man haue an vlcer whether it be come to him before his sickenesse or in the sickenesse and the sicke die that vlcer shall bee before hee die drie blewe or pale The same Hippocrates saith also that those who haue vlcers accompanied with tumor doe neither fall in conuulsion rauing nor phrensie but if the tumor goe away without manifest cause if the vlcer be in the backe the sicke falleth in spasme if before in the bodie in rauing and phrensie if in the thorax before he falleth in empâ—â—m and pleurisie all vlcers accompanied with varices or inteÌ„perie and those also that haue the sides hard are difficill to heale all vlcers in the extremities of the muscles of the legges and armes are difficill and dangerous as also those which penetrate in the bodie such vlcers as chaunce in the extremities of the bodie as in the feete or handes make oft phlegmons or other tumors against nature and in crisis of a maladie are difficill CO. Which are those which are of easie curation LO Those which happen in bodies of good complexion in the which none of the foresaid accidentes doe happen CO. Which are the chiefe causes that hinder the healing of vlcers LO According to Galen the chiefe cause is want of good bloud to ingender flesh or else that it is euill either by quantitie or qualitie of it selfe also dolor intemperie apostume contusion erisipelas echymois superfluous flesh hardnesse callositie of the sides corruption of the boane varices hemoragie of bloud also roundnesse in figure for the which Hippocrates counselleth if the vlcer bee round to put on it an other forme Imbecillitie of the part vlcered indisposition of the lyuer or milte retention of the monethly course in women and of the hemerroihdes and also the applying of medicines vnmeete for such vlcers Many ignorant barbors faile herein thinking one kinde of emplaister to bee good for all sores in the which they are deceiued for hee that would cure vlcers must first take away the cause as also the impedimentes and accidentes otherwise he trauaileth in vaine as saith Paulus for the perfourmance whereof we must ordayne first good dyet secondly take away the cause antecedent to witte the humor which falleth which shall be done by purging bleeding according to the cause on the parte thirdly correct and heale the accidents and indispositions which accompanie the vlcer these thinges done hee may come to the curation hereof as shall be particularly set downe of euery kinde of vlcer in his proper place The second Chapter of Vlcers sanions and the Curation thereof AS in the former Chapter I haue spoken of Vlcers in generall of their difference cause signes and iudgements cure so now I will particularly intreat of them All Vlcers are either simple or composed with some other maladie the simple Vlcer requireth onely desiccation those which are composed and ioyned with some other accident except those accidentes be taken away cannot heale for the cure of the which there are foure Intentions first in the way of life which shall bee according to the strength of the sicke nature of the maladie aboundance of the humors in the bodie as if the humors be hotte and sharpe we ordaine colde thinges The second Intention is in diuerting and intercepting the matter antecedent which is done by purgations and bleeding if the strength permit also by frictions ligators application of emplaisters that haue the force to repell the matter The third Intention is in correcting the accidents ioyned with the vlcer as dolor tumor contusion excrescence of the flesh callositie of the lippes rottennesse of the boane varice and wormes First then wee must labor to take away the intemperie which shall be knowne by the colour of the member by the touching and feeling of the patient which sometime is hotte sometime colde which if it be drie wee remedie it by purgation and bleeding also if neede be foment the place with hotte water till it growe redde as counselleth Galen thereafter vse this vnguent made of mallowes sodden in water with a little hogges grease and honney mixed with nutritum ceratum galeni rosatum populeon incorporate with plantaine water morrell and housleeke If the Intemperie be humide vse vnguents that drie as pompholigos de plumbo cerusa allom water vnguent basilicon citrinum fuscum de althea or this fomentation of claret wine in the which hath beene sodden roses betonie wormewood roch allom If the Intemperie bee cold we foment the part onely with wine wherein wormewood hath beene sodden hyssope calamint rosemary vnguent basilicon de althea If the Intemperie be hotte we remedie it by water of plantaine solanum housleeke or vnguentum rubrificum cum camphora or cerat galen if there be dolor with vlcer which commeth of intemperie erosion of a subtill humor or solution of continuitie or plenitude of grosse humors or a flatuous spirite for the which take vnguent populeon oyle of yolkes of egges vnguentum album camphoratum with other such as are in tumors if the dolor be vehement we make a cataplasme narcotick of barly flowre oyle of roses henbane mandrager poppie all sodden in milk If the dolor be accompanied with tumor first looke to the cause of it thereafter ordayne the dyet straight and cold bleeding purging according to the nature of the humor with such particular remidies as ye haue heard in tumors The excrescence of the fleshe shal be taken away with caâ—ters rasors sheeres pouder of mercurâ—â— burnt allom â—â—â—stum squama aeris vnguentum aegiptiacum apostulorum vitrioli romani The hardnes is cured by Remollientes and Resoluentes as goose henns ducke and calues greace oyle of Lillies lumbricorum vulpinum muscilaginis of althea and fenigreci basilicon diachilon magnum de muscilaginibus thereafter scarifie as couÌ„selleth Auicen then put pouder of mercurie or cut it with a Rasor to the soft part If the vlcer become blacke and Red scarifie it and lette it bleede well and applye thinges drying If it bee accompanyed with Varice it must bee taken awaye as yee haue heard in the Chapter of Varix If there be rottensse in the bone yee shall haue recouse to the proper Chapter If there be wormes in the vlcer wee must consume the rottennes and humiditie they are ingendered of and kill them also take the decoction of Wormewood Agrimonie Centorie Calamint which is to wash the vlcers also in the eares fasting spittle is good for vlcers in the eares and make the Cicatrize well fauoured with the foresayde dococtioÌ„ wash the vlcers as also with Oyle of Wormwood the pouder Aloes mixed with the Oyle of Absynthe and a little waxe is verye good Millefolum taken the weight of one dramme in white Wine sleaeth the wormes in bellie also The fourth intention consisteth in healing of the places vlcered which shall bee doone in taking away the impediments as ye haue heard thereafter ciâ—atrize the vlcer with such
at Fâ—runole called by the Grecian Dothene Fâ—runcle is a tumor sharp pointed with inflamation and dolor chiefly when it groweth to matter and is ingendered of a thicke 〈◊〉 or in the soft parts and groweth commonly to the bignesse of a doues egge and is for the most part in the skin The causes are externall or internall the internall is abundaÌ„ce of blood the externall is in the vice of the skin also the suppression of the purgations in womeÌ„ wearing vnaccustomed clothes also by suddaine taking a colde aire after a great heate or vehement heate immediatly after cold The cure first consisteth in generall remedies as purgations and bleeding next lay on it a little Diachilon with henns greace or Basilicon Galen counselleth to câ—â—we wheate in the mouth fasting and lay on it If it bee deepe and much inflamed oftentimes it degenerateth into Anthrax and Carbuncle and in that ease it must bee cured as yee shall heare in their proper Chapters The fourth Chapter of Anthrax or Carbuncle VVE must vnderstand that there is no difference betweene Anthrax and Carbuncle sauing that Anthrax is the Greeke worde Carbuncle the Latin worde and is so called because it burneth the place where it is like coales Carbuncle is properlye defiined to to bee a pâ—stule inflamed black burning the place where it is sore with many blisters about it as if it were burned with fire or water The cause is diuers according to the sundrye kindes thereof the cause of the simple Carbuncle is an Ebullition of blood thick and bot where it falleth in any place it burneth maketh vlcers with a scale on it accompanied with great inflamations and dolor The signs of the simple are those there appeare manye little blacke Pustules not eminent sometime pale and grow suddenle red with great inflamation about them the place is harder then it ought to be the sicke looseth appetite and coueteth sleepe accompanied with cold sweates and feuers The signes of the maling are vomiting continually want of appetitâ—e trembling sounding beating of the hart the face waxeth white and liuide The iugdmentes are if it happen neare the stomack or throate it hindereth the respiration as sayth Celsus That which rypeth and coÌ„meth to matter is good that which appeareth and goeth away with Feuer is mortall that which is first red neâ—t yellow is not euill as sayth Auicen that which is first pale and afterwardes blacke is euill all those which are in the emunctions of the noble partes are most dangerous The cure consisteth in vniuersall and particuler remedies the vniuersall are a good dyet of life which shal be called and humide like vnto the regiment in Phlegmon resisting alwayes to the malignitie of the humor his drinke shal be made with sirupt of LemmoÌ„s acetosis sâ—plicis capilli veneri granatorum bluglossi with water of the sayd things vse alwayes the tabletts of the margarite frigide conserues of Roses and buglosse bol armenie and terra sigillata and Iuorie in pouder the opiats which shall bee made of the same ingredientes are made of sirupe of Lemmons and Treacle vsing rhis epitheme on the noble partes Rec. aquae scabiosae rosarum nenupharis an 2. vnc aquae buglossi 1. vnc trechiscorum rasis camphorâ—â— an 1. vnc corallorum rubrorum 1. drag di triasandali boli armenici an vnc 1. croci aceti parâ—um fiat epithema Vse clisters and bleede much as counselleth Galen and that in the same side vsque adauimi defectum The perticular remedies are these first we make deepe scarifications and it with water and salt called aqua marina we laye horsleacheâ— on the scarifications vsing a cataplasme on the part of Crummes of white bread leaues of Plantine arnoglosse flower of Lentilles soddeu in vineger and honey Hipprcrates counselleth to applie canters actualls or some caustick medicament as oyle of vitrioll vnquenched lyme quoniam in extremis morbis extrema sunt adhibendaremedia and also ventouses medicines which haue vertue to draw the venim from the noble partes Paulus doth counsell to seperate the infected from the other partes and rase it from the roote afterwardes vse this cataplasme to prouoke the fall of the scale which also mitigateth the payne composed of Lyn-seede Mallowes Violets yolkes of Egges Butter and Barley meale For the sharpnes of the humor put about the parte affected vnguentum de bolo and on the pustulles the pastules of Andronius and Musa When the scale is fallen cleanse the vlcer with sirupe of Roses honey of Roses and Turpintine mundificatiue di apio this done cicatrice fill it vp as other vlcers Some counsell to take the consolida maior and bray it betweene two stones and lay on it The fifth Chapter of Gangren and 〈◊〉 VVHen the inflamation neither resolueth returneth inwardly nor suppureth nor becommeth hard it degendreth into Gangren which is a mortification not altogether of the part but tending by little little through the great violence of the inflamation for thereby the veines and arters are stopped that the naturall heate may not passe so the parte easily corrupteth and waxeth gangrenated The cause is great quantitie of bloud in the member which letteth the spirite to passe so bindeth and intercepteth it in such sorte that the arters cannot worke their transpiration and requisite exhalation so for want of naturall heate the members suffocates Also great application of cold medicamentes as repercussiues in phlegmon and erisipelas or some violent externall cause chiefely in the feete or handes as colde sometime crisis of feuer or maligne maladie strait ligatures contusions stroakes or biting of venemous beastes chiefely in the wayes and passages when the spirites doe passe The signes are if it came of inflamation wee perceiue the redde colour to decay dolor pulsation and feeling it waxeth pale soft and blacke and in pressing on it with thy fingers it falleth downe and riseth not If it come of colde we perceiue great beating paine great coldnesse without motion or feeling accompanied with trembling and shaking If it come of straite binding hurtes or biting wee knowe it by the markes and precedent signes and others according to the diuersitie of the cause The iudgementes are if it be not helped presently the force of it is so vehement that the parte dieth presently and the partes neere to it and so causeth death of all the bodie If the muscles and nerues be not hurt and the person young and of good constitution and well seene vnto in the beginning it is not difficil The cure after generall remedies as purgations and bleeding is diet in vsing cordialles deepe scarrification on the part and washing it with water and salt applying on the part cataplasmes made of flowre of beanes barley Orob and Lupines sodden in honey and vineger putting to it a little powder of
