the needle in the lippe or edge of the vvoūde vvithout dravvinge of the foresayed needle qvite through althoughe shee be threded but must suffer her to continue therine and vvinde the threde about her in form of an S as the Taylers doe vvhē as they are mynded safely to keepe there threeded needle anye vvher one ther apparrell as you may see in the figure or form of the haremouth soe put as manye needles therin as shal be needfull accordinge to the greatnes of the vvounde vvinde the threde ther about and let them cōtinue therin vntill such time as the vvoūde shal be healed ioyned agayne This sovvinge or suture is vsed in such vvoundes as stande vvyde opē in those in the vvhich the lippes are separated the one sōvvhat vvydlye frō the other they vvhich vvith the common stitchinge might not be contayned or Kept together The thirde incarnative sovvinge is called The thirde incarnative suture the penned stitchinge because most commōlye it is done vvith little quilles or shaftes of a penne not that the foresaved qvilles doe effecte the sovvinge but because they contayne it alsoe are a lett hinderāce that the threde dothe not cut the lippes of the vvoūde cleane throughe vvhich if vvith al expeditione vvith the least payne vve desire to make thē vve must doe as heerafter follovvethe VVe shall first of all take a stronge double threde vvhich is separated in tvvo at the end having a knotte vvhich vvith the needle vve must thruste throughe both the lippes or edges of the vvounde redoinge the same soe often in divers places as the greatnes of the vvoūde shall reqvire allvvayes remēbringe that everye stitch must be a fingers bredthe the one frō the other situated layed or therabout This beinge in this sort finished we must as then one that syde of the vvound vvhere the knott lyeth of the threde betvveen everye dubblethrede sticke a little shaft or qville or els a little stick of vvoode vvhich is vvounde in linnen clothe must be as longe in the vvounde it selfe vvhich aftervvardes vvith the threde vve must dravve close vnto the lippe of the vvounde and one the other lippe of the vvoūde vve must through that same dubblethrede in like sorte alsoe put a qville or a little sticke vvound about vvith linnē vvhich in the first must be dravvn vvith one of the foresayed thredes and vvith a dubble knott be knitted together bringinge by this meanes the lippes of the vvounde as close together as is possible in this vvyse proceedinge vvith dravvinge together and knittinge all the thredes vvhich ther are in such sorte as the first vvas dravven together knitte Such sovvinge is vsed in greate deepe vvoūdes in the vvhich vve feare least the cōmon sovvinge or stitchinge might chaunce to breake cut through the edges of the vvounde The fourth is called the drye stich or sovvinge The fourth incarnative suture because this may be done vvithout pearcinge of the skinne or fleshe vvhich vve are vvonte to doe vvith tvvo strōge peeces of linnen cloth vvhich are cut of the syde or edge of the clothe and vvhich in the endes are cut sharpe or picked as heere before in the figure vve may see on the vvhich other ende vve must spreade a verye dravvīge fast houldinge playster vvhich qvicklye may be dryed vvhich must thus be praepared vve shall applye this same one both sydes of the vvound a little higher then the foresayed vvounde in such sort that bothe the sharpe endes of the peeces of cloth may be situated close vnto the edges of the vvounde This beinge cleaved verye fast to the skinne vve must as then sovve bothe ther endes close together vvithout touchinge of the skinne and dravve them together vvith the threde through the vvhich meanes vve may compacte the lippes of the vvounde as close together os vve please Such a māner of stitchinge is very vvillingelye vsed in the vvoundes of the face vvhēas vve desire to have noe great cicatrice left therin The fith kind of sovvinge is noe more in vse The fifth incarnative sovvinge or stitchinge is effected vvith iron hoockes vvhich one both there endes vveare crooked vvith the vvhich vve must hould both the lippes of the vvounde bringinge the foresayed lippes close together but because they cōtinuallye pricke are never vvithout causing of payne moreover might chaunce to sticke in anye membrane vvhich might suscitate cause payne concurringe of humors inflammatione in the vvoūded parte it is novve a dayes noe more in vse The secōde generall suture The seconde suture is the bloode-stoppinge suture soe called because she stencheth stoppeth bloode and hindereth that the ayre can not enter into the vvoūde vvhen as in manner of revolutione vve turne the needle as the furriers are vvōte to doe vvhen as they sovve together the skinnes lay the stiches reasonable close harde on by the other Some vse this suture or stitchinge vvhē as the great vaynes or arteryes are hurt or cutt of cōsideringe the great sheddinge of bloode through the vvhich they are compelled to doe soe soe the more easyer to ioyne bringe together and shutt the lippes of the vvounde But this stitchinge is nothinge to certayne because the one stitchbrekinghe all the other breake goe loose moreover the bloode vvhich is therin cōtayned causeth that part to svvell and leeseth as it vveare himselfe betvveen the muscles vvhich alsoe therafter by cōtinuance of time corrupt are mortifyed VVherfor I vvoulde councell the yonge Chirurgiane that he should rather tye or binde the mouth of the vayne or arterye or vvith a Cauterium cauterize it together thē to vse such a stitchinge vvhich is farre cōvenienter in the vvoundes of the small guttes or entralles of the blather or in the vvoūdes of the stomacke to be effected