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
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
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
fewe woordes I haue proued here bothe by reason and by experience that the knowledge of this part named Phisiologia doeth chiefely and specially apertein to the arte of Chirurgerie and without the knowledge hereof we shal neuer rightly or methodically cure any maner of woūd griefe or disease neither is he worthie to take the name of a Phisition neither yet of a Chirurgion but to be called by the name of an Emprike or experimenter curing onely by chaunce without any reason but euen as the blinde Carpenter which Galen hath spoken of before sometime cutting to much and some time to little and many times marring all his woorke for want of skill ere that he beware Now to conclude for this first part he that will be further instructed herein let him reade Hip. de natura hominis humoribus elamentis de natura formatione fetus many other bookes of Hyppocrates and chiefelie that where he diuided the similer parts As Osteotome that is to saie the diuision of the bones Condrotome the Cartalages Syndestmotome the ligaments Arteriotome the Arteries Phlebotomae veines Neurotome the nerues Miotome diuiding of the Muscles Tenontotome the tendons c. There be diuers other bookes of Galen which be verie profitable to be read for this matter as his bookes of Anathomie also his bookes De temperamentis de optima corporis constitutione de facultatibus naturalibus de placitis Hippocrates Platonis de motu musculorum de causis respirationis and manie more worthie bookes of his which we will let passe There bée manie other bookes also written by diuerse men as Guido and other which doe intreate of these naturall things and speciallie of the Anatomie of mans bodie and for that you may the easilier better vnderstand these naturall things which euerie Chirurgion ought to know and haue in perfect memorie to that end he may remoue those things which doth hurt them or let them of their perfect operation which you may easilie knowe if you vnderstand their natures and properties figures c. Which Table followes héereafter as you may heholde Naturall things Eelements be foure Fire Aire Water Earth Temperaments Simple be foure Hot. Colde Moist and Drie Equall one Cōpound be foure Hot and Drie Hot and moist Colde and moist Colde and drie Foure humours Sanguine Flegmatike Cholerike and Melancholie Members Similer Bones veines arteries cartilage flesh fatnesse pannicle ligament nerues and skinne cōpound Head heart liuer lungs armes and legges Three faculties Animall Vitall and Naturall Operations or actions Animall Feeling and moouing Vitall Beating of the pulse And breathing Naturall Generatio Auctio and Nutritio Spirites be three in nūber Animall Vitall Naturall In The braine The Heart The Liuer Pathologia is that part of the arte which hath the knowledge of sicknesse against nature with their Symptoma and accident and they be thrée in number that is to saie sicknesse it selfe the cause of sicknesse and the accidents which followeth after sicknesse sicknesse it selfe may come two waies either of outward causes or of inward causes we do commonlie call the outward causes primatiue the Gréekes call them Cathertica the inward causes we do cōmonlie name Antecedent or Internam The affectes commonlie followe these causes and if the affectes come of outward causes then commonlie they be wounds contusions fractures dislocations biting of mad dogs of serpents c. If they come of inward causes then they make tumors against nature as Phlegmō Eresipula Oedema Sirrhus with many kinde of malignant and stubburne vlcers to be cured which tumours and vlcers cannot be made whole except their causes with their euill affects may be remoued and taken awaie I suppose that there is no man but hée will iudge this part of the art chieflie to pertaine to Chyrurgerie for that it taketh cure of wounds vlcers and tumors against nature as I haue said before Then if this part doe appertaine to the art of Chyrurgerie as it is most certaine it doeth it behoueth the Chyrurgion perfectlie and rightlie to vnderstand what kinde of sicknesses there be with their differences names what partes of the bodie these sicknesses may be in and what manner of sicknesse it maketh in the same partes As for example euill complection maketh a distemperature in the similer parts euil constitution or euil cōposition maketh a deformitie or imbecilitie in the instrumentall partes And solution of vnitie or continuitie chaunceth both in the similer partes and instrumentall And all these doe appertaine to the Chirurgion to haue most exact knowledge of for he that taketh vpon him to cure an vlcer or a wound or anie other manner of griefe and doth not know the nature of the parts neither yet what part it is in neither yet the cause neither how to remooue the same cause it is vnpossible as I haue sayde before that he shoulde cure the same griefes or diseases rightlie And therefore these blinde emperikes that haue neither reason nor method to leade them to doe those things which they dailie doe I saie their dooings are so pernitious that many people taketh great hurt thereby shall I saie hurte nay rather brought to vtter destruction and many times to death The Symptoma or accidents which followeth sicknesse is also diuided into thrée partes The first is the qualitie being altered as with vehement heate in Phlegmon The action or function hurt but not vtterlie depriued The action vtterlie depriued and taken awaie For these causes aboue rehearsed it is speciallie required that a Chirurgion shoulde be learned and also to haue greate experience that hée maye rightlie iudge and discerne one disease from another with their natures and causes to the end that when you come to the curation thereof you may take right indications what to do first