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
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
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
be as it were of a natural disposition in the right easie obtaining of things with that he hath to do of a stedfast memory of a quick remembrance handsome in his doings of a good iudgement diligent and apt in searching or inuenting remedies but chieflie of all as concerning manners let him be deuout or religious towards God mercifull of minde and vnfearefull in sure things and such as must néedes bée done and in things doubtful and perillous he must be warie and not too rash in like maner he must be familiar gentle and pleasant towards his Patients milde tractable amongst the brethren of his Arte and as the Gréekes do call him Philectairos that is to saie a louer of his companions Also he must be prudent very circumspect and slow in prognosticating not a gréedie catcher chast also and temperate not couetous of monie for he which doth exercise the art of Chyrurgerie rather for lucre sake desire of gaine than for anie good wil toward his neighbour he is no right Chyrurgion but as it were borne out of time and thus I make an end Thus farre I haue declared vnto you the saying of Valleriolus that learned man But forasmuch as some men doe more regard the authorities of authors than they doe the true iudgement of reason and experience which two are the foundation of all Artes and wil alleadge and saie this is but his owne inuention wherfore I wil not beléeue him though it appeare neuer so much to be reasonable shal I credit one or two mens sayings that the art of Chyrurgerie is so auncient or that the instruments appertaining to the same art is diet and medicaments no I will not beléeue it for those instrumentes doe pertaine onelie to Phisicke and not to Chirurgerie for the instrumentes of Chyrurgerie be onelie outward medicines as Plaisters Vnguents oiles pouders c. with a great many of yron instruments fit for his art wherefore I am not bounde to beléeue Franciscus Valleriolus The answere My friend hast thou so soone forgotten Hyppocrates who confuting all dispearsed sects did conclude That diet wherein consisteth the gouernment and nourishment of the sicke man That purgations being necessarie for the euacuation of euill humours And also outward medicines as plaisters vnguentes oyles balmes c. That all these thrée were vnited together by the authorie of Hyppocrates and that in no case they might be separated one from another if we wil rightlie cure the body of man and follow a right method which method Hyppocrates hath constituted and set forth and willeth all men to follow the same Then I saie either we must breake Hyppocrates precepts and by that meanes grow into ignorance againe either else we must follow the true and right method set out by him wherein he did vse all these instruments generallie and indifferentlie as time and cause dyd require And also Galen as it may more at large appeare in his fourth booke De Methodo Medendi in his bookes of purging medicaments where he doth confute diuerse Physitions which woulde not admit purging medicines in outward diseases as Asclapiades c. Saying That purging medicaments are necessarie to be vsed where there be great and daungerous wounds and where there be great accidents that chanceth vnto the same to purge draw awaie the superfluous quantitie of those humours which might hurt the grieued part or hinder the curation thereof as he doth declare in the same booke De Methodo Medendi And he saith in his bookes of purging medicamentes That purgations are needfull for the curation of Cancers Herpis Erisipulas Spasalus Gangrena and many other outward griefes which chanceth vnto mans bodie And he doth affirme that without these things he could not haue brought to health his diseased patients Thus it doth manifestly appere both by Hyppocrates Galen that these be not onelie generall instruments but also common instrumentes and therefore of necessitie must be vsed either else the Chirurgion must leaue these euill affects vncured which he ought take first to indication off Obiection Yea sir you saie verie well for in the time of Hyppocrates and Galen the Chyrurgions were Phisitions and were great learned men and vnderstoode all partes of the arte and the nature of Medicines both simple and compound wherefore it was lawfull for them to vse all these instruments generallie indifferentlie but it is not so for our Chyrurgions and that I will proue by the authoritie of Tagaultius in his institution of Chyrurgerie The aunswere You haue sayd verie well sir and by him I am verie well content to be iudged for he is both a man of excellent learning and also worthie to haue perpetuall fame for his painfull trauaile in that excellent booke of Chyrurgerie that we may the sooner come to our purpose I will recite a few of his sayings whereas he declareth what the art of Chyrurgerte is and what manner of man hée must be and what properties he must haue that ought to vse the same arte how he should be trained vp in the same art and what is the subiect of the same and what be the things that he must cure the same subiects with with what instruments the same must be cured Now I will recite you certaine sentences as héereafter followeth which are taken forth of the same booke of Tagaultius that you before haue alleadged and I trust being well and indifferentlie construed shall make more with my sayings than with yours The vvordes of Iohannes Tagaltius declared in his booke vpon the art of Chirurgerie TO the exact knowledge of the arte or science which is called Chyrurgerie it behooueth the Artist to know foure things First what Chyrurgerie is what is the matter subiect to Chirurgerie what is the end of Chirurgerie and also what order is to be obserued kept in the learning of Chirurgerie And we doe knowe what Chirurgerie is by thrée manner of waies First by the Etimologie of the word or name by his definition and by his diuision Chirurgerie after his Etimologie is called the operation with the hand for it is named Apo tes chiros cai tou ergou that is to saie of the hande and his worke because this Arte is exercised by the administration with the hand and héereof commeth it to passe that the minister with the hand is called Chirurgus that is to saie a Chirurgion Chirurgerie according to the assentiall definition is an Arte which by the administration of the hand doth expell driue awaie sicknesse out of mans bodie whereof chieflie principallie it taketh cure and charge or else Chirurgerie is an art which by the cunning working with the hand doth put awaie or remoue the sicknesses or diseases of mans bodie The matter subiect to the art of Chirurgery the whole intention which the Artist doth occupie himselfe about is onlie mans bodie subiect to diseases infirmities which diseases and infirmities requireth the help of medicaments ministred
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
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
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
many people which other wayes through your ignorance and lacke of knowledge might vtterly perish Thus I besech the eternall God to blesse vs all to giue vs grace to honour and praise his holy name and to trauaile in this our vocation and Arte truely rightly and without deceit so that it may be to the glorie of God to the common welth and your further knowledge and finally to the health and safegard of the people through Iesus Christ our Lord. FINIS A briefe declaration of the worthy Arte of Medicine and of the inuenters of the same and of the parts names that it is deuided into and to what ende it serueth THE mâ—… famous and auncient authors doth manifestly affirme that the arte of Medecine was geuen to mankinde by the almightie Lord God that it might helpe our weke and frayle nature in the time of most greuous sicknesse seÌ„t vnto vs for our sinnes for if we should alwayes remaine in health in good and perfect state neither should we know our selues neither yet the great might and power of the Lord God which doth both geue health and sicknesse neither should we seeke out the vertue of his creatures as herbes trées stones mettals mineralls beastes foules fishes and all other things that crepeth on the face of the earth which hath receued of the high and mightie Lorde both qualities and properties to helpe and cure most greuous diseases being rightly aplied and vsed according to reason