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
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
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
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
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.
handes without medicine I thinke there is no man that is so ignorant or stupidious that thinketh that to be true then of necessitie it must followe that these bée thrée instrumentes and not thrée partes of medicine as manie men haue misconstrued both Hyppocrates and Galen both contrarie to reason and true experience for the hands alone cannot cure without Medicine neither can the medicines bée ministred without handes neither yet can anie man take meat or drinke except it be ministred with the hand then of necessitie it must followe that these thrée cannot bée diuided forasmuch as one is holpen by another and the desired health brought to an end by all these thrée and not by anie one of these alone as Hyppocrates dyd right well prooue in confuting of certaine sectes that were in his time as Tragus dooth make mention by the authoritie of that noble King Democrates affirming that there were certaine sectes which then dyd vse the arte of curing some by inward medicine onelie which they did purge the bodie withall and some by dyet onelie which they did vse as it séemed vnto them good and some by mininstring of outward medicines to such partes of the bodie as they thought good And euerie one of these did affirme that they would restore mannes bodie to health what disease so euer it were affected withall if that the saide disease were curable onelie with one of these thrée wayes and that the other two were superfluous and néede not to bée vsed By meanes whereof there did growe greate contention and great disputation was had therein and in conclusion they did séeme to confound all thrée partes each of them thus confuting other Then Hyppocrates hearing of this great contention amongest them they all thrée professing the curatiue parte of the Arte of Medicine sent for them and appointed vnto them certaine men to cure and asked them in what space they would cure the same persons and they appointed a certaine time and Hyppocrates gaue them foure times so long space Then euerie one of them with great diligence according to his owne sect and waie dyd minister Notwithstanding the Patients were not made whole so that they were constrained to leaue them vncured when they coulde doe no more When Hyppocrates sawe their dooinges howe farre wide it was from a reasonable methode yet how ingenious and wittie they were in deuising and inuenting of medicines to bring their purpose to passe hée did not a little meruaile Then with curteous wordes he perswaded them to leaue off their precisenesse and seuere sectes and to vse a generall methode wherein all those thrée were ioyned together and to vse euerie one of these in his conuenient time and place each one of them to helpe other and then ther was no doubt but with their excellent inuentions they would cure wonderfull griefes and diseases which otherwise could not bée brought to passe Nowe when Hyppocrates had made these thrée men friendes hée required them to goe with him to their sicke and grieued Patients and sayde vnto them That with the same medicines which they had ministred before by the permission of the immortall Gods hée would make all their thrée Patients whole So Hyppocrates ministring no other dyet but such a diet as hée that ministred the dyet had vsed before neither yet anie other purging medicamentes than he that vsed to cure with purging medicaments had vsed before nor yet anie other plaisters or ointmentes than hée that vsed to cure with plaisters and ointmentes had vsed before euen with the same medicines that they did vse by vsing of them in conuenient time and place methodicallie did cure all their sicke Patients By meanes whereof they were perswaded to followe his doctrine and to vse these as common and generall instruments for the arte of curing and all they to be exhibited and vsed with the hand Thus it doeth appeare by Hyppocrates that none of these may be absent from him that vseth the arte of curing Galen also as concerning purging medicaments where hée intreateth of the same sayth they bée verie profitable yea and also most necessarie in the curing of Cancers olde stubburne and rebellious vlcers and also in Herpis Herisipelas c. And these purging medicines were chiefelie inuented and found out by experimentes wherewithall they dyd purge and drawe awaye these vicious and euill humours which was the maintaining cause of all those Vlcers and grieued partes as it is afore sayde which other wayes could not haue béene cured Galen also in his fourth booke De Methodo Medendi by the authoritie of Hyppocrates doeth saie thus That Purgations of the bellie is profitable to manie vlcers and also to woundes of the head of the bellie and of the ioyntes and where there is daunger of corruption of the bones or where stitching behooueth in woundes or where Erosians be or where Herpis and other affectes bée which hindereth the curation of Vlcers and also where rollinges must bée vsed By these wordes it is apparant truelie that Purgations are profitable both to woundes and vlcers at all times when they bée greate and grieuous I meane not onelie Purgations ministred by the vpper partes but also Purgations ministred by the neather parts as Clisters and such like Thus I doe conclude that these thrée Instruments are most necessarie for those men that shall cure hurts griefes and diseases and in no case maye bée separated or taken from them For lyke as the Carpenter shipwright must of necessitie vse lyke instrumentes to finish and bring to passe their worke withall euen so must the Artists in this arte by what name so euer you will call them haue and vse conuenient Instrumentes to bring to passe the desired health which is the end of this art If the Carpenter should saie vnto the Shipwright thou maist not vse the Axe the Saw the pearcer nor yet the hammer for that they be proper instruments for my arte then the shipwright might aunswere him and saie they be proper for my Arte also and without those instruments I cannot build my shippe nor bring to passe the desired end of my Arte. Euen in lyke manner it may be sayde in the Arte of medicine for whether he be called by the name of a Phisition or by the name of a Chirurgion of by the name or a Léech or by what other name you wil cal him if ye wil admit him to cure wounds Tumours against Nature vlcers or what diseases so euer they be it is necessarie that hée haue his proper Instrumentes apt and méete to bring the same to passe withall But if wée shall stand vppon the names of the Arte and confound the instruments then shal we séeme to maintaine a vaine disputation and spend time about those names which are to small purpose for the name is not the thing that doth cure but the arte béeing methodicallie and rightlie ministred For Galen in his third and fourth booke De Methodo Medendi doth name him
Medicus that dooth cure vlcers and woundes therefore it séemeth to mée that Mtdicus and Chyrurgus bée indifferent names for those that professeth the arte of curing and for anie thing that I can perceiue either by the wordes of Hyppocrates or Galen or by anie other notorious and famous writers that haue written in this arte The Chirurgions ought not to bée forbidden neither the ministring of purgations nor yet of dyet for as much as they be their chiefe and principall instruments without which they cannot bring to passe their desired scope of health And if we shall speake of the antiquitie of names I suppose the name of Chirurgia to be much more auncient than the name of Phisicke for I suppose Phisicke to be deriued of Phisilogia which worde doth signifie naturall knowledge of mannes bodie and of all the partes and members of the same c. And Chirurgia is deriued of Chiro which is a hand or as we might saie a ministration of Medicamentes done with the hand vnto mannes bodie onelie by experience So that all those that were before the time of Hyppocrates were accounted but as experimenters and to followe an arte without a right methode which that noble man Hyppocrates perceiuing dyd lyke a most famous Philosopher according to reason ioyne together all these vnperfect sects which were in his dayes verie manie and taught them one perfect and true waie methodicallie to worke and also certaine rules howe they shoulde learne the same arte and diuided it into fiue speciall partes as we shall declare héereafter which partes béeing perfectlie vnderstanded is the right waie to procéede to the curation of mannes bodie and without knowledge of these fiue partes no man can methodicallie and rightlie cure anie Vlcers Woundes Apostumes or anie other diseases as wée haue sayde before for whosoeuer taketh vpon them hauing not knowledge of these he may be called a practiser and experimenter or an emperike as the most parte of our Chirurgions may be called that bée not learned in these partes and doth worke onelie by experience without reason but those that vnderstand these partes and followeth a methode in their curing whether they doe cure Wounds Tumours against nature Apostumes Vlcers or what other thinges so euer it bée that doeth appertaine to the arte of curing that same Artist may be called Medicus a Medendo that is to saie of curing for so doeth Galen name him in his third and fourth booke De Methodo Medendi according to the translation of that learned man Linaker And forasmuch as ye shall the better credit the worthinesse of this arte of Chirurgerie as well for the antiquitie thereof as for the Instruments appertaining to the Artist I haue héere set forth before your eies an Epistle made by Franciscus Valleriolus in the commendations of the arte of Chirurgerie which Valleriolus is one of the most notable learned men in the arte of medicine that is nowe liuing whose wordes héereafter followeth The office of a Chirurgion and the Instruments appertaining vnto the same Art set forth by Franciscus Valleriolus Medicus Anno Domini 1562. IT is commonlie knowen I haue shewed it before that the other part of the Arte of Medicine is that which cureth with the hand which also the Gréekes doe call Kyrurgicon for the manner of working wée kéeping that name doe call it Chirurgia This part as it is counted among the olde writers the ancientest so trulie both for the magnitude and for the profite of the effects it is counted the chiesect Moreouer Podalirius and Machaon being the first authors of that art as it is supposed and the lawfull issue of Aesculapius the father of the art of Medicine doe declare the ancientnesse thereof whom as Homer writeth followed Agamemnon their Captaine in the Troyan warres and to haue bene no small helpe to his souldiers in curing of them not by the helpe of inward medicines onlie but in curing diligentlie of their wounds with yron instruments and with other fit medicines therevnto appertaining whereby it doeth appeare this parte of Medicine to be onelie proued of them and the same to bée auncientest Furthermore the profit and vtilitie thereof doeth of it selfe manifestlie appeare by the curations of greate Apostumes of wounds of vlcers of luxations and of Fractures all the which this part of Medicine doeth intreate of exactlie And of this part we will intreate in this Chapter and of the same we will shew forth these things what that art is and what be the parts of it what is the end thereof who be the authors what the office and dutie of a Chirurgion is what be his instruments which he hath accustomed to vse in healing what a one he ought for to be and to conclude who ought to be accounted the best Chirurgion and thus we will finish our Chapter Chirurgerie is defined of Galen to be a certaine order of curing which is accomplished by accustomed incisions and adustions and other thinges which are done by the hande Moreouer the author of the Introductorie whosoeuer hée hath bene hath defined the same after this manner as they doe properlie call it a taking awaie of things hurtfull by incisions and concinations by a certaine methode reason In like manner it is the curation of wounds and vlcers which is administred to mans bodie But if anie man will set forth the order of it more curiouslie and expreslie he wil call it the third part of the methode Therapeutichon which doth cure diseases by the artificialnesse of the hand by adustions and incisions and by curing luxations and by putting broken bones into their places and such like Guido of Caliacensia hath so defined that it maye be a science which may both teach the order and qualitie of operation chiefelie by adglutination and incisions and other operations of that kinde which bée done by the vse of the hand restoring men to their health as much as is possible Also it behoueth vs to vse this name of Science more largelie in this place and applie it vnto that parte of Chirurgerie which doth profit by meditation of preceptes and giuing of Methode and not by curing with the hand For it is manifest that Chirurgerie is an Arte and not a Science properlie whose end is the bringing to effect and not the contemplation of the veritie onelie and for that cause Aristotle would haue the same worthelie to be an arte and also hath thought it good to place it amongest those artes which do pertaine to the vse of the hand But other things being put in the definition doe kéepe their place of difference in like manner this parte is not put vnaduisedlie to the definition that men be restored to their health as much as is possible for although that health is counted to a Chirurgion for a perpetual scope yet that same cannot alwaies be obteined by arte because there be many diseases vncurable which doe chaunce eyther because they are such by their owne nature as Elephantiasis
