vntemperature of the flesh being subiect The second by the vice ill qualitie of the bloud comming to it The third of a great measure and quantitie of the said bloud Ought not the diuision to be made thus or otherwise That is to saie the cause wherefore some vlcers are stubburne and difficill to be healed is for the mistemperance of the flesh exulcerate or else for the gathering of humors vnto the vlcerate part Yet againe the mistemperate flesh ought to be diuided into two differences The first is when the flesh being subiect is out of his nature onelie in qualitie The second is whē with the euill qualitie it hath tumor against nature The flowing of humours is diuided into two differences that is to saie into the qualitie and quantitie of humours Sometime diuerse of the said dispositions are mixed together and sometime all But the methode for to cure them ought not to bée giuen all together but each one by himselfe The second Chapter AND if the distemperance of the flesh bée drie moderate it with bathing and wetting in temperate water But at all times that this remedie shall be vsed the end of the bathing and wetting shall be till the particle come ruddie and rise in a lumpe Then cease the bathing and moisting for if you bath it anie more you shall close the humour againe that was loosed and so you shall profit nothing Likewise the moistning facultie of medicines ought to be greater than is accustomed in a whole part If the flesh be more moist than naturall habitude you must haue regard to the contrarie for the facultie of medicines in the case ought to be desiccatiue and to vse no water But if thou must wash the vlcer take wine or Posca that is to saie Oxicratum or the decoction of some sharpe hearbe Likewise you shall coole the pride of the flesh that is too hot and heat that which is too cold you shall know such intemperatures partlie by the coulour and partlie by féeling of the diseased patient For sometimes they confesse they feele great heate in the particle sometime manifold coldnesse and so delight themselues in hot or colde medicines And sometime appeareth rednesse and somtime whitenesse But to distinguish these thinges it is not the duetie of this our proponed worke in the which worke we shew not the method to know the affectes but to cure them in such wise that by consequence of words we bée come vnto the said methode to knowe the affects Againe let vs returne to our purpose If anie parts are vlcerate with tumour against nature first the tumour must be cured What ought to be the curation of all tumours we shall saie héereafter Presentlie we shall intreate of that which is ioyned vnto vnkind vlcers But when the lips of the vlcers are discoloured and somewhat hard they must be cut vnto the whole flesh But if such affect is like to procéed further deliberation must be had least that which doth séeme to be repugnant vnto nature shall be cut out or in longer space to be cured without doubt in such a case it is good to know the patients mind For some had rather to be long in curing than to suffer incision and other are readie to endure all thinges so that they may the sooner be made whole Likewise héere shal be spoken of the ill iuyce which floweth to the exulcerate part and in as much as it is a malignant and a wicked humor it shall be spoken of héereafter in his owne place When as therefore the humour which floweth to the vlcerate parts is not farre of nor doth abound in qualitie or quantitie it shall be then conuenient to direct it and to restraine the fluxe which commeth vnto it and also to coole the heate of the parts that be néere the vlcer Furthermore you must behold the ligature or rolling at the vlcer and leading it to the whole part as Hyppocrates commandeth in the fractured bones Also that the medicines that are ministred to the sayd vlcers must be more stronger than they that are applied to a simple vlcer And if the fluxe of humours wil not staie with conuenient medicines then you must séeke further the cause of the said fluxe and take it awaie If the fluxe come by weaknesse of the member that receiueth it the sayd weaknesse must be cured And such curations also shal be proper for the vlcerate part But if the cause of the fluxe be through the abundaunce of the bloud or of the ill disposition of all the bodie or of anie of the superiour parts you must first take awaie the said causes The weaknesse of the part forth of which abundance of iuyce doth flow cōmeth whole of the intemperancie not altogether Wherof it followeth that the vlcerate flesh is only intemperate and not weake and féeble sometime it chanceth both the one the other For the great intemperancie is the cause of the imbecilitie of the affected part the which intemperancie is cured as is aforesaid in refrigerating the heate humecting the dry warming the cold desiccating the moist And if the place be too colde moist together the medicines must be in warming drying together so of the other intemperances in putting away euery qualitie the surmounteth by his contrarie The reason is Euerie thing the behaueth it selfe wel is according to nature not only in liuing things but in plāts also in al other things ther is an equality which the Gréeks cal Simmetron without excesse of al vicious humors For the thing where nothing can be taken fro or put to neither anie part or anie qualitie it is all perfect in one equalitie contrariwise the thing that must haue taken fro it or else somewhat added to it is not in a naturall perfect estate Wherefore it is not possible to cure rightlie but in taking awaie that which is excesse putting to it the which lacketh In another place we must speake of the ouermuch or lacke of things but when anie qualitie is ouer much it is necessarie that the other qualitie contrarie to him ouercome him againe and the corruption of humors or intemperancie bée remoued in restoring the said qualitie that wanted for in cooling that which was too hot thou shalt restore that which lacketh diminish that which was too much abundant Thus it is necessarie that the curation of the things that are put farre from their naturall habitation by some intemperancie be made perfect againe by thinges of contrarie vertue And thus the flesh or anie part thereof wherein is fluxe of humours because of weaknesse ought to be made in this manner as is sayd before and when the intemperancie is cured then procéede to the cure of the vlcer first curing the intemperancie as if it had come without the vlcer By the which thing it is manifest that all such curation is not proper to the vlcer but to the intemperancie Likewise if anie fluxe of humours
Chirurgerie is not onelie to know the names of sicknesses and diseases but the name of euerie perticular medicament as wel simple as compound And also to know all other strange tearmes appertaining to this arte Wherefore Galen in this booke of Tumours against Nature hath taken greate paines not onelie in setting forth of their names but of theyr true diuisions natures and dispositions with their figures formes and humours by which they doe grow and are maintained without which knowledge no Chirurgion can either rightlie cure either else vnderstand the nature of those things which he doth take in hand Therefore I haue thought it good to set before your eies this most worthie booke which Galen hath writtē of tumors against nature wherein he hath most excellently set forth not onely the most apt names but also the humors that the same tumors doe spring of For like as he hath declared in his methode of curing the diuersitie of wounds and vlcers with their natures formes and properties and also with their accedents symptomata and causes Yea I say not onely with these but also with the knowledge of the temperaments natures and qualities of euery medicament proper for their remedies with their trew deuisions and names to that ende that euery one of them may be exactly and perfectly knowen from other And for the better vnderstanding hereof I haue added in the ende of this booke of Tumors against nature an other booke of Galen of the names of medicines which be proper for diseases which I haue thought very meete and conuenient for you to vnderstand to that ende that you may be accounted men of knowledge in your arte not onely to be accounted so but to be so in deede Thus taking my leaue of you I desire you most hartely to be studious herein and so being you shall incourage me further to procede in other things of this arte which may be much for your profit And thus I commit you to the almightie Lord who illuminate you with knowledge of this most worthy Arte. Your louing brother to the vttermost of my power Thomas Gale maister in Chirurgerie An. Domini 1563. Mense Septembris 25. Claudus Galeni de Tumoribus preter naturam OF those things which chaunceth to mans bodie one thing is that which the Gréekes do call Oncos which we name a tumor or swelling for so doe they tearme that thing which is a swelling or a distention in length breadth and déepnesse Also sometime that bignesse which is aboue natures constitution they do cal Oncos These do not onlie chance vnto them that be sicke but to those that be whole also For corpulent persons and women with childe are more bigger in breadth and thicknesse than according to nature and yet they are not affected against Nature as we haue sayde in other places The other tumor is that which is according to natures constitution or as we may tearme it a naturall tumour in the braunes of our armes and caufe of our legge which is in a meane betwixt those that be according to nature and those against nature For corpulent bodies also leane bodies are not against nature but the one is aboue natures constitution and the other vnder and so both these dispositions are called not naturall But that tumour which cōmeth of the dropsie and leanes in a consumption both these are against nature But now in this presēt booke we doe purpose to intreate of those Tumours which bée against nature which doth not onelie occupie the whole bodie but also may chaunce to anie part thereof so that it bée alwaies determined that the agreuation of this vnnaturall constitution be against nature and the end of the same to be the hurt of the naturall action But we néede not to speake much of these Tumours for that they be commonly knowen vnto all men not onelie to the Phisitions but