experience and for as much as we doe sée that mankinde is altered ouerthrowen and corrupted through the fraylnesse of nature by meanes wherof we cannot alwayes remaine in health we are therefore driuen by necessitie to séeke out those thinges which may restore vs againe vnto health Health is restored by the vertue of medecines and the vertue of medecines was founde out by long experience experience and reason being ioyned together maketh an arte and this arte by the common consent and testimony of all authors is the most worthy honorable and most profitable in all the world For lyke as man which is subiect to this arte or the matter whervpon the artest doth worke is most excellent amongst all creatures both in the sight of God his creature and in the sight of the world so is the artist which worketh vpon his body most excellent both in the sight of God and in the sight of Princes wherefore Salomon did say Honora medicum pro necessitate for the highest Lord hath created him for thy help and health Here it is manifest that this arte is most noble for that it taketh her beginning and foundation of the omnipotent God as it doth more manifestly apeare in the creation of the world for the Lord God coÌ„maunded the earth to bring foorth all maner of herbes fruitfull trées and all other thinges necessarie for mankinde that he might haue the vse of them to his sustenance for the defence of his life and that he might by the same thinges put away greuous diseases wherefore the most wise Hebrecion Iesus Sirach did say Medecine doth proceede from the most highest and the auncient and most wise men of the lande haue brought it forth and he that is wise will not abhorre it What can be spoken more in the commendacion of this arte or who dare say that it is not worthie to be coÌ„mended séeing that these wordes are spoken by the spirit of God in these holy men Saint Paule doth saye that the gift of healing is the gift of the holy Ghost and Iesus Christ the sonne of God did minister in this Arte and cured manie people by meanes whereof it doth most manifestly apeare that it is in estimation both with God and man If I shall speake of familiar examples which daylie chaunceth before our eyes as in those which be infected with most greuous sicknesse who hath neither comfort nor ioye of all their worldlie goods neither yet hath any space without tormeÌ„ting paine to eate their meate The greuous and bloudie woundes of those that be in battaile which should perish without present helpe if it were not for this Arte many other which daylie be brought to health of innumerable diseases Let all these declare the benefit of God in receiuing the commoditie of this Arte let them testifie I saye what it is to be lightned from so great euills froÌ„ so great feare of death and manie times from death it selfe how profitable how honorable and how worthie this arte is let them declare There be diuers opinions of the first inuention of this art for some suppose it was first fouÌ„d out emongst the EgiptiaÌ„s and other some saie that the Hebrues did first inuent it some suppose the Grecians to be the chiefe founders thereof but if we may beléeue Herodotus or Diodorus they saie that the Aegyptians were the first inuenters and séekers out of the nature of hearbes and other things to cure griefes and diseases withall and that they chalenge vnto themselues the chiefe preferment for the antiquitie of medicine and also to be the first inuenters of the worthie art of Astronomie as it may appeare by their bookes which they haue written of the course of all the Starres And they haue brought to light what things were profitable to liuing creatures by inuenting and exercising of diuerse artes as Medicine Astronomie Musicke and Arithmetike and the worthie tillage of the ground was inuented by them Also Diodorus hath giuen this honour or victory vnto Mercurie he doeth attribute the inuenting of Medicine vnto him Osiris the son of Saturnus for his excellent wit extolled him with greate honour for the inuenting of so many noble arts the which things Strabus doeth séeme plainelie to confirme in the last booke of his Geografie Where as he doth also write great commendations of the fruitfull ground of Aegypt for that it doth bring forth abundantlie all manner of things necessarie for the arte of medicine which doth excell in such plentifulnesse that no Countrie is to be compared vnto it And he supposeth that Mercurius Trimegistus was the first that found out the nature properties and qualities of hearbs fruits trées rootes mettalls stones and many other things appertaining vnto the arte of Medicine he had diuerse men appointed to be at his commandement by the king of Aegypt whose name was Apis which men did continuallie trauaile in séeking of hearbes and other things throughout all Aegypt and brought the said things vnto Mercurius and he made experiments and trials vppon them and did wonderful greate things by their vertues properties afterward deuised and inuented letters and ioyned them so together by meruailous arte and taught them in such sorte vnto his disciples or schollers that they dyd perfectlie vnderstand them and did write and read their owne language in such a perfect sort that in short time throughout all the couÌ„trey they sent letters one to an other wherein one vnderstoode an others mynde then Mercurius for as much as
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
of Medicine not onely to the sauegarde of their Prince and people but also to their immortall fame and perpetuall and euerlasting honour The noble Latinestes haue also deserued no lesse fame both in séeking out the knowledge of simples and also in setting foorth of most worthie woorkes in the Arte of Medicine as these worthie men Cornelius Celsus Plinius and before them Cato Verro Alexander and many more which were men of worthie fame all these as I haue saide béefore haue taken their originall and beginning from Hippocrates and Galen It is also most apparant that there are manie worthy men that haue written in these latter dayes no small number in our time and of manie Countries some dyd wryte in Fraunce some in Spaine some in Germanie and some in our owne Countrie and many of them were famous men and menne of great and excellent knowledge and practise As Lamfranke Archbishoppe of Millon Guido of the schole of Mompillor and Commissarie to the Pope Rogerus and Roulandus of the schole of Mompilor and Chirurgians vnto the King of Fraunce Rose Anglus Gilbertus Anglus Hugo Wiklefe Anglus of the schoole of Cambridge Theodoricus and Brunus of the schoole of Bonane Arnoldus de villa noua and Plasentinus of the schoole of Mompilior Petrus de Argilat and Gordonus all these dyd write of the Arte of Medicine about two or thrée hundred yeres since and all these builded their foundation and tooke their originall of Hippocrates and Galen and nowe in our tyme there hath bene famous writers as Iohannes Vigo Antonius Muse Antonious Gallus Nicolaus Masse Iohannes Baptista Montanus Iacobus Siluius Alfonsius Ferrey Hollerius Leonardus Fuchius Iohannes Tagaltius Gabrielus Falopius Rioldus Columnus Antonius Calmisius Vassalius Ioh. Fernelius Amatus Lucitanus Frāciscus Valleriolus Ieronimus Cardanus Matthiolus and a great many more of learned men who we will passe ouer the troubling of tyme. All these which I haue spoken of of what Countrie so euer they were they tooke their originall and foundacion of our Father Hippocrates and Galen although they haue founde out many thinges appertaining to the Arte of Medicine which we finde no mention made of neither in Hippocrates nor in Galen yet they had their foundation from them and all these men of what countrie so euer they were they haue dronke of the water that flowed out of their two welles and doe greatly reioyce therein and who that list to reade their workes may perceiue the truth thereof Now my friendes to tell you the truth in my iudgement what was the cause of these mennes writinges I take it to be chiefely to sette forth the glory of God in his wonderfull creatures and workes as touching their natures qualities and properties which doth appertaine vnto this artist which doth vse the Arte of Medicine to consider vppon for all maner of thinges vnder Heauen doe serue either for mannes nourishment or else for the making of his bodie or else for necessarie remedies in the time of sicknesse or else for preseruatiues to kepe him from sicknesse and to preserue health So carefull was the highe