what next and so foorth to the end for other waies you may applie medicines nothing fit for the purpose but those that might doe great harme and you might also applie those first that would be applied last and those last which should be applyed first and in the end marre all your workes as the blinde Carpenter doth Thus farre I haue proued for Phisiologia to be one part of Chyrurgerie or of the Art of curing as we may tearme it and I thinke there is no man that will count him to be a right Chyrurgion that lacketh this part of the Arte or that is not verie expert in the same And for the further knowledge héereof there be certaine bookes appointed of Galen and other auncient writers that you may reade concerning the same part as hereafter followeth Libro Hippocrates de Morbis libro Epedimsorum Hippocrates Galen de locis affectis Galen de Morbis Symptomatis de 4. temporibus morborum Galen de differentijs morborum causis Smptomatis Galen de inequali intemperie Galen de arte Medica Galen de tumoribus praeter naturam Hippocrates de Vulneribus vlceribus Fistulis fracturis immorodibus c. And also
Galen in his whole Worke called Therapeuticon and in another worke to his Disciple Glaucon as it is manifest to be séene These two most excellent men béeing the patrones and fathers of the arte haue written most excellentlie and perfectlie of many diseases as woundes tumours against naturne vlcers and many other diseases appertaining to the same art as it maye more manifestly appeare in these bookes aboue rehearsed and in manie other more of their workes If I shoulde write of all men that accounteth this a proper and a principall parte of Chyrurgerie then I must néeds confesse the truth all men learned in this art since the time of Galen haue so written and so taken it Thus I conclude for this parte that hée that vnderstandeth it not ye must giue him a baser name ye may not call him a Chirurgion that neither knoweth the principles of his arte neither yet the nature of his subiect that he worketh vpon I remember when I was in the warres at Mutterell in the time of that most famous Prince King Henrie the viii there was a great rablement there that tooke vpon them to be Chirurgions some were sowe gelders some horse gelders with Tinkers and Coblers This noble sect did such great cures that they got to themselues a perpetual name for like as Thesalus sect were call Thessalions so was this noble rable for their notorious cures called Dogge léeches for in two dressings they did commonlie make their cures whole and sound for euer so that they neither felt heate nor cold nor yet no maner of paine after but when the Duke of Norfolke who was then general vnderstood how the people did die and that of smal wounds he sent for me and certaine other Chirurgions commaunding vs to make search how these men came to their death whether it were by the grieuousnesse of their woundes or by the lacke of knowledge of the Chyrurgions and we according to our commaundement made search throughout all the camp found many of the same good fellowes which tooke vppon them the names of Chirurgions not onelie the names but the wages also we asking of them whether they were Chyrurgions or no they sayde they were we demaunded with whom they were brought vp and they with shamelesse faces would aunswere either with one cunning man or another which was dead Then we demaunded of them what Chyrurgerie stuffe they had to cure men withall and they wold shew vs a pot or a boxe which they had in a budget wherein was such trumperie as they did vse to grease horse héeles withall and layed vpon scabbed horse backes with neruall and such like And other that were Coblers and Tinkers they vsed shoomakers waxe with the rust of olde pans made therewithall a noble salue as they did terme it But in the end this worthy rablement was committed to the Marsialsie and threatned by the Dukes grace to be hanged for their worthie déeds except they would declare the truth what they were and of what occupations and in the end they did confesse as I haue declared to you before wherevppon the Dukes grace gaue commaundement that they should auoide the Campe in paine of death and if at anie time they came within the Campe afterward they should immediatlie be hanged as murtherers his Grace calling them by the name of Dogge léeches commaunding his Captaines that they should entertaine no more such Thus you vnderstand by what name those men were then called which tooke vpon them vnworthilie to vse this Arte knowing neither the principles of this arte neither yet the nature of the diseases nor yet the medicamentes wherewithall they could cure the same diseases Thus we conclude with these examples before that it is necessarie for a Chirurgion to know these partes or else not to be admitted to so worthie an Arte which doeth take charge not onelie of mans health but also of their liues and lims And thus we end this part Eugiena is the third parte pertaining to the art of Chyrurgerie or Medicine as we haue sayde before This part doth consist in the sixe things not naturall called Res non naturalis which followeth Sixe things not naturall In receiuing of the aire In Meate and Drinke In sleeping and waking In mouing and rest In fulnesse and emptinesse And in affections of the minde This is also a speciall and a necessarie part to be knowen of the Chirurgion for without this knowledge he cannot giue conuenient diet neither yet conuenient order for the gouernment of the diseased and sicke Patient nor yet at what time he shoulde sléepe at what time he should eate and drinke or what manner of meates and drinkes hée should haue and whether they shoulde bée liquide in substaunce or grose and thicke neither shall he knowe whether the same meate and drinke maye augment the disease or not by meanes whereof he may giue such diet to his patients as may confirme their diseases As for example in