to all other persons The other tumours which groweth of immeasurable fatnesse and flesh and also women béeing with childe doe make those which are aboue natures constitution And we considering all other Tumours which are according to nature and necessarie for the making of our bodie as in the braunes of the armes and cause of the legges c. All other tumours which doth excéede that which is aboue nature and those which be naturall we account against nature And taking our beginning at the first of them called an inflammation or Phlegmon Of Phlegmon or Inflammation Chap. 2. THe Grecians vse to call that an inflmmation which commeth with great tumor or swelling in the fleshie parte strained and stretched forth resisting with pulsation dolour hot and red The cause of these accidents is not onelie vnknowen to the multitude of the common sort but also vnto manie Phisitions or as we terme them those that vseth the art of Medicine for diuerse of them not séeking out diligentlie doe simplie pronounce that which séemeth good vnto themselues mistaking the thing But consideration must be had héerein if you will procéede in this mattier Therfore there is neuer anie great tumour that chaunceth in anie parte of the bodie against nature except the same parte be affected with one of these two thinges For either it is made flowing increased and stretched forth through ouer much hotnesse either else it taketh some new substance outwardlie And when this fluxe doth happen is stretched out with swelling it is tourned into spirites and béeing refrigerated it doeth easilie tourne againe into his accustomed swelling But we sée no spirits in the inflamed parte neither yet the part inflamed being refrigerated doe not alwaies come againe into their former constitution And it is manifest by incision also that there is no spirites therein contained for if the inflamed part be cutte much bloud will runne out and all the place séemeth euidentlie full of bloud like vnto a wet Spunge But yet you shal sée no spirits come forth either presentlie or yet long after and the coulour of bloud is altogether inseparable There is no part of the bodie that is red but bloud and flesh neither is the multitude of flesh the affect of inflammation for although the multitude of flesh be in the bodie without multitude of bloud yet the tumour trulie shall be bigger than natural and the coulour shall be healthfull and not swarue from his accustomed nature for in anie thing which naturallie increaseth the coulour is not augmented for then should Snow be made more white Pitch more blacke and Golde more yeolowe And the increasing of substance differeth manifestlie from alteration for thinges increase according to their quantitie and altereth according to their qualities but coulour sheweth the qualitie of the substance and not the quantitie Therefore the multitude of flesh differeth from an inflammation and for that cause the bodies which abound with bloud bée most troubled with inflammations Now séeing that sometime in wounds there be greate inflammations and yet there floweth forth thin and watrie humours the place
happen to the vlcerate partes as wel by the occasion of anie perticular member as of all the bodie wherevnto the bloud or anie ill humours doe resort first remedie must be had either to the particle that is cause of the fluxe or else to the whole bodie Thus then we shall cure first the varices that are often resorting vnto the vlcered place before you cure the vlcer and then afterward you may the easilier cure the vlcer Likewise in them that haue a disease in the splene or in anie other notable part first it behoueth to cure the sayd parte and then after to procéede to the curation of the vlcer howbeit none of the curations héereof is proper to the vlcer but some other affects or dispositions that either engendereth the vlcer or that nourisheth and conserueth it The third Chapter BVt now I thinke it time to define that there is no indicatiō of outward or as they terme it of primitiue causes of curation but the indication or curation to haue his beginning of the affects it selfe But those thinges that ought to be done perticularlie are found out either of that which the indication sheweth either of the nature of the affected part or of the temperature of the aire or other like things but to speake brieflie no indication may be taken of things that be not yet come But forasmuch as we ought to know the affect that is not manifest vnto vs by reason or wit we are often constrained to enquire of the extreme and primitiue cause For this occasion the vulgar people supposeth that the saide primitiue cause is Indication of curation which is altogether otherwise As it appeareth likewise in those where the affect may be exactlie knowen For if Ecchymosis or an Vlcer or Erisipelas or putrefaction or Phlegmon bée in anie parte it is a superfluous thing to enquire the efficient cause of these diseases except they be remaining For in so doing we shall cure that thing which is alreadie finished and shall prohibite the efficient cause to procéed anie further But if the said efficient cause which produced the effect hath no longer biding there then we shall remooue awaie the affect For to put awaie the cause that is not there it were impossible For curation appertaineth to the thing present as prouidence to the thing to come For that thing which doth not now hurt neither is to be feared that it will hurt héereafter is out from both the offices of the arte that is to saie from curation and prouidence Wherefore in such thinges there ought to bée no searching of anie indication neither yet to cure nor to prouide as is sayd before notwithstanding the knowledge of the primitiue cause is profitable to vs in things vnknowen Neuerthelesse the Emperikes take sometime the primitiue cause as parte of the course of the disease that the Gréekes call Sindrome wherein they haue obserued and experimented the curation as in that that hath bene hurt with a mad dog or venimous beasts Thus doth also some Dogmatists which doth affirme to cure such diseases by experience onelie without rationall Indication for they take the cause primitiue as part of all the Syndrome and vniuersall course but the primitiue cause serueth nothing to the indication of curing although it be profitable to knowe of the nature of the disease to them that haue not knowen the nature of venimous beasts by vse and experience and thereof taketh indication curatiue trulie the outward cause of curation béeing knowen doth nothing profite to the indication but to the knowledge of the present affect For put we the case that we knowe that the venime of a Scorpion is of a colde nature and for that cause as of a colde thing I take Indication for the remedye howbeit the case is suth that I haue no signe whereby I doe vnderstand that the bodie is hurt of a Scorpion it is manifest that if I doe knowe that the bodie is hurt of a Scorpion that then I would inforce me to warme all the whole bodie and also the part affected without abiding for anie experience in taking mine indication of the nature of the thing We haue declared in the booke of Medicaments wherein it behoueth them to be exercised that will take anie profit of these present Commentaries no such facultie can be foūd without experience Truelie it should be a gifte of felicitie if anie hauing the sight of Litargerium Castoreum or Cantarides forthwith to vnderstand their vertues For like as in all things is committed error as well by those that excéede as by those that lacke so héere as the Prouerbe is among the Gréekes this Thiapauson that is to saie they differ among themselues Also they affirme that the vertue of medicines is not yet knowen and that after so great experience the other that suppose and saie that the saide vertues be knowen onelie by experience The first speaketh vndiscréetlie if that be a thing imprudent to affirme a thing impossible the other be altogether stupidious sturdie and foolish But for this present time we will saie no more because I haue spoken more plainlie in the third booke of Temperamēts also in the bookes of Medicaments Neuerthelesse for the knowledge of diseases some primitiue causes are profitable but after that the present disease is altogether knowen then the cause primitiue is totallie vnprofitable Now we haue declared that it doeth not become vs to meddle and confound both the doctrines together but the Emperikes ought to be spoken by themselues and the rationals by themselues We must now call to mind because we haue purposed in this present Commentarie to intreate of the doctrine Rationall although to some things that we do saie we doe not adde absolutelie that all be not true but onlie after the sentence of the methodicall sort but that euery man ought to adde and reason that thing by himselfe And at this time we haue said that there is no cause primitiue which is profitable to the Indication curatiue although it serueth well to the knowledge of the disease And we confesse that the cause primitiue is part of the Syndrome and of all the Emperikes course that they cure all diseases by reason by experience But in all that we shall saie héereafafter it is not necessarie to adde such words Then let vs returne to our first purpose in taking the principall indication certaine and vndoubtfull whereof we haue also vsed héere before as we haue said that the disease that requireth to be cured iudgeth the end whervnto the Surgion ought to intend and of the same all other indications are taken Wherefore we haue begun to speake that the said indication hath no manner of affinitie with the cause primitiue for put we the case that anie vlcer be come of a fluxe in anie part then it is manifest that the sayde vlcer procéedeth of corrupt humours for nature is accustomed so for to doe in diseases when she purgeth the bodie