and mightie Lorde God for his creature man that he made all these thinges to serue his vse as necessarie helpes in the time of his necessitie and placed him in the place of ioye with great solemnitie But alas his frayle nature was the cause of his sodaine ouerthrowe from ioye to sorow from pleasure to paine from rest and quietnesse to perpetuall labour and vnquietnesse from a most temperate Ayre and pleasant place into a miserable worlde tormented with innumerable contrarie ayres and chaunge of windes Yea I saye euen from the place of health into the worlde of sicknesse and miserie where our bodies be altered and weakened euerie daye by mixing together of contrary Elements and we being subiect to the same are dayly tormented with innumerable diseases And although Adam at the first creation was indued with most excellent wisedome and knowledge by the power might of the Lorde God so that he dyd know all things that were vpon the face of the earth in the waters and déepe partes thereof not onely their qualities and properties but their substanciall formes and figures and gaue them names as he himselfe thought good for he had perfect knowledge of all thinges by the deuine spirit of God which dyd worke in him according to his first creation but when he had sinned against the Lord God then was taken from him his diuine knowledge and lefte here in this world bare and naked to take paines and studie for all those things that he would receiue commoditie of Now man as I sayde before being wrapped about with innumerable sicknesses diseases and sodaine chaunces which bée subiect to the arte of Medicine which Arte I call the arte of curing and healing was constrained to séeke for remedies in the tyme of his necessitie And sought out Herbes Rootes and manye other thinges to helpe his diseases and griefe withall and by vse and longe time of practising they dyd finde out the natures and properties of many thinges wherewithall some tymes they dyd good but by chaunce for they obserued neither the natures of bodyes nor their temperatures nor the disease neither yet the causes thereof but onely regarded those thinges which they dyd sée and féele Thus farre wyde was man from that excellent knowledge which was geuen him in the beeginning for in the beginning he was not onely indued with most beautie but also with most excellent giftes of knowledge and wisedome All other creatures besides man which hath not sinned against the LORD GOD but followed the nature of their first creation all these wée sée by experience haue a certaine deuine nature in them which man lacketh for man dyd lose it through sinne which these creatures haue not done and for the proofe héereof we will begin with the dog which being sicke séeketh for a certaine grasse eateth thereof and with the same cureth his griefe and disease Onelie a diuine nature teacheth him this without anie studie The Squirrell also prouideth her selfe nuts against Winter The little Ant or Pismere doth gather séeds into the ground and biteth them in the end after such a cunning sort that they may not grow The Storke also being grieued or anoyed with anie vncleane thing that she hath eaten flyeth to the sea and giueth her selfe a clister with salt water ministring it with her bill at her neather end by meanes whereof she purgeth and cleanseth her selfe of her griefe and sicknesse Thus may you perceiue the diuine and wonderfull workes of almightie God working in his creatures by a diuine nature but man lacking this diuine knowledge and lefte onelie to reason and Experience is constrained by greate studie to bring to passe those thinges which by imperfection of Nature dooth lacke in him By meanes wherof all these most worthie men afore said haue put in writing manie worthie Bookes of this arte which arte they haue obtained by greate
studie and experience and by a reasonable method or waie haue taught the same vnto others not onelie to that end that the glorie of God in his great and wonderfull workes maye be the better knowen as I haue sayde before but also for the common wealth of their owne Countries wherein they did dwell The Princes and subiects being wounded hurt or diseased by their greate and painefull trauaile and by theyr greate studie and most approued experiments might be restored againe vnto their health and the rest which bée in good health might bée defended from most cruell plagues and sicknesses by the helpe of this most worthie and excellent arte This art I saie is most worthie for that it worketh vppon the bodie of man which is the most excellentest creature of all the world and as the subiect is excellent which the artist dooth worke vpon it must néeds followe that the artist must be most worthie which worketh vppon so excellent a subiect And furthermore to prooue this art to bée most excellent and most of all other to be had in honour and reuerence I proue it by the saying of Saint Paule That some men had the gift of wisedome some of prophesying and some of healing and Saint Paule saith That these were done by the spirit of God that is to saie by the holie Ghost Therefore Hyppocrates and Galen hauing the spirit of wisedome and of the art of Medicine most abundantlie poured into them dyd excell all men before their times and set forth this art so perfectlie and exactlie by the power and vertue of the same spirite that all the vniuersall worlde hath receiued such commoditie by them that their most excellent fame shall indure to the worlds end All other men being endued with the same spirit and with the examples of them to set foorth such knowledge as they are endued withall for the helpe and maintenaunce of their common wealth and for the reliefe and comfort of the diseased subiectes haue bene from time to time mooued with the spirite of God to write manie volumes of bookes to their posteritie wherein they haue taught them the methodes of waies of curing not onelie of grieuous wounds great Apostumes vlcers fractured bones and dislocations but of all other infirmities and diseases that chaunceth vnto the bodie of man with their proper signes and tokens to iudge them by their natures properties their distemperatures with their names and most exact diuisions to that end that they maye bée more rightlie vnderstanded iudged and aptlie cured Héere may a question arise what this arte of medicine is and what you call him that vseth the same for many men suppose that he is properlie named a Physition and other some supposeth that hée shoulde bée called a Chirurgion by meanes wherof in times past ther hath growen some contention as perteining to the Instruments proper vnto the said arte of curing that is to saie the vse of the hand called Chirurgia conuenient diet named Dieta and ministring of conuenient medicaments named Phermacon For answere therof I haue told you my opinion before that in the beginning the Artist was called Iatros amongst the Grecians and amongst the Latinists Medicus and in our Countrie in our auncient tongue he was called a Léech which thrée wordes that is to saie Iatros Medicus Léech signified no other thing but to cure that is a curer of diseases sicknesse and sores wherewith mans bodie is grieued Now these diseases cannot be cured without cōuenient instruments which instruments are first chieflie the hands of man that doth make readie conuenient nourishment or medicines and ministreth the same vnto the sicke man or else commaundeth the same to be ministred in conuenient order The second is diet which is a speciall instrument as well for the curation of Wounds Apostumes Vlcerations and tumours against nature as for all other diseases which chaunceth vnto mans bodie Both Hyppocrates and Galen doth prescribe proper diet for wounds according to the temperature of the bodie according to the nature of the wounded part and according to the nature of the accidents that may be ioyned with the same wound In like manner Galen prescribeth a diet for those that hath vlcerations not onelie in Cancers but also in many other kinde of vlcers which may neither be conuenientlie cured neither yet preserued in good state without conuenient diet and as for tumors against nature they require no lesse helpe of diet than the residue for it is a generall rule that we first take indication of the nature of the disease which we entend to cure and of the effects of the same As for example in Phlegmon which is an inflammation ingendered of bloud for of nature Phlegmon is hot and moist but his affect is to make