such bone risings which are named Exostosis like as the natural distentiō of the yard not ceasing some name it Satyriasmus and other some call it Priapismus Of Achoris Myrmecia Acrocordon Psydrax Epynectes Furunculus Bubo Struma and Hernia Chap. 15. THere is also a little vlcer in the head which you must coniecture to grow of salt nitrous fleame and out of it floweth mattier not verie watry neither yet so thick as honie or as it doth in those which are called Faui for those are with a certaine tumour and full of holes and as it were with an humour flowing like vnto Honie and these Tumours are verie little and not lyke vnto the other And there are lesser Tumours against nature than these which also happeneth vnto the skinne Myrmetia and Acrocordon Psydrax and Epinictes bée affectes to all men knowen and so is Furunculus most manifest and it is gentle béeing onelie in the skinne but if it bée déepe in the fleshie partes it is malignant like vnto Phyma and Furunculus differeth from Phyma onelie in hardnesse both these affectes are inflamed beside the third which is called Bubo the fourth which is named of many men Phigethlon doth differ from Phyma both in heate and quicknesse of generation There be some also which chaūceth onely in the flanks and arme pits which some suppose to be Phygethlon because it commeth with an inflamation in those glandulus parts these affectes when as they are made hard are called Choeras that is to saye Struma like as the hardnesse of the testicles are named Sarcocele and like as the watry humor gathered in the pursse of the testicles is called Hidrosile In like maner when Epeplon which we call Surbus falleth out the disease is named Epiplosile and when both these that is to say the intestines and Surbus falleth downe to gether it is named Enteroepiplosilen the later Phisitions call all tumors of the testicles by the name of Cele that is to say harnia or ramix And like as all that is now spoken sheweth the sicknesse of those parts which we haue spoken of so Cirsocile being a newer name sheweth the affect of which it was now deriued Of Varicis Rupturies Inperitoneum and Hidropsie Cap. 16. VAricis the aūcient writers name all veines which are delated and swelled not as the Athenians suppose that Varicis should be onely in the legges by the reason of their weakenesse and chiefely when the bodie aboūdeth with grosse bloud which may fall vnto them Also the inward rimme of the belly called Peritonium either being wounded or ruptured and not ioyned together againe causeth a soft tumor in that place which if it chaūce in the flancke it is named Bubonosile but if it happeneth in the nauell many Phisitions call these Exomphalos and there is no such disease of Peritonium but of necessitie the Naruus apendix of the muscle must suffer What this apendix is I haue shewed in the administracion of the Anathomie Therefore these affects are of the ouerthwart muscles that Harnia which is in the flāckes is of the oblike muscles the filme or apendix of those which are in that parts being either broken or dilated with peritonium There are also other tumours which belongeth to this place that commeth by the hurt of the intrailes the affectes which ingēdreth these tumors are spoken of amongst inflamacions and other Sirrhus tumours with other like as those that haue dropsies where there is gathered a multitude of water as in that which is called Ascitis and of winde which is named Timpanitis and that which cōmeth of flegme which is called Anasarca or Leucophlegma c. Of Epulides Parulides Thimus vua Tonsilla Parysthmia Polipus Vnguis and Stapheloma Cap. 17. THere are also other tumors which haue proper names as Epulides Parulides Thymus and such like which are fleshie braunches or buddes growing forth like vnto a graine Vua Paristhmia and Tonsilla are nothing else but inflamaciōs Vua is an inflamacion of Gurgulia which we call the vuila Tonsilla of those kirnells which be opposite wée name them the Amigdalines Paristhmia is in the parts of the iawes or nigh vnto the throate It séemeth that of these parts Hippocrates dyd not vnderstand all these inflamacions of Gurgulia to be Vua but one onely kinde in which the ende of Gurgulia is like vnto the seede of a Grape Also Polipus commeth when as either inflamacion or Phyma or any braunch thereof call it what it please you for this affect is alwayes in the nosethrilles they are inflamed chiefely because of the place Encanthis is also a tumor against nature bréede in the corners of the eyes but yet in all his kinde he is not against nature Vnguis is also a braunch growing outward in the eyes to the tunicle or membrana which is dilated of Sircumossale and cōmeth to corona Those that are called Staphiloma some onely by position some by disposition be against nature We haue in an other place spoken of all such affects as are in the eyes therefore now it is time to finish this booke seing there is no other kinde of tumors against nature which we haue
handes without medicine I thinke there is no man that is so ignorant or stupidious that thinketh that to be true then of necessitie it must followe that these bée thrée instrumentes and not thrée partes of medicine as manie men haue misconstrued both Hyppocrates and Galen both contrarie to reason and true experience for the hands alone cannot cure without Medicine neither can the medicines bée ministred without handes neither yet can anie man take meat or drinke except it be ministred with the hand then of necessitie it must followe that these thrée cannot bée diuided forasmuch as one is holpen by another and the desired health brought to an end by all these thrée and not by anie one of these alone as Hyppocrates dyd right well prooue in confuting of certaine sectes that were in his time as Tragus dooth make mention by the authoritie of that noble King Democrates affirming that there were certaine