Elephantiasis and Cancers which by eating of melancholike meates or such meate and drinke as doth make adustion of the bloud which doth confirme them There might be many more thinges saide of meate and drinke which is not materiall to be spoken héere for I thinke no man doubteth but that this instrument doth chieflie appertaine vnto this Arte for it is not possible for a Chirurgion to cure his grieued patient except he giue conuenient diet with conuenient diet many greate grieuous wounds and manie other cruell sicknesses by the helpe of other conuenient medicines haue bene cured And as for the gouernment by the aire euerie man that hath anie knowledge will confesse that colde sicknesses which are taken by cold are to be cured in places where the aire is warme or else it ought to be made warme by art according to the time of the yeare for it is one of the principles and speciall rules which Galen commaundeth vs to kéepe that we shall cure euerie thing by his contrarie as heate by colde colde diseases by hot thinges drinesse by moisture and moisture with those thinges that bée drie fulnesse by abstinence and euacuation by emptinesse by things of good nourishment to fill withall watching by thinges that mooueth sléepe ouer much sléepe by kéeping of them waking Thus euerie thing is ouercommed and holpen by his contrarie by meanes whereof the Chirurgion doth more safelie and readilie restore to health his grieued wounded patieut without which thinges and their right vse could not be done And therefore this part is called a most necessarie and principall thing appertaining to the Artist There is another vtilitie in this part also which the Chirurgion of necessitie must vse for Galen saith that euerie Artist that will rightlie cure must intend two thinges The first is to conserue and kéepe euerie thing that is in good state by his like The second is to expell and cure those things that bée contrary to nature by their contraries which we cannot do without
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
and sendeth all the corruption to the skinne in such sort that the skin is vlcerate and all the bodie purged What is then the curation of such vlcers certainlie as of other vlcers wherein no corrupt affect or disposition is which the Gréekes call Cacoethae But if it be so it is euident that no indication is to be taken of the cause which hath excised the vlcer but if the vicious humour remaine some indication might then be taken of the saide cause for otherwise it should be an absurde thing that that which is no more remaining shuld require curation or if he shuld shew curation where there is no néede Wherfore it is a strange thing and wholie against reason to saie that the indication curatiue ought to be taken of the cause primitiue And for because that the said Indication is not taken of the same cause it is euident that it must be taken of the cause present But what is such an Indication forsooth if a man will properlie define it it is a thing which appertaineth to prouidence which the Gréekes call Prophalacticae but if anie will abuse the word it is called Therapeutica But for as much as of the vlcers themselues certaine be simple and certaine be hollow if a man will diligentlie marke and consider the curation of them is brought to passe in eschuing and foreséeing those things which bée hurtfull vnto nature And when we woulde bring anie thing to good successe wee had néede of Natures helpe as in closing of an Vlcer and regeneration of flesh in the which things the chiefest care and regard appertaineth vnto that part of the arte which is called Prouidence but it is called vulgarly healing And therefore this part of the art that is named Prouidence is diuided into two kindes The one is that which doth remoue awaie the disease present the other which withstandeth the disease that it maye not come to his fulnesse Therefore the younger Phisitions héere doe not vnderstand that their disputation and contention consisteth onely in names wherfore if they were studious in things they should finde out that there were two differences of the functions and actions of medicine that is to saie the disease alreadie come or to withstand those that are not yet present Then there is no man but he wil confesse that to cure or to heale is no other thing but to take awaie the disease that is present whether it be done awaie by the worke of nature or by medicines but prouidence is a thing that letteth the disease that hée may not come truelie they which doe cure the ill humours which come to the vlcer doe minister the art of medicine by reason and methode in purging and taking awaie those things which doe hinder the course of Nature And these two manners of curing are properlie called in Gréeke Prophilactica for they let as it was sayde before that the filthie mattier engendereth not in the vlcer neither yet ouermuch moisture which may hinder the curation The fourth Chapter IT is but in vaine truelie thus carefullie to striue about the name but it is more conuenient in my iudgement to giue some good method to cure the vlcers such as I haue spoken of as wel in the booke going before as in this But I doe much meruaile at the dulnesse of Thessalus writing thus of the curation of vlcers the which are called Cacoethae The communities of vlcers that continue long time and that are vncurable or els returne againe after the matter induced be verie necessarie in likewise as in vlcers that may not grow together be closed it must be considered what is the cause that letteth and procureth the saide growing together the which cause ought to be taken awaie But in them that renue the ciccatrise againe it behoueth to kéep the same ciccatrise that is to saie in strength for so we haue translated To metafuicrinen and in comforting the suffering member or all the bodie in common and in ordering it that it endure not lightly by the remedies