shall not take an Indication of it after foure â—…neths but that which we haue taken at the verie beginning And for a truth that I may not permit such an vlcer to abide so long time but at the first I will take awaie the cause thereof But I cannot coniecture what may shewe the time more than the number of daies except Thessalus will saie that to haue knowledge of such an vlcer we must tarrie the time but in such a case he sheweth himselfe altogether foolish That is to saie if he confesse openlie that hée knoweth not the first affect which hath inueterated the vlcer Furthermore he must plainlie also confesse the Indication curatiue to be taken of the disease and the knowledge of the disease to be taken of other things But bée it so that time serueth somewhat to the disease neuerthelesse the Indication curatiue is not taken of time But to what purpose serueth it if any Vlcer bée inueterate to do away that which letteth the coition to renue the place which is pained For thou foolish fellow if for the maligne fluxe which the Gréekes call Cachoethae the lippes be affected in such sort what shalt thou profit if thou doe cut them before thou hast prouided to stop the fluxe Trulie thou shalt but make the Vlcer wider than it is as some doe that cure vlcers after the same manner as thou doest For the cause remaining which before made the vlcer harde and flintie thou shalt doe no other thing in cutting awaie the lips but enlarge the vlcer For those which thou cuttest shall be made hard come again as they were before Although that prudent Thessalus hath not added this thing that the partes of the vlcer which are hard stonie and discouloured ought to be cut awaie but commandeth by an absolute sentence that those thinges which hinder the closing of the vlcer ought to be cut awaie and to be renued But if trulie hée had counsailed to take awaie the causes that hinder the adglutination of the vlcer and that this reason were auncient and olde I would not accuse him for it is commanded almost of all the auncient Phisitions which doe write of the curation of vlcers by a certaine reason and Method that those causes which doe excite the vlcers ought to be cut awaie euen trulie as of all other diseases For trulie I do thinke it expedient that the efficient cause remaining which exciteth the vlcers ought first to be taken awaie In other diseases it is not expedient but chieflie there the curation must be taken in hand where the efficient cause remaineth And if the sayd Thessalus hath not spoken of the causes that let the conglutination and hath onelie spoken of the lips as he hath said afterward it appereth that he is ignorant of more than he knoweth of those things which appertaineth to the curation of vlcers But it is possible that this alone is the cause which hindereth the cure of the vlcer And it may as it is aforesaid be the cause that intemperauncie which is without a tumour against nature be in the vlcerate partes and also that it be ioyned with a tomour the which doth not require that the lips should be altogether cut awaie It maye also bée the cause that Varix which is aboue it or that the milt which augmenteth it or some disease in the liuer and beside this the weaknesse of the affected part be nothing else but a manifest intemperancie And besides this a vicious humour in the bodie which the Gréekes call Cacochimia and the chiefest of all the causes which may be to the vlcers an incommoditie Truelie great abundance of humours which the Gréekes call Phlethora resorting vnto the vlcer doeth hinder the curation But if Thessalus be of that opinion that the lippes onelie must be taken awaie I saie that of many things he knoweth but one alone which is so euident that the shepheards are not ignorant thereof for if a shepheard sawe the lips of an vlcer hard flintie wan blacke or a leadie coulour hée would not doubt to cut it awaie Then for to cut awaie is an easie thing but for to cure by medicines is a greater matter and that requireth a true methode Neuerthelesse Thessalus neuer knew howe the lips might be cured by medicines for all men confesse that he hath swarued from this part of the art and as he himselfe hath shewed it séemeth that he had neither experience nor rationall knowledge of medicines which is a manifest thing by the booke that he hath made of medicines before rehearsed But of this one worke consequent wée shall entreate of those things which hée hath not writâ—…n well And now we doe intend with deliberation to speake of the curation of inueterate vlcers of the which he hath before intreated Certainlie it had bene better to haue called them Cachoethae and not inueterate theÌ„ to declare their nature disposition and cause of their generation and the curation of either of them And first to know the common curation of all vlcers for as much as they be vlcers of the which I haue written in the third booke next after the perticular and proper cure of either of them afterward the kinde of the efficient cause as I haue spoken of in this present booke And although Thessalus hath done nothing of all these things yet he doth thinke that the vlcerate place must be renued when it is made like vnto a new wound to cure it as a bloudie vlcer what is he that is exercised in the workes of the Arte that vnderstandeth not euidentlie that such a doctrine hath bene written by him that neuer cured vlcer Is it possible that a man may cure an inueterate vlcer as you may cure a bloudie wound and after he hath made it lyke vnto a fresh wound shall it be in drawing of the vlcer together by rollers or ioyning them by stitches or neither by the one or by the other but by conuenient medicines What is he that knoweth not that an vlcer called Cachoethae is caued or hollow séeing that it is made by corrosion Is it possible O foole and impudent Thessalus that a caued vlcer may grow together and be adglutinated before the cauitie be filled with flesh is not that to cure an vlcer as a gréene wound then hast thou thy selfe written in vaine that hath taken indication to cure caued vlcers not with closing but with the filling of the cauitie But if euery vlcer called Cachoethae were not hollowe of it selfe yet when it is made bloudie in cutting the lips awaie as thou commaundest then of necessitie it is made hollow and requireth great space betwixt the lips euen in such manner that I cannot sée how thou maist make them conglutinate together as a bloudie wound for if thou assaie by force and violence the lippes that are so farre a sonder of necessitie there commeth Phlegmon which letteth the sayde lyppes to close together The which thing I suppose that
happen in the similer and simple partes but also in the compound and instrumentall but yet there be other indications of remedies taken of the similer partes then of the Instrumentall of which they that follow Hyppocrates methode know both because they know the natures of both partes But those that follow Erasistratus and Herophilus haue but one Indication that is to saie that which is taken of the Instrumentall partes Wherefore they haue no certaine method in these which follow whatsoeuer indications are taken of the bodie or sicknesse hot colde moist or drie but yet they are not ignorant of the Indications taken of the forme position excellencie quicke féeling of the part or those which are contrarie That which we saie shal be more manifest if we set out the the partes themselues Therefore because alreadie abundantlie we haue entreated of those Vlcers chieflie which happen in the fleshie partes it is time to speake of them which chaunce in the veine and arterie and nerue and not of these absolutelie by themselues but as they are in the instrumentall partes of man Wherefore if anie hath a greate arterie or veine wounded there followeth presentlie great flux of bloud and the wound in the veine will hardlie be glutinated in the arterie it can more hardlie be done as many Phisitions suppose but peraduenture cannot be done at all Therfore we must againe speake of either of them and first of the fluxe of bloud and next of adglutination But for that such fluxes are caused by Anastomasin and Diepedesin as we presentlie declare it shall not be from our purpose for that they both haue a common cure to make mention of them in this place although they séeme to be another kinde of disease trulie the bloud floweth out of the veine or arterie the mouth of them being opened or their coate diuided or as I may tearme it strained or sent out in manner of sweate surelie the coate of thē is diuided either by wounding or contusion or ruption or erosion Anastomasis happeneth both through the imbecilitie of the vessels and also through the plentie of bloud which breaketh to the mouth of it with violence furthermore by anie thing cōmming outwardlie hauing a sharpe qualitie Diapedesis commeth when as the coate is made more thin and the bloud attenuated and furthermore it maye come to the mouth of anie of the small veines béeing opened Therefore we must speake of either affect by himselfe and first of all of that diuision which we haue sayd to come of erosion or wounding or contusion or ruption so that those things which doe wound are edged tooles and apt to cutte those that make contusion are heauie and harde those that cause ruption doe it by straining the same doth also the vehemencie of anie action the abundance of ill iuyce or humours not in respect of the strength but for that it is not contained in his vessells Also anie heauie or hard thing falling from aboue entering in for anie such thing when the vessels or veines are emptie or else containing but a small substaunce entering in it if it hath an obiect which is hard it causeth contusion if the vessell be full it bruseth it before it maketh cōtusion When that which happeneth is like as if thou diddest fill a bottle or bladder and diddest let a stone fall on it or else violently diddest strike it against a stone truely the like to this is that which happeneth to falles from aboue for looke what respects the bottle hath to the stone the same hath the man vnto the ground and whosoeuer breaketh any vessells of the lungs with great and most vehement clamour must refer the ill receiued vnto the violēce of the action In like manner he which hath broke any vessells that is to say any veine or arterie by bearing a great burden or by going about to lift it on his shoulder or else to lift it vp with his hands so much the rather to whome it happeneth of most swift running or most strong leaping or otherwise any part being violently extended For it is like as if one should stretch out a rope or leather though many vesselles are broken because they containe not the bloud in thē chiefly when it is flatulent as may appeare both in hogs-heads which full of must doe oftentimes breake also in other of most strong bodies The third