time we will referre till our next meeting against which time I would haue you to bring mee in writing your opinion of woundes in particular aswell made by Gunshot as otherwise and then we will intreate of vlcers after the same manner The second Chapter of the particular and simple wound in the flesh without losse of Substance I haue spoken in the precedent Chapter that woundes in the organic parts receiue no curation now according to your direction I will prosecuâ—e these which happen in similare or simpler parts begining with the simple wouÌ„ds in the flesh which is without losse of subâ—tance either with accidentes or without As for the causes signesâ— Iudgmentes ye haue heard suffitiently in the precâ—dent Chapter but for the Cure the simple wound in the flesh healeth by ioyning the lippes of it together and help of nature yet for the more assurance we vse to let it blede a litle if it hath not bled suffitiently alredie next we dresse it with a cleane cloth or soft sponge then we close and put on it the white of an egge with lint binde the wounde and sturre it not in two or three dayes the white of the egge preserueth it from inflammation heate dolor and bleeding If the wounde be great that it ioyneth not by the simple lâ—gator we vse a future with pouders incarnatiue or retentiues composed of sâ—nguinis draconis thus mastick hollarmenie wheate flower all mingled with whites of egges and a little oyle of Roses with lint on it as before Also a double cloth broader than the wounde wet with oyle of Roses and vineger binde it and stirre it not for two or three dayes if accidentes do not chaunce and being remoued wash it with Claret wine wetting plumations in the same wine which haue the vertue drie comfort If the wound be depe these remidies not suffitient we make a liâ—quor of oyle of Hypericon Turpentine with the yolke of and an egge or a little of my balme set downe in the Chapter of Gunshot I vse especially following the warres this digestiue made of yolkes of egges hard rosted and beaten with a little oyle of hypericon Turpâ—ntine and Mirrh so this keepes a long time and bringeth the wounde to matter the which not auoyding for the situation which is to high wee situate the part in such sort that the orifice is lowest as for example if the wounde be in the thigh and there be a cauitie in the knee we situate the knee in such sort that is much higher than the thigh if it auoyde not that time and the cauitie be great we make incision in the bottome of the cauitie or cutte it altogether Thoâ— mayest knowe which of those issues is best by the greatnes of the wounde and nature of the part it shal be best to make it in the bottome of the cauitie vsing a hollow tent in it to auoyde the matter We vse also a seton which is a little corde or peece of cloth rolled in forme of a cord annoynted with some liquor mundificatiue drawing it sometime from one issue to an other and so continuing till it bee cleansed dressing it thrise a daye thereafter I vse some glutinatiue medicine as ye shall heare in the next Chapter The third Chapter of of the composed wound with losse of Substance THe Composed wounde is when there is losse of substance to wit skyn flesh and bones for the cure we vse two intentions that is reparation of the substaÌ„ce lost and induction of the cicatrize which is lost if the body be wel disposed is repaired by nature only vsing in the meane time medicameÌ„ts that are cleansing and drying If the flesh renue not in his fashion we vse medicameÌ„ts sarcotricks which shal be made of Iris of florence Thus Mastick Aloe Colâ—phonie Pix resnia Farina Hordei Orobi Fenugreci LupinoruÌ„ Apopanax Mirrha Saccocolla and sanguinis draconis with vnguentum aureum mesue If the wound be deepe mix some of these pouders with wine wash the wound with Turpentine in form of vnguent and put it in the wound either with plumations or tentes dresse it twise a day in SoÌ„mer and once in Winter vsing an emplaster that drieth and comforteth with bandages In these woundes there are foure intentions to bee obserued first to ingenâ—er such substance as is lost secondâ—e to know the temperature of the bodie and hurt part to the effect we may iudge whether the medicaments should be cold hot or drie thirdly to know the accidents which happeÌ„ to the sore fourthly the regioÌ„ aire way of life The swouÌ„de being filled vp we induce the cicatrze with epulotick medicameÌ„ts as red Deficcatiue album Rasis cerusse plantine also to wash the wound with wine wherein hath been sod balaust alluÌ„ or this emplaster Rec. tuthiae preporatae pluÌ„bi crudi antimoni crudi corticis mali granati balaustâ—â—ruÌ„ nucum gallarum boli armenici sanguinis draconis an drag 1. accipi antur omnia simul cum vngueÌ„to epompholigos onc 3. fiat magdaleon bone cousistentiae you shall finde diuers other remidies set downe by Holler Take heede that the cicatrize bee neither high lowe hard soft nor inequall the high happeneth when it is not dried enough and must be mended by scarrifications medicamentes catereticke s and corrosiues The low contrary wise commeth through lacke of some piece of boane or too much drying and is helped onely by frictions the inequalitie coÌ„meth through the pointes of the needles which hath beene ouer thicke and ill done and is helped by medicamentes emollientes discutientes and astringentes The fourth Chapter of the contused Wound THe contused wound to the which chaunceth great accidence according to the instrument it is done with is a kinde of solution of continuitie made with a bruise and is called by Galen and some late wtiters echymosis in the which there is separation and dilaceration of the flesh muscles thereof with great quantitie of bloud and differeth somewhat from attrition as saith Auicen for contusion happeneth in the fleshie partes and attrition is done in the head and ende of the muscles The signes are like vnto other woundes with inequalitie and roughnes in the flesh and skinne diuersitie of figure according to the diuersitie of the cause the part and partes about are blacke and liuide by reason of the bloud which is out of his place and remaineth in these partes and cannot be euacuated by sensible or insensible transpiration but by suppuration The Iudgementes shall bee according to the greatnesse of the hurt for great contusions are dangerous for the corruption of the member and consequently the bodie also As for the Cure there are foure intentions first to stay the fluxe if the contusion be with wound as oft happeneth next to stay the fluxion of humors on the part by euacuation as purgations bleeding ventousing
THE WHOLE COVRSE OF Chirurgerie wherein is briefly set downe the Causes Signes Prognostications Curations of all sorts of Tumors Wounds Vlcers Fractures Dislocations all other Diseases vsually practised by Chirurgions according to the opinion of all our auncient Doctours in Chirurgerie Compiled by Peter Lowe Scotchman Arellian Doctor in the Facultie of Chirurgerie in PARIS and Chirurgian ordinarie to the most victorious and christian King of Fraunce and Nauarre WHEREVNTO IS ANNEXED THE Presages of Diuine Hippocrates LONDON Printed by Thomas Purfoot 1597. TO THE MOST PVISSANT and mightie Prince IAMES the Sixte by the grace of God King of Scotland MOST Renowned and dread Soueraigne as heretofore I haue presumed to shrowd the first fruites and degrees of my studies vnder your Highnesse Name and protection So now both humble and entire affection haue moued me to present this Treatise to your royall View as a Testimonie of humble duetie to expresse my poore yet vnfeigned zeale For to your Maiestie the protection of all our doinges doe iustly belong and to your Highnesse are wee principally bound to doe all Seruice the which I being willing to performe and also tendring the commoditie and benefite of my natiue Countrey which GOD willing no occasion shall cause me to omit I haue published this Treatise and these my painefull labours to exonerate my selfe of the burthen which euery man is bounde to vndertake for the Common wealth if my industrie could haue produced better effectes it would reioyce to passe vnder the protection of so excellent mightie a Prince But the Arcadians can giue Pales but a fleece of woolle the Athenians a dish of Oliues to Pallas and my selfe haue nothing but these vnpollished lines to present to your royall Maiestie May it theÌ„ please your Highnesse as Minerua harbored an owle vnder her target Cytherea a deformed Cyclops in her louely bosome and Apollo the night-rauen vnder his heauenly Lute to accept in good part the trauailes of your humble subiect vassall which I humbly offer to your Highnesse praying dayly that all the blessinges in heauen may increase vpon your Maiesties Person and Progenie to your Princelie content and immortall glorie Giuen at London the xx of Aprill Your Maiesties most humble and obeisant subiect Peter Lowe To the friendly Reader IT is commoÌ„ly said as it is of truth good friend that idlenes is the mother of all vices which doth not onely ingender them but also nourisheth intertaineth the same for auoyding wherof as also hauing promised in my Treatise of the Spanish sicknes to further thy knowledg with the whole Course of Chirurgerie now doe I publish the same not as Plato did his common wealth Cicero his Orator sir Thomas Moore his Eutopia leauing to the worlde any wished perfectioÌ„ not practised but I impart to thee my labors hidden secrets and experiences by me practised daylye put in vre to the great comfort ease and delight of such as had occasion to vse my help For being Chirurgian maior to rhe Spanish Regiments two yeares at Paris and since that time following the King of Fraunce my Maister in the warrs where I had commoditie to practise all points and operations of Chirurgerie vpon the which occasion I collected my practise with the opinion of both auntient late writers at vacant howers into a booke which is that I offer to thy view Seing then I doe not entreat of any vaine fable but of such earnest serious matter as toucheth the profit of all men in generall and the benefit and coÌ„modity of euery man in particular I hope the readers hereof will vouchsafe to attribute and graunt such diligence and willing eare mynd and attention hereunto as they are accustomed to do in those causes which they account most weightie graue and necessarie and which they are most desirous to know learne and vnderstand Herein thou maist reape the fruits of my trauells and studies and by the friendly acceptance hereof gaine to thy selfe fruition commodity of my other like labours like as my Treatise of the help of women in the time of their infantmeÌ„t with the curatioÌ„ of such diseases as happen coÌ„monly to maides maried womeÌ„ the treatise which is called the poore mans guide which are works esteemed by such learned men as haue seene them most necessary for the coÌ„mon wealth Some men perhaps more respecting their owne priuat gaine then the publique profit will thinke that I should haue coÌ„cealed those things as did the Egiptians by writing in letters Hydrographicks But I rather follow the Grecians who vsed euery yeare to write in the temple of Esculapius in Epidauro in the presence of all the people all the sicknes they had cured together with the seuerall remedie for as the Philosopher saith bonuÌ„ quo communius eo praestantius Also being moued by the counsell of Cicero where he saith that we should not onely haue regard to our owne particuler but also to the profite and commoditie of our kinsfolkes and frindes and generally to the common wealth of that Countrey where wee tooke our birthe the which counsell also was obserued amongst the old Romaines when their estate most florishtd for they did accompt him amoÌ„gst the number of the infortunate that during his life did not manifest in some one publique benefit or other his affectioÌ„ thankfull hart to the place wherin he first bread neuertheles there be som enuious and ignorant persons whom I may iustly compare to Antipholus that pearelesse pick thanke whose filthy hart being inflamd with malice will find fault with this my labour to whom I wil answere according to the saying of Erasmus Roterodamus vt ignaui canes omnibus ignotis allatrant ita barbari quicquid non intelliguÌ„t carpunt ac damâ—aÌ„t only vpoÌ„ this hope I rest that as in good wil loue I haue done this so the well disposed wil ceÌ„sure it in the best sort and where fault is they will in friendly and charitable maner correct and amend the same the ignorants I would desire onely to put to their hand and doe better wishing euerie man as much profit and benefit in reading hereof as my willing attempt hath intended them and so I ende bidding the gentle Reader most hartelie farwell From London the 20. day of Aprill 1597. Omnibus clarissimis Doctoribus Regii collegij chirurgicoruÌ„ ParisiensuÌ„ nempe D. Rodolpho Lefort D. Petro Pigret D. Anthonia Portal D. Seuerino Pineau D. Hyeronimo de la Noue D. Philippo Colot D. Simoni Pietro D. Iacobo Guilmean D. Loudouico Hubert D. Iodoco de Beauuais D. Gerardo Oliuier D. Francisco de Leury D. Iohanni de Hayes D. Iohanni Girard omnibus alijs Petrus Low Doctor in Chirurgia S. P. D. MEus naturalis zelus erga patriam meam Domini Asclepiadaei fecit vt generaliter ea celare non potuerim quorum notitiam legendo atque exercendo mihi acquisiui quandoquidem in his partibus non inueni viros tam