appropriate therto And when Thessalus had propounded such wordes in the beginning of his booke of Surgerie he writeth afterward more plainelie of this matter The vlcers that endure long and may not be healed or that renue and come after the ciccatrise giue such indications that is to saie if they come not to ciccatrise it behoueth you to let the vnion and comming together to renue the vlcerate place againe And after that you haue made it like vnto a fresh wound it must be healed as a bléeding wound But if the said cure profit nothing you ought to mittigate the inflamation make as much diligence as you can But the vlcers that come to a ciccatrise and open againe in their accessions exulcerations you ought to cure them like vnto thē where there is a fresh inflamation afterward you ought to applie vpon the said vlcer a plaister of mittigatiue things vntill the ire and fearcenesse be abated after this is done you ought to dresse the ciccatrise and then make the parts about it waxe red in wrapping it about with a Malagma made of mustard séed or with some other medicament that may change the said parts make them lesse subiect to diseases And if they cease not with these things you ought to haue cure of all the body in strengthening it with diuerse exercitations gestings and vociferations in commanding thē that kéepe him to such things as these be That is to saie in manner of liuing by diminishing or augmenting by degrées in beginning vomiting made by Raphanus You shall also vse white Eliber and all other thinges which we vse in diseases that be difficult to take awaie which are subiect to reason and manner of liuing This is the saying of Thessalus Now it is time to consider the stupiditie of the man I saie the stupiditie if he thinke he hath sayde well and the boldnesse of him culpable to saie nothing and by this meanes supposeth to deceiue the Readers But tell mée Thessalus what is the Indication curatiue that is taken of an olde Vlcer Trulie I neuer found out curation of the olde Vlcers nor of the newe not by time in what disease so euer it bée but of the affect that I purposed to cure But if we altogether regard time as if the Indication curatiue were taken of it the second daie we should giue an other indication than the third likewise to giue the fourth daie another then the fift and so of the sixt all other daies following For by this meanes we shall no more consider the affect of the disease that we goe about to cure and the Indication no more to bée taken of them whereby we coulde neuer thinke of a straunger reason howe then are the communities of vlcers necessarie that continue a greate while seeing that the time it selfe can indicate nothing at all For when an Vlcer is with erosion that commeth of all humours we
many wayes friuolous and foolish For our bodies doe not consist of little bodies called Atomes and of little passages or pores but if this were true it should not be possible to shewe in what maner musterd might change or alter the state of the same pores if any of them should shew the truth yet we would not agrée vnto their sect because they promisse that they wil be content with their apparent communities therefore lette them not vse these names neither let them hinder vs no more in our matters For it is lawfull without the name Metasincrisis to say in other wordes the curation of inueterate vlcers as the Emperickes doe Also we haue declared in the second booke how they talke of this woord Atonias that is to say imbecilitie yet know not what it meaneth For if they vse this name as the Emperickes do then it should signifie nothing else but that the actions are not kept for if they say that certaine faculties doe gouerne liuing creatures which we all the auncient writers doe affirme but yet notwithstāding they repugne against the precepts of Asclepiades also they propound vncertaine things to the which the authors doe not agrée they touch the truth a little yet they commaund to eschew it But tell me true Thessalus what meaneth this worde Metasincrisis if thou saie that it betokeneth to change the pores thou art deceiued and supposest vncertaine thinges But if thou saist that it is a great matter to cure the particle grieued of the bodie as the man thou saist no more thā the Emperikes except the name For they doe knowe that men are made whole by medicines but they know not the cause or reason by what meanes the remedies restoreth health For none of the Emperikes can tell if the facultie of the medicaments chaungeth the pores or if it maketh a Simitrie or if it altereth the qualitie of the Patients particle that is grieued Howbeit the Emperikes are discréete men if they saie that they know onelie one thing that is to saie if they haue noted and obserued the times how vtilitie hath followed when the medicament of mustard hath ben ministred to such vlcers and in what time Neuerthelesse they speake not of method neither yet repugne against it neither be displeased with the notise thereof nor dispraise the ancient writers neither Hyppocrates but rather praise him and affirme that he hath said all thinges well But Thessalus doth not onlie despise Hyppocrates but all the other auncient Phisitions neither doth he vnderstand that he hath written all the precepts of rebellious vlcers without reason emperiklie For if he had written them well then it should haue bene counted a worke most profitable But it appeareth not that he hath done so séeing that he peruerteth the right order of remedies and vseth his remedies to the grieued part before he hath prepared the bodie For this is an argument of great ignorance séeing that almost it is a principle in Chirurgerie that all the bodie must be purged of the euill excrementes before anie strong medicine be applyed vnto the affected parte For who is he that will iudge either by reason or experience for there is no other third thing to iudge by in