Chapter AND if the vessell be ruptured either of wounding clamour fall or contusion the cause of these truely doe cease but if it come of aboundance it may againe happen that the vessell may be ruptured the efficient cause is yet remayning also in this affect the abundance truly is to be euacuated then the bloud to be suppressed and after the vlcer to be cured but where as the efficient cause is ceassed there the bloud is first to be stenched and after the vlcer is to be cured How therefore will we stench the bloud truely by stopping the ruptured vessel the bloud that was caryed by it being auerted and conueied to another place for if the bloud should be caried to the place vnto which it dyd in the beginning flow and that the mouth of the vessell be in like sorte open the man truelie being vexed with the fluxe shall sooner die than the fluxe of bloud shal cease surelie the wounds wil be closed if the sides which are diuided be brought together or that the mouth of it be stopped and the sides of the wounde closed by the helpe of our hands if we may come to it with ligature or such remedies as are colde and astringent Neither is it lawfull to stitch the wound of a veine or arterie as they affirme who saie that no Indication is to be taken of the substance and nature of the wounded part the mouth of the vessell shall be stopped the bloud being then coniealed the Gréekes call it Thombros and also by things outwardlie applied on both sides about may be put vpon it and also in many wounds the skin it selfe or what else we mixt with it such are linaments in Gréeke called Motos those medicines because they haue a clammie and grose substance doe stoppe the pores the Gréekes name them Emphlastica as also medicines which make a crust which the Gréekes name Escharan The olde Phisitions despised these in such like wounds as it were a great ieopardie These also are done not onelie by the fire it selfe but also with medicines hauing a firie facultie and the mouth of the vessell is stopped by these medicines the bloud trulie shall be auerted and turned to other members both béeing drawen vnto the next partes and also by reuulsion to the contrarie the Gréekes call that Parochetensis but this Stuti Pasis and these also bée inuented of Hyppocrates being verilie the common remedies of all immoderate euacuation Deriuation is made vnto the next parts when as that which is voided is euacuated by the nosethrilles Also reuulsion to the contrarie partes is when
be these Dogmatists which are not able by reason to vnderstand the naturall principles of bodies but of these Thessalions voide of method what doest thou yet speake Therefore those which cure by right method doe finde apt remedies for euerie kinde of vlcers as also conuenient diet they do most apparantlie declare by the things it self how much it profiteth and how great light it doth bring to the arte of curing the Treatise of nature it selfe declareth for I haue not once declared vnto you how that sometime they which goe from one medicine to another doe let slip and neglect that which is profitable and that with some one of their remedies which they haue vsed the same vlcers haue béene cured therefore they haue worthilie despised the facultie of such remedies which because of the vntimelie vse they haue séene not onelie the profite but much for to hurt and that in the first vse it hath done no euident thing Furthermore thou hast séene no lesse the grieuous pains of the eies to be healed either with bath either with drinking of wine either with foments either with letting of bloud eyther with purging vnto which these common sort of Phisitions haue applied no other thing than these medicines which are made of Opium and Mandrake and Henbane bringing great daunger vnto the eies inasmuch as they taking no other thing awaie for the present but the paines it selfe these doe kill the sence as thou hast knowen many by the vse of these medicines when they haue bene too much applied neuer after to haue come to their naturall state and that first their eyes were dim and they haue hardly séene after to be vexed with suffusion which is called Hipochysis or with too greate dilatation of the ball of the Eie named Mydriasis or with Tabes or Corrugation called Rhetiosm Thou hast knowen also being with me from sixtéene yéeres of age neuer to haue seene vnder anie maister this worke but to haue excogitated it by reason and how long time I did consider that Aphorisme of vnalayde wine or bath or foment or letting bloud or purging taketh away the paines of the eyes And what trust I had by the rest of Hippocrates laborers that there was nothing in this Aphorisme either false or might not be brought to passe that was it which stirred mée to search vntill going Hippocrates way I found by what meanes I should discerne when and how euery of the forenamed should be vsed By which reason I made manifest to many which haue séene the like things of how great force the medicinall methode is and how great occasion of euill they are which haue not obserued the olde arte of Phisicke haue builded new sectes and now truely although from the beginning I haue refused it yet by entreating you haue compelled mée to take al this whole worke in hand which I pray the gods may be profitable by others truely I haue small hope aswell for the contempt of good letters which now do raigne as also for the admiration of riches estimation and ciuill power vnto which whosoeuer doe turne himselfe is not able to finde the truth in any thing But these things shall be determined as pleaseth the gods and we now for our power shal restore the Methode of curing which was found of the auncient Phisitians being now neglected repeting againe the disputation which we haue begunne of the hollow vlcer and of the first inuention of those things which doth fill an vlcer with flesh let that suffise which hitherto we haue saide and let vs graunt if they will vnto the Empericks all that they say And for the vse of things foūd out I haue often shewed to thée in themselues and now nothing lesse I will go about to demonstrate by reason how these Empericks cannot by certaine reason go vnto another medicine whē they haue nothing profited with the first and that rightly chaunceth for when as they know not the cause of the vnhappie successe of the first medicine neither can declare the lyke in the second and when they are ignorant of the cause wherefore the first medicine doth not his affect neither are able to vnderstād why it taketh no place this thing truely being not knowen they cannot reasonably go to another when as they cannot in the same medicine perceiue the like cause The third Chapter NOw therfore let vs set out Hyppocrates waie and the true method of curing an hollow vlcer surelie it behoueth to begin thus that is of the substance of the thing therefore séeing that an hollow vlcer that is our scope that the flesh which is lost may be restored it is néedfull to knowe that the thing which engendereth flesh is good bloud nature as I may tearme it being the workman and author notwithstanding it is not sufficient to name simplie Nature vnlesse we consider also whose nature and where For it is manifest that Nature it selfe is the ingenderer of flesh of those bodies that be subiect whereas flesh is to be made and surelie it is declared that the nature of euerie bodie doeth consist of the temperament of hot cold moist and drie therefore it is manifest that the iust temperament of these in those parts whereas we shall restore the lost flesh is as it were the workman And first of all in euerie hollow vlcer these two things are to be considered whether the bodie being subiect be in iust temperature that is to saie whether it be according to nature For we haue declared that health of similer bodies is the iust temperature of the foure qualities and whether the bloud that floweth to the part be good or else but indifferent for if either of these doe offend there are trulie many affects against nature notwithstanding there is now put to vs but onlie the hollownesse in the fleshie parts Therefore let vs imagine the part to be sound and the bloud which floweth to the parte to be frée from fault either in qualitie or quantitie surelie these thinges béeing as is sayde there is no impediment but that flesh shall prosperouslie growe and that without the helpe of anie outwarde medicine for both causes which ingender flesh béeing present and nothing outwardlie hindering then it cannot bée but that flesh must bée ingendered But in the first engendering of flesh there must of force spring a double excrement as we haue shewed in our commentaries of Nature that there followeth euerie mutation of the qualitie of the nourishment an excrement grose and thicke and another thin And these excrementes chauncing euer through the whole bodie that which is thinner is inuisible by persperation notwithstanding it is forthwith visible as often as the naturall heate diminisheth or that hée vseth more large diet than is méete or that there happeneth to the creature more vehement motion The other excrement is the filth that is sent to the skin Furthermore in vlcers the thinner excrement is called Sanies in Gréeke Icor the groser is named Sordes and the