inflammation not onelie in the part where it is aggregated but by consent and affinitie which the grieued member hath with the rest of the bodie it doth often times moue a Feauer which might grieue and trouble all the bodie and cause the inflammation to be more vehement in the grieued part Therefore the Artist ought chiefelie to prouide for this mischiefe and there is no better waie to resist the same than by giuing of conuenient diet which must be colde and drie contrarie to the nature of the disease which commeth of bloud being hot and moist for these be generall rules taught both of Hyppocrates and Galen that euerie disease with his affects bée cured with his contrarie Thus I thinke there is no reasonable man that will denie this instrument to appertaine chiefelie to the arte of Chirurgia for reason doth approue and allowe it and experience doeth finde it most necessarie and true Therfore I must saie as Galen saith in his third booke Methodo Medendi All artes are grounded vpon reason and experience neither is there anie third thing to be added therevnto If anie man can shew me how we may cure vlcers tumors and other things appertaining to the art of Surgerie by a third waie and with other instruments than these worthie men haue found out by reason and experience then I will giue place and be glad to learne it and if I finde the same to be more profitable commodious for the common wealth and for the grieued persons I wil not onelie endeuour my selfe to learne it but also to followe it extoll it and teach it vnto other but if no man can shew me anie other waie than reason ought to teach him to suffer me to restore my sicke Patient to health by the permission of God with those instrumentes that bée most necessarie and proper for mine Arte. Furthermore as concerning Pharmacon which is called Medicamentum or Medicine I thinke there be no men ignorant no not so much as those that be vtterlie vnlearned but that they knowe that medicine is an instrument to helpe to cure diseases and sicknesses withall for who can cure a wound a tumour against nature or an vlcer onelie with his
greatly delighting them selues in the onely dignitie of the Arte not knowing what it meaneth which doe oftentimes let bloud their poore patients without any IndicatioÌ„ or councel of one learned in the same arte or of some graue and learned Phisition but also they will geue inward medicines a gods name a matter truely most worthie of publike punishment For as much as I haue séene many by such their rash and bold enterprises brought into daunger yea and some haue I séene miserably languished and depriued of lyfe Therefore let not that young Chirurgion which would be estéemed worthie of his arte presume to take in hande these thinges without the councell of an auncient maister learned in the same arte or else a graue Phisition such a one which is learned in the arte of medicine the matter it selfe geuing also such libertie or time But otherwise if there be no learned maister present or that any present necessitie doe constraine the same then truely the younger Chirurgions may boâ—…t bloud and also if néede bée minister a medicine so that he haue good erudicion iudgement and experience Moreouer the Vnguentes where with the Chirurgion ought to be furnished and the same to haue alwayes in his saluetorie as these Vnguentum Basilicum Vnguentum Apostolorum Vnguentum Aureum Vnguentum Album and Vnguentum de Althea as Basilicon to superate and materate and Apostolicon to mundifie and clense Vnguentum Aureum to incarnate and to fill Vnguentum Album to cicatrise Vnguentum de Althea to cease dolour and paine and to make soft Moreouer as for emplaisters pouders fomentations and such like the expert Chirurgion doth prescribe of them very many sortes according to the reason of curing And these are the medicinall instruments pertaining to the art of Surgerie By the manual instrumeÌ„ts ye shal chiefely vnderstaÌ„d instrumeÌ„ts of yron very méete most necessarie to the ChirurgioÌ„s vse wherof some are to make incisioÌ„ to cut of a thing other some are to draw out certaine are to search also some be properly to stitch or sowe and other some to make adustion to cut or make incision Forfices Nouacula rasorius scalpellum Chirurgicum for Phlebotomie seu lancetam forsipes to draw out called commoÌ„ly Tenaculae volcellae seu volcellae which in French they call pinsettas the crooked hooke vncus seu vncinus and that Yron instrument which the Grecians call Diocleum graphiscum is apt as Celcus writeth to draw out arrowes For to serch we doe fitly vse a probe for to sow a néedell and a quill are properly vsed and to adustion diuerse kindes of cauteries commonly called actuall are occupied and for the variable meanes of their vse they haue diuerse figures and diuers names for some be sharpe at the point and other be not and other cauteris they call myrtea oliuaria dactilica cultellaria so called of the similitude of thinges which these instrumentes doe represent for the cauteris called Mirtia doe imitate the figure of the leaues of Mirtills Oliuaria of an Oliefe dactilica of the Date as Cultellaria doth represent the forme of a knife these are the common instruments necessarie for Chirurgions There are certaine other instruments proper and appointed to certaine partes of the bodie as modioli which the common Chirurgions call Trepans malleus scalpri and the same are conuenient to scrape cut or pul out bones as well of the head as other parts euen as Falx is proper to the fundament speculum oris to the mouth and speculum matricis to the matrise there are innumerable other sorts of instrumentes conuenient to drawe out dartes gunshots other infixed things whereof to speake I doe now cease and will prepare my selfe to set out a Chirurgion what maner a man the best ChirurgioÌ„ should be which thing I often times haue declared to be the chefe effect of the matter for wée know what Galen hath saide of the Phisition aswell in his booke De institutione artis medicinalis as also in the third booke de naturalibus facultatibus and in his third fourth de methodo medendi Galen calleth him that cureth woundes and vlcers medicus that is to say a Phisition he saith that the Phisition ought to be prudent and well exercised and also he ought to be of quicke nature and of pregnant wit that he may promptly obtaine all thinges and verie well instructed in learning and moreouer appointed to the best maisters to learne of and one induring labor paine a great louer of the truth studious and most déeplie vnderstanding his art approoued by much vse and long experience and all this saie I must be applied to the Chyrurgion which will bée most excellent estéemed for an vndoubted Artist but beside these there be certaine things which doe pertaine priuatlie to a ChyrurgioÌ„ as to the manual Artist do not so much pertaine to the ancient maister of the art of Medicine for a Chyrurgion ought to be a young man or els but little past youth that is betwéene the same and auncient mans estate for the age flourisheth most in sense strength to exercise rightlie whatsoeuer belongeth to his art wherfore they which are aged men cannot so aptlie bring things to passe which arte requireth for the imbecilitie of their senses for they follow them rather by counsaile Furthermore he must haue a sure and strong hand and steadfast to all workes that hée shall doe whether it be to make incision adustion also for the cutting awaie of a member Also it behooueth him to haue a quicke and cléere eie and he must not be fearefull of mind but rather without pittie if he do intend to cure him that he taketh in hand Furthermore neither let him make the more hast neither let him cut Canteries or cut off lesse than néede requireth for the clamor or crying out or for the tendernesse of the sicke Patient but let him doe all things as though he heard not the clamors of the sicke neither let his minde be therwith anie thing troubled And wée haue declared that a Chyrurgion ought to excell in learning for therein chiefelie doth his erudition manifestly appeare if he vnderstand exactlie both the Theorike and the Practike parts that is to saie to know things naturall and not naturall and also those that are against nature Also if hée know what be the causes of wounds vlcers fractures and luxations with their accidents and also what be their conuenient remedies and how to remoue the same In lyke manner he shall excell in practise if hée haue had much and good exercise in the operations of his Arte by working spéedelie trimlie and readilie consulting with the auncient maisters of the same arte in those things that pertaine to Pharmaceuticen Diateticen And although he vse those things which be searched out by reason confirmed by frequent vse wherein truelie the faith and honestie of a Chyrurgion séemeth chieflie to consist The Chyrurgion ought to