what art so euer it be nor in anie part of life he shal finde that it is agréeable to reason for a man to minister strong hot medicines to anie particle of the bodie before he hath purged the bodie of all anoiance prepared the same to health for the said medicine draweth the excrements and superfluities from all the bodie like as boxing or Ventosis doth it doth so fasten to the affected part that it may be scarcelie remoued Therefore it must be asked of these Thessalions frō whence this opinion cōmeth to Thessalus to write fables as cōcerning the curatiō of rebellious vlcers séeing that none of the Emperiks nor yet Rationals haue written so before this time For neither Thessalus himselfe neither anie other of his sect dare affirme that the order of such remedies either doth agrée with experience or reason For neither can they giue Indication of time neither yet of the affect of the disease Yet for all that Thessalus is not all together ignorant because he iudgeth that the cause the hindereth the ciccatrise must be considered and taken awaie because also that he iudgeth that this must be done not onelie in vlcers but also in all other diseases as the ancient writers do admonish But they answere nothing to the purpose for they saie alwaies that we do not vnderstand them as if they knew perfectly the thought of Hyppocrates and of all the ancients And they affirme the Thessalus hath a good opinion when he saith that there is a communitie of inueterate vlcers that Hyppocrates vnderstood it so in his booke of Vlcers which writeth in this maner It is profitable that the bloud doe flowe continually from the inueterate vlcer when so euer it séemeth néedfull It were not farre from my purpose if I should speak of the iudgement and opinion of Hyppocrates though I haue not promised that I would so do in this place But that which I will saie shall be of the interpretation of the wit knowledge of the auncient Phisitions the which truelie as yet haue giuen no sect but studying with simple pure minde to inuent some thing profitable to mans health It is well perceiued therfore that they haue found some thing by reason and some thing by vse and experience Then dyd they write their inuentions many times without giuing reason thereto and sometime they did and if they did giue anie reason it was to profit the readers For if they intended to be profitable to their successors and when as they knew reason of inuēting things then diligentlie they set it forth and where they thought it obscure they thought it superfluous to rehearse and therefore let it passe Now it is well knowen vnto all men though I hold my peace that the ancients haue loued no verbositie For that cause afore recited not only Hippocrates but also all the other ancient Phisitions sometime not making mention of the middlemost speaketh of the third thing For if the first be a signe of the second the third of necessitie must followe after the second And thus oftentimes omitting the first and second they spake of the third I haue oftentimes declared how the ancients and chieflie Hyppocrates haue written after this manner But he that will know and perfectlie vnderstand the maner of curing ought to be exercised in their stile and manner of interpreting For this I will intreate of that which I haue purposed The fift Chapter FOr those Vlcers which after medicines to them ministred be not cured those the Phisitions cal in Gréeke Cachoethae but we cal them maligne and rebellious to cure But we haue spoken in the booke aforesaid what the curation of vlcers is Therefore in these kindes of vlcers that be
maligne we may vse these names indifferentlie that is to saie we call them Cachoethae inueterate or Diuturnus In like manner the affect of the disease called Cachoethae that is to saie stubburne and rebellious to be cured that maketh some thing for our purpose to know neuerthelesse the saide diuturnitie of the saide vlcers because they come againe or be of long continuance waxe olde haue no conuenient indication of curing but that must hée considered because the vlcerate part is ill affected that ill affect béeing once knowen the cure is manifest But thou wilt aske how can this be done trulie if thou wilt heale the vlcerate part affected thou must first take awaie the abundance and corrupt vicious humors from all the bodie for in cleansing awaie the same the diuturnitie is taken awaie but the finding out which is profitable to vs commeth not first of the diuturnitie but of the ill disposition malignitie of the humour by meanes whereof these thrée things following must chiefly be considered that is the signe the affect and curation The signe is the diuturnitie or continuance of the vlcer the affect is the vicious humours repairing to the vlcer and the curation is the taking awaie of the saide humours By this meanes you shall finde that the auncient Phisitions manie times after the first made mention of the third leauing the middlemost as Hyppocrates did whē he said it is vtill to cause the bloud to flowe out often of inueterate vlcers But it is inutill that the indication curatiue should be taken of the diuturnitie of the vlcer but of the ill disposition of the bloud For a little after he saith thus the vice and euill bloud hindereth greatlie the cure of the said vlcers Also putrefaction of the bloud all things that commeth by transmutation of the bloud letteth also the curation of the sayd vlcers And afterward he speaketh of vlcers that come not to a cicatrise The vlcers trulie saith he may not be closed together if the lips and partes that are rounde about be swart or blacke with rotten bloud or Varises that causeth the fluxe if you cure not the sayd partes that bée about it they will not come together And afterward hée writeth of the cure of Varises and then maketh mention of the purging of all the bodie as well in woundes as in Vlcers where feare of daunger