or else that as the curation is taken in hand doeth bring more discommoditie and also a more grieuous sicknesse than that which is taken in hand to be cured As when we goe about to cure Vitiliginem Antiquam Lichenas Hemorroidas Sinuosa vlcera and the old Fistulas Cancers and to conclude when as we haue a stubburne patient which doth giue no regard to the Surgions that gouerneth him these are the causes why that all cannot be brought to their health by arte In like manner Chirurgerie is diuided into two partes generallie the one is which doth declare what things belong to the art doth set forth the precepts wherwith the workman being furnished may worke rightly This part the Gréeks do call Theoreticon we do cal it Theorica that is to saie the learned or speculatiue part the other doth folow that doth perform in effect that precepts of the former it is called in Gréek Practica or rather Poetica that is to say a bringer of things to passe for it wholy doth consist in doing and bringing to effect and séeing that the whole Arte doth depend of these we maye with good cause thinke Chirurgerie worthie to be called an arte as whose ende is affection and woork For she doth exercise all her properties either in soft mēbers or in harde parts The soft parts are those which haue their beginning of bloud and are called fleshie and the hard parts do spring of séede And chirurgerie doth exercise her facultie in those partes by incision by cutting or by taking away by reposition and adustion And truely of this arte there are certaine other more speciall partes as those about the which the arte it selfe is speciallye occupied that is to saye Tumors against nature wounds vlcers fractures and Luxacions Therefore as there be fiue parts which the art doth intreate of so there be fiue partes of Chirurgerie in the whole as which doe teache vs to cure tumours which woundes and which vlcers and which can put fractures and luxacions in their proper place But the ende wherevnto Chirurgerie directed all his actions and prouisions is the ablation and taking away of those sicknesses which maye be cured by ministracion of conuenient medicines with the hande to restore the sicke vnto his health which ende truely the workeman cannot alwayes obtaine vnto For those causes which we declared before séeing that it is not in his power to cure euery sicknesse And this long arte vaunteth hir selfe vnto the famous companie of excellent and noble authors worthie of great renowne In whose register that diuine man Hippocrates the patron and defender of the noble arte of Medicine doth of very right challenge to him selfe the chiefest place by whose meane this parte of medicine is better declared then it was before his time the which thing the deuine monuments which he left to his posteritie doe witnesse I doe meane his bookes wherein he doth speake of the woundes of the head of fractures of the lyms of vlcers of fistules of the emorodes and of the furniture of Chirurgerie and of cutting out of the Anathomies Furthermore Chirurgerie béeinge as it were deuided at length from the other hath chosen vnto hir selfe a proper place and beganne to haue hir proper professors for in the time of olde writers in the florishing age of Hippocrates Chirurgia was not deuided from the other parts of medicine for they were then both Phisitions and Chirurgions And Philoxenus declareth it to haue florished in Egipt which hath set foorth and garnished this Arte in many volumes And after him Gorgias Sostratus Hieron and the two Apollonij Amomus Alexandrinus and many other excellent men and it is certaine that there was no meane professors of the same arte at Rome as the auncient Fathers Tryphon Euelpistus and Meges the most excellent of all as Celsus writeth But how much Galen excelled in restoring and enriching this parte of medicine his learned Commentaries vpon the bookes of Hippocrates wherein he doth declare of the Arte of Medicine and vpon his booke De articulis de fracturis And moreouer his sixe bookes of the first methode of curing called Therapeuticon and the last two of the same the two also De arte curatiua ad Glauconem his booke De tumoribus preter naturam his booke De compositione medicamentorum secundum genera doe testifie abūdantly Moreouer Paulus oegeneta ought greatly to be commended who in a method compendious but yet most exact hath comprehended all Chirurgerie both in his fourth booke and also in his sixt Furthermore Auicenna Rasius Albucasis and Haliabbas being of the schoole of the Arabians haue intreated most diligently of the Arte of Chirurgerie as Auicenna in his fourth Canon and the third fourth and fifte féen Also Rasus in his seuenth booke to Almanser the King Albucasis in a whole volume Haliabbas in his ninth booke of practise of the regall disposition neither hath she lacked hir honour of Latines Celsus and Plinius Captaines who with great beautie and like dignitie haue intreated briefly of this parte Why should I passe ouer Guydo de Gauliaco who onely among the French we haue knowne to haue intreated very well of Chirurgerie if ye regard the reason of the arte We may trulie gather by his rude spéech that he wanted onelie such happie time wherein he coulde not come to the knowledge of the Gréeke tongue nor to the pure eloquence of the Latine tongue whilest at that time ignorance and barbarousnesse exercised tyrannie ouer good learning which was the cause that in rehearsing the place of Galen the truth of the author was much desired But if God graunt me life I will diuide those places of the Arte of Medicine from the common place I trust that I shall helpe Guido and I will of a barbarous and impure writer make him a fine and eloquent Latinist restore him to his beutie which our friēd Siluius hath performed in correctīg Mesueus the same doe I faithfullie promise to the studious to multiplie in repairing of Guido if God prosper our indeuours although perhaps without méete or equal thanks yet shall I doe it with due labour and good will But now I will returne to my purpose for manie famous men and authors most worthie of fauourable commendations haue set forth this arte among the which Guido Vigonius and among the men of this age Tagaltius being my fellowe in office and my companion in my studies haue done greate things and worthie of praise in amplifying and garnishing this part whereby it may be gathered how much is vnto this art to be attributed which so many renowmed haue each one in his workes and monuments set forth increased and enriched that men might know it to be most profible and in effects most euident among all the partes of medicine Now must we show what are the duties and office of a Chirurgion and howe he should enterprise the same for there be thrée chiefe points
fewe woordes I haue proued here bothe by reason and by experience that the knowledge of this part named Phisiologia doeth chiefely and specially apertein to the arte of Chirurgerie and without the knowledge hereof we shal neuer rightly or methodically cure any maner of woūd griefe or disease neither is he worthie to take the name of a Phisition neither yet of a Chirurgion but to be called by the name of an Emprike or experimenter curing onely by chaunce without any reason but euen as the blinde Carpenter which Galen hath spoken of before sometime cutting to much and some time to little and many times marring all his woorke for want of skill ere that he beware Now to conclude for this first part he that will be further instructed herein let him reade Hip. de natura hominis humoribus elamentis de natura formatione fetus many other bookes of Hyppocrates and chiefelie that where he diuided the similer parts As Osteotome that is to saie the diuision of the bones Condrotome the Cartalages Syndestmotome the ligaments Arteriotome the Arteries Phlebotomae veines Neurotome the nerues Miotome diuiding of the Muscles Tenontotome the tendons c. There be diuers other bookes of Galen which be verie profitable to be read for this matter as his bookes of Anathomie also his bookes De temperamentis de optima corporis constitutione de facultatibus naturalibus de placitis Hippocrates Platonis de motu musculorum de causis respirationis and manie more worthie bookes of his which we will let passe There bée manie other bookes also written by diuerse men as Guido and other which doe intreate of these naturall things and speciallie of the Anatomie of mans bodie and for that you may the easilier better vnderstand these naturall things which euerie Chirurgion ought to know and haue in perfect memorie to that end he may remoue those things which doth hurt them or let them of their perfect operation which you may easilie knowe if you vnderstand their natures and properties figures c. Which Table followes héereafter as you may heholde Naturall things Eelements be foure Fire Aire Water Earth Temperaments Simple be foure Hot. Colde Moist and Drie Equall one Cōpound be foure Hot and Drie Hot and moist Colde and moist Colde and drie Foure humours Sanguine Flegmatike Cholerike and Melancholie Members Similer Bones veines arteries cartilage flesh fatnesse pannicle ligament nerues and skinne cōpound Head heart liuer lungs armes and legges Three faculties Animall Vitall and Naturall Operations or actions Animall Feeling and moouing Vitall Beating of the pulse And breathing Naturall Generatio Auctio and Nutritio Spirites be three in nūber Animall Vitall Naturall In The braine The Heart The Liuer Pathologia is that part of the arte which hath the knowledge of sicknesse against nature with their Symptoma and accident and they be thrée in number that is to saie sicknesse it selfe the cause of sicknesse and the accidents which followeth after sicknesse sicknesse it selfe may come two waies either of outward causes or of inward causes we do commonlie call the outward causes primatiue the Gréekes call them Cathertica the inward causes we do cōmonlie name Antecedent or Internam The affectes commonlie followe these causes and if the affectes come of outward causes then commonlie they be wounds contusions fractures dislocations biting of mad dogs of serpents c. If they come of inward causes then they make tumors against nature as Phlegmō Eresipula Oedema Sirrhus with many kinde of malignant and stubburne vlcers to be cured which tumours and vlcers cannot be made whole except their causes with their euill affects may be remoued and taken awaie I suppose that there is no man but hée will iudge this part of the art chieflie to pertaine to Chyrurgerie for that it taketh cure of wounds vlcers and tumors against nature as I haue said before Then if this part doe appertaine to the art of Chyrurgerie as it is most certaine it doeth it behoueth the Chyrurgion perfectlie and rightlie to vnderstand what kinde of sicknesses there be with their differences names what partes of the bodie these sicknesses may be in and what manner of sicknesse it maketh in the same partes As for example euill complection maketh a distemperature in the similer parts euil constitution or euil cōposition maketh a deformitie or imbecilitie in the instrumentall partes And solution of vnitie or continuitie chaunceth both in the similer partes and instrumentall And all these doe appertaine to the Chirurgion to haue most exact knowledge of for he that taketh vpon him to cure an vlcer or a wound or anie other manner of griefe and doth not know the nature of the parts neither yet what part it is in