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
these same diuelish and wicked sectes which doth thus abuse this noble arte of medicine to the vtter defasing of the same may be reformed and amēded and euery one to get their liuing with truth in the same arts that they haue ben brought vp wel experiēced in either els to be greuouslie punished as they be in all other Countries and as they haue bene héere in this Countrie in times past For séeing there is lawes made for him that stealeth a shéepe an oxe or an horse which is but a beast and serueth to mans vse and hée that looseth the same looseth no more but the value of the vse thereof why may it not be as well considered for the losse of an arme or a legge yea and many times of the life which these wicked generation doe spoile I thinke the Prince is bound in conscience as wel to punish those false and wicked pernitious deceiuers which doeth not onelie destroie the lims of man but his life as to punish these which steale shéep oxen or horses Of this sort I think London to be as well stored as the Countrie I thinke there be not so few in London as thrée score women that occupieth the arte of Phisicke and Chirurgerie These women some of them be called wise women or holie and good women some of them be called Witches and vseth to call vpon certaine spirits and some of them vseth plaine bauderie and telleth Gentlewomen that cannot beare children how they may haue children What manner of other sorts and sects there be of these as some for sore breastes some for the stone and Strangurie some for paine of the téeth some for scald heads some for sore legges some cunning in Mother Tomsons tubbe and some to helpe maides when they haue lost their maidenhead when their bellies are growen too great to make thē small againe with a thousand more Galen in his booke of sects did neuer make mention of the fourth part so manie I thinke if this worshipfull rablement were gathered together they would make a greater profession than euer did the Monks the Friers the Nuns when they did swarme most in London This vnprofitable companie haue so increased within the Citie of London that all the Countries in England haue taken insample thereof yea and at this daie all the Countries in Christendome may wonder at our lawes in suffering and maintaining of them Well I say wée will let all these passe with tinkers coblers souters and sow gelders and a great many of occupations more whereof some commeth out of Fraunce some out of Germany and so of other countries some for religiō some for picking of purses c. All these now are become great Phisicions and Chirurgions to no small aduancement of this noble Arte of Medicine for their noble and worthie cures doth beare witnesse thereof and giueth so good report vnto them that at this day the learned Phisicions and Chirurgions may not a little reioyce Well I say no more but God amend all and except these things be quickly amended I thinke the diseased people and such as haue vlcers woundes diseases and sores are like to haue small helpe and if it shall chaunce the prince to haue wars then are this company that I haue spoken of like to serue and I doubt nothing but that the souldiers shal haue great courage to fight for so much as they shal haue such a goodly companie of Chirurgions to cure them when they be wounded As for other Chirurgions there will be but a fewe left except better order be taken and that with spéed Well now wée will procéede to our matter againe Now my welbeloued brethren ye haue hard of this vngratious company with their damnable déedes which may be vnto you an example to incourage you to flye ignoraunce and to learne the exact and methodicall way of curing according to knowledge also to know these things that doth appertaine vnto the same not onely these v. parts aboue rehearsed or thrée or two as it séemeth good to you to deuide them for it is not materiall as Galen saith so that you vnderstād the thing Not onely these I say ought to be perfectly knowen but also all medicines both simple and compoūd with their natures and properties their operations and right applicatiōs and at what time the same ought to be ministred to what partes of the bodie and for what griefes and diseases and also according to right indications taken what ought to be first ministred what next and so to the last All these thinges as I haue saide doe appertaine vnto the right and true Chirurgion not onely to know but also orderly to follow or else he shall be accounted an emprike and little better then one of these rude rablement which I haue spoken of before Wherefore my well beloued bretheren that vse this arte of Chirugria I exhort you in the name of Almightie God that you your selues be not onely diligent in learning of all these partes and other thinges necessarie appertaining vnto your arte by meanes whereof not onely murther and other greuous misfortunes which might happen through your ignorance may be auoyded but also perpetuall slander with all other infamous report and displeasure may be likewise auoyded also And that in like maner your seruaunts and children which you doe intend to bring vp in this Arte be learned not onely to write and reade but also in the tongues that he may more exactly vnderstand these parts as I haue said before And so by this meanes you shall not onely restore the Arte againe vnto her good name which is almost lost at this present daye through that foule and vgly monster ignoraunce but also get vnto your selues perpetual honor and good fame And furthermore by your excellēt knowledge and vertuous liues and cunning déedes which followeth after and are the fruites of knowledge by these thinges I saye and with the helpe of the high and mightie Lord God you shall abolish and put downe these wicked and pernitious sectes which are no lesse vnprofitable vnto Gods people in the common wealth of their countries then caterpillers and Grassehoppers are vnto the fruites and herbes of the ground which sectes be not onely pernitious as I haue said before but perillous and selaunderous vnto you that be the true professers of the Arte for they call themselues by the name of Phisitions or Chirurgions And the simple ignoraunt people doe so receue them or thinke them to be but in déede they be such as Christ speketh of wher he saith that they come in shéepes clothīg be rauenīg wolues so these come with good names be craftie and pernitious deceauers which are to be driuen out of euery good common welth Thus most gentle Reader I haue troubled you with a long talke desiring you to beare with my simple and rude stile wishing with all my heart that it had bene better and desiring you most humblie where you finde anie fault
audience vnto vs for I will haue to doe in fewe wordes with the professour of onelie Experience for it is méete that he also do vtter by what meanes he hath found out this drying medicine that dooth incarnate which hée nameth Cephalicin and that is compound of Iris and Aristolochia and Eruus Olibanum and Manna that is to saie the drosse of Olibanum There is also another medicine which besides these that are rehearsed hath the rinde of Panax and another medicine to which is mixed with washed Cadmia Now let him tell me how these medicines be found but what skilleth it saith he to aske of that finding of thē out is it not better to vse those things that are found out right And this at the first they answere afterward they saie that these medicines be found out by dreames in the meane time by chaunce one medicine was put to another afterward one was bolde to vse them mixed but yet they shewe not the successe of their boldnesse Therefore these be manifest trifles The third waie of inuention trulie is reason or some prouing euerie one of those simple medicines separatlie to be Sarcoticall afterward beholding that sometime it doth not make flesh he findeth out by reason that euerie one of those agréeth not to euerie nature for vnto whome Aristolochia doth not fill the vlcer with flesh there Olibanum hath and where Olibanum hath not profited there Iris hath done good for I suppose that to be reasonable