or putrefaction in Gréeke called Sphaselos doth remaine and besides in Vlcers called Herpes and Esthioninus that is to saie which doe erode and eate the skinne And thus Hyppocrates is wont to call those vlcers after this sorte wherein anie ill humour doth cause erosin And thus when he speaketh of them that ensueth he saith in such wordes In euerie Vlcer whereas chanceth Erisipelas all the bodie must be purged And finallie if you reade diligentlie the booke of vlcers you shall finde that he taketh Indication alwaies of the affect of the disease if he haue anie consideration of time it is onelie to knowe the affect And that it is so you may know it in the beginning of the said booke which concludeth thus You may not minister anie moist thing to Vlcers what vlcers so euer they be but wine Then sheweth hée the cause and saith Drie vlcers are néerest to health and moist the contrarie then after he saith it is an vlcer for that it is moist but if it be dry it is whole Therfore in all his cure in as much as he hath constituted the end of al the cure of vlcers to be drinesse it ought to be considered Then he findeth out the perticular thinges admonishing vs manie times of the same end writing in this manner Euerie wound that is diuided with a cutting Instrument receiueth medicines in the beginning that ought to be applied to rawe and bloudie wounds the which Medicamentes in Greeke is called Enaimon which is drying and letteth the wound to come to suppuration for it is more drier by the reason of the bloud which floweth out of it And agayne Hyppocrates sayth All vlcers that are well purged they come sooner to drynesse and ciccatrize but if anie superfluous flesh do grow it is by the reason of some contusion And againe he saith if that anie of the wound cannot consode together the moistnesse is the cause thereof In all these sayings Hyppocrates admonisheth vs of the first Indication curatiue of all Vlcers for of a truth the curation of an Vlcer for as much as it is an vlcer is moderate drynesse whereof the demonstration hath bene giuen in the booke going before For the curation of an vlcer that is coniunct with another affect whereof the cure ought to procéede is not like to a simple vlcer for the first curation of such a one as is coniunct with anie other affect shall begin first of the same affect and then at the vlcer For if there be either Phlegmon or swart coulour or Ecchymosis or Erysipilas or Oedema in the vlcerate part first you must begin the curation at one of the sayde affectes Neuerthelesse all men knowe well that sometimes these Vlcers are not well cured but are made greater for that the partes round about the Vlcer is affected either with Phlegmon either by brusing either with some other tumour which should haue ben first taken awaie before you had procéeded to the cure of the vlcer And for a certaintie it is not possible to heale the vlcer if the place where these be be not first cured And therefore Hyppocrates putteth vs in memorie of those things which he hath spoken of in the beginning of his booke and also of those things before especified and of those that be present he writeth thus Euerie wound that is diuided with a cutting Instrument or sharpe pointed receiueth Medicament called Enaemon and also a medicament desiccatiue that may let the filthie mattier But if the flesh be contused or cut with a blunt weapon remedie must be giuen in such wise that it come soone to suppuratiō For in so doing it shal be the lesse molested and grieued with Phlegmon And also it is necessarie that the putrified flesh which hath bene contused incised come first to suppuration and afterward new flesh to be engendered By these wordes Hyppocrates sheweth manifestlie that all the affects of the vlcerate partes ought to be desiccated except those where Pus will sodainelye bréede And so he going forward saith that Pus commeth through some putrefaction Furthermore that all putrefaction commeth through moistures and heate and therefore the Cataplasmes made of Barlie meale séeing that they are hot and moist we will minister it to all diseases where it is expedient to engender Pus for the Barlie meale with water and oyle and likewise bread with oyle or a fomentation of much hot water or the Malagma called Tetrapharmice and to conclude all things that moist and heat ingender Pus And if in the parts where Phlegmon is there ariseth pulsation in such wise that there is no
hope of the curation of the said parts without Pus or suppuration all the auncients trulie applie the said medicines and not before The which thinges Hyppocrates sheweth plainely in the wordes before rehearsed whereby he commaundeth to vse drie medicines to the wounded parts where there is contusion but they that be with contusion must be quicklie brought to suppuration Moreouer when he saith that all vlcers which be not wel mundified begin againe to increase in them there groweth supercrescent flesh but those that are mundified as they ought to be cōmeth soone to ciccatrize for in thē there groweth no superfluous flesh except there be contusion Of a truth when he speaketh of contusion he calleth to mind that which he hath said before That is all vlcers require drie medicines except those be contused For if you doe applie to the parts where as Phlegmon is a Cataplasma that is hot and moist it is not done by the first and principall reason that is as a remedie to the affected part but to mittigate the accidents For the remedies of Phlegmon are of desiccatiue vertue Hearken now what Hyppocrates saith the Cataplasmes for Oedema and Phlegmon ought to be made of Verbescum sodden the leaues of Trifolium the leaues of Piretron and Polium sodden All these medicaments haue vertue desiccatiue as we haue made mention in the booke of simple Medicaments And to be short the curation of the parts where Phlegmon is is done by kinde of these remedies which doth remoue