according to nature which maketh the actions of our bodie perfect CO. How many kinds of maladies are there LO Three to wit Intemperiâ— Euill confirmation and Solution of contiâ—â—â—nitie CO. What is Intemperie LO It is a maladie in the similar partes digressing from the owne temperature CO. Howe many wayes is that done LO Two wayes to wit eitheâ— by the simple intemperie by the aboundance of a humor onely as colde hot moist or drie CO. What is Euill confirmation LO It is a vice in the partes organicks eyther in the figure magnitude or scituation as for example that which should be naturally right is oblique so forth as if a part were augmented or diminished contrarie to nature in like maÌ„ner in the number of partes as if a man had sixe fingers or foure also in the scituation or collection as if partes naturally ioyned were disioyned as happeneth in dislocations CO. Which is the third kind of maladie Lo. Solution of contiâ—â—itie both in the similar and organicke parts which hath diuers names according to the varietie of the partes where they are The second Chapter Of the cause of Maladie CO. What is the cause of Maladie LO It is some affection which maketh sickenesse of the which some are externes some internes CO. Which are the externes LO They are called procatarticks or primitiues as strokes falles shot and such like or euill nourriâ—â—r CO. Which are the internes LO They are two to wit anticedents and coniunct CO. Which are the causes antecedents LO Euill humors in the body CO. Which are the causes coniunct LO It is that which maketh the sicknes presently and is alwayes with the sicknes and where the sicknes is not it is absent CO. Howe commeth the cause of maladie LO There are some we haue from the Mothers wombe and from the parents which wee call maladies heriditaries some doe ingender after our birth as by the regiment of life strokes and falles as you haue heard The third Chapter of accidents and Symptomes CO. What is accident or Symptome LO Galen sayth that symptome is any thinge that chaunceth to man by nature so the causes interne of sicknesses may bee called Symtomes CO. How many kinde of Symptomes are there LO Three to wit the first is when the action is offended which may be done three waies that is eyther abolished diminished or deprauated as for example in blindnes the sight is abolished dimished as suffocation as happeneth in the beginning of Catarack deprauated as for a certaine time as in changing the simple affection of our body or the whole habitude from one extremitie to another as the naturall heate into inflamatioÌ„ the scabs of the flesh into leprosie the third is in the vice of the excremeÌ„ts by immoderat retention or expulsion as the Hemorhoides the purgations of women the vrines these or any of these retayned or euacuated ouermuch maketh great accidents and so we end this treatise THE FOVRTH TREATISE OF tumors or aposthumes against nature in generall which contaynes XIII Chapters Written by Peter Low arellian Doctor in Chirurgerie and Chirurgian ordinarie to the King of France and Nauair Of tumors in generall Chapter 1 Of Phlegmon Chapter 2 Of furuncle Chapter 3 Of Anthraâ— or Carbunele Chapteâ— 4 Of gangrene or hâ—stiomen Chapter 5 Of Sphasell Chapter 6 Of tumors bilions Chapter 7 Of Herpes Chapter 8 Of tumors petuitoâ—s Chapter 9 Of flatâ—ons tumors Chapter 10 Of â—â—heorâ—ma steâ—tema mellericeris Chapter 11 Of melancholicke tumors Chapter 12 Of Cancer Chapter 13 The first Chapter of the causes signes and curation of Aposthumes in generall COinteret Now it is neceslarie wee come to the exercise of Chirurgerie for the more sure vnderstanding of the same wherein wee will begin at tumors er aposthumes against nature demaunding first of you what is an aposthume LO It is a disease composed of three diuers maladies to wit euill coÌ„plexioÌ„ in the similar parts euill composition or constitutioÌ„ in the instrumeÌ„tall parts dissolutioÌ„ of coÌ„tinuity in both similar instrumentall parts offeÌ„ding the actioÌ„s of the meÌ„ber where it is CO. What is the cause of Apostumes LO Some are generals and some are specials CO. Which is the generall cause LO Either fluxion or congestion CO. What is fluxion It is a mouing of the humors of the body to some certaine part the which either by the quantitie or qualitie or both together may not be receyued by the parte without offence CO. Which are the causes of fluxion LO They are double to witte eyther in the parte or partes that sende or in the parte or partes that receiue CO. Howe is the fluxion made in the part that sendeth LO When the facultie retentiue of the part is ouercharged with humors which offend either in quantitie qualitie or both for then the part dischargeth it selfe by the vertue expultrix chiefly when it is strong also when the parte that sendeth hath connexion with the part that receiueth or when the patt that receiueth is inferior to the part that sendeth or if the said partes haue any sympathie togâ—â—her as the stomacke with the braine CO. Which are the causes in the partes that receyue LO They are diuers as weaknes not hauing force to repell or driue them elsewhere the vesselles and conduites large where the matter doth passe or else because it is soft in substance and so easie to receiue sometime for the dolor which maketh attraction of the matter from the partes neare to it or great heate which draweth and prouoketh fluxion CO. What is congestion LO It is a masse of matter contrarie to the nature ingendred of the superfluities of the thirde concoction of the aliment and foode which are distributed for the nouriture of the parts of the bodie which chauÌ„ceth when the aliment is not so digested as it may well be appropriated to the part which shoulde be nourished CO. Which are the causes of congestion LO They are either imbecillitie of the facultie concoctrix of the part that it can not digest that which is sent to it by nature for the nouriture of it or imbecillitie of the facultie expultrix that can not expell the superfluities that resteth commonly in the partes CO. By what meanes knowe you the tumors made by fluxion and congestion LO The tumors made by fluxions are with great dolor rednes pulsation and make the degrees faster than the other which are done by congestion Those which are done by congestion gâ—owe little and little and doe diminish in like manner when they come to their declination CO. Which are the speciall causes of aposthumes LO Three to wit primitiue antecedent and coniunct CO. Which are the primitiue causes LO They are external causes as falles strokes and other externall violences which moue the humors of our body also great heate of the aire or meate or drinke taken ouer hot or ouer cold CO. which are the causes antecedent LO They are internall not knowne
for example if the choller domaine amongst the bloud more then the rest of the humors the tumor shal be called phlegmonerisipelatus and in like manner in the rest as phlegmon edematus or schirrus so Galen saith that the humors are seldome found alone but mixed together The cause is triple primitiue antecedent and coniunct The primitiues are externall and first motiues as great vsage of meates which ingender much bloud also all those thinges which may moue the humors and prouoke fluxion falles strokes breaking of the bones contusion heate excessiue labour and such like The antecedant cause â— great superfluitie and aboundance of bloud offending either in quantitie qualitie or both intemperie euill confirmation and dolor of the part The cause coniunct or continent is the bloud or matter affixed in the affliged parte The signes are inflamation rednes hardnes feuer dolor and pulsation chiefly it being in maturitie The iudgementes the small ones doe often resolue the great ones doe often apostume sometiâ—e degender into great sickenesses according to the euill disposition of the bodie and partes where it chaunceth as mortification and schirre Sometime it returneth to the place it came froÌ„ as in the emunctoires of the noble parts As for the curation it shall be reduced to foure pointes according to Fâ—chius and Togatius the first in good diet of life secondly in staying the humour that floweth to the place thirdly in euacuating that which is in the place fourthly in correcting the accidents which often chaunce as saith Galen As touching the first which is good diet as saith Galen it shall be obserued in sixe thinges not naturals which shall be colde contrarie to the humor which is hotte sometime it shall be colde and humide and if it be with feuer the humor that floweth shall be diuerted by taking away the cause as repletion of the euill humors by bleeding purgations and also by strengthening the parte if it be debille also by frictions ventouseing and binding The humor shall be euacuated in diuers wayes according to the degrees of the apostumes as in the beginning we must vse repercussiues as whites of egges oxycrate rose and plantaine waters cataplasmes of bol armenie terra figillata barke of pomegranate henbane oyle of roses vnguent of roses album rasis diacalcitios or populeon For the augmentation which is the second degree we vse repercussiues and resolutiues like as mallowes plantaine roses wormewood barley flowre oyle of camomill oxicrate pouder of roses and mirtle sodden wine called sapa rose water vinegre saffron of which things you may make cataplasmes liniments fomentations as you shall finde expedient In the vigor we vse repercussiues and resolutiues in like force like as mallowes parietarie althea rosted vnder the ashes oyle of roses camomilli with a little beane flowre In the declination we vse only resolutiues Auicen counselleth to soften a little which shall be done with fomentations of althea origan lyne seede fenigrec flowers of camomill roses which thinges shall all be sodden in white wine mingled with a little barley meale and hony vnguent of aragon martiatum or agrippa de althea de melilâ—to or diachilon paruum We correct the accidents which is the fourth point as dolor which must be appeased by all meanes for the great accidents which often doe ensue For the which we vse oyle of roses waxe and wine sodden together as counselleth Galen Also cataplasmes of white bread and milke water oyle of roses violettes or camomill or annise seede or sweete almondes yolkes of egges with a little saffron in like manner the flowers of mallowes camomill and mellilot sodden in wine putting thereto a little barley flowre and goose grease lyne seede also vnguentes of roses and populeon If these thinges be not sufficient we take the leaues of henbane poppie rosted vnder the ashes and tempered with the iuice of sorrell and housleeke put to it a little hennes grease and saffron If the matter take the course inwrdly to some noble parte wee remedie it by application of ventouses cornettes frictions straight ligatures and such like If the matter com to a dispositioÌ„ schirrus we must vse medicameÌ„ts that soften digest as ye shall heare in the Chapter of schir If â—t tend to putrifaction it shal be helped by deepe scarifications cataplasmes made of beane flower soddeÌ„ in vineger and honye and such other remedies as ye shall heare in the Chapter of Gangren Oftentimes this tumor tendeth to suppuration which we knowe as sayth Paulus by the great swelling and rednes of the place eminent great heate dolor pulsation and feuer and such like those thinges being perceiued we passe from resolutiues to suppiâ—atiues as to foment the place first with hot water or oyle also with honie and water called Hydreleon making a cataplasme with wheate flower sodden in Hydrelâ—on putting to it a little fresh butter Calues greace Henns or Goose Also you may make a suppuratiue of Lillie roots Sorrell Parretarie and Mallowes sodden in Hydrelion put thereto a litle flower of Fenegreck Lyu-seede oyle of Lillies with a little sower leauen after it is taken of the fier put to it twoo yolkes of Egges this sort of remedie appeaseth well rhe dolor for the same effect we vse the emplaster called Dilachilon magnum or Basilicon The suppuration made we know by the diminution of the accidents and the tumor which is pointed also with pressing on it with the two thumbes we find it soft with great innundation Then if it open not shortly of it selfe it must be done by a ruptor or lancet otherwise it waxeth hollow and putrifieth within In the opening of it there are three tules to be obserued as yee haue heard in the generall Chapter Here we must obserue that the incision be made in the inferior part the matter must not be euacuated at one tyme make the incision the length eschewing nerues sinewes veines and arters and not by the breadth as sayth Auicen When it is opened we vse the yolke of an egge with a litle Turpintine oyle of Roses for a certain space therafter hony of Roses or sirupe of Roses mundificatiue de apio apostolorum or my mundificatiue set down in the poore mans guide or any other thing that munifieth sometime we adde a little egiptiac specially to those which withstand the former remedies the vlcer cleansed wee mixe with a little Turpintine and Honye some pouder of Irish aloes and thus or some little aureum with these pouders thereafter the emplaster of Diacalciteos or red desiccatiue and such like so the vlcer healeth The third Chapter of the tumor Feruncle or Dothine which proceedeth of Phlegmon WE haue spoken in the generall Chapter of diuers tumors which come of the sanguine humor as Phigethton Phinia and diuers others but by reason they may be cured by the generall râ—râ— of Phlegmon we let them passe and speake of the rest beginning
album cum camphora also the cataplasme of Barley flower Lyn-seede sodden in Hydromell or oxycrate putting to it a little pouder of Camomill and oyle of Roses remember that all these remedies must bee liquide often remoued and the place well cleansed that no thing remaine on it If it come to a bile or vlcer cure it as Herpes The eight Chapter of Herpes HErpes is a little vlcer accompanied with tumor which proceedeth of the pure bilious humor without mixture of any other humors It occupieth most commonly the extremities and outward partes of the skinne and is comprehended vnder erisipelas like as formica and impetigo which are called commonly chollericke pustulles There are three kindes of it the first is made of the thinne cholar which burneth onely the skinne and is called simply Herpes the second is made of a more thicke choler which vlcereth a great part of the skinne and is called Herpes depascens by reason that it eateth and consumeth the skinne the third kinde is made of choller and pituite together accompanied with some malignitie as commonly happeneth to those who are infected with the neapolitane disease and is called by our auncientes Herpes miliaris because the pustull is little like the graine called milium The pustulles haue diuers denominations some call them papula or eruptions pituiteous others call them ecthimâ—ta others call them apenthemata The cause signes differ not from those which ye haue heard in the precedent Chapter As for the cure it consisteth in three partes first in staying the fluxion by euacuation vniuersall and prouocation of vrine and good dyet as ye haue heard in erisipelas secondly in euacuating that which is in the place by such thinges as haue the vertue to discusse digerre and drie lightly and not humect as in erisâ—pelas Then in the beginning we shall vse vine leaues plantaine gooseberrie leaues arnoglosse putting thereto a litle barley flowre with some honie Furthermore the barke of the pomegarnet dissolued in wine with a little fine flowre made in forme of a cataplasme is good The third intention is in drying vp of the vlcer by reason that all vlcers whatsoeuer require deâ—â—cation by gentle medicaments excepting alwayes the maligne vlcers and in them we vse