that all men are not affected to all things alike And when this came first into reasoning it was thought good that many medicines of one kinde should be mixed together that there might not want a méete medicine for euerie nature And friend the action of euerie substaunce doth not remaine in mixed kindes so that in euerie kinde of bodie there might be present that should helpe the disease for if they coulde finde out the nature of the bodie or the force of the Medicine applyed peraduenture there should not néede such varietie in them in as much as they shoulde alwaie readilie finde that one medicine that should agrée to one bodie Now for as much as they are ignorant in both they doe crookedlie mixe all together studying to make one medicine that might agrée to all natures and I suppose this reason of compounding medicines to be found out of the first Phisitions and you receiue it as an auncient inuention notwithstanding I suppose that it is not so farre from the true medicinall method as it is reasonable to be emptied into another for if they doe not first thinke of that method whose composition standeth in medicines like of kinde and not of that which is of contrarie by and by you shall finde in the mixture of these medicines some one that may be profitable to the sicke and peraduenture not one contrariwise seauen or eight which shall not néed so that the medicines shal more hurt that profit These thinges I saie if he doeth not remember I will account him more ignoraunt than to knowe the thing it selfe for oyle being put into a hollowe wound is most contrarie of all other medicines for if thou wilt that waie cure thou shalt by vse finde the vlcer to be filthy and stinking but if the time also of the yéere be hotter or the man hath Cachochimia or by nature is apt vnto rumes or offend in his diet it is to be feared least that part do putrifie in which the vlcer is made In like sort if thou doest vse waxe either alone either dissolued in oyle for they trulie do make the vlcer putrifie but if thou doe put in Aerugo beaten fine they shall by no meanes putrifie yet it bringeth great paine and corrosion Furthermore it doth eate and prouoke inflammation and if thou vse it more largelie it will also make conuulsion therefore séeing that neither oyle nor Aerugo nor wax can fill an hollow vlcer with flesh it is manifest that none of those which professeth onelie Experience will mixe them together yet I trulie will mixe them yea in due waight not onelie these but a thousand other medicines which bée not hurtfull to a hollow vlcer for if they hurt not with the same faculties but as it were with their contraries trulie they are vnlike and immoderate to fill an hollowe vlcer notwithstanding like as of too immoderate temperatures there shall bée one made temperate that wée haue set out in the waie of compounding medicines therefore it is not hard to make a medicine of oyle waxe and Aerugo that shall make flesh for if thou doest know that the same vlcer is moderatlie to be dried and doest not vnderstand the wax or oyle doth not drie neither that anie of them or both mixt together can fill a hollow vlcer nor that Aerugo alone can moderatlie drie therefore if thou doest mixe all these together thou maist make a medicine which shall moderatlie drie what the quantitie or proportion of euerie one of them should be that I haue now set out in my bookes which be entituled the composition of medicines and nowe also if it be néedfull it shall be declared in talke héereafter But first we must driue from these our bookes following this Thessalus but first declaring vnto him howe much hée hath erred frō a truth for vnto anie that is wise that which is now spoken doth sufficientlie shew what the methode of curing ought to be but with these we néed not talke Therfore it is necessarie that we dispute yet with those taking héere our beginning Euerie hollownesse that is against nature doth require to be filled wherefore also that which commeth in the fleshy part and that filling in the end of finding out remedies which we desire And that thou maist finde those remedies which doe fill thou hast néede of much reason and manifold indication and exact reasonable and perticular method for thou hast often séene vlcers harde to cure not to be cured neither of those which professe experience I meane those which abound in remedies neither of those which claiming reason to themselues for these Thessalians whō they name Methodicians being indeede most farre from a methode as the Asse to the Harp be vnméete to heare this speculation much lesse cure they find out by reason that which is right Thou hast seene many times in the like vlcers the Emperikes to goe from one medicine to another when truelie no reason did shewe them the waie because they haue tried manye thinges which may fill a hollowe vlcer the same as they call it Idiosyncrasian that is properties of bodies in which euerie of them are séene to haue force neyther can they discerne neyther yet remember Therefore now also not knowing whether to goe but trusting in the proofe of many perticulars whatsoeuer they finde by the waie that may profit they goe from one to another following Fortune rather than Reason which may help in the inuention of remedies like vnto these although they will not
or all is not séene or séene also of the generation for that is all cut or all broken or part cut and parte broken and if thou wilt perceiue the differences of the place in which the vlcer is as in the end of a muscle or beginning of a muscle or middest of a muscle or that the skinne is vlcerate or that the vlcer be in the liuer or bellie they be forsooth differences of vlcers not taken of the proper nature of them but of the places in which they are but when anie saith the vlcer is not infected with inflamation or pressed with supercrescent flesh or hollow and thinketh that they be like those which lately I rehearsed he must of force be deceiued in the curatiue method for in Gréeke Phlegmon Elcos by the forme of speech hath the like figure of interpretation with a little vlcer but yet that which is meant thereby is not alike for déepe and hollowe when we speak of an vlcer we shew these proper differences but Phlegmon is not at all the difference when as the part may be infected with inflamation yea whereas there is no vlcer so that I thinke it lawfull to chaunge the forme of spéech if thou wilt saie an vlcer with inflamation to haue come to anie man thou shalt goe néerer than to the nature of the thing and shalt interpret it more cléerely but not if thou shalt saie some with bignesse and some with littlenesse to be made for thou maist speake more euidentlie and after the nature of the thing if thou shalt saie he had a great vlcer and a little so that if it maye be done that the forme of spéech be chaunged both more conuenient to the nature of the thing and more manifest to the hearers we shall not leaue of whereby it may lesse be done for the waie to flie deceit in things is that to vse defined spéech therefore what methode may we appoint in such there is to be noted a certain precept and as it were a scope wherby the diligent may easilie discerne by and by whether anie speaketh of the difference of anie affect of the ioyning of another affect Therefore let this be to thée a difference that which may seuerallie and by it selfe stand that shall neuer be difference of anie other affect therefore magnitudge littlenes equalitie inequalitie time and figure be of the number of those which happen to other but an vlcer inflamation Gangrena and corruption maye stande seuerallie and by themselues There are certaine affects of our bodies against nature as chance necessarily to affects for vnto al these it followeth necessarily that they be either little or great or equall or inequall or new or olde or they appeare euidently or they are hid not séene To be infected with inflamation is not of the sort which happen to an vlcer as neither to begin to putrifie or infected with Gangrena all those be in the number of diseases for they are affects against nature corrupteth the action Againe there are other as it were differences of vlcers spoken of as a tormenting vlcer a filthie vlcer But héere also is some compound shewed but after another sort than was spokē of an vlcer infested with inflamation or a rotten vlcer for héere inflamation and putrefaction be affects their dolour filthinesse be of the kind of accidents in like condition whē we saie Cachochimō vlcus