altogether the affects And if the said remedies haue left anie thing remaining that will come to suppuration it is néedfull than to haue another medicine which is more strong to make it sooner to come to suppuration or if the skin that be about be thin and that thou wilt that the Patient shall be sooner eased you must make incision The taking awaie of Phlegmon is by mittigation of Barlie meale not curation for that fighteth onelie against the disease but of these differences we will speake héereafter at large Now I thinke we haue manifestlie shewed how that Hyppocrates hath commaunded that all vlcers shall be desiccated and that he hath confirmed it to be the proper end of curation But now in as much as the indication is taken of the affect and not of time If anie desire to haue greater perswasion let him diligentlie reade all the Bookes of Hyppoorates that he hath written of Vlcers for he shall perfectlie vnderstande that there is one Indication generall of all Vlcers which wée haue shewed in the booke precedent and there is no Indication to be taken of time but of the affectes of the vlcers as Phlegmon and other such like accidences as before is especified And séeing now we are come to the place to speake it is a thing most true that Hyppocrates hath bene the inuenter not onelie of that which we haue said before but also of all other things that are to be knowen to him that wil cure an vlcer well It appeareth trulie that he hath inuented the reason and the manner to cure simple vlcers and also the kindes of the affects which consist in drinesse For either the ill humours resort vnto the grieued part or els they resort no more vnto it If they come no more then it is requisite to helpe and succour the grieued parte that is if it be pale blacke or red it must be scarified that the euil bloud may come forth then afterward because that I may vse his wordes you must laie thereon a Spunge more dry than moist For I doe thinke that there is no person so ignorant but will thinke that a drie spunge ought rather to be applyed than a moist and also to vse desiccatiue medicines And then if it be requisite for to drawe bloud againe doe as you haue done before vntill the time that health be altogether recouered And if the lips of the vlcer appeare hard and stonie they must be cut awaie the which thing is spoken héere But if the vlcer that is round be somewhat hollow you must cut it according to the roundnesse which is swollen which swelling the Gréekes call Apostema either all the roundnesse or as much as necessitie requireth according to the length of the member Also it is written of all Tumors against nature that are ioyned with an vlcer howe they ought to be cured Likewise of the Varises for they be the occasion that the vlcers be so stubburne and hard to be cured if that anie humour of the said Varises do repaire vnto the vlcer And in like manner when the fluxe of an humor commeth from all the bodie he commandeth that all the bodie shal be purged without taking anie indication of time Trulie it were a ridiculous thing that so many and contrarie Indications should be taken of one communitie For put we the case indications to be taken of tyme. But if we graunt that time giueth a certaine indication it is necessary to aske what indication it giueth and comprise it in a summe as Thessalians doth which taketh indication of a bodie that is bound that that may bée vnloosed againe and that bodie that hath a lax is to bée stopped Likewise in vlcers that are filthie mundification is to be required and those that be holow to be filled with flesh and those that be equall to be ciccatrized that which hath superfluous flesh to be taken away Thessalus himselfe is author of these but now let him shew that ther is any indication proportioned to the time of the vlcer as there is in all these that we haue rehearsed which is not possible for him for he biddeth that they should be cut and a Malagma made of Mustardséede to be applied vnto it I praye you what reasonable indication hath he taken now of time which taketh and vsurpeth this vaine woord Metasincrisis and after that he prouoketh vomit by Raphanus and then when he findeth no other remedie he vseth Eliber and when these nothing profit he sendeth the pacient lyke a wyse Phisition into Libia for chaunge of ayre the which things shal be more plainly spoken of hereafter whē we shall shew that indication in what disease so euer it be shall be taken of time Yet for all that it shall be good to know the diuturnitie of the disease The sixt Chapter BVt I wil returne to Hyppocrates whome I doe greatly maruail at not onely for his diligence but also for al other things chiefly for that he hath not forgotten that which is to be considered of all Phisitions as touching the indications of all diseases That is to say the indicatiō which is taken of the greatnesse and magnitude of the affect which not onely the Methodicians haue permitted this is to be maruailed at but also many of the Rationales yea and of the Emperickes although it be after another sort For when they say that they haue cōsidered the euacuation in the course of the bloud they confesse then