neither yet the cause neither how to remooue the same cause it is vnpossible as I haue sayde before that he shoulde cure the same griefes or diseases rightlie And therefore these blinde emperikes that haue neither reason nor method to leade them to doe those things which they dailie doe I saie their dooings are so pernitious that many people taketh great hurt thereby shall I saie hurte nay rather brought to vtter destruction and many times to death The Symptoma or accidents which followeth sicknesse is also diuided into thrée partes The first is the qualitie being altered as with vehement heate in Phlegmon The action or function hurt but not vtterlie depriued The action vtterlie depriued and taken awaie For these causes aboue rehearsed it is speciallie required that a Chirurgion shoulde be learned and also to haue greate experience that hée maye rightlie iudge and discerne one disease from another with their natures and causes to the end that when you come to the curation thereof you may take right indications what to do first what next and so foorth to the end for other waies you may applie medicines nothing fit for the purpose but those that might doe great harme and you might also applie those first that would be applied last and those last which should be applyed first and in the end marre all your workes as the blinde Carpenter doth Thus farre I haue proued for Phisiologia to be one part of Chyrurgerie or of the Art of curing as we may tearme it and I thinke there is no man that will count him to be a right Chyrurgion that lacketh this part of the Arte or that is not verie expert in the same And for the further knowledge héereof there be certaine bookes appointed of Galen and other auncient writers that you may reade concerning the same part as hereafter followeth Libro Hippocrates de Morbis libro Epedimsorum Hippocrates Galen de locis affectis Galen de Morbis Symptomatis de 4. temporibus morborum Galen de differentijs morborum causis Smptomatis Galen de inequali intemperie Galen de arte Medica Galen de tumoribus praeter naturam Hippocrates de Vulneribus vlceribus Fistulis fracturis immorodibus c. And also
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
for that they onely are the woorkes of medicines Wherefore thou must haue the more regard of the iust teÌ„perature of the vlcerate partes as often as thou wilt either incarnate or glutinate or ciccatrise the motions of nature are to be obserued which euery of these rehearsed doe follow but otherwise they shall not be obserued except the part be founde according to nature as if there were inflammation With an vlcer no man will atteÌ„pt either to incarnate or conglutinate or ciccatrise before the inflammation be expelled so in lyke sorte I suppose that if there be onely intemperatenesse without inflamation we shall not hope for any of the foresaid before this be cured Therfore hereof spriÌ„geth again a certain indicatioÌ„ of the finding out of medicines which were before coÌ„prehended for all they were siccatiâ—… but they did differ among themselues by reason of excesse and defect it is not before defined how forsoth they should make hot or refrigerate But the Methode as it were enforceth to search out also this thing But it behoueth to marke not onely whether it doe exciccate but also whether it doe greatly heate or refrigerate Wherefore thou shalt eschew the vse of Altercum and Mandrage and Meconium although they excicate as much as is méete for an vlcer because they vnmeasurably refrigerate Resin and Pitch and Asphaltus although they doe moderately exciccate yet they be moderately hot therefore no man will vse these alone neither otherwise than mixed with other which doe gently refrigerate making of all one temperate medicine But if these thinges are thus as truely they are it is conuenient also to marke the temperature of the ayre for this being as a certaine medicine comming outwardly to our bodies if it be to hot or colde it hindreth the cure Therefore diligence is to be had that the medicine doth helpe the excesse of it Therefore Hippocrates vseth medicines of colder facultie in the hot times of the yeare and in colde times hotter medicines And here truely thou art not ignorant howe a certaine dul methodician did coÌ„fesse that he did marke how the ayre about the pacient was affected in heate and colde and yet not to suffer the times of the yere to be regarded as though the names it selfe of the times of the yere did either profit or hurt and not their temperament or that the olde wryters for this cause had not respect to it But I thinke it abundantly shewed that who so will by a certaine methode cure an Vlcer he must of force both come to the first Elements and also consider the times of the yeare and the temperaments of bodies not onely in the whole but also in euery part Againe we must repeat that that hath béen spoken of indication which is taken of moist and dry for like as the moist nature requireth moister medicines and dryer natures drier medicines so here the hotter nature requireth hotter ayre the colder requireth colder For that in those which are against nature and those which are according to nature there is a contrarie indication For those that are according to nature shew the lyke those that are against nature contraries If wée will conserue them these must bée of force remooued The ninth Chapter ANd thus I suppose that I haue cléerely taught that he who shall well cure an vlcer must consider the complection of bodies times of the yeare natures of partes also that the first indication curatiue is taken of the onelie effect but for all that the remedies cannot be thereby found out except we first do ascend to the elements of bodies and way the patients temperament not onely of the bodie but also of the sicke part and considering with these the temperature of the aire which truelie doe both pertaine vnto the present state and also vnto regions that there are together in one curation contrarie indications how to vse them it shall be set out héere after more largely notwithstanding now also it shall not be from the purpose to speake also in this place thereof in few wordes for I do think no meruaile although the patients complection be moister and yet the part affected to be drier or contrariwise that the part be moister the teÌ„perature of the whole bodie drier in like sort than the part is of contrarie temperament in hotnesse coldnesse with the whole bodie therefore like as if the whole bodie were in meane temperature which we haue called best we shuld not neede to alter anie thing in medicines touching the nature of the Pacient so whereas the bodie is soone drier or moister or hotter or colder than is requisite it behoueth so much to increase the force of medicines as the bodie is declined vnto natural intemperatnesse We haue not forgotten to thinke what naturall temperatures is what is against nature for wée haue spoken of that inother our works but chieflie in the booke which is intituled of inequall temperatures admit therefore that the whole complection of the sick bodie is more moist and for that cause require medicines lesse deâ—iccatiue that the affected part is in the number of those which are more drie such we haue said be the parts lesse fleshie as about the fingers ioynts also the parts about the eares nose eies téeth And to be briefe wheras there are many cartilages cotes ligaments bones nerues for héere is no fat or flesh or but verie little the indication within these is héere taken of the nature of the part is contrarie to that which is taken of the nature of the whole bodie wherfore if so be that howe much the complection of the Patient is more moist than is requisite so much the parte affected is more drie we shal neither adde neither yet subtract from the medicine but we must vse such a medicine as we wold apply to the vlcer made in the parte of meane temperature and where the bodie is moderatlie temperate but if the part be so much the more drie than is requisite as the temperameÌ„t of the bodie is moister we must so much increase the drinesse of the medicine or the temperament of the part excéede the temperament of the whole as if the exulcerate part excéed in drinesse foure parts the iust temperatnesse that the patients nature is thrée degrées moister it is manifest that the part which is nowe vlcerate requireth a medicine one degrée drier than where as the part is temperate it is euident that all these are taken by coniecture and that he shal best coniecture which is exercised in reasoning of these trulie in all such there are together at one time contrarie indications neither shall I néed to speake also of those indications which are taken of hot colde because they may be vnderstood by the which is spoken Trulie in other the indications are separated by times in which there are finished it behoueth also chieflie in the beginning of the curation that one to cease
shall not take an Indication of it after foure â—…neths but that which we haue taken at the verie beginning And for a truth that I may not permit such an vlcer to abide so long time but at the first I will take awaie the cause thereof But I cannot coniecture what may shewe the time more than the number of daies except Thessalus will saie that to haue knowledge of such an vlcer we must tarrie the time but in such a case he sheweth himselfe altogether foolish That is to saie if he confesse openlie that hée knoweth not the first affect which hath inueterated the vlcer Furthermore he must plainlie also confesse the Indication curatiue to be taken of the disease and the knowledge of the disease to be taken of other things But bée it so that time serueth somewhat to the disease neuerthelesse the Indication curatiue is not taken of time But to what purpose serueth it if any Vlcer bée inueterate to do away that which letteth the coition to renue the place which is pained For thou foolish fellow if for the maligne fluxe which the Gréekes call Cachoethae the lippes be affected in such sort what shalt thou profit if thou doe cut them before thou hast prouided to stop the fluxe Trulie thou shalt but make the Vlcer wider than it is as some doe that cure vlcers after the same manner as thou doest For the cause remaining which before made the vlcer harde and flintie thou shalt doe no other thing in cutting awaie the lips but enlarge the vlcer For those which thou cuttest shall be made hard come again as they were before Although that prudent Thessalus hath not added this thing that the partes of the vlcer which are hard stonie and discouloured ought to be cut awaie but commandeth by an absolute sentence that those thinges which hinder the closing of the vlcer ought to be cut awaie and to be renued But if trulie hée had counsailed to take awaie the causes that hinder the adglutination of the vlcer and that this reason were auncient and olde I would not accuse him for it is commanded almost of all the auncient Phisitions which doe write of the curation of vlcers by a certaine reason and Method that those causes which doe excite the vlcers ought to be cut awaie euen trulie as of all other diseases For trulie I do thinke it expedient that the efficient cause remaining which exciteth the vlcers ought first to be taken awaie In other diseases it is not expedient but chieflie there the curation must be taken in hand where the efficient cause remaineth And if the sayd Thessalus hath not spoken of the causes that let the conglutination and hath onelie spoken of the lips as he hath said afterward it appereth that he is ignorant of more than he knoweth of those things which appertaineth to the curation of vlcers But it is possible that this alone is the cause which hindereth the cure of the vlcer And it may as it is aforesaid be the cause that intemperauncie which is without a tumour against nature be in the vlcerate partes and also that it be ioyned with a tomour the which doth not require that the lips should be altogether cut awaie It maye also bée the cause that Varix which is aboue it or that the milt which augmenteth it or some disease in the liuer and beside this the weaknesse of the affected part be nothing else but a manifest intemperancie And besides this a vicious humour in the bodie which the Gréekes call Cacochimia and the chiefest of all the causes which may be to the vlcers an incommoditie Truelie great abundance of humours which the Gréekes call Phlethora resorting vnto the vlcer doeth hinder the curation But if Thessalus be of that opinion that the lippes onelie must be taken awaie I saie that of many things he knoweth but one alone which is so euident that the shepheards are not ignorant