that is an vlcer infested with ill iuyce or an vlcer vexed with sluxe or corosion the cause is coupled with the affect And hereby it is manifest that the first simple imfirmities void of cōposition be as it were the elements of the curatiue method which is now instituted Wherefore the rather I haue numbred all such infirmities in our cōmentaries of the differences of infirmities Trulie all is one whether thou call thē the first or simple when that which is first is simple that which is simple is first therfore elementarie There is an indication taken of the differences although not of all for a new or olde vlcer sheweth nothing although some thinke contrarie but these deceiue themselues not otherwise than in the order of diet where they affirme that there is one indication in the beginning another in the augmentation another in the vigor another in the declination of which seeing héereafter I shal more largely intreate ther is no cause why héere I should make more words yet for all this I wil here ad the shal serue the time present They think that a new vlcer whē as it is frée frō anie other affect hath no accident ioyned with it doth shew another curation than an old vlcer But that is not so for in that it is onelie an vlcer and no other thing it is such a one as hath no hollownesse or dolour or filth and is free from euerie other affect doth onelie require the cure of an vlcer whose end set by vs is either vnition or adglutination or coition or continuation For I haue a thousand times said that thou maist cal it as thou pleasest so that the thing it selfe be not chaunged therefore this kinde of vlcer whether it be new or olde requireth alwaie the same curation That difference which is taken of the time sheweth nothing proper at all But if the vlcer hath hollownesse déeplie hid vnder the skinne it behoueth to consider whether it be in the higher part that the matter may readilie flow out or in the lower part so that it is there stayed The cure of that vlcer where ther is no fluxe is like the cure of other But it behoueth that we make certaine issuing out where there is none and that is two waies either the hollownesse being cut in the pendent place onelie opened both the nature of the partes and also the bignesse of the vlcer shal shew when as either of them must be done for if the places themselues make the cutting dangerous and the vlcer shall be great it is more conuenient to open in the pendent place but otherwise it is better to make incision and wheras there is an issue let the rolling be begun aboue and end beneath We haue héeretofore spoken that the difference of vlcers which is taken of all the wounded partes is verie necessarie to shew the cure but the indication was of similer this which I now speake of is as it were of instrumentall trulie we will in the bookes following speake more largelie of that indication which is as it were of similer bodies or as of instrumental Now we must goe to the proper differences of vlcers and define of it whether it be ouerthwart or right or déep or shalow or little or else great Vlcers made ouerthwart for that their lips do gape more and are asunder do require to be more diligently ioyned therefore we must vse both stitching and hookes Those that are made in the length of the muscle if thou bind it with a roller of two
happen to the vlcerate partes as wel by the occasion of anie perticular member as of all the bodie wherevnto the bloud or anie ill humours doe resort first remedie must be had either to the particle that is cause of the fluxe or else to the whole bodie Thus then we shall cure first the varices that are often resorting vnto the vlcered place before you cure the vlcer and then afterward you may the easilier cure the vlcer Likewise in them that haue a disease in the splene or in anie other notable part first it behoueth to cure the sayd parte and then after to procéede to the curation of the vlcer howbeit none of the curations héereof is proper to the vlcer but some other affects or dispositions that either engendereth the vlcer or that nourisheth and conserueth it The third Chapter BVt now I thinke it time to define that there is no indicatiō of outward or as they terme it of primitiue causes of curation but the indication or curation to haue his beginning of the affects it selfe But those thinges that ought to be done perticularlie are found out either of that which the indication sheweth either of the nature of the affected part or of the temperature of the aire or other like things but to speake brieflie no indication may be taken of things that be not yet come But forasmuch as we ought to know the affect that is not manifest vnto vs by reason or wit we are often constrained to enquire of the extreme and primitiue cause For this occasion the vulgar people supposeth that the saide primitiue cause is Indication of curation which is altogether otherwise As it appeareth likewise in those where the affect may be exactlie knowen For if Ecchymosis or an Vlcer or Erisipelas or putrefaction or Phlegmon bée in anie parte it is a superfluous thing to enquire the efficient cause of these diseases except they be remaining For in so doing we shall cure that thing which is alreadie finished and shall prohibite the efficient cause to procéed anie further But if the said efficient cause which produced the effect hath no longer biding there then we shall remooue awaie the affect For to put awaie the cause that is not there it were impossible For curation appertaineth to the thing present as prouidence to the thing to come For that thing which doth not now hurt neither is to be feared that it will hurt héereafter is out from both the offices of the arte that is to saie from curation and prouidence Wherefore in such thinges there ought to bée no searching of anie indication neither yet to cure nor to prouide as is sayd before notwithstanding the knowledge of the primitiue cause is profitable to vs in things vnknowen Neuerthelesse the Emperikes take sometime the primitiue cause as parte of the course of the disease that the Gréekes call Sindrome wherein they haue obserued and experimented the curation as in that that hath bene hurt with a mad dog or venimous beasts Thus doth also some Dogmatists which doth affirme to cure such diseases by experience onelie without rationall Indication for they take the cause primitiue as part of all the Syndrome and vniuersall course but the primitiue cause serueth nothing to the indication of curing although it be profitable to knowe of the nature of the disease to them that haue not knowen the nature of venimous beasts by vse and experience and thereof taketh indication curatiue trulie the outward cause of curation béeing knowen doth nothing profite to the indication but to the knowledge of the present affect For put we the case that we knowe that the venime of a Scorpion is of a colde nature and for that cause as of a colde thing I take Indication for the remedye howbeit the case is suth that I haue no signe whereby I doe vnderstand that the bodie is hurt of a Scorpion it is manifest that if I doe knowe that the bodie is hurt of a Scorpion that then I would inforce me to warme all the whole bodie and also the part affected without abiding for anie experience in taking mine indication of the nature of the thing We haue declared in the booke of Medicaments wherein it behoueth them to be exercised that will take anie profit of these present Commentaries no such facultie can be foūd without experience Truelie it should be a gifte of felicitie if anie hauing the sight of Litargerium Castoreum or Cantarides forthwith to vnderstand their vertues For like as in all things is committed error as well by those that excéede as by those that lacke so héere as the Prouerbe is among the Gréekes this Thiapauson that is to saie they differ among themselues Also they affirme that the vertue of medicines is not yet knowen and that after so great experience the other that suppose and saie that the saide vertues be knowen onelie by experience The first speaketh vndiscréetlie if that be a thing imprudent to affirme a thing impossible the other be altogether stupidious sturdie and foolish But for this present time we will saie no more because I haue spoken more plainlie in the third booke of Temperamēts also in the bookes of Medicaments Neuerthelesse for the knowledge of diseases some primitiue causes are profitable but after that the present disease is altogether knowen then the cause