more shrong and mordicant remedies first we shall vse fomentations of roses and plantaine sodden in wine or water and an vnguent made of oyle of walnuttes and waxe thereafter washed in smithes water also the vnguent cerusse or this vnguent thus made Rec. vnguent populeonis cerat refrigentis Galeni cerussae an dram one dim litargyri 3. ounces olei rosacei 1. ounce malaxentur omnia simul et fiat vnguentum The other pustulles like as formica and impetigo be cured commonly by generall euacuations other defedations of the skinne which proceede of the humor melancholicke or chollericke are cured by vniuersall euacuations by sweating and bathing and by applying some vnguent on the part affected as vnguent enulat putting thereto sometime a little mercurie This vnguent is most excellent for this purpose as also for the itch which happeneth to young children Take elle campagne rootes and seethe them in the iuice of plantaine fumitorie yolkes of egges hogges grease or fresh butter being all mingled together put thereto a little brimstone well puluerized with oyle of hypericon so make an vnguent of good consistance The ninth Chapter of tumors which proceede of the pituite and first of Edema HAuing amply spoken of the two hot tumors as also of those which doc commonly come of them nowe in like manner we shall shew of the two colde humors the one ingendred of melancholie the other of phlegme or pituite Edema is a soft tumor without dolor white coloured Of it there are two sortes like as of phlegmon the one is the true naturall Edema ingendred of the pure phlegmaticke humor the other is bredde of the phlegme mixed with the other three humors taketh diuers names according to the principall humor as ye haue heard And like as there are two sortes of it so it may bee named two wayes to witte either maladie or symptome of maladie as happeneth in the feete of those which are hydropicke and haue bene long sicke which are accidents of these maladies and require no particular curation sauing onely rubbing of the part with oyle salt or water and salt or oxycrat in wetting a cloth therein laying on it The cause is a phlegmaticke vaporious fluxion of humors pituitous and flatuous in any part of the body as also imbecillitie of the part which can neither digest nor expell that which is contrarie also great idlenesse The tokens are these the tumor is soft colde in pressing on it with the fingers there remaineth a hole and riseth not againe it is cleare and not dolorous and happeneth oftenest in the weakest parts as in the ioynts and glandulles and in the extremities as in the face and feete in colde weather and in olde folkes or after maladies in people that are full of humors and make no exercise This tumor turneth seldome to matter except in hot places by reason the matter is cold it endeth often by resolution sometime it turneth to schirre or nodosities or some other kinde of cold abscesse and that by the great vsage of digestiues which make the matter waxe hard In the cure there are two pointes to be obserued first to diuert the fluxion by remedies that haue the vertue to cleanse the pituite humor as Diaphenicon Catholicon Diacartami agaric such like for the administration of the which you shall vse the counsell of rhe learned Physition also in dyet in the sixe vnnaturall thinges tending to heate and drought eate rosted meates rather then sodden but in little quantitie abstayne from all thinges that breede phlegme as fruites potages cheese fish hearbes water sadnesse and much sleepe drinke wine with little water and vse bread that is well baked vse things to corroborate the principall partes Abstaine from women espeacially if the sicke be weake yet wee finde the vsage of women to be good in maladies pituitous for that heateth and drieth vse sildome bleeding in this disease The second intention consisteth in taking away that which is in the place which is in the place which shall bee done according to the times and degrees of the tumor first we shall vse medicines repercussiues and discutients which shal be meane and not strong Galen doth much commend oxicrate in this case by reason the vineger repelleth by the colde vertue and resolueth by the drie vertue if it he not sufficient mixe with a fewe ashes of the oake tree sal nitre or quicke lyme also the emplaister di vigo or a fomentation of camomille melilot rosemary sage wormewood Origan hyssope redde roses of each one handfull one ounce and halfe an
Mercurie egiptiac or such like thereafter incarnate and close the wound as in others Some vse only resolutiues on these tumors but such things are both tedious and vncertaine The twelfth Chapter of tumors ingendred of the Melancholick humor called by the Latins atra bilis or nigra cholera and first of Schirre SEing we haue suffitiently spoken of tumors ingendered of the sanguine chollerick and pituitous humor now it resteth to speake of those which proceede of melancholy called tumor Schirrus by reason the Greeke word Schirr signifieth hardnes Schirre is a tumor hard with litle or no dolor or feeling whereof there are two kindes the one is called the true Schirre exquisite the other is falles The true is as ye haue head the false is altogether without feeling yet hardly may it bee perceiued There is an other sort of Schirre ingendred of a phlegmaÌ„tick thick tough matter and is composed of an humor thick and cold The cause is a cold drie humor either of matter melancholick phlegmatick or both for first when the blood is made in the liuer there is ingendred in it a malancholicke humor which is like the dreggs of wine which afterwards is drawen to the milt for the nouriture thereof specially by the vsage of such meates as are apt to make the same and the milt weake to draw the same then it goeth into the veines and is mingled with the blood which by there vertue expuitrix expell it by the Hemorrhoides or varices sometime disperseth it through the skin and breedeth the Morphew or Leprosie Sometime it is caste on the most weake partes and according to the place and qualities of the humor breedeth eyther Schirre or Cancer If it bee cast on any drie part as ligamentes tendons ioyntes ends of the muscles or in the milt kidneis lyuer or matrix it causeth Schir If it bee cast on the softe partes as partes glandules as the pappes the emunctoires and face and the priuie partes it maketh cancer The cause also maye bee sadnesse suppression of the Hemorrhoides and menstruous purgations also by too much applying of cold medicines on tumors as erisipelas or phlegmon for by that meanes the most subtill doth resolue and the rest doth become hard The signes are these the tumor is hard and groweth slowly of colour liuide when it commeth of melancholie when of phlegme it is white and when of both humors together it is of a mixed colour as liuide and white and insensible because the humor is so thicke and drie which closeth the conduites of the nerues so that the animall spirite is inclosed in such sort that the part hath no feeling Those which haue no feeling are altogether incureable those that haue any feeling if they be taken in the beginning may be helped in some sort but hardly those which come to suppuration degendreth easily into schirre The Cure consisteth in three thinges first in diet tending to heat and humiditie abstayning from anger sadnesse feare and venerian exercise the second point consisteth in euacuating the matter antecedent by purgations bleeding by prouocation of the flowers hemerhoides the third point is to euacuate that which is contayned in the place which is done by things remollientes and resoluentes like as the grease of hennes cockes calues or geese also guÌ„me armoniac stirax galbanum rootes of althea lillies camomill of these we make liniments and cataplasmes also the emplaister of Diachilon magnum et album de vigo with double mercurie Galen commendeth goates dirt to bee an excellent remedie to discusse tumors schirrous Sometimes it happeneth in the tendons and then it is healed by perfumes made thus Take the stone called pyrâ—â—es or any other stone that is red hotte and quench it in strong vineger and then receiue the smoake on the sore part then apply remollientes sometime after the perfume the guÌ„me ammoniac dissolued in vineger is good and must be vsed with great discretion If none of these serue and it tende to suppuration we must not vse too hotte remedies to stirre it by reasoÌ„ it degendreth easily into Cancer for the which haue recourse to the next Chapter In some partes it may bee cut so yee cut all and leaue nothing adherent to the whole partes nor no roote of it For the great fluxe of bloud which happhneth either knit the veines or staunch it with canters actuall the which is dangerous when it occupieth the internall partes for the which Hippocrates forbiddes to seeke the exquisite cure of the occult Cancers The thirteenth Chapter of Cancer which the Greekes call Carsimonia VVE must vnderstand that Cancer is comprehended vnder the tumor Schirrous yet there is great difference for in Cancer there is great dolor punction and pulsation which is not in schirre it groweth sooner and hath great veines about it Cancer in Latine is the sore of a beast Guido saith it is called Cancer either by reason it sticketh to the parte like the fish Cancer or because it is round and hath veines about it like the feete of a Crabbe and is also like vnto it being liuide of colour as also because it gnaweth eateth and goeth like this fish It is a tumor inequall hauing the sides hard eminent turned and dolorous There are two kindes of it vlcered and not vlcered the vlcered is immobill hot by accident hauing many veines about it like the feete of Cancer the not vlcered is called Cancer occult The cause of it is a melancholicke humor drie not onely in the part as schirre but also in the veines about it the which by continuation of time maketh it more sharpe and maligne whereof commeth Cancer vlcered also euill diet vsing of thinges that breed thicke corrupted bloud with other such causes as ye haue heard in the precedent Chapter the debilitie of the milte and weakenes of the part These tumors for the most part are ingendred in womens pappes chiefly in those who haue great very fleshie pappes by reason they are glandulous and colde of themselues they breede also in the conduites of women lippes nose eyes eares roofe of the mouth legges handes and fundament by reason those partes are weake haue little naturall heate The signes are dolor tumor and they seeme soft but in touching are hard the vlcers inequal sordides the sides swelled horrible to looke on pale coloured euill sauoured by reason of the humor which is most sordide and stinking As for the iudgement those in the stomacke head shoulders necke and vnder the armes are all incureable because these places can not be cut for the great fluxe of bloud which may happen in them Some are little vlcered some much some recent others inueterate some in one parte and some in another some more maligne then others and for the most part are incureable It hath diuers denominations according
time nature ingendreth a certaine peice of flesh in the hole of descent The twentie sixe Chapter of the rupture Zirball called Epipâ—cele EPipocele is a descent of the caule in the codde or flanck the Cause is not different from the precedent accompanied with aboundance of humidities in these partes the Signes are like the precedent sauing that it is softer and vneasie to reduce not dolorous The Cure must bee like to the intestine in all cutting the production that falleth knitte canterize it to let the fluxe of bloud of the veines and arters whereof commeth great danger if it be reduced and yet bleedeth it causeth fluxe of the bellie and often death The twentie seuen Chapter of the waterie Herne called Hydrocele or Hernia aquosa THE waterie Herne is a Tumor in the coddes which groweth by little and little sometime to great bignesse and is contayned sometime in the codde otherwhiles betwixt the membranes that couer the stones called Dartos and Heretroidos sometime within them sometime it is accompanied with the guâ—te and is called Hydrointerocele The Cause is like as yee haue heard in Hydropsie and is a particular Hydropsie sometime stroakes the vesselles being riuen the bloud chaungeth into a waterie humor The Signes are the Tumor is cleare and becommeth long still in one estate not painefull heauie sometime hard and is knowne by holding the codde betwixt thee the candle and beeing inclosed in membranes it appeareth to bee a third testicle The Iudgementes some resolue oftentimes the intestine also falleth chiefely in the left side by reason of the milte which is full of colde melancholicke humor which oftentimes corrupteth the testicle As for the Cure the sicke must be purged with fitte medicines according to the nature of the humor vse meane exercises meates hotte and drie in small quantitie abstayning from drinke and keepe thy bellie loose sleepe little and prouoke vrine by diureticke thinges abstaine from all things which breed winde The particular remedies are in vsing fomentations as in Hydropsie next the astringent emplaister made of redde desiâ—catiue the vnguent Comitisse with the pouder of lapis calaminaris extinguished in vineger oaker balaust bol armenie allom mustard seede and euphors malax all together with a little oyle of camomil and lay on the sore If these remedies suffice not by reason of the great quantitie of the water we put a Seton through the lowest part â—f the codde and drawe it twise euery day till the humor be euacuated If the humor be in the membranes that couer the stones make incision in the side of the codde eschewing the testicle put a tente in it and dresse it twise a day keepe it open till the humor be euacuated vse remedies anodiâ—us for to appease the dolor and â—ic catrize it as other woundes The twentie eight Chapter of the Herne windie called Physocele THis Herne is a collection of winde in the Scroton called Hernia ventosa the Cause is imbecillitie of natural heate in these partes and phlegmaticke matter with such other causes as yee haue heard in windie apostumes The Signes are the Tumor is somewhat hard light round sodainely ingendred occupying for the most part the