sectes which then dyd vse the arte of curing some by inward medicine onelie which they did purge the bodie withall and some by dyet onelie which they did vse as it séemed vnto them good and some by mininstring of outward medicines to such partes of the bodie as they thought good And euerie one of these did affirme that they would restore mannes bodie to health what disease so euer it were affected withall if that the saide disease were curable onelie with one of these thrée wayes and that the other two were superfluous and néede not to bée vsed By meanes whereof there did growe greate contention and great disputation was had therein and in conclusion they did séeme to confound all thrée partes each of them thus confuting other Then Hyppocrates hearing of this great contention amongest them they all thrée professing the curatiue parte of the Arte of Medicine sent for them and appointed vnto them certaine men to cure and asked them in what space they would cure the same persons and they appointed a certaine time and Hyppocrates gaue them foure times so long space Then euerie one of them with great diligence according to his owne sect and waie dyd minister Notwithstanding the Patients were not made whole so that they were constrained to leaue them vncured when they coulde doe no more When Hyppocrates sawe their dooinges howe farre wide it was from a reasonable methode yet how ingenious and wittie they were in deuising and inuenting of medicines to bring their purpose to passe hée did not a little meruaile Then with curteous wordes he perswaded them to leaue off their precisenesse and seuere sectes and to vse a generall methode wherein all those thrée were ioyned together and to vse euerie one of these in his conuenient time and place each one of them to helpe other and then ther was no doubt but with their excellent inuentions they would cure wonderfull griefes and diseases which otherwise could not bée brought to passe Nowe when Hyppocrates had made these thrée men friendes hée required them to goe with him to their sicke and grieued Patients and sayde vnto them That with the same medicines which they had ministred before by the permission of the immortall Gods hée would make all their thrée Patients whole So Hyppocrates ministring no other dyet but such a diet as hée that ministred the dyet had vsed before neither yet anie other purging medicamentes than he that vsed to cure with purging medicaments had vsed before nor yet anie other plaisters or ointmentes than hée that vsed to cure with plaisters and ointmentes had vsed before euen with the same medicines that they did vse by vsing of them in conuenient time and place methodicallie did cure all their sicke Patients By meanes whereof they were perswaded to followe his doctrine and to vse these as common and generall instruments for the arte of curing and all they to be exhibited and vsed with the hand Thus it doeth appeare by Hyppocrates that none of these may be absent from him that vseth the arte of curing Galen also as concerning purging medicaments where hée intreateth of the same sayth they bée verie profitable yea and also most necessarie in the curing of Cancers olde stubburne and rebellious vlcers and also in Herpis Herisipelas c. And these purging medicines were chiefelie inuented and found out by experimentes wherewithall they dyd purge and drawe awaye these vicious and euill humours which was the maintaining cause of all those Vlcers and grieued partes as it is afore sayde which other wayes could not haue béene cured Galen also in his fourth booke De Methodo Medendi by the authoritie of Hyppocrates doeth saie thus That Purgations of the bellie is profitable to manie vlcers and also to woundes of the head of the bellie and of the ioyntes and where there is daunger of corruption of the bones or where stitching behooueth in woundes or where Erosians be or where Herpis and other affectes bée which hindereth the curation of Vlcers and also where rollinges must bée vsed By these wordes it is apparant truelie that Purgations are profitable both to woundes and vlcers at all times when they bée greate and grieuous I meane not onelie Purgations ministred by the vpper partes but also Purgations ministred by the neather parts as Clisters and such like Thus I doe conclude that these thrée Instruments are most necessarie for those men that shall cure hurts griefes and diseases and in no case maye bée separated or taken from them For lyke as the Carpenter shipwright must of necessitie vse lyke instrumentes to finish and bring to passe their worke withall euen so must the Artists in this arte by what name so euer you will call them haue and vse conuenient Instrumentes to bring to passe the desired health which is the end of this art If the Carpenter should saie vnto the Shipwright thou maist not vse the Axe the Saw the pearcer nor yet the hammer for that they be proper instruments for my arte then the shipwright might aunswere him and saie they be proper for my Arte also and without those instruments I cannot build my shippe nor bring to passe the desired end of my Arte. Euen in lyke manner it may be sayde in the Arte of medicine for whether he be called by the name of a Phisition or by the name of a Chirurgion of by the name or a Léech or by what other name you wil cal him if ye wil admit him to cure wounds Tumours against Nature vlcers or what diseases so euer they be it is necessarie that hée haue his proper Instrumentes apt and méete to bring the same to passe withall But if wée shall stand vppon the names of the Arte and confound the instruments then shal we séeme to maintaine a vaine disputation and spend time about those names which are to small purpose for the name is not the thing that doth cure but the arte béeing methodicallie and rightlie ministred For Galen in his third and fourth booke De Methodo Medendi doth name him