thereof for if a shepheard sawe the lips of an vlcer hard flintie wan blacke or a leadie coulour hée would not doubt to cut it awaie Then for to cut awaie is an easie thing but for to cure by medicines is a greater matter and that requireth a true methode Neuerthelesse Thessalus neuer knew howe the lips might be cured by medicines for all men confesse that he hath swarued from this part of the art and as he himselfe hath shewed it séemeth that he had neither experience nor rationall knowledge of medicines which is a manifest thing by the booke that he hath made of medicines before rehearsed But of this one worke consequent wée shall entreate of those things which hée hath not writâ—…n well And now we doe intend with deliberation to speake of the curation of inueterate vlcers of the which he hath before intreated Certainlie it had bene better to haue called them Cachoethae and not inueterate theÌ„ to declare their nature disposition and cause of their generation and the curation of either of them And first to know the common curation of all vlcers for as much as they be vlcers of the which I haue written in the third booke next after the perticular and proper cure of either of them afterward the kinde of the efficient cause as I haue spoken of in this present booke And although Thessalus hath done nothing of all these things yet he doth thinke that the vlcerate place must be renued when it is made like vnto a new wound to cure it as a bloudie vlcer what is he that is exercised in the workes of the Arte that vnderstandeth not euidentlie that such a doctrine hath bene written by him that neuer cured vlcer Is it possible that a man may cure an inueterate vlcer as you may cure a bloudie wound and after he hath made it lyke vnto a fresh wound shall it be in drawing of the vlcer together by rollers or ioyning them by stitches or neither by the one or by the other but by conuenient medicines What is he that knoweth not that an vlcer called Cachoethae is caued or hollow séeing that it is made by corrosion Is it possible O foole and impudent Thessalus that a caued vlcer may grow together and be adglutinated before the cauitie be filled with flesh is not that to cure an vlcer as a gréene wound then hast thou thy selfe written in vaine that hath taken indication to cure caued vlcers not with closing but with the filling of the cauitie But if euery vlcer called Cachoethae were not hollowe of it selfe yet when it is made bloudie in cutting the lips awaie as thou commaundest then of necessitie it is made hollow and requireth great space betwixt the lips euen in such manner that I cannot sée how thou maist make them conglutinate together as a bloudie wound for if thou assaie by force and violence the lippes that are so farre a sonder of necessitie there commeth Phlegmon which letteth the sayde lyppes to close together The which thing I suppose that
manifestly that they haue no regarde of other things that appeare in the affected part for to come to such euacuation But I doe not say thus that purgation is euacuation the which is no indication of the course of the bloud but for bicause wée must sometime haue consideration to the letting forth of bloud although there be no course of bloud present which may flow to the greued part for when the disease is very strong there is none which vnderstandeth the arte of medicine but will let bloud And truely the Emperickes themselues let bloud when any is fallen from an high place or when there is any part sore brused hurt with any wound though the pacient were whole and sound before and without superfluitie of bloud By the which it appeareth that it is not the flowing of the bloud to the affected parte which giueth indication but the magnitude and vehemēcie of the disease the force of the strēgthes excepting yet from our talke children As for example If a man be whole and sound and without any maner of hurt and hauing abundance of bloud it is not necessarie because of his abundance to take his bloud from him For there is no indication to be taken of the bloud for because the man is whole for to such men fasting doth profit small eating and sometime Purgation or bathing and Frications may suffise Letting of bloud is not necessary to such as the Emperickes say Likewise Purgation is not good in the onely abundāce of humours for euen as letting of bloud is done either for abundance of bloud or for the magnitude of the disease so is purgation giuen either for the abundaunce of ill humours or for the force of the disease As touching letting of bloud we haue spoken of in another booke and shall doe againe hereafter But in this present booke I will speake of purgatiōs for they that be diseased require them not onely because it doth euacuate the noysome and superfluous humours with the which the bodie is grieued but also putteth foorth and clenseth the excrements within the bodie And for this cause Hyppocates as well in his other works as in that he hath written of Vlcers considereth the vehemencie and strength of the disease whereof he taketh Indication of purging and sayth thus Purgations of the bellie is profitable to many Vlcers and also to woundes of the head of the bellie and of the ioynts and where there is daunger of the rottennesse of the bones or where stitching behoueth in woundes or where erosions bée or where Herpis other affects be which hindereth the curation of Vlcers and also where rolling must be vsed By these words it is apparant truelie that Purgations are profitable both to wounds and Vlcers at all times when they be great and grieuous For not onelie the sayd affects but other bée made great and grieuous thrée manner of waies that is either through the excellencie of the afflicted part either else through the greatnesse of the affect or else because the said affects are Cacoethae that is to saie hard to be cured Hyppocrates hath made mention of all these thinges perticularlie when he dyd intreate of woundes of the head and bellie and of the excellencie and dignitie of hurt parts I thinke it is manifest to all men that he must bée vnderstoode not onelie the lower bellie but also the superiour for in diuiding the Trunke of mannes bodie which is betwixt the necke and the legges is two greate capacities The first is contained vnder the Thorax and aboue Diaphragma and the second vnder Diaphragma vnto Os Pubi or to Peritoneum which couereth the inwarde parte of the bellie And for certaine those woundes which hath pearced within the Thorax or within Peritoneum is verie dangerous chiefelie if anie of the inward parts bée wounded Likewise there are verie fewe but they doe know that the woundes of the ioyntes are Cachoethae and are harde to bée cured Which thinges the Emperikes vnderstand onelie by experience and they that haue studied and haue attained to the knowledge of mannes bodie vnderstand these thinges by the nature of the hurt parte For in tendonie and sinnowie parts where bones are void of flesh there is great daunger of paine waking and priuation of rest and also of conuulsion Such woundes as these be and such as be stitched that is to saie those that are so great that they néed stitching or at the lest of binding or rolling requireth purgation We haue declared in the last booke that all the greater wounds ought to be ioyned together either by stitching or by binding Likewise the vlcers where there is daunger of corruptiō of the bones are oftentimes ioyned with great inflamations Also they that procéede of ill humours bée Cachoethae and with erosion Also Herpetes come of cholerike humours and all other olde vlcers come of such like cause Wherefore in all the vlcers before especified Hyppocrates commandeth to purge by the bellie and afterward he addeth these wordes In all vlcers whereto Erisipel as is come the bodie must be purged in that part most profitable for the vlcer so that the purgation be made either by the vpper partes or else by the lower which difference hée hath set forth in the booke of Humours where he commandeth to tourne awaie the humour to the contrarie parte As for example There is a great flux that commeth to one part of the bodie where there is an vlcer it behoueth to make another in the contrarie parts and thereof he speaketh in the said booke Wherefore if there be as yet a great fluxe which dooth runue to the sore part we shall make reuulsion to the contrarie part that is to saie if the vlcer be in the vpper parts by purging downward and if it be in the neather partes by purging the vpper ventricle But if the fluxe bée newe stopped in such sorte that is fixed in the member it is expedient to driue it out by the next partes séeing that the passages be the next places séeing that the accesse and attraction of purging medicines is more easie and prompt to remoue those things that be néere rather than those thinges that be farre of the which reason belongeth to another part of the art which entreateth of purging medicines therfore hereafter it shall be declared and made perfect Now I will shew the force or if you will call it the magnitude of the disease to be appointed for a certaine indication of taking away bloud or giuing purgation And also that Hippocrates was the first inuenter of the sayd indication I will speake in the bookes following of diseases and in this booke I will speake of vlcers I haue alreadie spoken of Purgations For séeing that euery disease is greuous thrée maner of wayes it is either for the excellencie and noblenesse of the part or for the magnitude of the affect or for the frowardnesse of the same affect called in Gréeke Cacoethia Hippocrates hath made
corruption bréedeth in it and occupieth the space that is betwéene the lippes of the wounde so that the ruption cannot close Wherefore these aboue rehearsed declare vnto vs all causes howe small so euer they bée For although some hath had rigour or though the bodie hath béene ouerthrowen by some Feauer so that there bath not bene good concoction or that it hath béene defatigated and wearied then immediatlie there shall bée paine in the part where the ruption and wound is because that the said ruption hath bene latelie ioyned together but not so substantiallie because of time Wherfore it followeth that a little thing may easilie part them fil the place againe with superfluous humours But what engendereth in such wounds or ruptions nothing but new Ecchimosis and much like vnto the first That is to saie when the flesh was first broken except that this Ecchimosis that is new of more and corrupter mattier than that which was at the beginning which came of bloud and therefore now this is more easilie digested and resolued than that which was at the beginning And thus the which we haue spoken hetherto shall suffice for the disputation of Vlcers thus we conclude this fourth Booke of our Therapeutike methode called Methodus Medendi FINIS THE FIFT BOOKE of Galen called in Greeke 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 and in Latine Methodus Medendi The effect of the same 1 The curation of vlcers which chaunce in the fleshie partes and then the curation of Vlcers in the Instrumentall partes 2 Of the ruption of a veine or Arterie 3 How a fluxe of bloud may staie by deriuation 4 The Medicaments that wil make a crust which doth much to the stopping of a flux of bloud 5 Of spitting and distillation of bloud 6 The curation of Vlcers in the pudend places 7 The curation of a veine or diuided Arterie 8 The reiecting of bloud both from other parts also from the lungs The first Chapter SEeing that in the two last bookes we haue taught how anie shall rightlie cure Vlcers we will by the waie shew that all other Phisitions which vse the arte not searching out the Elementes of those simple particulars in vs cannot cure anie thing onelie by reason but yet least of all other those which professe Thessalus doctrine The rest which are by méere experience onelie taught suppose that at the least those Vlcers which are in diuerse partes are to bée cured by diuerse reasons But those that followe Thessalus as their Captaine for his excellent wisedome thinke that euerie Vlcer in what parte of the bodie so euer it bée requireth like curation for if it bée hollowe they saie it must bée filled with flesh if it bée equall then to bée ciccatrized if there bée supercrescent flesh then that flesh must bée diminished if it bée bloudie and new then it must bée adglutinated As though he that knew this must of force cure rightlie or that this reason were vnknowen to the common people when as there is none that is héerein ignoraunt But they vnderstand not howe the hollownesse is to bée filled with flesh neither howe that which is filled ought to bée