sâ—roton and wand resisting to the touch cleare as a bladderfull of winde the wande greater in one place then in another The Iudgementes if this vapour dissip not it causeth many euilles sometime occupying the whole bodie and proceedeth often of matter venenous The Cure shall be first in good dyet as in Edema next to applie on the place thinges resolutiue and corroboratiue as yee haue heard in windie apostumes some allowe the plaister of Vigo with mercurie or diapalma malaxed with wine also the dregges of claret wine boiled with bran laid warm on the place The twentie nine Chapter of the Herne carnosa called Sarcocele THis is a Tumor in the cod sometimes in the membrans dartos and heretroidos chiefely about the stones like vnto a tumor schirrous and as it were accompanied with veines varicous The Cause is aboundance of grosse humors in these partes which doth corrupt the testicles and at last degendreth into a harde fleshie disposition The Signes are vnequall tumor hard alwayes in one estate dolorous and being touched all which is in the testicle doth moue The Iudgementes are that when it happeneth to young folke and handled in the beginning it doth some time heale but commonly it is incureable and the worst of all the eight kindes If by feeling it at the vppermost parte of the didim it seeme vnnaturall great the tumor is incureable and better it is not to touch it then to attempt any cure if ye finde the didim small there is some hope of cure For the which we must scituate the sicke as yee haue heard next make the incision in the vpper part of the cod knitte the didim and canterize it as ye haue heard in interocele If it adhere to the codde separate it and cutte off the testicle with the excrescence if after the incision there commeth inflammation and dolor let the patient bleede and rest fiue or sixe dayes as counselleth Franco and leaue the cure to giue order to the accidentes The thrrtie Chapter of the Herne varicous called Câ—rsocele THis Herne is a Tumor and dilation of the veines that nourish the testicles which are full of melancholicke bloud and also the membranes hereof The Cause is some grosse humor or melancholick bloud gathered in that part by reason of the debilitie and decliuitie of the place and heauinesse of the humor The Signes are the repletion of the veines sometime fewe in number sometime many wrapped together like a vine braunch soft in touch and returning into the bellie by pressing on the didime The iudgmentes are it is without dolor most dangerous and difficill to be cured as ye shall heare in the varices of the legges The cure shal be first in purging the bodie of melancholick then bleede if neede be therefore make incisioÌ„ on the scroton the breadth of two fingers in the place of the varice thereafter make passe a needle with double thread vnder the varice and in the vpper part of the wouÌ„d an other in the lower part leauing an inch betwixte then open the varice and euacuate the humor contayned if there be any moe doe the like that done knitt the thread and handle the wound as others If the testicle be infiltred with veines accompanied with dolor that it may not bee handled this way the didime must bee cut as in the preâ—â—dent and so proceede in the cure The one and thirtieth Chapter of the herne Humâ—rall THis herne is an aposthume and defluxion of humors together in the codd or membranes that couer the testicles and sometime in their proper
conceiued in the time of the monethly purgations or else the mother or father hath beene elephanticke After we are borne it commeth eyther of corruption of ayre as in places neare the Sea which maketh the humors of the bodie thicke also dwelling in hotte countries as in Aphricke Spayne and others where many haue this disease also in colde partes which thicken the humors plenitude of the humors chiefly of the melancholicke retention of the hemerhoides or purgation menstruall defect in the milte corrupteth the humors chiefely melancholy great vsage of melancholike meates ae Swine Goates Hares cheese and such like The Signes are great tumor occupying the whole member or some parte thereof which augmenteth by little and little not dolorous insensible which sometime is inflamed The iudgementes when it is vniuersall or particular it is incureable yet some remedies palliatiues may be vsed to lette and stay the maladie by purging the melancholicke humor bleeding bathing ventousing prouocation of the flowers and hemeroâ—hes vsing of good regiment and thinges that ingender good blood abstayning from things of contrarie qualitie the which must be done by the aduise of the learned Physitian If there come inflammation in the hart vse such remedies as are set downe in the Chapter of Phlegmon I haue seene some haue this maladie and liue 20. yeares and more by the vsing of good regiment but I haue knowne none to come to perfect cure The thirtie seauen Chapter of the tumor which commeth in the extremities of the fingers called Paneris or Paranochia THis Aposteme which occupyeth the extremities of the fingers and rootes of the nailes is called by the Greekes Paranochian by the Latins Reduuiae The Cause is melancholick humor venemous and most hot of the nature which proceedeth from the bones nerues tendons and membranes which couer the same The signes are vehement dolor whic maketh the â—icke almost beside himselfe great inflamation feuer and sundry other lik accidents as in Carbuncle The Iudgments it is sometime vlcered with virulent matter is verie dangerous as saith Gordonius oftentimes afore there bee any outward apparence in the flesh it rotteth both the bones and ligaments and membranes and then there is no remedie but to cut it for feare it infect the rest and also cause death as reporteth de Vigo The Cure first the sicke shal be purged and bleede in the arme opposite vsing good regiment and abstayning from all strong drinke as for the topicall remidies there are diuers opinions amongst our old writers some counsell repercussiues and â—nodins and supuratiues other counsell for the greatnes of this disease not to abide the maturation but presently make incisioÌ„ in the inner side of the part or ioynt the length of the said ioynt going to the bone to giue issue to the venim which is coÌ„monly the periost and bone let it bleed till it â—â—aunch of it selfe thereafter washe the part with strong vineger and Aquauitae wherein hath been delayed a little Treacle vsing a liniment of vnguent rosat Populeon with a little oyle of Roses or a cataplasme made of the leaues of Henbane Sorrell mandrakes rosted vnder the ashes and mingled with a little Butter or Hogges greace this doth appease the dolor and prouoke matter This being doone cleanse the vlcer and cicatrize it as in others The thirtie eight Chapter of the litle hardnes in the feete commonly called Cornes THose hard tumors which coÌ„monly occupie the toes and feete chiefly the ioyntes and vnder the nailes are called Cornes and in latin Clauus of the which there are three kindes to wit Corpus Callus and Clauus The Cause is chiefly in wearing straight shoes superfluous excrements which cannot auoide so remaineth in the partueruous and acquireth a certaine hardnes according to the nature of the part where they are The Signes are apparent to the sight The cure is that those that are little not deepe are to bee cut finely at the roote and filled vp with a little wax and greene copperous or else a little of the sande which remaineth of the vrine take heede yee cut not to deepe amongst the ligaments tendons for the great accidentse that followe as inflamation sometyme conuulsion and Gangren so that some loose their toes feete In cutting a part of it the roote groweth more large then it is best to foment the part with water of mallowes and Althea or water wherein Tripes haue been sod thereafter vse Gum Ammoniac dissolued in Aquauitae and laye one it or this which I haue often vsed made of lyke quantitie of Turpintine wax and verdegreace and applye thereon And so we end this Treatise and shall followe out to intreate of woundes in like manner THE SIXT TREATISE Of Woundes and containeth twelue Chapters Chapter 1 Of woundes in generall Chapter 2 Of the simple wound Chapter 3 Of the composed wound with losse of substaÌ„ce Chapter 4 Of the contused woundes Chapter 5 Of woundes done by gunshot Chapter 6 Of woundes in the veines and arters Chapter 7 Of woundes in the Nerues Chapter 8 Of wuundes by biting of venemous beastes Chapter 9 Of woundes in the bones Chapter 10 Of woundes in the head Chapter 11 Of woundes in the thorax Chapter 12 Of woundes in the bellie The first Chapter of the cause signes and curation of woundes in generall CO Like as wee haue proceeded in the former Treatise of Tumors wee shall follow out the same Method in woundes and so I demaund what is a wound LO It is a dissolution of the continui-tie recent bloudie without putrifaction in the soft hard or organicke partes CO. Which is the cause of woundes LO Whether they be animate or inanimate they are of three sortes of the which they take their denomination as if the wound be made by a thing sharpe pointed as a rapier launce or darte it is called thrust or stabbe if with a cutting thing it is called incision or cut if with a heauie blunt thing as a stone or club which commeth by force and breaketh contundeth the flesh it is called coÌ„tusion CO. Which are the signes of wouÌ„ds LO They are manifest according to the iudgement accideÌ„ts that follow CO. Which are the differents LO Some are simple others coÌ„posed CO. What is a simple wound Lo. It is that wherin is no lacke of substaÌ„ce healed one way only to wit by coÌ„solidatioÌ„ as sayth Hyppocrates CO. What is composed LO It is that in the which there is losse of substance and hath diuers intentions for the cure thereof CO. Differ woundes no otherway LO They differ also in that some heale easily some are difficill and some are mortall some without intemprie some little other great sperficiall profound in the simple or similar others in the instrumentall or orgaine parts some in soft some in hard partes CO. Which are those which heale easily LO
Those which are in the flesh not touching veines nerues nor arters in bodies well composed and where there are no great accidents nor in partes dangerous CO. Which are dangerous LO All those which are interne also in the membranes of the braines in the heart lightes lyuer Diaphragma and great intestins and those that are within three fingers to the iointes also woundes in the nerues which cause conuulsion for their communication with the braines those in the Esophag vines Ingulare in the flanck thighes betwixt the fingers and all those yet are without tumor all woundes in the head both great smal wouÌ„ds that are depe made ouerthwart also some are difficill for the excellencie of the part being necessarie to all the bodie and life it selfe CO. Which are mortall LO All those in the substance of the braines heart lyuer midst of the lightes chist of the gall midst of the Diaphragme stomack milt kidneis small intestines bladder matrix trachearter and spinall medull Also those at the rootes of the emunctoires and noble partes in like manner in the veine caâ—e descending or ascending the veine part great arter or in the back cause present death be reason of the great euacuatioÌ„ of the bloode and spirrits CO. Which aere the particuler signes whereby you know those partes to be mortall LO Euerie one hath a perticuler signe as if the braines or membrane thereof be hurt the blood commeth foorth by the nose by the eares with vomiting of choller voiding of the excrementes vnawares to the partie the face vgly to the sight the feeling dull and vnderstanding hurt the patient falleth into rauing convulsion within 3 or 4 daies We know the heart to be hurt when there cometh out quantitie of blood thick black chiefly if the right side be hurt if the left it is more red and subtill the pulse becometh weake variable the colour pale with vniuersall trembling casting a cold ill sauoured sweat the extremities wax cold often sounding and dieth shortly We knowe the Lights to be hurt when the sicke doth breath with difficultie voyding a spumous blood at the mouth and wound lying on the wounded side speaketh and not on the other side some raue the red colour and heate goeth to the visage in the end issueth quantitie of matter at the wound The Diaphragme being hurt the flancks retire close there is great weight on the part dolor in the rig back cough difficultie of breath with issue of a spumous blood at the wound as in the Lightes If the Liuer be hurt there cometh out great abundance of blood the flanckes retire towards the back the colour like death the eyes sinke in the head want of rest the vrine is bloody the excrements purulent the sick cometh to lie on the belly the dolor is pricking extending to the breast bone and ribbes in respiring he draweth in his shoulders and vomiteth choller Paulus Aegineta reporteth that one lobe of the Liuer may be hurt and yet death not follow of necessitie If the Milt be hurt the blood cometh forth black thick at the wound or left flanck which with the stomack waxeth hard there is great drought dolor in the furcilles as in the Liuer If the Kidneys be hurt the dolor descendeth to the roote of the thigh testicles there is difficultie of vrine pissing of blood sometime blood staieth within the sicke dieth all swollen If the Orifice of the stomack be hurt there ensueth vomiting of choller as also of that which is eaten presently the pulse is weake sweating the extremities cold The stomack and intestine ieiunuÌ„ being hurt haue the same signes with the meat drinke issuing forth at the wound the flancks dolorous and hard the Patient voydeth choller at the mouth spitteth blood with great cold in the extâ—mities The Spinall medull hurt the sicke becometh paraliticke in a conuulsion and looseth the feeling the inferior conduites are relaxed so voydeth the seed vrine or excrements If the Bladder be hurt there is great dolor aboue the yarde pissing of blood voyding of vrine at the wound vomiting of choller cold in the extremities If the Matrix be hurt the dolor doth communicate to the liskes haunches thighes the blood cometh forth partly by the wound partly by