and sendeth all the corruption to the skinne in such sort that the skin is vlcerate and all the bodie purged What is then the curation of such vlcers certainlie as of other vlcers wherein no corrupt affect or disposition is which the Gréekes call Cacoethae But if it be so it is euident that no indication is to be taken of the cause which hath excised the vlcer but if the vicious humour remaine some indication might then be taken of the saide cause for otherwise it should be an absurde thing that that which is no more remaining shuld require curation or if he shuld shew curation where there is no néede Wherfore it is a strange thing and wholie against reason to saie that the indication curatiue ought to be taken of the cause primitiue And for because that the said Indication is not taken of the same cause it is euident that it must be taken of the cause present But what is such an Indication forsooth if a man will properlie define it it is a thing which appertaineth to prouidence which the Gréekes call Prophalacticae but if anie will abuse the word it is called Therapeutica But for as much as of the vlcers themselues certaine be simple and certaine be hollow if a man will diligentlie marke and consider the curation of them is brought to passe in eschuing and foreséeing those things which bée hurtfull vnto nature And when we woulde bring anie thing to good successe wee had néede of Natures helpe as in closing of an Vlcer and regeneration of flesh in the which things the chiefest care and regard appertaineth vnto that part of the arte which is called Prouidence but it is called vulgarly healing And therefore this part of the art that is named Prouidence is diuided into two kindes The one is that which doth remoue awaie the disease present the other which withstandeth the disease that it maye not come to his fulnesse Therefore the younger Phisitions héere doe not vnderstand that their disputation and contention consisteth onely in names wherfore if they were studious in things they should finde out that there were two differences of the functions and actions of medicine that is to saie the disease alreadie come or to withstand those that are not yet present Then there is no man but he wil confesse that to cure or to heale is no other thing but to take awaie the disease that is present whether it be done awaie by the worke of nature or by medicines but prouidence is a thing that letteth the disease that hée may not come truelie they which doe cure the ill humours which come to the vlcer doe minister the art of medicine by reason and methode in purging and taking awaie those things which doe hinder the course of Nature And these two manners of curing are properlie called in Gréeke Prophilactica for they let as it was sayde before that the filthie mattier engendereth not in the vlcer neither yet ouermuch moisture which may hinder the curation The fourth Chapter IT is but in vaine truelie thus carefullie to striue about the name but it is more conuenient in my iudgement to giue some good method to cure the vlcers such as I haue spoken of as wel in the booke going before as in this But I doe much meruaile at the dulnesse of Thessalus writing thus of the curation of vlcers the which are called Cacoethae The communities of vlcers that continue long time and that are vncurable or els returne againe after the matter induced be verie necessarie in likewise as in vlcers that may not grow together be closed it must be considered what is the cause that letteth and procureth the saide growing together the which cause ought to be taken awaie But in them that renue the ciccatrise againe it behoueth to kéep the same ciccatrise that is to saie in strength for so we haue translated To metafuicrinen and in comforting the suffering member or all the bodie in common and in ordering it that it endure not lightly by the remedies appropriate therto And when Thessalus had propounded such wordes in the beginning of his booke of Surgerie he writeth afterward more plainelie of this matter The vlcers that endure long and may not be healed or that renue and come after the ciccatrise giue such indications that is to saie if they come not to ciccatrise it behoueth you to let the vnion and comming together to renue the vlcerate place againe And after that you haue made it like vnto a fresh wound it must be healed as a bléeding wound But if the said cure profit nothing you ought to mittigate the inflamation make as much diligence as you can But the vlcers that come to a ciccatrise and open againe in their accessions exulcerations you ought to cure them like vnto thē where there is a fresh inflamation afterward you ought to applie vpon the said vlcer a plaister of mittigatiue things vntill the ire and fearcenesse be abated after this is done you ought to dresse the ciccatrise and then make the parts about it waxe red in wrapping it about with a Malagma made of mustard séed or with some other medicament that may change the said parts make them lesse subiect to diseases And if they cease not with these things you ought to haue cure of all the body in strengthening it with diuerse exercitations gestings and vociferations in commanding thē that kéepe him to such things as these be That is to saie in manner of liuing by diminishing or augmenting by degrées in beginning vomiting made by Raphanus You shall also vse white Eliber and all other thinges which we vse in diseases that be difficult to take awaie which are subiect to reason and manner of liuing This is the saying of Thessalus Now it is time to consider the stupiditie of the man I saie the stupiditie if he thinke he hath sayde well and the boldnesse of him culpable to saie nothing and by this meanes supposeth to deceiue the Readers But tell mée Thessalus what is the Indication curatiue that is taken of an olde Vlcer Trulie I neuer found out curation of the olde Vlcers nor of the newe not by time in what disease so euer it bée but of the affect that I purposed to cure But if we altogether regard time as if the Indication curatiue were taken of it the second daie we should giue an other indication than the third likewise to giue the fourth daie another then the fift and so of the sixt all other daies following For by this meanes we shall no more consider the affect of the disease that we goe about to cure and the Indication no more to bée taken of them whereby we coulde neuer thinke of a straunger reason howe then are the communities of vlcers necessarie that continue a greate while seeing that the time it selfe can indicate nothing at all For when an Vlcer is with erosion that commeth of all humours we
mencion of all these things where he speaketh of Purgations But some perchaunce will say How then doth not Hippocrates councell vs to take away the bloud for these causes aboue especified By my iudgement he commaundeth them thus but in few wordes and that not without demonstration as he and all the auncients were accustomed to doe Thou shalt vnderstand that it is so if that thou wilt reade againe his words that are these In euery fresh wound except it be in the belly it is expedient to let bloud flow out of it more or lesse For by that meanes the wound shall be lesse grieuous the inflamation lesse and all the places about it But if thou shalt remember hereafter those wordes that he writ when he did entreate if vlcers and also those thinges that he hath propounded in all his other bookes that is to say how that a Phisition ought to be an imitator and follower not onely of nature but also of those things which shal be profitable when they come to their naturall state Then thou shalt plainly vnderstād the minde of Hippocrates and also how that bloud ought to be drawen when wounds be great but if out of such wounds bloud doth not flow especially when as it is a thing most conuenient then thou must adde and supply those thinges that be néedefull and necessarie The matter that followeth he conioyneth it with that which is abouesayde Also it is profitable that from inueterate vlcers bloud doe flow and also from the parts which are about them But forasmuch as he hath said before that bloud should flow from euery gréene wound except that he made mencion now of inueterate vlcers it would séeme to some that he dyd entreate onely of greene and fresh wounds Therefore he did well adde this that is to say how that it is a thing most méete to draw bloud from inueterate vlcers Wherefore now seeing that the doctrine which we haue taken of him is true and firme that is to say how a flux beginning at the contrary parts ought to be drawen how that which is alreadie fixed in the partie ought to be purged either from the payned part or from the part next vnto it therefore it is now easie for vs to conclude of the detraction of bloud how that in the beginning it ought to be done in the part farre of and then in the vlcerate parts Furthermore if you doe adde vnto these which I haue before spoken how that Hippocrates coūselleth to euacuate the superfluous humour and that detraction of bloud ought to be vsed when it surmounteth and that a medicament ought to be giuen which hath vertue to purge humours Chollerike Melancholicke and Phlegmatike Yet haue in remembraunce all these woords how that none of them is the curation of vlcers no not so much as of an vlcer but rather of Cacochimia that is coniunct with the vlcer or of Plethor or of Phlegmon or of Herpis or other like dispositions Neither yet be not forgetfull of this thing that is to say that none of the accidents of the vlcer giueth such proper indication as magnitude In the booke precedent we haue intreated of vlcers wherein we haue declared all the differences of vlcers how many and what they be what is the indication of either of thē Howbeit I haue not sppken in the saide booke how the indication of purging is taken of the vehemencie of the disease bicause it should not be to much prolixitie demonstration Neither in the saide booke I haue connixed the curation of all the bodie with the vlcers but yet I haue declared in this present booke in as much as it was agréeable and vtill for my purpose The seauenth Chapter BVt the firme and perfect demonstration of this kinde of Indication which is taken of the vehemencie of the disease shal be shewed héereafter In like maner the indication which is takē of the age that which is takē of purging humours Likewise the Indication which is taken of the afflicted parts shal be declared in the bookes which follow But as yet we haue onlie made mention of the curatiue Indication that may be taken of the nature of the said parts that is to saie of temperance substance But trulie we haue nothing touched the Indication which is taken of the scituation figure of the partes Therefore we will speake of the indications that be profitable for the curation of Vlcers The part trulie that hath sharpe and quicke senses ought as much as is possible to be cured without dolour or paine But the Anodinon of such remedies is spoken of in the Booke which entreateth of the simple medicaments But he that hath but small senses and those that be not quicke may if the disease require suffer strong medicines But we must haue regard and consideration to the strength of the principall member whereof we will more copiouslie héereafter declare when as we shall haue occasion to speake of Phlegmon But if it be not a principall member surelie without daunger you may minister vnto it such medicines as mittigate and asswage