ciccatrized or to take awaie that is ouermuch encreased or to ioyne together that which is pure and bloudie without hollownesse such workes trulie are properlie appertaining to the art of Medicine found out by the helpe either of Reason or Experience or both Therefore repeating againe let vs briefelie ouer-runne those things wherby the beginning of these which are to be spoken may be ioyned with the aid of those which we haue alreadie set out Wée haue declared that euerie Vlcer requireth desiccatiue medicines but that which hath hollownesse beside that it needeth desiccatiues it also doeth require abstersiues that which requireth to haue the lippes ioyned together such is a gréene wound called in Gréeke Enema doth aske both more drying medicines and also that be gentle astringent without anie abstersion Furthermore those vlcers which néede to bée ciccatrized require not onelie yet more drying medicines but also strong astringent remedies and whereas there is supercrescent flesh against nature there are required sharpe and abating medicines such of necessitie bée hot and drie If anie accident bée ioyned with the Vlcer the Indication of curation must bée taken of the nature thereof and of this all the faculties of medicines also to bée had If there should superfluous mattier growe in the Vlcer it behooueth to haue medicines which should take it awaie and such haue a greate deale more abstersiue vertue than some incarnatiue medicines haue Also if there bée séene more copious moisture there is néede of a medicine more desiccatiue but yet not to exceede his kinde and if the medicine shoulde be glutinatiue it ought to bée drying and astringent if it shall incarnate it must be desiccatiue and some thing abstersiue and so in all other as is alreadie declared Also if the flesh subiect should be intemperate first truelie we must cure this intemperatnesse that which is drier by medicines humectiue the moist by desiccatiues Also that which is hot by refrigeratiues the colde by medicines that are hot And if by coniunction of two qualities the flesh bée intemperate it must be cured by ministring a contrarie medicine which hath double qualities for this one thing is common to all affects against nature that they cannot come againe to their owne nature without such medicines as haue contrarie qualitie Furthermore at this time the causes of these intemperatiues are to be considered whether these be common to all the whole bodie or else proper of some partes which should infest the vlcerate member by societie the Gréekes call it Simpathia First of all trulie the cause that nourisheth this intemperatnesse is to be cured and after that the intemperatnesse it selfe which is now made for this indication is common to all such as spring of anie cause We haue also declared that there are diuerse indications taken of the differences of vlcers and also those which are taken of the temparament of the sicke bodie haue a contrarie reason for those Indications séeing they are taken of those things which are against nature declare that all contrarie things must be applied these Indications because they are taken of natures selfe shew that like things must be vsed for if how much the part is drier so much the more it requireth to be dried that which is lesse drie is lesse to bée dried In like sort trulie it is declared in making hot or colde Neither haue we let passe that of the excellencie of the member or contrarie state Also to the sharpnesse or dulnesse of féeling there is to bée had a contrarie scope of curing The second Chapter THerefore we will now consider that which remaineth of the curation of this kinde of infirmities we call this kinde for more euident doctrines sake solution of vnitie neither is it anie matter if thou call it solution of continuitie This kinde doth not onelie
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
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
the bladder matrixe and Intestines and lungs which you must vse in euerie of them taking the kind of the medicine of the substance of the sicke parte but first considering the affect and taking the waie of vsing them of the forme and scituation and héereof sprang clisters for the mouth in Gréeke called Otenchitas and Clisters for the Matrixe named Metrenchitas Catheteras and the Clisters for other partes Vlcers in the stomacke breast and lungs are cured by those medicines which are eaten and dronken the Vlcers in the Intestines are two waies cured for those that are next to the stomacke are cured by those medicines which are eaten and dronken and those which are lower in the intestines are cured by iniections made when neither that which is ministred by low by Clisters can come to those Vlcers that are néere vnto the stomacke neither that which is receiued at the mouth can in full strength come to the lower partes and so the Vlcers in the breast and lunges are more hardlie cured than those in the stomacke for that they are further off and there the strength of the medicine somewhat abated and for this cause the medicines receiued at the mouth ought to bée stronger than those which are presentlie applied to the Vlcer and for that cause the Phisitions haue excogitated most strong and cutting medicines whereas they will purge the mattier in the breast and lunges yea verilie such as would ciccatrize the Vlcer if it were in the stomacke Also that this is throwen out by coughing that is taken of the forme of the partes because these haue no such passage as the matrix bladder eare nose and mouth and hereof commeth it that the stomacke may be purged two waies vpward by vomite and downward by the stoole for this kinde of Indication is taken of the Instrumentall partes inasumuch as they be instrumentall like as those that are to bée exiccated are taken of the nature of the similer partes of the affectes themselues againe such as in Vlcers because our disputation was of them but that they are to bée dried as is before set out and also if they will purge mattier in the stomacke they cannot without daunger prouoke vomite for if there bée fleame fixed in it to cleanse it by Oximell and rootes but they shall more safelie vse deiection when it is perlllous least hée that vomiteth shoulde teare that is vlcerate and should attract some ill iuyce from the partes adiacent and for this cause the Vlcers of the lungs are most harde to bée cured because thou canst not purge them but by coughing and if thou prouokest the cough thou tearest the partes so that the ill by mutuall successe cōmeth to a circle or as we may terme it made worse for those partes which are torne doe againe make inflammation and secondlie the inflammation must bée maturated and the mattier againe requireth to bée purged so that of all these the cure is made difficill both for that those medicines which are conuenient cannot touch the Vlcers as they may in the stomacke and that in the midde waie they loose well néere their vertue And further because by respiration they are mooued and are rent by coughing wherfore when as anie vessell in the lunges is ruptured if it be not adglutinated before there commeth inflammation knowe thou that afterward it is incurable The xij Chapter BVt the vlcers which are in the inward cote of Aspera Arteria chieflie which are néere Larinx or else in it these may bée cured and we haue healed diuerse which were so affected trulie we finde the curation of these vlcers by this occasion in the beginning of this great Pestilence which I praie God may once cease a young man who had béene sicke nowe nine dayes all his bodie brake out full of vlcers which happened well néere to all that escaped that daie he coughed somewhat the daie following when he had bathed him he forthwith coughed more vehementlie and therewith voided a little crust named Ephelcis and the man had manifest féeling of an vlcer in Aspera Arteria that is in the necke néere vnto Iugulum and he also opening his mouth we looked in his throate if that there were anie vlcer in it but we could sée none and truelie the patient should manifestlie haue felte it by the going downe of the meate and drinke if anie had béene there and wee also to bée more certaine made him take certaine things with Vineger and Mustard but none of these did bite him and yet hée felt dolour and paine in his necke in which place hée was so vexed that hée was constrained to coughe wée perswaded him all that wée might that hée should resist it and not cough which thing hée did and that with the more ease For that which dyd irritate was little and wée by all possible meanes gaue diligence to ciccatrize the Vlcer applying outwardlie medicines exiccatiues and hée lying vpright wée gaue him moist of those medicines which are good in such lyke vlcers bidding him to holde it in his mouth and by little and little to let it flowe into Aspera Arteria he so dooing saide he felt manifestlie the force of an astringent medicine aboue the Vlcer whether that the force of it by transumption was sent thether or whether the medicine it selfe in forme of a dew floweth through the Arterie as it were strained to the Vlcer the patient himself was voide of the knowledge in Phisicke being of the number of those which cure by vse and exercitation emperiklie Therefore hée sayd that hée felt both the medicine flow into the arterie and that it also sometime prouoked coughing but he did much striue and staied the cough and hée of his owne accord being taken with the sicknesse at Rome remained thrée dayes after the nine daies were past after taking shippe first hée sailed through a Riuer to the Sea the fourth daie after hée came by shipping to Tabia and vsed the milke which hath a meruailous vertue and not without cause commended Of which somewhat to speak the time it selfe giueth occasion and not onelie of that milke we will speake which is at Tabia but also of all other milke neither must we onelie helpe those which are in Italie but all other Nations as much as we can Wherefore touching the milke in Tabia there doe come many things touching his praise both the place it selfe béeing of sufficient light and the aire compassing about béeing drie and the healthfull fodder for the Cattell and this also may anie doe by arte in other places if anie shew the hearbes and shrubbes in an hill somewhat high which may make the milke both astringent and healthfull of which we wil héereafter shew examples But yet thou canst not also make the aire ambient in like sort therfore thou maist choose the likest there as thou art The aire shall bée most like where there are such things like it the height of the hil moderate thirtie furlong
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
if they shall exiccate without mordication That is also an healthfull medicine which is made of Honie Plaister wise béeing made of the best Honie and this be resolued in oyle of Roses which in all respectes is the best and voide of Salt yea and the Waxe also which is put into such medicines must be washed in like sort If thou puttest in anie Turpentine it behooueth that thou wash it and so much the sooner if thou put anie other Turpentine in for the sharpe and biting Sanies is washed and purged awaie by all medicines which thou doest wash But if hée that is wounded bée strong in bodie and voide of superfluous excrements in him it is requisite to vse more strong medicines As I once did whē as a young man studious in Philosophie was wounded in the breast hauing a good strong bodie and burnt with the Sun in the Summer season The Trochifce of Polida dissolued in Sope and afterward made warme beeing put ouer hot water I applyed it as a Liniment For that first of all we must haue regarde that nothing bée colde which toucheth the wound For because the affected part is most sensible and also the chiefe of the principall partes are continuall and of temperament cold by which all occasions that is grieued is with cold sendeth also his greiefe to the braine But if it be of these that come into the muscles it causeth also conuulsiō For we haue shewed in our Anathomie that the muscles are the instruments of voluntarie motion and the like conuulsion shall be looked for in the tendons by the same causes but when as I had applied the foresaid medicine to the wound of this young man and had couered much of the partes aboue the wound with the same I did continuallie foment with hot oyle the partes about the arme pits neck and head and opening a veine the first daie I tooke some bloud from him and the fourth daie this young man also was well insomuch as the vlcer looked wrinkled small and shrunke together notwithstanding I thought good to continue with the same