the nature some lose sence and reason and some speach haue the same accidents with those that are hurt in the heart If the Intestines be hurt there is great dolor with continuall voyding of the fecall matter at the wound CO. What is to be considered of the Chirurgian touching the Iudgement of wounbs LO First to know what part is hurt the nature thereof whether there be any or no hope of health knowing the parts that are easie to heale difficile mortall also the vsage actioÌ„ substance situation of the same likewise the figure of the wound actions that happen the temperature age sex region season constitution of the time Wounds in the nerues teÌ„dons ioints bones without apparence of tumor are euil signes shew the humor to be brought to the noble part Wounds with fracture behinde are in danger of spaâ—me such being before are in danger of raâ—ing freÌ„sie Iâ— convulsion happen in a wound chiefly after some great inflaÌ„mation it is for the most part mortall sheweth the parts neruous to be hurt Wounds in the head if after x. daies symptons do happen signifie abscesse in the liuer and likewise great desire of drinke signifieth the same Wounds that haue bled much if conuulsion ensue are dangerous as also all thrusts in nerues tendons the vnuoluntarie vomiting of choller wheÌ„ the sick is hurt or the inflaÌ„matioÌ„ lasteth is an euill signe CO. Vntill what time should we stay our Iudgement of woundes in the heade LO Vntill Fortie daies and some late writers till fifteene and twentie daies dayes after which time commeth often feuer and other euill accidents which chaunce often at full Moone and dyeth as I haue sometime noted CO. What time of the yeare is most expedient for curation of woundes LO The spring time when the weather is neither hot nor cold the Autume is euill for the moystnes of the ayte as also the cold winter which is enimie to vlcers and woundes in the membranes and bone as sayth Hyppocrates CO. Howe many pointes are there to bee obserued in curing of woundes LO Fiue first in ordring of vniuersall remedies regimeÌ„t of life aire which must bee hot and temperate the sicke must be nourished with litle meate and of light digestion some-what refrigeratiue if there be feare of feuer or inflamation which danger is most to be feared afore the 7. day abstayne from wine and all strong drinke except through losse of much blood the hart be faint supp lightly abstayn from women and all vehement passions of
the nerues makeing inuoluntari mouing drawing the muscles tendons towards theire beginning vneasie to relax CO. What is the cause of Spasme LO Repletion euacuation and dolor CO. Is it dangerous LO Auicen saith that all spasme confirmed in woundes is mortall others are cureable that which chaunceth through thrustes in the nerues is euill If it happen by great euacuation of bloud it is mortall as saith Hippocrates and better it is that a feuâ—r come in a conuulsion then conuulsion in feuer spasme after feuers is mortall as saith Hippocrates CO. Which are the signes of spasme LO Difficill mouing of the bodie tension of the necke contraction of the lippes astriction of the iawes peruertion of the eyes and face which if it take the course to the partes appointed for respiration it is lamentable and the sicke shall soone die that which is confirmed is incureable CO. What is the cure of it LO First we foment the parte with hydrelâ—on or hydromell sometime bathe with water wherein hath beene sodden mallowes althea violettes extremities of calues mutton goates lambes such like with a certaine quantitie of oyle being taken out of the bath rubbe the parte with oyle of violettes sweete almondes hennes grease or mutton also rubbe the necke backe and head being rased with oyle of lillies vulpinum turpentine phâ—losophorum For the same purpose drie perfumes are good it shall bee good sometime to drawe bloud on the same side if there be plenitude with inflamation if there bee cacochymie purge the bodie of the humors which abound if the cause come of dolor or some bite of a venemous beast the dolor must be appeased and apply on the sore treacle and ventous to drawe out the venenositie CO. What is Paralisie LO It is a mollification or relaxation of the nerues with priuation of the moouing whereof there is two kindes vniuersall and particular CO. What is the vniuersall LO It is that which occupieth all the body sauing the head and if it occupie the head also it is called apoplexie which is an other kinde CO What is the particular LO It is that which possesseth occupieth one member onely as the hands feete tongue legs and such like CO. Which are causes LO Some are intern some externe Interne as grosse humor which moysteÌ„ the nerues in the braines the marrow in the which let the vitall spirit to passe Externe are wounds incisioÌ„ falles strokes conâ—usioÌ„ aposteme cold al outward things that may let the animall spirit to passe CO. Is it cureable LO Al paraliâ—â—es are difficill by reasoÌ„ the nerues are destitute of their natural heate which is the efficieÌ„t cause of curatioÌ„ yet some are cureable when the nerue hath lost the feeling mouing it is called Aploplexie when it commeth to one side it is called Resolution of the part CO. Howe is it cured LO By vniuersall and particular remedies vniuersall as purgations Clisters bleeding good diet hot and drie particular as emplasters linimentes ventoses cataplasmes fomentatioÌ„s also the balme of Guido who counselleth to applie ventouses in the beginning of the nerues Togatius counselleth a liquor set downe in ad ditionibus Petri apponensisde scriptionis mesue also to rubbe the neck back parts most offended with vnguentuÌ„ martiatum or agrippae CO. What is Sincope LO It is suddaine fall and decay of all the whole forces of the bodie and of al accidentes it is the worst CO. Which are the causes of it LO Great euacuation of blood inâ—emperatur of the noble partes vehement passion of the spirit feare lacke of courage rotten vapors as happen in pestilent feuers and all thinges that may intercept and destroy the vitall spirit CO. What is the cure LO First to encourage the sick speake little giue him a little wine cast water in his face and hold vineger at his nose drawe his extremities and chiefly the fingers and rubb the part affected with this Rec. olei costini terebanthine an vnc 2. misceantur et vngatur With this vnguent Rec. vnguenti martiati vnguenti Agrippae an vnc 1. se olei costini nardini et de piperibus an drag 1. sagapeni apopanocis dissolutorum in vino an drag 2. cerae parum fiat vnguentum quo vngatur neruorum origo CO. What is alienation LO It is an inordinat perturbation of the mind with diuersitie of speach wherof there are two kindes proper and accidentall the proper is that which we call madnes the accideÌ„tall is that which we call rauing as chanceth in hot feuers and other maladies wherein hot fumes ascend to the head or by hott and cold aire as saith Auicen also by putrifaction and venenositie of our meate and drinke and is cured by diuerting the fumes with frictions and ligators of the extremities vsing Clisters and rubbing the head and necke with Oxyrodinum CO. What is the fift thing to bee obserued in curing of woundes LO To conserue the substance and the temperature of the hurt parte and consolide the wounde which is done with vnguentes emplasters tentes plumations as ye shall heare in particular CO. Tell me some thing of plumatiens tentes and there vse LO Plumations are made of little peeces of cloth the threads drawen out or the peeces of cloth themselues woll or tow the pith of the Elder tree the haires of a hare gentian Of these some are round some triangulars and quadrangulars the auntients giue them diuers denominators eyther of the matter they were composed of or of their forme some are applyed drie others wet in diuers liâ—quors as whites of egges wine vineger or oyle according to the disposition of the part we apply them vnto Sometime we apply many otherwhiles few as the case requireth The tentes are sometime made of cloth other-whiles of sponges or rootes of certaine plantes of brasse lead siluer some caue within others not of length greatnes according to the hurt some are euen others crooked yet alwaies rounde and are vsed for diuers causes as when woundes are to be amplified or cleansed also in caue woundes with losse of substance in contused woundes altered by the aire also when the wound is affliged with phlegmon or any other tumor against nature also in woundes which come of biting for such wounds haue some venenositie In wounds with corruption of bone In all other woundes we vse not these thinges but induce the cicatrize and conâ—solide the wounde CO What is consolidation It is that which hath force to ioyne consolide and drie the wound maketh if like vnto the skin CO. Whaâ— skin is it LO It is nothing else but the fleshe made drie and harde by the worke of nature vertue of medicaments and is like the other skin but not of the same nature in all pointes CO There are many other thinges which may be spoken generally of wouÌ„des which for lacke of
ligators frictions good regiment in vnnaturall thinges thirdly in vsing particular remedies first digestiues for such woundes must sodainly be brought to suppuration for the which vse this cataplasme of mallowes violets althea sodden in fresh broth putting to it a little barley flowre butter basilicon and the yolkes of egges with a digestiue or this Take waxe turpentine calues grease goose grease honney mirrhe and oyle of roses mingle all together To appease the dolor vse oyle of camomill roses lillies mirtles oxyrodin and bol armenie The fourth intention is in correcting of the accidentes as dolor apostume gangren for the which vse such remedies as yee haue heard in the seconde Treatise The wound suppured and the accidentes corriged it must be cleansed with honney of roses and turpentine mundificatiue de appio apostolorum and such like as yee shall heare in the introductioÌ„ to Chirurgerie in the pooremaÌ„s guide Being cleansed wee vse incarnatiues and desiccatiues as was set downe in the former Chapter The fifth Chapter of woundes done by gunshot I Haue spoken of simple compound and contused woundes nowe will I intreat of woundes with dilaceration and losse of soft and hard partes and is made by diuers sortes of instrumentes as bulleâ—tes of lead iron steele brasse stones and other such like matter in diuers figures as round triangular quadrangular pointed flatte little and great which sometime penetrate sometime not whereof our auncientes haue made no mention except onely Celsus who telleth not with what instrument they were shotte with therefore though some haue written of late yet because they are of diuers opinions and written in sundry languages I will shewe my opinion touching the same not making any mention of others who haue written of the same This kinde of woundes is accompanied with tumor dilaceration of flesh veines arters nerues tendous ligamentes and boanes superficiall profound otherwhiles through the bodie and according to the difference the Chirurgian must take his indication to diuersifie the remedie in like manner apostume dolor corruption of the partes gangrened and mortified through the great aboundance of bloud dispersed betwixte the muscles also for the dissipation of the naturall heate sometime one onely accident otherwhiles diuers together for the which we vse two curatiue intentions to wit restitution of such things as are lost and to conioyne the partes deuided These wouÌ„ds come indifferently to all parts of our bodie whereof there are diuers opinions some thinke that there is venenositie in the pouder and burning in the bullette which is false for the thinges whereof the pouder is ordinarily made as brimstone saltpeter coales of diuers sortes of trees water wine and aquauitae haue no venenositie in them likewise there is no burning in the bullet for if the bullette of lead beeing shotte a great way should burne through heat would be melted it selfe I haue cured diuers within these tenne yeeres of diuers nations which haue followed the warres in Fraunce in the which I haue found no more difficultie then in other contused woundes so I thinke these accidentes come onely by contusion and dilaceration of the flesh and not by any venenositie nor vstion yet there may be some extraordinarie mixtion in the pouder which causeth venome for the which we take some other indication acccording to the thing The Causes Signes differences and Iudgements are not much different from those of other woundes set downe and sufficiently discoursed in the generall Chapter as for the Cure there are fiue intentions first to draw the ball secondly to appease the dolor thirdly to cause suppuration fourthly in mundifiyng generation of flesh and consolidation fiftly in correction of the accidents As touching the first and second to draw out the bullet and appease the dolor I haue discoursed at length in the generall Chapter neuerthelesse because in these woundes there is vehement dolor which weakeneth the sicke hindereth nature causeth fluxion letteth suppuration and consumeth the flesh which is contused I will set downe things more particularly for the appeasing thereof in chaunging the temperature of the whole bodie in due vsage of the sixe vnnaturall thinges by purgations bleeding and abstayning from thinges which cause dolor as great tentes sections straight bandages wrong situation of the part incision vnlesse there be great neede The topicall remedies as cataplasmes with bread milke yolkes of egges and a little saffron also mallowes sodden and beaten with wheate flowre oyle of roses and hogges grease and saffron are good or this Rec. sanguinis draconis boli armenâ—ci an onc 1. pulueris rosarum et myrtillorum an onc di aceti onc 1. albumina ouorum quatuor olei rosacei quantum sufficit fiat vnguentum If there be great heat oyle of roses with whites of egges and vineger layde about and on the part is good Also cerat Galen or vnguent rosat mesne with bol armenie sanguinis draconis pouder of roses and myrtles If we feare inflamation which oft chaunceth till the seuenth day vse the same remedies and shift them twise or thrise a day The tentes shall be soft wette in turpentine with a little hypericon and aquauitae according to the nature of the part and vse this remedie hotte and continue it till the inflamation bee past let the sicke eate and drinke little that he ingender no superfluities Auicen couÌ„selleth to giue meate to the sicke onely for sustentation of nature abstayning from wine for it is enemie to al wounds drinke sodden water with sugar or honey or ptysane till the inflamation be past keepe rest and quietnesse abstayning from all actions of the spirrit watching and women according to the disposition and nature of the hurt Third intentions consisteth in medicameÌ„ts suuppuratiâ—es which must be done with speede to the end they be lesse subiect to inflammation vsing remedies which are of qualitie hot and dry with vertue to correct the putrefaction let the GangreÌ„ mortification of the parte there are of diuers formes the simples are made of oyle of HypericoÌ„ of eggs yolkes of egges lynit seede Lillies Turpentine Mirh such like or this Rec. tereb enthine onc 2. corticis thuris drag 1. mastichis drag 3. olei hypericonis et rosaruÌ„ an parum vitellum vnius oui fiat medicamentuÌ„ Or this which I most coÌ„monly vse of HypericoÌ„ Turpentine and yolks of egges or my balme which is excellent in all kindes of woundes made thus Rec. summitatuÌ„ et florum scrophularie et hyperico nis an quantuÌ„ volueris offiâ—glossi vel herbe carpentariâ—ruÌ„ et consoli dae regis an quantum volueris terebenthinae venetae quantum sufficit macerentur in sufficienti quantitate olei hypericonis insolentur omnia in sole calidissimo spatio 40. dierum in vase plumbeo vel vitreo duplicato posteo fiat fortis expressio seruetur liquor pro balsamo The fourth intention is to mundifie and regenerate that which is lost which must