the Gréeks call them Calasticke whereof we will plainlie and more at large declare héereafter At this present we will declare the indication which is taken of the scituation and figure of the partes and then we wil finish and conclude this fourth booke For this cause haue we excogitated and inuented certaine medicines that must be giuen to him that hath his ventricle vlcerate the which medicines must be dronken at once but to him that hath his throate vlcerate they must be ministered at sundry times by little and little because of the passing which bringeth great vtilitie to the vlcer neither they must be ministred so in such case as to him that hath his ventricle vlcerate Likewise we haue declared by the situation and figure of the said part that such medicines ought to be made grosser and thick more clammy than the other because that the throte is a passage of things that is eaten and dronken And for that cause remedies which may conioyne cleane on euerie side of it is most conuenient and not such as are thinne and easie to slide away For the thicke are alwaies about the parts and the clammy doe cleaue vnto it Likewise vlcers that are in the thick intestines haue more néede of medicines which are cast out by the fundament in asmuch as they be next vnto it But the vlcers that are in the thin intestines because they be fardest from the fundament require both medicines that is to say those that are receued by the mouth and those that are cast in by the fundament Now truly the cōmon indication of all the interior parts is that we ought to choose things that be most familiar to the nature of man be they meates or medicaments and to eschew those things which be contrarie vnto it Although to Vlcers which bée in the outwarde partes the vse of such medicaments be
as it draweth downeward Againe that which floweth by stoole that is deriued by the womans shape but Reuulsion is vpwarde for so truelie Nature is woont to doe To the woman sayth Hyppocrates which vomiteth bloud her naturall sicknesse following is a remedie for this cause if her tearmes abundantlie break out or that bloud by anie waie floweth out of the matrice thou shalt drawe it vpward by fixing a great cucurbite or boxe vnder the paps For this also is inuented of Hyppocrates And by like reason the bléeding at the nose is stayed by great cucurbites fixed vnder the ribs and if it floweth out of the right nosethrill then the cucurbite is to be set vpon the liuer but if it commeth out of the left nosethrill then set cucurbite vpon the splene but if the bloud floweth out of both nosethrills then fixe the cucurbits vpon both liuer and splene but if the patient be not yet holpen open a veine on the cubite that is right against the fluxe and when as thou hast taken a little bloud awaie stop it for an houres space and then take againe more bloud and so againe and againe according to the strength of the Patient In like sort because it is a common waie of curing thou shalt bring all other fluxes both to their contrarie parts and also make deriuation by the next places for that which floweth by the stoole to euacuate by vrine or the matrice and that which floweth by vrine must be voided by stoole or matrice And of the fluxes of the Eies Eares and pallet of the mouth the next doriuation is by the nosethrils reuulsion trulie of all these higher parts is euer to be made downward and also of the lower parts vpward Also from the right side to the left as also from the left side to the right In like sorte reuulsion of that which is within must be made outward and of that which is outward in like sort inward therfore friction of contrarie parts is done chieflie by those medicines which doe heate Also straight ligatures are to be reckoned among those remedies which bring to the contrarie partes and so also is the shutting of the naturall pores set in the opposite place but by what medicines that shall be done the matter thereof is set out in our bookes of Medicines But it behooueth to intreate of all Fluxes in the Bookes following Now we must returne vnto the flux of bloud and the band put on the vessells that flowe are to be accounted among stopping medicines and also our fingers which do close and presse the vessels There is also another ligature hereto appertaining which the Gréekes call Epidesis although it goeth not roūd about the member as a bande doth but ioyneth the gaping lips of the wounded part by his embracing also holdeth such things as are put vpon the parte and is numbred among closing medicines Besides all these rehearsed the apt situation of the wounded part is accompted among the remedies which stay the flux of bloud Surely the situation shall be apt if it be directed vnto these two endes that the part be frée from dolor and be directed vpward for if the part hang downe or is pained it will not staye the fluxe but will cause it if there be none Therefore he that knoweth these things if at any time he shall stand by him out of whose wound bloud floweth for first I will entreate of these let him put his finger vpon the mouth of the vessell gently strayning it and compressing it without dolor for so he shall at once both staye the bloud also make it congele in the wound but if the vessell from which it floweth be déepe hid let him then surely both know the position and magnitude of it And furthermore whether it be a veine or arterie then put it in a hooke and lyft it vp and a little wryth it but if the bloud will not so be stayed if it be a veine let him without bynding assay it to stench the bloud with some of those medicines which haue power to stay bloud truely the best are those Emplastique which are made of Rosin fryed and the finest wheate flowre and Gipsum and such lyke but if it be an arterie thou shalt stay the flux with one of these two either by binding it or by cutting a sunder the whole vessell and sometime truely we are also constrained to bynde the great veines and to cut all these ouerthwart and this necessitie happeneth in those where as the fluxe issueth out of the déepest place chiefely by those parts that be straight and principall for so is part of the other part drawen back and the wound is hid and couered of the parts lying on it but it is more safetie to doe both that is to binde the roote of the vessell and also to cut of that remaineth I call the roote of the vessel his former part which is néerer the liuer or the heart this in the neck is the lower part in the armes and in the shankes from the higher part so in all other parts as thou maist learne by the anatomie which these methodelesse Thessalians do not allow The fourth Chapter THese things being done the wound is first to be filled with fleshe before thou take away the bande from the vessell except the flesh engēdred doeth fill the place about the cut arterie but the there is some wide space the affect doth follow which the Grecians call Aneurisma wherefore I counsel thée to vse rather those kinde of medicines which stench bloud for that through their clamminesse they stop the pores the Gréekes call it Emplasticon than those which make an asker because the wound after it is soner and with lesse daunger filled for it is daunger in the other least there be made presently a new flux of bloud out of the vessel if the crust falleth of Therfore that medicine that I will now set here out is the best that I know of all other which I also vse without perill in fluxes of bloud of the coates called Membrana of the brayne one part of Frāconcense mixed with halfe one part of Aloes after when thou wilt vse it tēper it with so much white of an Egge as it may be thicke lyke Honey put to these most soft haires of an Hare and then apply it largely both to the vessell and also to the vlcer binding it outwardly with a soft linnen roller and let the roller goe foure or fiue times about the vessell that flowed then go toward the roote of the vessell in those parts I meane which may be rolled toward the roote you may in all parts of the body except in the coates or membranes of the braine this being done if thou wilt lose it the third daye if the medicine doe cleaue hard to the vlcer put another vpon it as it were a liniament moystening that which is made of haires and roll it againe as thou didst the
haue Pthoe For like as all other things are rightly set out of Hippocrates so also is that Aphorisme rightly sayd that vnto extreme diseases principally extreme remedies profit by what opinion therefore was Erasistratus so madde so slow dull in the beginning of such affects but after when occasion was past to be so diligent for being perswaded by a most fond reason he neuer doth let bloud when as bloud is required nor purgeth any man or yet doth exicate his head Frō which things if the patient being in daunger of that Pthoe kéepe and abstaine himselfe although all other things be rightly done I think he doth nothing more for he refuseth to let bloud and doth onely vse to diuert it with binding of the ioynts whereby as he himselfe saith there may remaine plentie of bloud against the time of inflammation and that we be not for want of it to nourish the patient but peraduenture some wil say sir how Erasistratus If after the ruptured veine the inflammation occupieth the lungs there is no cause why thou shalt hope to cure the man for considerations which I haue set out before Wherefore he shall now no more néede this trauell being betrayed or deceiued by thée at the beginning for he doth like to a gouernour of a shippe when through his negligence the ship is cast away he geueth to some one of the passengers a borde in his hande and perswadeth him so to saue his lyfe but Erasistratus perchaunce did suppose that an inflammation was in the number of those that necessarily follow a wound Notwithstanding if he so thought he was in great ignorance when any man may behold great woūds without inflammation to be glutinated of sixe hundreth such as dayly doe fight a combat so that the second or fourth daye they be in safetie and we haue cured many of those who had some vessells of the lungs ruptured by falling crying or stripe before that any inflammation sprang in the ruptured vessel and if he doe affirme any of these to haue inflammation of the lungs he doth repugne with his owne decrées affirming both that and the principall couering which is next to the heart to haue