medicines vntill the seauenth daie after which daie he was perfectlie well Trulie you may foment this wound with oyle and chieflie as we haue saide when it is cured for oyle is of contrarie nature to the Trochisce and maketh the Vlcer filthie neither is there small difference to applie oyle to a bare nerue where the skin couereth it Therefore the mattier is to be wiped awaie from the wound with a probe hauing soft lint rolled about it You may if you will wet your Lint in Sapa least that thou touch the Vlcer with drith with Sapa that is Sirium called also with vs and in Asia Hepsama therefore dipping thy lint in this and after pressing it out thou shalt mundifie the Vlcer and let this Sapa bée warme the first daies chiefly but if all things doe prosperously succéed thou maist wet it also without daunger with swéete Wine for all swéete wine is void of all biting qualitie such is the wine called Thereum and Scybelites And next these is Carginum what Wines so euer are swéete and yeolowish such is Falcrun being vnprofitable for all these are sharpe and vnmeasurable hot And the vlcer comming now to ciccatrize white and thin Wine and that which will not abide the mixture with water neither swéete smelling is better than swéete wine and thou shalt eschue the vse of water to a wounded nerue and also a relaxing Cataplasme next vnto the vse of these Trochisces is the vse of Diachalciteos which we openlie vse this must be molten in Sūmer with oyle of Roses but in winter with the Oyle of Sauine we haue described this medicine in the first booke of compounding medicines the Pastilles or Trochisces or call them how you lyst of Polyda are knowne to all men which if you haue not you may take the Trochisce of Andro or Pasio or else our owne which is stronger than the rest And we haue declared that to strong bodies strong medicines are conuenient as to tender bodies gentle medicines this right Methode haue I inuented and experience doth confirme it but Thessalaus with his Sophistes sitting in his high throne shall be had in reputation among brute people as Cercidas saith While he confirmeth by his reasons that there is one curation of gréene wounds neither this to require any Indication to the nature of the parts yet one of so great same in his learning hath excogitated a marueilous cure of wounded Nerues for presently he cutteth them a sunder geuing the wounded man no warning thereof although in this he goeth from his secte for it had bene better to cut a sunder the wounded muscles and arteries veines or any other thing but not the Nerue otherwise that thing which they flie they are found to doe that they may take a contrary indication for the difference of the parts but let vs leaue them and intreate of a Nerue wounded ouerthwart in which there is greater feare of conuulsion inflammation comming of Feuers which are not cut but those which pertaine to the cure of the Vlcer are like also to these Yet it behoueth more largely to take away bloud and vse more thinne diet and to kéepe him altogether quiet in a soft bed and to foment largely with hot Oyle the arme pits necke tendons ligaments and head if the wounded Nerue be in these that are in the legges like as we vsed Oyle to the arme pittes when the wound was in the hand so in these the flankes are largely to be fomented with Oyle and so to ascend by the whole spine to the necke and head And the contused Nerues whereas the skinne also is contused and wounded require the same medicines which is vsed in drying the wounds of the Nerues But yet such medicines as may further draw constringe or binde the parts diuided by contusion but those which are contused without the like affect of the skinne ought to be fomented often with hot Oyle which haue power to euaporate and to haue like regard to the whole bodie as I saw this to happen and dyd spedely cure it fomenting it with oyle but haue often séene the Nerues to be contused with the skinne and the wrestlers for the custome of the accident being taught by vse haue a Cataplasme made of Oximell and Beane floure which truely is an healthfull medicine but if dolour also commeth with contusion it doth behoue to put in molten pytch and boyle them well together and so to apply the medicine hot and if thou wilt make it more drying put in the floure of Eruum and if thou wilt haue it yet more drying put in Iris ilirica the regard to be had to the whole bodie it is common to these as if the Nerue be all cut there resteth after no perill of conuulsion but yet the part shal be weake it hath the same cure that the other Vlcers haue although the Thessalians know
but one therefore we haue aboūdantly intreated of Nerues but how we shall cure the inflammation that commeth to them we shall set out when as we shall intreate of Phlegmone The fourth Chapter SEing that the ligaments called in Greke Syndesmous be of like kinde to the tendones they can suffer the force of most vehemēt medicines because they do not come to the braine and be voide also of feeling for all the Nerues come either from the braine or else from the marow in the spine of the backe the tendones also as we haue shewed their substaunce is compounded of the Nerue Ligament they so farre forth spring from the braine as they participate of the substance of the Nerue But yet are lesse vexed with cōuulsion than the Nerues But the ligaments forsooth séeing they spring of the bone those that are round are like vnto Nerues but differ from them much in hardnesse yet in that they are white without bloud and not hollow and deuided into Fibers they are like the Nerues and tendones so that they which are ignorant in the Anatomie when as they sée the round ligaments and tendones they take them for Nerues and chiefely they which vnderstande not that they are harder than the Nerues but where they are brode there they know them to differ from Nerues But they cannot discerne thē among them selues but thou which knowest the natures of all their parts and also their forme and in what place they are in the whole bodie and in what part of the bodie it happeneth a wound to be made thou doest presently vnderstand whether it be a Nerue that is wounded or a ligament or tendon If the ligament woūded be such one as goeth from bone to bone it is chiefely without daunger and that thou drying it with all kinde of desiccatiues shal not any thing hurt the patient but if it goeth into the muscle how much it is lesse dangerous than in the Nerue and Tendon so much the more it ought to be feared if it be not rightly cured and none of these can be brought to passe by a methode of these Phisitions which deny the indication that is taken of the part to be profitable to the curation of Vlcers neyther yet of such as doe confesse this if they be ignoraunt in the nature of euery parte which as we haue shewed consisteth of the temperament of Elements But although these know no other thing yet at the least they vnderstād that they are shewed of the constitution of the instrumentall parts Thessalus truely and his Disciples are also very ignorant herein as if Abdomen were now presently wounded so déepe that some intestine came forth they know nothing at all how it ought to be put in and if Omentum fall out whether it is to be cut away or not or whether it is to be trussed vp or no or whether the wounde must be stitched or not or if it be stitched in what wise it ought to be done neither should we haue vnderstanded these things if wée had not learned by reason of the Anatomie the nature of all the parts therein conteined which truely to declare is a thing necessary not onely for the better vnderstanding that shall follow but also for probation the skin is most outward of all this and is ended in a thinne pannicle called Membrana within the skinne as it was in the mid place there is a double neruous thinnesse of the Muscles which the Grecians call Aponeurosin stretched out in manner of coates or membranes many Anatomistes are ignorant that they be two when as they so cleaue and ioyne together in such wise as it requireth labor to separate them and also for that they are most thinne nexte these immediately followeth two right and fleshie muscles which stretch from the breast to Ossa pubis and all these rehearsed cleane and grow together and that which is made of these the Grecicians which haue set out the way when the stitching of Abdomen ought to be made called Gastroraphias named Epigastrion that is to say Abdomen that which is next these is called Peritoneon and they thought it to be one simple bodie but falsely séeing that it is made of two bodies both which are without bloud and Neruous but one of these Neruous thinne pānicles belōgeth to those muscles which goe ouerthwart the other being very thin lyke a cobweb is the true Perotineum and Abdomen is such a like thing in the middest of it selfe the parts of it which are distant and on both sides as it were foure fingers bredth at the side euen from the skinne haue the oblike muscles the former which came from the brest the next which ascend from the intestines after these muscles that which is ouerthwart Vnder which is Peritoneum therefore there is lesse daunger in this place than in the middest séeing it hath no such thinne coate or pannicle and that they cal Aponeurosis and that stitching may hardly be made in the middest because that chiefely in this part the intestines goeth out and may hardly be put in and the muscles that dyd constraine and draw them be the right and fleshie muscles which I sayde came from the brest to Os pubis therefore of force the intestine commeth out through two causes as oft as anie of these bée wounded from the partes which are on the side because that is gathered together by the muscles which are there from the middle partes because the muscle which should containe them is not strong inough that the place is verie apt for comming forth if the wound be greater then of force more Intestines must fall out and are more hardlie put in againe Furthermore for another cause small woundes are harde to bée handled for except that which commeth out bée presentlie put in his place againe it is inflamed and riseth in tumor so that it cannot be put in by so straight an hole therefore in such woundes the meane hole is lesse daungerous and it is truelie necessarie to knowe these thinges then it followeth next that wée consider how one shall most conuenientlie handle these kinde of woundes for Thessalus precept which thinketh these woundes to bée glutinated with medicines called Enema doeth serue so little to the purpose that I thinke it more manifest that it shoulde bee vnknowen to anie hauing his wit therefore first of all séeing wée must doe that that the Intetestines which are falne out bée put in againe into theyr place secondlie that the wound bée stitched thirdlie that thou applie a conuenient medicine and last to regard that most worthie to be affected Goe to now let vs speake of the first séeing therefore there is as is sayde a thrée folde difference of these wounds in bignesse let vs attempt to take of euerie of them a proper Indication admit that in the beginning the wound be so small that the Intestine which fell out béeing inflated cannot againe bée put in whether or no