primitiue is totallie vnprofitable Now we haue declared that it doeth not become vs to meddle and confound both the doctrines together but the Emperikes ought to be spoken by themselues and the rationals by themselues We must now call to mind because we haue purposed in this present Commentarie to intreate of the doctrine Rationall although to some things that we do saie we doe not adde absolutelie that all be not true but onlie after the sentence of the methodicall sort but that euery man ought to adde and reason that thing by himselfe And at this time we haue said that there is no cause primitiue which is profitable to the Indication curatiue although it serueth well to the knowledge of the disease And we confesse that the cause primitiue is part of the Syndrome and of all the Emperikes course that they cure all diseases by reason by experience But in all that we shall saie héereafafter it is not necessarie to adde such words Then let vs returne to our first purpose in taking the principall indication certaine and vndoubtfull whereof we haue also vsed héere before as we haue said that the disease that requireth to be cured iudgeth the end whervnto the Surgion ought to intend and of the same all other indications are taken Wherefore we haue begun to speake that the said indication hath no manner of affinitie with the cause primitiue for put we the case that anie vlcer be come of a fluxe in anie part then it is manifest that the sayde vlcer procéedeth of corrupt humours for nature is accustomed so for to doe in diseases when she purgeth the bodie
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
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
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
Hyppocrates bookes but for that he séemeth to mée first to vse a conuenient waie and yet not wholie to haue finished it when as certaine things are not yet limited and wée maye finde other which are setre forth of him obscurelie and vnperfect therefore I haue studied to open all those things cléerelie and to make distinction where they were smallie diuided to supplie where as wanted Therefore whereas anie hath first of all exercised himselfe in these our Commentaries let him applie himselfe to the reading of Hyppocrates Bookes and let him both reade his booke of Vlcers and also that which he wrote of mortall Woundes then truelie hée shall receiue great helpe of these our Bookes and also shall vnderstand that none of the Mothoditian sect which challengeth to himselfe this glorious Title but in verie déede bée furthest from a methode can rightlie cure an vlcer or wound and also that none of the Emperikes which thinke to exercise the arte little knowing the Elements or temperamentes of the similer partes of man for these knowe not the rationall cure of the similer partes of man because they onelie take their Indications of the organike members wherfore a few wordes hetherto vttered against these Methoditians of those woundes which happen in the Stomacke we will conuert our stile to other thinges Peritoneum béeing wounded Omentum doeth presentlie fall out which whether it bée similer or no or of which it is made or what action or vse it hath they doe not vnderstande therefore it is woorth the trauaile to heare what they will doe whereas that parte which is fallen out of his place being swart and blacke whether will they cut it off or put it againe within Peritoneum Surelie either they shall vnderstand all together by Experience what is to be done or else take Indication of the nature of the parte but both these flyeth from them both that knowledge which is ministred by Experience while they extoll a methode béeing the reuerend name of their sect and that which is taken of the nature of the part for that they knowe not his substaunce nor action nor vse of it while they abhorre the Anatomie as a thing vnprofitable therefore they know not whether it bée anie of the partes necessarie to lyfe or else not necessarie although these are not the least to bée knowen neither whether through the affect of it anie of the principle members shall be molested or otherwise also whether anie of the vessells or partes within it contayned maye kill the man by fluxe of bloud neyther whether that which is blacke béeing cut awaie that which is sound may bée tied whereby the fluxe of bloud maye bée eschued or whether that may bée to anie daungerous for that Omentum euen at the first sight séemeth neruous so that one knowe the nature of it perfectlie hée durst not for feare of conuulsion binde it but since these wonderfull Methoditians knowe not of these thinges they cannot tell what is to be done when as Omentum is waxed blacke but I thinke wée knowe which vnderstand that the vse of it is not so great for man and that his substance is composed of the thin pannicles arteries and veines we will eschue the fluxe of bloud and will not feare by consent that the nerues shall bée affected wherefore we will binde the parte that is aboue the blacke and cut that awaie that is vnder the band and will foresee that the endes of the band hang in the lower end of the stitching of Abdomen whereby wée may easilie take them forth when as they are throwen from the wound comming to suppuration The fift Chapter AND hetherto it is abundauntlie spoken of the other partes of the bodie nowe therefore there remaineth to speake of the bones when as to these also that disease of which wée intreate doth happen which wée call solution of vnitie or continuitie when as this disease falleth to this part it hath a proper name giuen to it in Gréeke Catagma verie vsuall to them that can speake Gréeke for Apagma is the proper name vsed of Phisitions béeing out of vse to the common people they vse thus to name it when as the end of the bone in the part where it is to be ioyned with another that is broken but of the fractures themselues what part so euer of the broken bene are vtterlie separated they saie in Gréeke that they are named Caulethon it is euident that such diuision is ouerthwart and another diuision made more by the length in which the partes of the affected bone bée not altogether separated asunder but are clouen right forth which kinde they accustomablie do cal Schiducedon There want not some of the later phisitions which so ambitiouslie interprete by proper names all the differences of fractures that they call some Raphanidon that is made to the figure of a Raddish not béeing satisfied with this talke to saie that the bone is diuerslie fractured but Hyppocrates was not of this minde but as néere as hée coulde vsing the most accustomed names refusing not to interpreate by Oration not onelie these differences of Fractures but also those which happen in the bones of the head which if I hadde done also in euerie affect I shoulde haue made this Treatise short Now for that hée hath shewed the waie of manie which must bée considered but haue not begunne or defined what is perticularlie to be done it is necessarie that we tarrie in thē no longer than is méete but repeate brieflie those which he hath set forth perfectlie And we will also adde demonstration to those which he hath smallie defended by reason and wée will define certaine things which are left vndefined and place them in order which want order last of all we wil giue light to these things which are obscure But if I shall in euerie one adde his wordes our booke shall be as long as a large Commentarie And peraduenture some héere will condempne our Prolixitie when as they shall complayne thereof without cause In the thirde and seauenth Booke in these it was necessarie to adde manye places out of Hyppocrates booke De vulneribus wherby I might shew other Phisitions what it is to write by a certaine methode the curation of vlcers and woundes but his doctrine set out in his booke of Fractures who is so dull that will not receiue it all as cleere most profitable but if anie man doth saie that he doth a little meruaile thereat To this manner of saying may most aptlie be repeated Hos vnum atque alterum permit to be sure Therefore it séemeth good time now to shew the true method of curing a Fracture with the nature of the things prescribed taking our beginning from hence because there is solution of Continuitie of the partes of the broken bone their vnition is at the fore first scope whereto hée must bend him that will cure them but if this séeme impossible to bée done because of the drynesse
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