Land The eleuenth Chapter of woundes in the Thorax THe Thorax which is domicill to the heart and lights suffereth solution of continuitie in diuers manners whereof some are externe and doe not penetrate others penetrate to some of the partes contayned therein as the heart lightes mediastin and diaphragma some passe throughout of the which some are cureable some incureable and some mortall as yee haue heard in the Chapter Generall as also the Causes and Signes Those which penetrate at the backe are more dangerous then at the interior part because of the veines arters nerues and such like The Cure consisteth in good dyet in the sixe vnnaturall thinges purgation letting of bloud according to the temperature of the body time and Region Those which doe not penetrate differ nothing from the generall of other simple woundes sauing onely in binding which must be incarnatiue sometime narrowe otherwhiles broad according to the difference and scituation of the wounde Touching those which penetrate there is great diuersitie of opinion in the cure some are of the opinion to consolide the wound as soone as may bee to hinder the externe ayre to hurt the partes vitall others giue counsell to holde them open and in case the issue be not large enough to dilate it and make it larger that if there bee any bloud or other thing in the capacitie it may auoyde but which of these wayes ought to bee followed the iudgement of the expert Chirurgian is to bee required knowing first if it doth penetrate which shall bee done in closing his mouth and nose and then holding a candle to the wound if the ayre coÌ„meth forth it is sure that it penetrates if there be bloud in the capacitie you shall know by the ponderositie of the diaphragma accompanied with dolor feuer and vomiting if any chiefe part be offended ye shall know by the signes set downe in the Chapter Generall If neither bloud bee shedde nor any parte offended yee shall conglutinate the wound putting no tent therein vsing onely a little of my balme set downe in the Chapter of Gunshot in the meane time vse one potion vulnerar which doth penetrate If there be any little thing left in the wound nature will easily discharge it for as saith Galen it doth expell not onely that which offendeth through the pannicles but also through the middest of the bones Those which penetrate with effusion of bloud on the diaphragma are not mortall must be tented with a threed at the tent to the ende that if it goe in it may bee drawne out agayne cause the sicke lie on the sore side chiefly when you dresâ—e him that the bloud and mattir may issue at the wound vsing alwaies iniections of barley pimpernell pilosell buglosse scrofularie cheruill all sodden in water putting thereto a little honney or syrrâ—pe of roses with a little white wine for a certaine time Sometime the bloud cannot euacuate by the wound it being higher then the diaphragme which causeth difficultie of respiring for the which make an issue as ye haue heard in Empiema to euacuate the humor contayned if the putâ—efaction be great mixe with the foresaid iniection a little egiptiac the wound being mundified with this or such like thou shalt vse this iniectâ—oÌ„ which is somewhat desiccatiue Rec. rosâ—rum balaustiorum myrtilorum an onc 1. mirabolani citrini an onc 2. mellis rosati parum coquantur in aqua plantaginis ad consumptionem tertiae partis with this thou shalt washe the wounde twise a day If the body be of an euill temperature or that the nether part of the lightes be hurt it stayeth not quickely but will voyde much then we must vse a tent of lead or siluer that is hollow within that the matter may enacuate we vse also this decoction to drinke in the morning fasting foure howers after Take scabions buglâ—sse borage pimpernell aristoâ—â—lochia agrimonie betonie pilosell an M. se vnarum mundatarum seminis hipericonis et cardui benedicti an onc 1. florum trium cordialium an P. 1. coquantur in aqua adde in sine vâ—ni albi parum sirupi rosati et cinamomi an onâ— 2. vsing on the wound the emplaster Diacalciteos malaxed in wine If notwithstanding these remedies it remaineth long in healing it doth degenâ—er infistull for the curation of the which haue recourse to the Treatise of vlceâ—s Chapter of Fistula The twelfth Chapter of wnundes in the Bellie THe inferior venter wherein the Lyuer with the Kydneis milt are inclosed is often wounded in diuers manners some penetrates and some not offending the parts contayned as the stomack liuerr milt kidneis guttâ— veines arters the epiplon and vâ—iâ—ers or some other part the causes signes and Iudgments whereof ye haue heard in the generall Chapter The Cure is those that do not penetrate are cured like other simple woundes those which penetrate into the capacitie require an other manner of cure Woundes in the side in the oblique muscles are not so dangerous as those in the transuersall because that the peritone is vneasie to sow specially in musculo recto which descendeth from the brest to os pubis Also little woundes in those places are more difficill than those that are more ample in them if the gutts come not they tumifie and so are vneasie to put in againe for the which vse such remedies as ye haue heard in Axâ—mphalon vsing the future Gastoraphick if the gutts be pearced they must be sowed with future pellitor and cast on the wound the pouder of aloes mirre mastick and boll and reduce it softly in the owne place vsing an emplaster retentiue and agglutinatiue If the lâ—iâ—â—ium be cut it is impossible or most dificill to heale by reason of the great veines coÌ„tained therin if any of the guts hath changed coulor there is no hope If the caule of the venter be altered it must be knit and reduced as ye haue heard in the generall Chapter In all woundes in the bellie vse Clisters and innections astringents detersiues chiefly if the great intestine matrix or bladder be hurt And so we end this Treatise of woundes and shall follow out that of vlcers after the same manner THE SEAVENTH TREATISE of vlcers which contayneth Ten Chapters By Peter Low Arellien Chapter 1 Of vlcers in generell Chapter 2 Of vlcers sâ—nious and their curation Chapter 3 Of the vlcer Virulent Chapter 4 Of the vlcer profound and Cauernous Chapter 5 Of the vlce Sordide and Putride Chapter 6 Of vlcers difficill to Cure Chapter 7 Of vlcers with corruption of the Bones Chapter 8 Of vlcers Cancrous Chapter 9 Of Fistula Chapter 10 Of Burninges The first Chapter of vlcers in generall CO Seeing wee haue amply spoken of tumors and wounds of their definitâ—n cause signes and cure so in like manner we will proceede in vlcers seeing many tumors and woundes doe suppure and degender in vlcers so it is needefull after the Treatise hereof to speake of vlcers
and first I demaund what is an ulcer LO It is a solution of contimâ—tâ— made by erosion in diuers parts of the bodie out of the which procedeth a maâ—ter purulenâ— which hindereth the consolidation thereof CO. Are they not different LO Some differ in nature in substance in quantitie figure and accidents CO. How differ they in nature substance LO Some are simple in the flesh without any other indisposition as saith Galen or are composed with one or moâ— maladies as vlcers with intemperie corruption of the bone aposteme nodositie and diuers other accidents CO. How differ they in figure and quantitie LO Some are round long profound superficiall great and small CO. How differ they by accidents LO Some are putride dolorous fistulous cancrous some are inueterate some recent some in on member some in other places CO. How many causes are there of vlcers LO Three primitiue antecedent and coniunct CO. Which are the primiâ—â—tiues LO Contusion scratching heates applycation of sharp medicaments corrosion great cold that extinguisheth the the naturall heate chiefly in the extremities CO. Which are the causes antecedent LO Euill humors in the bodie which come of euill nouriture or euill disposition of the bodie or some part thereof chiefly the lyâ—er and milt CO. Howe are these humors causes of vlcers LO Partly by their euill qualitie partly through abundance thereof do spoyle open coâ—ode the most debill parts of our body not hauing force to resist such malignitie and so causeth vlcers CO Which are the coniunct causes LO The foresayd humors conioyned in the partes vlcered as also all other violent thinges that haue force to vlcerate the same part CO Which are the signes Lo. They are euident or are in the body are knowne by the dolor nature or the place accidents excrements such as you shall heare in the sixe kinds of proper vlcers CO. Which are those sixe kondes of vlcers LO The first is sanious 2. virulent 3. filthie 4. cancrous 5. putride or stinking 6. corrosiue or rotten awaye CO. Haue they no other names LO They haue fiue other names and first by the humors secoÌ„dly of the matter that coÌ„meth froÌ„ them thirdly of the accidentes fourthly of the sicknes fiftly by comparing them to the similitude of beastes CO. How take they their names by the humors LO Some are of the Phlegmatick humor and are called Phlegmaticks some by the blood and are called sanguinis by the choller chollerick and by melancholy melancholick CO. Howe take they the nemes of the matter LO Of the great abundance of sany or humidity it is called vlcer sanious of the pus purâ—lent of the sordidities it is called â—ordide of the virulence it is called viruleÌ„t CO. How take they their names of the acdents LO Of the hardnes called callositie it is hard and callous of the cauâ—â—ns of it it is called cauernous of the fistule it is called fistulate of the putrifaction putride of the corosion or malignitie of the matter corosiue of the cankers or hardnes turned ouer it called cancrous of the dolor dolorous of aposteme apostemus In all vlcers where any of these raigne they heale not till they be takeÌ„ away CO. What is callositie LO It is a drie flesh without dolor because it hath no veine to make it humide nor nerue to giue it feeling CO Howe is that called which commonly commeth from vlcers LO It is called sanie or matter CO. What is sanie LO It is a corruption of the part which nature cannot digest and make it to nourish the same CO. How many sortes of sanie is there LO Two to wit that which is commendable as it ought to be and that which is not CO. Which is commendable LO It is that which is white light equall in consisteÌ„ce neither thick thin nor euill tasted CO. Which is not commendable or euill sanie LO It is a corruptioÌ„ of the inâ—â—ument much altered through vnnaturall heate according to that alteration it produceth euill sanie CO. What call you pus LO It is a kinde of sanie made of the nouriture and superfluitie of the meÌ„ber tending to corruptioÌ„ by the alteratioÌ„ of the naturall heate debilitie of the member out of the which coÌ„meth a matter called virus sordities CO. Whot is virus Lo. It is that which is ingeÌ„dred of the most subtill and hotte parte of the pituitous humor which nature cannot digest for the great abundance thereof CO. What is it thou callest sordities LO It is a grosse matter ingendred of grosse humors CO. What callest thou durities or hardnesse LO It is a thing hard and solide not easie to bee corrupted which may come of three causes that is great heate congelation repletion CO. What callest thou fistula LO It is a profound vlcer hauing the entrie hard narrow deepe cauernous from the which proceedeth a matter virulent CO. What is putrefaction LO It is a chaunge of the substaunce of our whole body or of some parte thereof through an vnnaturall heate CO. What is the cause of putrefaction in our bodies LO It commeth either that the spirite animall is corrupted or cannot goe to the parte for colde heate apostume pustulles vlcers ambulatiues venenous also putting of oyles and such like in deepe vlcers doth corrupt the fleshe also too much vsing of refrigeratiues in hotte apostumes and ligators which intercept the spirite CO. How many sortes of putrefactions are there LO Three ro wit Gangren Estachiles and Histiomen CO. What is Gangren LO It is a putrefaction of the parte hauing yet feeling and differeth in that from others CO. What is Estâ—â—acheâ— LO It is a putrefaction of the member or parte thereof without feeling corrupting both flesh and boane CO. What is Hâ—stiomen LO It is a whole corruption of the member eating consuming the whole bodie away CO. What is Corrosion LO It is a consumption of the fleshe through the bitternesse and sharpenesse of the humor CO. What are the causes of Corrosion LO The malignitie of the fleshe the humor cholericke phlegmaticke salt admixed CO. What callest thou Cancer LO It is a maladie of a matter colde and drie being hotte by putrefaction hardnesse and other signes as ye shall heare in his proper Chapter CO. What are the Iudgementes LO There are diuers according to the accidentes that fall and first that vlcers remaining a yeere or more vncured make the boane vnder them altered rotten wheÌ„ such vlcers are whole there remaineth a cauitie in the part vlcered all vlcers that are euil colored blacke are esteemed malignes if any vlcer being filled vp ready to cicatrice begin sodainely to runne againe without manifest cause it is in danger to become fistulous Hippocrates saith that vlcers which haue no haire about them are vneasie to heale and cicatrice also those vlcers which come by reason of some maladie as hydropsie cachexie are hard to heale Hippocrates saith also if any