of the affected partes there remayneth another scope that is that they may bée adglutinated by the helpe of another thing which thing is a certaine humour comming betwixt the endes of the broken bones as it were a Glewe and to ioyneth them fast together which if that be found not to bée done thou maist call the affect vncurable and that such an harde bone as is in young men striplings and men and much more in olde persons cannot growe together I thinke it euident to all men for truelie that bone onelie will be vnited which is verie soft such are the bones in Infants but some doeth greatlie hope that the partes of a broken bone separated may againe bée adglutinated and knit by some other substaunce or glew comming betwixt It is shewed that euerie part of the bodie doeth attract to himselfe his owne and lyke nourishment which if it bee true then surelie the conuenient nourishment of the bones is groser and more earthlie than anie other nourishment in the whole creature so that it is not repugnant to reason neyther a thing impossible that of this same proper Element which aboundeth and groweth in the edges of the Fracture maye by his comming betwixt the bones close them together for to Vse sheweth and Experience consenteth to that hope which reason doeth geue therefore it is hence foorth to be considered by what meanes this thing that groweth in the fractures how much and what maner a one may comfort For it is euidēt that we require not what maner a one but such one as obserueth in both a mediocritie wherefore this simentrie both in qualitie and quantitie being found out Furthermore it is requisite to séeke out by reason whether we may attaine to them both or not but the time when this shal be done is no lesse necessarie to be sought out whether presently as the fracture is made shall wée make vnition as in woūds or that this be not a time cōuenient but a more apter must be found suerely thou being instructed by the nature of the thing maist find out this as wel as all other Therfore what is the nature of the thing Forsoth the broken bone comprehended vnder some of the rehearsed differences of fractures goe to now let vs sée whether any thing may be taken of euery difference which serueth to the curation beginning with that fracture which is made ouerthwart named Cauledon the parts of the broken bone doe here so lie one besides another that they lay not directly euen wherefore it is manifest that first they be brought directly euen to that ende they may the better grow together then to doe some of the things that follow truely that shall follow if one vsing the example of the whole part doth draw the bones that are a sunder to the contrary part of which is taken most sure indication of the transposition of them For truely it may happen that the trāsposition of the member shall be made forward backward into this and the part For it is méete that whatsoeuer are backward be brought forward and yet neuerthelesse the other part of the broken bone is to be moderately thrust to the contrary Contrariwise that which is forward is to be deduced backward the other part by little and little to be brought forward In like sort the consideration of those which are wressed to the right side is if they be brought to the left side and againe those which are in the left side if they be changed to the right side alwayes drawing the other part moderatly to the contrary but there is no smal daūger least in bringing the partes by contrary motion same of the shiuers which sticke out be broken neither are both the endes euen as those which are sawed asunder and if they be broken the endes of the broken bone cannot exactly be ioyned and that for two causes for if the péeces fall betwixt the two parts they let the parts to touch which are formed right or if any fragment falleth outwardly neither so shal there be perfect coniunction of the bones which thou hast framed in such wyse as they shal be like their first vnion for that onely happeneth when the shiuers of the bones be put againe in their owne places And if they being broken doe perish there must of force be a voide space betwixt the bones vnited together in which Sanies being collected and in space putrifying doth corrupt also the whole member And for these causes the bones which are a sunder ought to be drawen right out and this cannot well be done except first they be stretched backward the Gréekes call it Antithasis therefore it behoueth to make this Antithasis of bones either with thy hands if the member be little or with bands put about the member or else with such instruments as Hippocrates hath taught and when as they haue enough drawen back and that they be out of doubt least they in bringing together should touch them selues then put them right and losen the bandes and let the muscles of the parts to be in one and in the meane while helpe thou with thy hands and if any thing doth leape vp amend and forme it and next this whereto thou must bend is that the member doth remaine vnmoued least any of the parts which thou hast placed be moued for so of force they must againe separate And if thou commit it to the patient that he looke to the quiet rest of the member peraduenture waking he wil regard it But sléeping truely he wil moue it but that the bones formed may kéepe their situation not onely the man sleping but sitting and rising when the bed is made it behoueth to binde the fracture with a safe Ligature which may exactly kéepe the parts of the broken bone together But for that loose ligature suffereth the bones to mooue that which is too straight by compressing doth bring dolour let vs giue diligent héede that eschuing both discommodities we maye inioye both commodities which wée shall doe if wée eschue extremitie so that we shall not make the ligature so straight that it compresseth neyther yet so easie that it bée loose and if euerie member were of equall thicknesse then the broadest roller were most commodious because it shoulde embrace all the broken bone of euerie parte equallie and continentlie But seeing it is not so although to the breast thou vsest a most broade roller thou canst not so doe in the ioyntes and necke but in such a narrowe roller is better for that it will not wrinkle and that it toucheth the skinne of the whole member about which it is put but if it holdeth the Fracture with a fewe fouldes it is not without daunger Therefore how much surenesse wanteth through the narrownesse so much must bée added by often rolling about and by deducing it towarde the sounde partes but séeing all rollings which doe constipate and coarct the flesh without dolour hath that propertie to presse the humours out
of the partes where they are first put on and doth put and fixe them in those in which they end I thinke it reasonable to beginne the ligature vpon the fracture it selfe and so to proceede vnto the rest of the member for hée that doeth otherwise putteth the bloud to the affected parte but if he beginne vppon the hurt parte and endeth in that which is whole such ligature shall not onelie be voide of hurt in these which we haue saide but be also profitable for that it suffereth no inflammation to arise about the Fracture of which principallie regard must be had and it is to be feared least great inflamations folow both of the stretching into the contrarie part which we vse in forming rightlie the member and also that the causes which make the Fracture do first hurt the flesh inuesting the bones by constipation and contusion neither meruaile I if some such thing like an inflamation happeneth to the portion of the bones when as such as are not rightly cured are manifestlie séene to be more moist than nature requireth where wée sée a wound with a broken bone neither commeth Caries of the bone in Gréeke named Sphacelus anie other waie which is corruption of the whole substaunce of the bone Therefore thou shalt not bée negligent but expell thou all the superfluous moisture from the partes which are about the fracture Therefore thou maist begin vpon the affected part and bring the roller about twice or thrice and procéed then toward that which is sound for verilie he that thus doth roll shall defend the fluxe of bloud to come from the whole partes to those which are affected and doeth also put out from hence that which is héere alreadie collected Séein then that there are two partes which maye both receiue anie thing of the affected part and also send vnto it Forsooth they which lie vppon it are most readie vnto both as well for the multitude as also greatnesse But the extreme parts for the contrarie cause can receiue or send but little neither can minister much either to the affected partes either receiue of them againe Wherefore when as Hyppocrates made the first two ligatures with the first he did not expell that was in the affected part to those that are aboue and also doth expell that which floweth from them with the roller For with the first rollings about which he doth make vpon the fracture and by deducing it to the lower parte he thrust some mattier thether and letteth that none shall flowe from thence The rest of all the inuoluings with which he will haue the roller to goe from the lower partes vpward that they may in the same place with the first both repell to the higher partes and also preserue fluxe from these wherefore the two first rollers doe defend and strengthen the Fracture neither suffer they inflamation to arise Notwithstanding these alone are not sufficient to both these vses so that Hippocrates did deuise for their defence a remedie that splents bée applied with the last rollers which might also strengthen these and he commaūdeth to vse some one medicine which is against inflammation least there should follow inflammation such a medicine is Ceratune humidum Therefore all these are inuented as we haue sayd by reason and also the figure of reposition this also hath a two fold indication the first dependeth of the common knowledge onely the other which is taken of the naturall constitution of the members to be cured the first indicatiō sheweth that such figure is to be chiefely chosen which is most frée from dolor and griefe so that there follow no inflammation to the part and that the patient be best able to remaine longest in this without mouing The second indication which is taken of nature willeth that the arteries veines nerues and muscles be most rightly placed And these indications doe agrée For the rightest figure of euery part is frée from dolor and that which of the rest is most frée from dolor is most natural to the part for to the arme the figure which is cornerwise in Gréeke Eggonios for the leg that which is somewhat lesse stretched out Furthermore not onely the naturall habit is profitable to euery member not onely in auoyding of dolor but also the custome séemeth much to profit and this is the waye of finding out the figure in which the member is to be kept which also differeth not in séeking out the figure vsed in extending the parts a sunder called in Gréeke Diatasis and also when the partes of the broken bone are brought into their naturall place for it is cōuenient that both thou dost extend the member in the most right forme and that which is furdest from dolor and also that thou formest it into his naturall habit and much more that thou roll it in the same figure and also placing it to rest for the mouing thereof doth not onely prouoke dolor but also doth wrest the bones by mouing the member being in one figure and to change it to another for except I haue forgottē those precepts which we haue written in our bookes Da musculorum motibus it is necessarie that whereas the figure is altered there some of the muscles to be strained and to be made round as they were contracted and other to be lose and relaxed Therefore of force where they are extended there they are compressed of the roller and by the compression doe suffer paine and dolor And where there is no extention there the ligature is lose and slacke and so the fracture wanteth his staye and for because of all these we must studie that we doe both extend and forme the member and also roll and repose the member to rest vnder one and the self same figure and ther is no precept left vnset out which belongeth to the first worke in Fractures Thou shalt as Hippocrates commaundeth lose the roller the third daye least there should arise dolor and itching in the member vnaccustomed to be so couered and also that the perspiration of that which is now fixed in the member be not letted by whose occasion there doth not onely fall thereto an vnhappy itch but also the skinne to be vlcerate and coroded with the sharpnesse of Sanies wherefore we must poure in so much of temperate water as shal be sufficient to take away this Sanies And if thou wilt againe doe as it is aforesaid thou oughtest to doe it the vii daye All things now are apparent so that nothing hindreth being frée from inflammation and somwhat gentler than for naturall constitution Then it shal be lawfull to apply splents and roll it more wider asūder for it was not without danger to vse splents before the inflamation was past But now when as it is ceased that néede is to strengthen the fracture surely you shall vse thē with much commoditie And you may also let the rollers remaine longer time the partes hauing no néede to expell Sanies