facultie next in vertue is Molibdena and Pomphelix doth lesse induce dolor than the rest and is not to any of them inferior If the vlcers be moist both the rinde of the Pine trée alone and also Lapis Hematites be very good and if ther be any déepenesse when as thou wilt rayse flesh put to any of the foresaide medicines so much Manna as shall suffise to incarnate withall neither doth this Methodlesse sect know any of these so much as by dreaming séeing they suppose that euery wound in what part of the bodie so euer it be require one curation neither how it behoueth to cure certaine wounds as those which doe happen to Abdomen of which in the booke following we shall intreat with all those which yet doe remaine FINIS THE SIXT BOOKE of Galen called in Greeke 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 and in Latine Methodus Medendi The effect of the same 1 The curation of the Nerues contused and the tendons vulnerated 2 The curation of wounds which are in Peritoneum 3 The curation of the inward wounds of Peritoneum which reach to Abdomen and Omentum 4 The curation of the affects which chance to the bones The first Chapter I Nothing doubt but that there be manie vnto whome I doe séeme prolix in that I haue hetherto set out how by a methode one kinde of disease may be cured It is trulie méete that they do not so much impute the length of them vnto me as vnto these who litle vnderstanding such thinges as Hyppocrates most trulie hath written do vniustlie goe about to reprehend them who as I haue shewed doe not know how to cure rightlie an vlcer much lesse then that which is greater and that one kinde of disease in which an vlcer is numbred It skilleth not whether you cal it solution of continuitie or vnitie which now is shewed and the method of curing it in what member of the bodie so euer it bée kéepeth the common Indications which are taken of the affect but those that be taken of the partes will haue other affectes When this happeneth in the fleshie partes it is called an vlcer and hath indication of curing which is common to all affects against nature that is the affect it selfe which as it is an affect is to be taken awaie by his contrarie as diuision by vnition for the generation of this affect consisteth in diuision of vnitie and therfore in the bone it is called a fracture in Gréeke Catagma in the neruous pannicles Spasma in the muscles a ruption whose differences are before set out yet to this disease when as it hapneth in a vein or arterie it hath no proper name but borroweth sometime the name of an vlcer sometime of a wound and sometime of a ruption but wée haue often saide that he ought not to be so carefull for the names whose scope is to finde out the knowledge of things Therefore neglecting names let vs rather hast hither séeing that health to the patient commeth not of exquisite imposition of names but through conuenient remedies again let vs call to minde this most impudent Thessalus which setting out no method of curing an vlcer supposeth that he hath shewed them all for verie idiots do know that an hollow vlcer must be filled a simple wound adglutinated yet doth not the vulgar people know by what method he may finde medicines wherewith that which is hollow may bée filled or that which is simple may be adglutinated that is put out to be considered of the Phisition in which one excelleth another for as we haue heeretofore said who that is excercised in the curatiue method shall both finde out remedies and also vse rightlie such as are alreadie inuented The second Chapter ANd that we may now set out anie thing that may hence forth agrée with that is before set out let vs faine one to come vnto vs who hath only his skin pricked with a néedle if this man be such a one in whom vlcers will easilie be healed if thou let him go to his accustomed labours without medicine yea the mēber being also bare he shall tast of no ill but if he be such a one in whom vlcers will hardlie be cured then the mēber will first ake then haue a pulse also inflamation but the Emperike shal learne the nature of the patient by examining questioning we truly by such examination vsing al these things which are found out by experience nothing the lesse by those signs which we take of the natures of good ill iuyce And furthermore of those which be of quicke or dull feeling Moreouer of those which are burthened with fulnesse or haue but little iuyce being not ignorant that he shal be oppressed with inflamation which is either Plethorique or haue euil iuyce the Gréekes call them Cacochymci or is of quicke féeling or vexed with some of these or else with all that he that is contrarie shall féele no hurt we beholding these things wil not put to adglutinatiue Such are many of their medicines which are called Enema bée presentlie applied to gréene woundes but a soft medicine and gentle that shall asswage dolour but when as there is a great diuision there we must bend our studie that the lips of the wound may be vnited and closed with desiccatiues and where the diuision is made with a néedle or steele there regard must chieflie be had that the part be not vexed with inflamation and héereof it is manifest that the indication of a gréene wound set out of Thessalus doth hetherto teach vs no more than euerie priuate person knoweth for it is no great matter to knowe what behooueth to bée done béeing a thing naturallie grafted in all men but to know how thou shalt performe it that onelie doth belong to Artists for if anie should build a ship we all know yea being no Shipwrights in what place the things which gouerne the ship are to be placed in what place the starne must bée and where the beke shoulde stand and all the rest yet all these profit vs nothing being ignorant how the ship is to be builed In like sorte he that goeth about to build an house is not ignoraunt that the foundations of the walles are first to be layde neither that the walles set on these or that are to bée erected ought to bée directlie right neither that the roofe must be set on these walles neither that the windowes doores and other partes of the house must bée accordinglie placed but what doeth these thinges helpe to the building of a House insomuch as hée béeing ignorant in the arte of building knoweth not how to builde it Therefore it séemeth sufficient vnto Thessalus of all other men most sapient touching an artificious knowledge to vnderstand what ought to be done but wée haue shewed in these Bookes before written that this is but a certaine beginning of those workes which are looked for of the Artists being no
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