thinges as are set downe for the consolidation of woundes The third Chapter of vlcer virulent and Corrosiue HEre yee shall heare of those two vlcers which are not much different those vlcers which haue certaine virulencie and venenositie are virulent but after the bitternes augment and corrodeth the flesh and maketh 〈◊〉 greate it is called corrosiue or eating vlcer if eate much of the flesh nor going deepe it is called ambulatiue if yet it doth augment it becommeth in cancer or lupus as yee shall heare The Cause of these vlcers are euill bilioâ—s humors sharpe and byting the which get some malignitie venenositie by their adustion and happen oft after Herpes or woundes that haue been irritated by sharâ— and byting medicameÌ„ts The Câ—re is first in the manner of life according to the disposition of the bodie and humors that raigne nexte in purging partly for the euacuation of such sharpe humors thirdly in applying fit medicins on the vlcer as if it be very humide the medicaments must he more drying and lyke to the parr as this take water of allom or playntine decoction of Cypres Mirabalon baâ—k of Pomegarnet such like If there be great heate in the place coole it by refrigeratiues desiccatiues Guydo for such vlcers vseth a cake of leade rubbed with quicksiluer vnguentum pompholigos de minio or de plumbo vnguentum rubrum cum camphora take any of these mixed with a litle tuthiae preparate plumbi vsti cerusae lotae beaten in a morter of lead with water of plantaine a little terra sigillata with a little oyle of Roses make an vnguent If the malignitie be great oft the body is drie and consume these humors with canters actuall pouder of mercurie mixed with vnguent rosat till such time the malice be consumed thereafter wash it with the decoction aboue specified If by all these remedies wee profit not we vse the thochisces of diandron de musa arsnic copporous vsing alwaies defensiues to repercute the fluxion which may come through the violence of these remedies If these be not suffitient Auicen counselleth to cut the member infected and vlcered The fourth Chapter of the vlcer profound and Cauernous The vlcer cauernous hath theorifice staight the bottoÌ„ broad many cauernes some right some oblique with diuers fractuositiues without hardnes callositie so differ from fistules The cause of such vlcers is apostemes wounds euill healed in the which the matter hath bâ—n loÌ„g retayned the orifice higher than the bottom as ye haue heard the party debilitated so causeth defluxion of superfluous humors not only of the part but of al the body Thou shalt know these cauernes by the sonde either of lead siluer or a wax candle therin coÌ„tained by the iniection if it be white cernsse it is cold if it be subtil reddish the matter is hot those that are easie to heale haue litle matter with diminitioÌ„ of dolor humor The cure of such vlcers coÌ„sisteth first in the way of life with remedies according to the quality of the humor nature of the part vlcered as also the situatioÌ„ the dolor intemperie other accideÌ„ts that entertaine the vlcer As for the topicall remedies if the orifice be in coÌ„modious situatioÌ„ that the matter may euacuat by vngueÌ„ts emplasters muÌ„dificatiues deâ—iccatiues with lygaturs coÌ„presses fomentatioÌ„s iniectioÌ„s of red wine if the orifice be high the bottom low the meÌ„ber must bee siâ—uat in such fashioÌ„ that the nethermost be as ye haue heard in wouÌ„ds cauernous If by the situatioÌ„ the matter doth not euacuat or if it be in such places that it cannot be so situated theÌ„ make an incisioÌ„ froÌ„ the orifice to the bottom with mete instrumeÌ„ts thereafter appease the dolor and flux of blood if it be in such parts that this incision bee not sanely done theÌ„ make an issue in the bottom put a seton as in wounds caneruous or a tent wit some fit medicin that muÌ„difieth as ye haue heard in tumors or this Rec. mellis lib. 2. viridis aeris 3 5 olei rosati lib. 1. aristolachiae longe alluminis cerusae an onc 1. fiat vnguentuÌ„ or wash with wine honey called mulsum If the humor bee sanguinolent and euill sauored wash the vlcer with Oxymell Allom water or honey aqua marina with a little egyptiac Albucrasis counselleth to dissolue egyptiac with Hydromell which mundifieth and corecteth the maligninie If the matter be subtill and waterie take barley agrimony centory worme wood and seeth in honey and vineger it being cleansed vse this in carnatiue and glutinatiue take the rootes of Iris Plantaine Agrimony sodden in water and honey Auicen councelleth the emplastrum catholicon centorium which is of a merueilous effect in this put also the emplastrum de minio diâ—calciteos or nigrum composed with galles honey pouder of Iris aloes mirre and sucâ—like Togat setteth a marueilous good medicine to congâ—tinat vlcers made thus Rec. decoctionis hordei lib. 1. mellis rosati onc 3. sacrocâ—llae dâ—ag 2. mirrâ—thuris an drag 1. vini odoriferi onc 3. bulliant ad consumptionem tertiae partis addendo aloes paruÌ„ straine this put it on in the vlcers bynd it vpward shift it once a day till the vlcer be whole The fift Chapter of the filthy rotten vlcer THese vlcers which are oppressed with abundance of matter thick tough and euill coulored are called by Guydo and others sordids and filthie if they augment rot and mortifie the fâ—esh vlcered voyding a matter euill sauoured and cadauerous they are called vlcers putrids If the malignitie and rottennes continue it is gangren and is called vlcer gangrenous of the which ye haue heard The Cause is abundance of grosse humors proceeding of an adustion and ebulition of blood for the which they become venemous and maligne as chaunceth after carbuncles tumors and woundes euill dressed The Cure of them consisteth in regiment as ye haue heard in the Chapter of carbuncle the vsing of the decoction of gaiac is good to dry vp the humors and eucuat them by sweating Auicen coÌ„mendeth much purging of the bodie to discharge the part of these euill Humors by medycines mundificatiues like as humiditie by drying medicines by ventouses scarcifications horsleaches epithems Topicall remedies are first to wash the place with hydromell and aqua marina apostolicon or egiptiac and put on the vlcer applying on it an emplaister de bolo with cloth wette in oxicrate If the matter gender in corruption wash it with oxicrate water of cenders or white soape with this emplaister made of salt fish flowre of aristolochia longa orobie sodden in wine and put on the sore If this be not sufficient take this medicament quod recipit dragaganti rubri dicti auripigment onc 1. calcis vinae alluminis corticis mali punici singulorum onc 6. thuris galâ—â—rum
of naturall vnion and howe many wayes it is done LO Two wayes eyther without mediation but by succession of time groweth together as the nether iaw boane which manifestly is distinguished in children or else by mediation and is done three wayes to witte the cartilage as the boane pubis secondly by the nerue or tendon as the sternon and as illium are ioyned together thirdly by flesh as the teeth are fastened This as also all the Anotomie is most perfectly declared by Robert Achymutie Chirurgian of Edenburgh sometime Chirurgian in the great Hospitall of Paris CO. What is Dislocation LO It is an outgoing of the boane out of the naturall seate which letteth the mouing CO. Howe many differences are there of Dislocations LO Three of the which the first is called complete when the boane is altogether out of the place the second is imcomplete when the boane is not altogether but a little out the third is distortion elongation or peruertion of the ligament CO. How many wayes is Dislocation complete done LO Foure wayes before behinde outward and inward some vp some downe but not oft seene CO. Howe many differences hath incomplet LO It hath three the first that the ligament in the ioynt and about it is relaxed as chaunceth in the haunch the seconde when the ligament is forced by great violence as the legge or foote in making a wrong or croked steppe the thirde is when by little and little the ligament relaxeth bringeth the boane after it as chaunceth in the backe CO. How many differences hath the third which is called distortion LO No difference but onely the boane is made longer from the other CO. Which are the causes of luxation LO Two to witte externe and interne CO. Which are the externe LO Falles or stroakes and too violent extending of the member violently againâ—â— the figure naturall CO. Which are the interne LO Great aboundance of humor pituitous gathered in the ioynture which humecteth the ligamentes and maketh them softe and humide so the boane goeth out or by the extenuation of the muscles about the ioynture CO. Howe knowe you Dislocation LO By the extraordinarie tumor of the place by the emptinesse of the place where the boane was by the priuation of the moouing accompanied with dolor CO. By what iudgement or signe knowe you those that are easie and those that are difficill and those which are incureable and mortall LO I iudge by the kinde and diuersitie of the Dislocation and bodie as for example the 〈◊〉 is easie to goe forth to goe in also the finger in like manner members leane and where the nerues and ligamentes haue store of humiditie and moistnesse the arme difficill to goe forth and hard to put in againe and in grosse fatte and tender people those with fracture and apostume are euill to heale those are very difficill that haue the sides broken those which haue bene long out are almost impossible the two vppermost vertebres of the necke beeing out letteth the spiration and so the partie dieth within the space of three dayes CO. What method vse you for the cure hereof LO The methode generall for all Dislocations hath foure intentions the first is to put the boane in his owne proper place the extension of the member first made with handes or machins the second intention is to coatinue it in the place by good medicamentes and bandages as in Fractures the third is to put the member in right situation the fourth to giue order to the accidentes as by good dyet purging and bleeding if neede be reduce the Fracture before the inflamation be come otherwise stay till it bee past when it is neare whole or the accidentes past we shal vse thinges to corroborate and comfort the parte with certaine simples sodde in wine next the emplaister oxycrosiuÌ„ or ad fracturas CO. If the Dislocation chaunce with Fracture what is to be done LO First reduce the Dislocation next the Fracture if it be possible some reduce the Fracture next the Dislocation it being reduced and the Dislocation simple foment with oyle of roses whites of egges and cloth wette in oxicrate with splintes putting it in good figure with as little paine as may be It must not be stirred till the 7. day except inflamation or some euill accident doe fall at which time foment it with hot water thereafter the astringent as in Fractures keepe good dyet eate little for 4. or sixe dayes till the inflamation be past If the Dislocation be composed with causes interne as aboundance of humors which looseth the ligamentes wee vse astringent and drying medicines if it be accompanied with dolor and inflamation cure it as yee haue heard if feuer vse good dyet purgations and bleeding in the ende of the cure corroborate the parte with decoction of roses wormewood and wine thereafter the emplaister of oxycrosium The fourth Chapter of the embalming of dead folke SEeing that embalming of the dead is an auncient custome as appeareth by the olde and newe Testament and also prophane histories that the same is vsed in these our dayes aswell of Christians as infidelles I will shew the vsuall maner of it vsed in this our time First we lay the body oâ— a table and make incision from the clauicles to the os pubis next lift the sternon as also the musces of the inferior bellie taking out all which is contayned therein as also the braynes hauing first opened the panne with a saw which all shall be presently buryed in the earth sauing the heart which shall be embalmed eyther with the bodie or alone in a box of lead as the friendes shall thinke good â—hereafter thou shalt make long deepe incisions in the armes thighes buttocks and legges and other fleshie partes chiefly where there are veines and arters to the end they may the better auoyde which thing being done thou shalt diligently wash the three venters as also the partes incised with stronge vineger wherein hath been sodden Worme-wood Allom and Salt thereafter with Aquiâ—itae or fine spirite of Wine doe the lyke then dry all well with Lynnen clothes or sponges and fill vp the three bellies with pouders and a fewe flockes and sow them vp againe the incision shall be filled onely with the pouders and sowed vp likewise the pouders are commonly of Roses Camomill Meliot Mint Worme-wood Sage Lauendar Rosemary Marioram Time Cipres Gentian Iris of Florence all being dryee and beaten to fine pouder and mixed with Nutmeggs Cloues Cinamon Pepper Bengewin Aloes and Mirre Some vse onely for this purpose a fewe the most common of those hearbes with a little quick lime ashes of beane stalkes and of the Oake tree thereafter enroll the Corps in a cered cloth and tie him in all parts with small cords and put it in a coffer of lead well closed This is the common way to preserue dead bodies eyther vnder or aboue the earth for a