manual tractation of fractures in Cranio called Chirurgia Now I will héereafter shew how much of that is to bée cut awaie that is affected that which is vehementlie fractured is to be all taken awaie and if certaine fragments come out further from it as sometime it is séene to happen it is not expedient to follow these to the end being assured that hurt or damage shall follow to them that haue it if all other thinges be rightlie done wée doing so not once or twice but often haue had our desire And the Indication of doing things is héere also taken of the nature of the affected partes for the ligature which in other fractures reason hath found out to kéepe backe inflammations thou canst not vse to the head Therfore thou canst not staie that which floweth neither expulse out of the affected partes that is in them contained without which remedies none of the other bones can bée conserued sound For imagine that in the arme the bone is broken vnto the marowe and that none afterward doe vind it as it becommeth a Fracture it must follow necessarilie that not onelie the matter which is gathered outwardlie vnder the skinne and muscles but also which is in the marow doth both first and principallie corrupt the marrowes it selfe also with it the whole bone Séeing that when all things are rightlie done this doth sometime chance How then may not such things happen to the head séeing that it cannot haue the ligature which is due to Fractures and also the matter sinketh downe in such sort as all lieth vpon the coate or pannicle in other Fractures when it is well rolled it is so farre that it suffereth no superfluous moisture to be gathered in the affected bone that it maketh the member leaner than for his naturall constitution The waie that is excogitated by ligature cannot both so exact the fractured bone the parts about it that they shall neither be inflamed or yéeld anie mattier neither is there anie medicine which in other partes can without ligature as we haue said kéepe the fractured bone drie frée from superfluities Wherefore we had néede first to make bare some part of the Fracture wherby we may mundifie wipe awaie the Sanies from the coate and when the time of inflammation is past and all is exactlie drie then to incarnate and ciccatrize the place Our talke is not héere naked voide of matter as the Sophists which knoweth not the workes of the art do demand why the fractures of the head hath no Callus they haue O good sirs a Callus and you be so mad that you do assigne causes of that which are not as though they were we in times past did sée the bone of the fore part of the head broken which next followeth this is called Os temporis in which it happeneth that the commissares are ioyned as it were like scales in it there was most long and manifest Fractures which I nothing touching but cutting out the bone of the fore parte of the head did cure the man that he now hath liued many yéeres but if I had in like sort let alone the bone of the fore part of the head the coate vnder it would sure haue putrified then the fracture to haue engendered Callus for if no Sanies should flow inwardlie from the affected parts it shuld haue bene néedlesse to haue cut out the bone therefore they as their manner is doe trifle for I truelie in another hauing the like fracture did thinke to let the higher bone alone and to take out that which was in the sides whereby the Sanies might flow out But when I did marke both the thicknesse and the hardnesse of the bone I did iudge it better to take out the bone than for regard of the fluxe to finite vehemently the braine and I also thought that it might happen that if there were a great hole in the side that the braine might perchance come to this part Further there that not in one place is in the sides a springing of nerues and that of no small quantitie when as in the high bones of the head there neuer springeth the least nerue of all and I being by these things warned did abstaine frō taking out the bone that was in the side of the head and it euer had Callus and if it were rightlie cured and now trulie there resteth that wée séeke out what is our principall scope of all both medicines and eke of all our diligence when as the bone is perforated whether that which is most delicate and answerable to the pleasure of the Patient which now the most part vse or else that which is héereto repugnant that is that which is done by most vehement exiccatiue medicines which Meges Sidonius doth praise and a certaine Citizen of ours doth alwaies vse insomuch that he forthwith applied to the bare coate or pannicle an emplaister called Isen and vpon this outwardlie Oximell trulie this old man was sufficientlie exercised in this part of the art but I did neuer sée anie other vse them neither yet durst I doe so Notwithstanding I can thus much witnes with Eudemus for that was the olde mans name they rather escaped which were of him cured than of those who vsed delicate medicines and I had also gone about to trie the like waie of curing if I had continuallie remained in Asia but séeing I haue bidde at Rome I doe followe the manner of the Citie committing the greatest part of such workes to those whom they call Chirurgions But iudging the nature of the things it selfe I conceiue that such certaine determination to be confirmed by our experience The auditorie cunduit which stretcheth not onelie vnto Dura mater but also toucheth the nerue which goeth from it to the braine this although it be so néere doth abide as it is said most vehement medicines Therefore it is no meruaile if after the perforation of Cranium Dura mater before it is much molested with inflammation doth desire most strong medicines hauing naturallie as it were a drie substance FINIS Thomas Gale vnto the friendlie Reader IT is requisite that euerie one that vseth this art of Medicine in the curation of diseases or sicknesses not onelie to know the diuisions natures of the same but also to knowe the names by meanas whereof euerie one of the same may be knowen from another and chieflie in this part for the better vnderstanding of Tumours against nature wherin Galen hath taken great paines not onelie in their true diuisions but also gathering together their most apt and auncient names giuen vnto them by the olde writers And if anie names did lacke for such sicknesses as raigned in his daies he did deuise most apt and conuenient names for the same Aristotle saith whosoeuer is ignorant in the tearmes of his art that he is ignorant in the whole arte Therefore it is necessarie for those that professe so noble an art as
not spoken of FINIS AN EPITOME VPpon Galens three bookes of naturall Faculties verie necessarie for the Students both of Philosophie and Phisicke set forth by Maister Iames Siluius Phisition FAcultas is a certaine cause Effectrix place◠in the temperature of a parte in the beginning of simples The faculties gouerning our bodie in the which our life cōsisteth are in number thrée Naturall Vitall and Animall In time Nature vse 1. Naturall is in the liuer dispearsed by the veines into the whole bodie being the third and lowest 2. Vitall is in the heart distributed by the arteries into the whole bodie being the second and meane 3. Animall is in the braine and carried by the nerues into all parts indued with the fence of féeling and voluntarie mouing being first and chiefest Indignitie place and fortitude We must first intreate of the naturall as the nourisher or piller of the rest as we proued in the order of reading or teaching Galens bookes The natural faculties which bee first principall are Generatrix Engenderer Auctrix Increaser Nutrix Nourisher which are called powers Vegitable Arist de animal lib. 2 cap. 4. The first two falties 1. Actio 1. The verie motion actiue is a substantiall forme in Materia or production to substance or procéeding to forme And that is either of all or of part as generation of humours in a liuing creature of bloud through moderate heate of both kindes of choler by immoderate heate of fleame and melancholike humours by a slowe heate and that commeth of some meate more of some lesse in all temperatures And these humours are either naturall or vnnaturall 2. Opus 1. A thing made and finished by action as all parts the bodie fashioned in the womb and by generation complete vnto the which perfection of partes the séede being rightlie once conceiued Generatrix is the chiefe and principall worker Two other faculties 1. Alteratrix The which generallie be hot colde moist and drie in their first and element all faculties and doth change the séede bloud menstruall substance into a man in which is the qualities of féeling tasting smelling and séeing for it is necessarie that out of Alteratrix bones veines nerues and all other partes be made but perticularlie she doth worke vpon that substance by facultie making bones nerues veines c. For of the foure elements mingled doth grow the perticular faculties alteratrix wherof is made the substance of euerie similer parte and so many faculties of alteratiō ther. be in liuing creatures or of planets as there are found similer parts in them 2. Formatrix This facultie verie artificiallie and with great cunning and for some cause dooth fashion the matter which is chaunged so that it may haue an apt figure for placing composition hollownesse wholenesse soundnesse Apophyses Epiphyses and other things necessarie pertaining to the constitution of the bones natures veines arteries c. The which constitution is méete for the action and vse of the parte that after shal be created that nothing be lacking nothing superfluous which otherwise might be in better sorte Auxiliares or helping facultiez as they were hande-maidēs Nutrix Nourisher Austrix Increaser This doe not onely serue for the increase of the young being once ingendred but also from the time that the séede is conceiued for it is méete that the séede be augmented by nutrition that it may suffise to constitute so manie and such parts as be necessary The male séede is first nourished with the female and afterward with a small halituouse portion of the bloud of menstruum Facul auctrices nourishers 1. Actio Is an increasing that is to saie an ampliation of the found partes which were engendered of a liuing creature in length breadth and déepnesse kéeping the proper forme and first continuitie as it is sayde in the 1. li. cap. 5. De generatione This is the worke of nature onelie when as these things which are extended to vs or pulled from vs or are amplified in one measure onelie or not in all together then this facultie beareth rule from the birth vnto the flourishing age and as I saide helpeth the facultie Generatrix in the wombe and is onelie in a liuing bodie 2. Opus The small partes of a liuing creature borne into the world which are brought into a reasonable bignesse and the bodie being little made great Auxiliares or helping faculties Alteratrix Chaunger Coctrix Digester Nutrix Nourisher Of the which we will intreate héereafter more at large Facul nutrices 1. Actio That is nutrition or the perfect assimulation of nourishment with the thing nourished that is when that thing which floweth as the forme of nourishment is put vnto fastned made like vnto all the sound parts of the nourished bodie without anie ampliatiō for the iuyce or humor when it falleth a Vasis euen as certain dew so is it dispersed through all the part which ought to be nourished and by and by it is put or ioyned vnto it and after hauing gotten sufficient drynesse and clammie humour through naturall heate it is glued and fastned it increaseth cleaueth together and is vnited in one The which commeth not so to passe in Anasarca Hidrope when as the nutriment being more watrie and not so clammie by reason of the abundance of thin watrie humours falleth frō the sound parts of the liuing creature at the last it is made like vnto the parte which should bée nourished when it is nutriment in déede other are nutriments in power more proper and remoue The which is not in Leuce 1. Vitiligo 2. Opus All the parts enduring with nourishment so long as is possible Attractrix which draweth vnto the part conuenient qualitie and iuyce This facultie like as the rest being found in some instrument as in the stomacke reines wombe milt bladder purging medicines and Alexiteries is easilie transposed into the other parts Auxili facult helping facul 3. Retentrix The reteiner of the same vntill digestion be done Coctrix Digester in altering and that maketh it like Expultrix Expeller of that which molesteth the part in quantitie qualitie or both But we will intreate of these foure faculties as most principall héereafter more at large 1. Attractrix The drawer of conuenient qualitie and iuyce into euerie parte to nourish the same the which is common vnto all partes that drawe vnto them such nutriment as is most proper for them sometime thorough straight pores as in the stomacke and sometime onelie by the temperature of the parte as almost in all the other partes or else to the voluptuous delectation of the parte whereby the mouth of the matrixe doth drawe the séede of man to the verie end and whereby the gall doth separate and drawe yeolow choler from the liuer but in the Gall yeolow choler is not ingendered as Asclapiades saith like as neither he affirmeth melancholik humour in the splene but of him it is drawen from the liuer to nourish it selfe The reines doe diuide and onelie