inflammation and also to be frée from a feauer also the inflammation being broken the man to voyde out nothing Therefore againe let him heare of vs that the Vlcer can not be adglutinated if the lungs be inflamed and that if inflammation commeth of force he shall haue a Feuer and that when the inflammation is broken the patient shall with coughing voyde mattier Therefore if one hath neuer a Feuer or cough nor voided no Sanies from the vlcer and inflammation by what reason is ther in the lungs of this man any inflammation Therefore both this principall remedie is vniustly of him condemned also he letteth slip purging without making mention of it it is no medicine of affect set out of him against any of the forenamed kinde of griefes but if the head send downe flux it shall be kept in the same state or if that cough followeth through intemperatenesse of the members seruing respiration that shall also so remaine so that Erasistratus shall be like vnto the Image maker who when the partes were perfectly made and finished he left the Image without eyes for to what beautie I pray you are the other parts when as thou wantest thine eies Afterward a Gods name séeing so excellent men haue erred that famous man Thessalus which doth not at all know the art iudgeth himselfe worthie to be called a Methoditian and we sée now almost all his disciples to let bloud not onely to many vnto whome bloud letting is not profitable but also to those kinde of remedies which ought to be iudged hurtfull especially if they should stand in their owne suppositions and also to those that are strong which reiect and put foorth bloud either by vomiting or coughing but how shall these hang together that both they byd to let bloud where there is reiecting of bloud and that in their Commentaries they write the remedie herein to agrée with adstrict diseases Now therefore let them call them selues no more Methodicians but Emperickes If setting apart reason which they thinck to be right to vse onely experience to the finding out of remedies are they not in these most clearely found neither by reason neither by any Methode to doe any thing Much more when as they say the parts are vnprofitable to the finding out of the cure But if any doth call to minde those thinges which wée haue taught of the Eares Nose Eyes Mouth Breast and Lungs also of that we haue said of the matrix bladder and stomacke he shall finde them to erre all the way such one was he that to the inflammation in the secrete parts he applyed the Macedonian medicine and with this also a relaxing Cataplasme euen that notable one that is made of Bread water and Oyle also a nother like to him who vsed the same medicines to the place exulcerate But we will speake of such when we shall dispute of inflammations but those Vlcers which are in the yarde or fundament without inflammation require no relaxing Cataplasme but a Ciccatrizing medicine not onely of that nature that may ciccatize the Vlcers in the flesh but that they may so much the more exciccate as these partes are dryer than the flesh yea and that which thou maist more maruell the Vlcers which are in the ende of the yarde called Pene are more to be dryed and those which are in the necke of the Bladder called Cole and those which are without the ende of it called the Acorne or Glans But the Vlcers in the fore-skinne are to be lesse dryed and yet lesse than these whatsoeuer are in the skinne which couereth Therefore when as one of these Methodlesse Phisitions I meane these Thessalians could not cure a moyst Vlcer in the Acorne or Glance with Epulotike medicines that is with such as doe make a ciccatrize He chose mée of counsel when he heard of mée the part required a more drying medicin because it was of drier nature he did forth with beleue me but being of force cōstrained to vse some of our medicines the vlcer was cured in 3. daies and it did well appere that the Phisition reioyced not so much in the health of the patient as he was sorowfull he was trained vp in ill kinde of doctrine for the medicines vsed of vs which is made of Paper combust cureth these kinde of vlcers like as Dill and Gourds being combusted and strowed vpon the grieued part and vsed as before and other like which in like sort doe vehemently drye if there be any such vlcer voyde of moysture to such onely Aloes is a conuenient medicine it must be sprinkled in but dryed and made into most fine pouder and it doth also cure well the vlcers of the fūdament with dry Cadmia washed in wine and dryed hath the same vertue and Litharge is of like
vtter parts of the bodie ther the matter is stil reteined and doth diuide the vpper flesh from that which is vnder it and so in processe of time by his acramonie and sharpnesse it corrodeth through and runneth forth if that by scarification it be not preuented But oftentimes it commeth to passe nature being ouercommed of the fluxe that the bloud is not tourned into mattier but into some other certaine mutation sometime into one and sometime into another The auncient Phisitions doe commonlie call all these by the names of Apostumes and principallie these which be in the profound and déepe partes But many woulde not haue all these which tourne into good mattier be called by the name of Apostumes but onelie those which turneth into corruption like as they call all these which come to suppuration in the lungs by the name of Impiema and other some Diapiema and also like as Impiestem and Diapestem and manie would not haue them so called But when there is anie such thing amongst the little pannicles that they call Impyerna and him that is so grieued Impius But some other Phisitions would haue those called Impius in whom there is mattier gathered betwéene the breast and the lungs Wherfore I haue said we must so far forth regard the names as the thing signified may be made more euident For we must labour that the thing it selfe of which we do speak may be made so manifest that no part therof be left vnknowen for all these are preparatiues to the methode of curing by which methode we doe cure the dispositions themselues and not their names Therfore you bearing these things in remembrance we will procéede vnto those which remaineth and are necessarie to be spoken of Of Sinus or hollow Vlcers and the cure when it is difficill and hard Chap. 4. WHen as putrefactiō doth separate one part of the body frō another or separateth those things that be contayned to their subiects frō the same this mattier being euacuated or let forth so that the parts separated cannot take their accustomed constitution and vnition this affect is called Sinus And if this be not spéedelie cured there doth grow a certain hardnesse by length of time which is named Callus neither can it be adglutinated to the parte subiect but by conuenient dyet and medicamentes which bee exiccatiue for other wayes the parte shall séeme to inioye perfect health when it is not so For if anie man vseth a right diet and hath his bodie frée from superfluous humours Sinus is remoued and chaunceth not But if the bodie doe abound with superfluous humours the same may resort againe to the grieued part and cause the same Apostume which was before which might haue béene easilie euacuated Then you must cure the same as you dyd before with abstersiue and scarifying thinges and medicaments that may kéepe back humours But this Apostume shall not be so grieuous by a great deale as the first was for so much as the partes which were diuided are not ioyned together againe and that the humour doeth quicklie and spéedelie fill the same insomuch that Sinus as we may tearme it doth easilie receiue the fluxe againe and as it doth quicklie receiue it so doth it spéedelie euacuate the same hauing an apt waie for the fluxe to auoide at But if the partes were adglutinated and ioyned together then the Apostume would be grieuous before it were broken The generation of an Apostume commeth not onely of an inflamation called Absessus but sometime also it commeth by the meanes of other humors which by processe of time corrupteth separateth the parts that were ioyned together frō their subiect partes Wherefore it commeth to passe when these Apostumes be cut that there doth not onelie appeare in them all kinde of humours but also sound bodies and straunge things for there are sometimes found in these Apostumes things like vnto mier or dirte to vrine to conieled things called Grumos iuyce of Honey slime bones stones nayles and haire and some time like liuing things all which doth spring of putrifaction as it may easely be perceaued Of Fistula Atheroma Steatoma and Meleseridis Cap. 5. THere is also a narrow and a long Sinus which is called Fistula and is cured like as the other Sinus is and commeth againe to apostumation through the superfluous flux of humours euen as we haue said in the other Atheromata Steatomata and Melesirides are of some men accounted among Apostumes and some suppose them to be of an other kinde but the natures of them are manifest by their names For in Atheromata is things found like vnto potage or like to a pultes In Meleserides like vnto Honey And in Steatoma like vnto fat or suet and all these for the most part are conteined within a Membranus filme or skinne and are called tumors against nature Besides these there are other as Carbunculus Gangrena Herpis Erisipelas Scirrhus Oedema Cancers and inflamations all which the Phisicion that doth intend to cure them must not be ignorant of but he must be diligent in considering their differences as well as of their generation and substance Of Gangrena and Carbunculus Cap. 6. WHen the bloud of Gangrena and Carbunculus doeth waxe so vehement hot that with inflamation it burneth the skinne then they come with crustes and blisters and goeth before the vlcer like as it were brent with fire and they bring with them most sharp feuers and perill of death These vlcers in a Carbuncle doe alwayes appeare blacke or else in coulour like ashes but not as an inflamation for the coulour of an inflamation is red and these decline somewhat more to blacknesse then those doe which be of bloud or those which be refrigerated with colde For those tumors are more swart but these are glistering like vnto bitumen or pitch in so much as they come of black cholar for the malignitie that is in Carbunculus springeth thereof Therefore it must néedes follow that from the beginning either else in the vehement boyling the bloud be presently turned into melancholike humor by the reason of vehement adustion Of Cancers Cap. 7. OF black cholor without boyling that is to say melācholie commeth Cancers and if the humor be sharpe it maketh vlceration and for this cause these tumors are more blacker in coulour then those that cōmeth of inflamation and these be not hot but the veines in these are both more fuller more distended foorth then those which be inflamations For lesse matter goeth out of the veines into the fleshie parts which compasseth thē about through the grosenesse of the humor which bréedeth the Cancers neither yet are the veines so red as they be in inflamatiōs but sheweth them selues according to the humor that they be filled with Of Gangrena which commeth after great inflamations Cap. 8. THere followeth after great inflamations that which is called Gangrena and this disease is a mortification of the affected part and if it haue not spedie
drawe the vrine out of a hollow veine from the bloud and it is not carried of his owne accorde into the reines as though that were the best Neither doe the hollow veines drawe together and wind about thrust forth the vrine into the oblique reines nor into these which lie right vnderneath in the sides to be strained out with all the bloud and because it is thinner than bloud to be transmitted euen as all the Wine runneth into the vessell of the Wine presse and as the coniealed milke is strained the Whey alone runneth and not the chéese in like manner the reines doe expell the vrine into the bladder through Vreteras which are growing on the sides of the bladder and the humour which is receiued Asclapiades saith is resolued into vapours into the bladder and into the bodie hauing as it were two tunicles in it the vapors are let passe by waies vncertaine darke straight such as can by no sense be perceiued And they being once againe growen together do receiue their first forme and so out of vapours humours are engendered for so he hath depriued the reines and Vreteras of their function Neither doe the part of bloud receiue pure bloud aboue the reines but those things which are beneath doe receiue the bloud from the reines vnto whom they bring fastned through pressing wil as Serum be carried being purged and distilled as certaine of the scollers of Erasistratus saie for if Serum were heauie neither should it be carried of the stomacke into the liuer to be distributed neither into the reines by Caua neyther doth a watrie humour runne into the reines and a sanguine humour by Caua backward like vnto oyle and water mingled which when they are poured on the ground each run contrarie waie as other Erasistratians affirme Nor yet as Licius saith the vrine is the nourishment of the reines Therefore the reines doe drawe the vrine for that it is familiar and pleasant vnto them and not by following that which is made emptie For so when no more vrine did abound then was it made emptie by Ischuria that is to saie through suppression of the vrine in the reines bladder or other passage belonging vnto vrine as wée haue said before more largelie In the Tractice of the stomacke and the throate by their straight passages there is no Deglutitio by contraction as Erasistratus saith In the Tractrice of the liuer there is a distribution of Chylum out of the stomacke and entrailes into the liuer by the veines Meseraica In the Tratrice of all the partes there is distrubution of bloud out of the liuer and Caua into all partes by the braunches of the veine And not as Erasistratus affirmeth by the expression of the stomacke for this although it were so yet by reason of the length of time it should haue small power for the distribution of bloud through the veines not by the veines contraict about the bloud which they containe not with that succession vnto that parte of our substance which is made vacant and dispearsed from our heat the which thing those that recouer from sicknesse doe declare who if they haue not more nourishment flowing and abounding in them then there is place vacant they shall neuer recouer their accustomed helth moreouer the abundance of bloud in the bodie could neuer be gathered together vpon the liuer In the tracture of purging medicines it may appeare they drawe proper qualities or certaine humours familiar vnto them out of our bodies as Scamonium draweth yeolowe choler out of one that hath the Ianders Elleborus niger draweth blacke choler ex Melancolico Cnicus Coccum Gnidium draweth fleame ex Leucophlegmatico flos aeris Squamma aeris aes Vstum Chamedris Chamelion draweth a thin and watrie excrement ex Ascitico and these tumors are not engendered in vs of the medicines themselues making our bodies supple as Asclepiades doth falselie surmise denying the facultie attractiue vnto euerie conuenient qualitie whereby Magnes draweth yron Succinum a little moate and corne the water layde vnderneath it in earthen vessells and certaine medicines doe pull out splints and arrowe heads fastned verie déepe in the flesh and also poison of Serpents which was put in the same Likewise certaine medicines drawe the poison of Vipers some the poison of Pastinaca marina other of others insomuch that the poison drawen out hath ben found lying vpon the medicine By the which similitude the same substance may drawe thinges other medicines drawe not by hooke and crooke Attomos ioyning together as they mette one another with Epicurus the which he and Asclepiades did appoint to be the first elements of all things Retentrix The reteiner of proper qualities drawen vnto euerie parte vntill digestion be perfect when there is nourishment but if there be excrements which doe trouble the part wherein it lieth as in the entrailes the bladders c. swelling with quantitie or sharpe and biting qualitie or in both together The childe is reteined in the wombe vntill that through greatnesse weight biting or that the infant be auoide with sweate or vrine the Membranae béeing broken or through some other vrgent cause it is constrained to be deliuered This facultie like as the rest is in all parts which are to be nourished but it appeareth most plainlie in those parts which are greatlie hollow as in the stomacke womb bladder and is most delighted in these oblique passages but in other partes it is more obscure it is also placed in the temperature of those partes euen as all the rest are Coctrix The digester of the substaunce reteined in the part the which substance is so much the rather made like vnto the parte by alteration as it is more néerer of greater similitude to the same in qualities as of bloud flesh is soone made but that substance which hath lesse similitude with the part it is necessarie that it be chaunged flower first by all the meane qualities as of bloud hot moist and red ther cannot at the first dash be made a bone colde hard and white but there must néeds be many alterations and chaunges in the middle And for that cause there are two kindes of instruments pertaining to nutrition The one is that which draweth carrieth conteineth and digesteth the nourishment and as it were a straunge burthen expelleth and beareth it such are first Cocturae Os Gula Ventriculus Intestina second Mesaraice Venae Hepar Caua vena thirdlie all the parts Similares and of these Organice and Vene capillares the which as the chiefest prepare by alteration the nourishment méete for euerie part The other is that which by drawing the excrement of nourishment doth diuide carrie reteine and purge it as are Lien Rene Ambae Vesicae with the passages of the stomack chiefly by Crassa intestina Spincteres ambo Musculi octo epigastrij And those muscles which doe make the restraint of the breath and also those which is verie profitable and necessarie for the siege and vrine and vnto the bearing of a childe Thorough this nourishing alteration when as the partes are made that which remaineth is like vnto them and therefore it is called Assimulatio but through the ingendering alteration those partes which before were not are afterwards created Expultrix the expeller of those things which could not bée ouercome digested or perfectlie altered and that could not be made like vnto that which ought to be nourished when they are gréeued as it were with a strange burden the part which demaunded them either by concoction or attraction and when they stretching out in quantitie or troubling with sharpe qualitie or both doe greatly hurt it This facultie is excedingly delited with croked wayes which are these parts the stomacke entrailes wombe both the bladders veines and arteries Expulsion which is contrary vnto attraction is often times through one passage as vomite and swallowing downe through the throte the séede and the encrease through the neck of the priuie parts The distribution of nutriment the attraction of purging medicines voluntarie expultion of the iuice abounding in vs through Mesaraicas venas These nourishing faculties are vnderstanded by the name of naturall things for that from the conception of the séede euen vnto death they are in a liuing creature and also in a plant for they help generation action one likewise furthereth an other that by nutrition there may be a certaine particuler generation and corruption wherefore these thrée bookes entreat almost onely of these faculties vnto whome corruptio diminutio atrophia are contrary These faculties with certain instruments which haue action cōmon vnto all the bodie are of two sorts that is generall and perticuler The generall are either all present as in the stomack and liuer or else thrée of them onely as in the two bladders for one of them digest or two of them alone as in the reines for neither they digest nor reteine or at the least very little by reasō that they want great capacitie or else the facultie expultrix as the entrailes which haue for that cause onely croked passages in their tunikes And forasmuch as these ought to be nourished as wel as the other similer parts They haue foure particuler faculties nourishers of them placed in the temperature of their substance Hetherto wée haue declared which are the naturall actions how they be made and of what parts FINIS MIEVL X. VAVLT MOVRIR-EN VERT V. QVE VIVRE EN HONCTE AT LONDON Printed by Thomas East DWELLING BETWEENE PAVLS Wharfe and Baynards Castle 1586.