if at the least in the tvvo last it may anye vvay possible be brought to passe The thirde sovvinge The thirde Stitchinge or stitchinge vve call the conservative or the praeservinge suture because she praeserveth Keepeth the lippes op the vvounde vvhich are verye vvyde separated the one frome the other or els because they are plettered crushede or els because ther is anye parte of them lost throughe the vvhich they cā not by any meanes be brought ioyned agayne the one vvith the other reqviringe onlye to be defēded mayntayned in that estate till such time as the vvounde be come to a goode suppuratione incarnatione vvher through the vvoūde is soe much the the sooner cured cicatrised vvithout anye greate or deformed cicatrice remayninge in the place This stitchinge is alsoe vsed vvhen vve suspecte that ther is anye thinge cōtrarye to nature in the vvoūde vvhich vve vvillinglye vvould have therout vvherfore vve doe not bringe the lippes of the vvounde so close together as in other sutures contentinge our selves that in such sorte vve may
dravvinge the pipe therout the foresayed tunge internally shutteth cleaveth it selfe soe close to the hole as vve may see in a kind of ballon vvhen he is blovven vp Those vvhich are ignorant of this secrete stoppe occlude the hole vvith a little vvaxe vvhich in deede is not so necessarye and needfulle Those little Boxes vvhich are layed in vvarme vvater are aplyed after that vve have putt the flame of the candle therin and must then vvith all expeditione be theron imposed The vse of small boxes The vse of these small Boxes is thre fould Namely thervvith to vvithdravve and repell the blood and humors vvhich are concursed to anye place to dravve forth any particulare thinge vvhich nature cā not expell from her to dravve out or cause to consume any occluded ventosityes in any partes of our body vvherfore vve applye them one divers sundrye places they are very goode and commodious to be placed behīd in the necke agaynst all rheumes vvich are incident vnto the eyes behinde in the middest of the necke are they necessarye to be applyed for those vvhich are shorte of respiratione and troubled vvith the cough one both the shoulder blades agaynst payne and doloure in the heade agaynst Hemicraniam agaynst ophthalmye and payne in the teeth vve apply thē alsoe in place of phlebotomye one the right hippe agaynst bleedīge at the nose in like sorte alsoe close to vvoemens brestes vvhen as there menstruositye too superfluouslye flovveth from them and vvhen there lye included anye ventosityes in the Liver on the left syde vvhen as ther is any vvynde retayned in the Milte on the Navelle aganst the vvynde colicke on the Vreteres to cause the gravell to descēde vvhich is contayned in the kidnyes on the rumpe agaynst the vlcerations and the Hemorrhodes of the fundament on the hippes agaynst all vesicall disseases and of the vvombe and provocation the monethlye sicknes or menstruositye To conclude vve may applye them The Boxes may be applyed one all partes of mans bodye on all partes of mans bodye yea allsoe one the selfe same place vvhere the payn is vvhich vve endevoure to cure to retract and dravve therout all humors vvhich are therī secluded as vvhē vve desire to dravve any humors outvvardes vvhich lye profoundlye deepelye occulted and hiddē or els alsoe any ventositye vvhich in the foresayed parte lyeth inclosed as on anye bitt or pricke of any venoumous creature least that the venoume might chaunce to penetrate and pearce into some of the vvorthyest partes one the Venus botches or Bubones one the venoumouse Pestilentialle Parotides But desiringe to applye them agaynst anye superfluous efluxione of bloode vve must then situate them on the contrarye syde consideringe the allyance communitye of the vaynes vvhich is betvveene them throughe the vvhich the bloode is retracted dravven backe It chaunceth also somtimes that vve nether applye the Boxes on the disseased or dolorouse place nether one the contrarye syde therof but one that parte vvhich nexte and proximately thervnto is situated as vvhē vve desire to suscitate and provoacke the retayned and kept backe mestruosityes vve as then place the Boxes one the bone Pubis in the flanckes and allsoe one the flatnes of the hippes The Boxes or hornes are sōtimes applyed vvith scarificationes and somtimes vvithout If soe be vve applye them vvithout scarificationes they then onlye dravve certayn dampes vnto them but if ther be anye badde humors in those partes vve as then scarifye it And the dissease proceedinge out of vvindes and ventosityes vve then applye them vvithout scarifications but vvhen vve are minded to scarifye anye parte vve first sett the Boxes therone and havinge agayne removed and taken the same of vve thē pricke or scarify therin ether vvith a lancet or vvith the poyncte of a rasor vvhether it be deepe or not deep accordinge as vve suppose and iudge the bloode to be grosse or subtile but allvvayes vve must note not to scarifye deeper then the skinne touchinge the number of the foresayed scarificatiōs if soe be vve are not intēded to dravve much blood ther out vve may not as then make manye scarificatiōs but if vve intend to dravve much blood therout vve must then make many scarifications vvherō vve must agayn applye the boxes soe that vvhē vve desire to dravve much blood therout vve must applye the foresayed boxes tvvo or three times theron everye time scarifye the place especially vvhen ther is contayned in that part anye venoumouse ventositye or grosse and corrupt bloode In delicate and dayntye persons vvhich are tender of fleshe and have an aperte or open skinne in such persons vve must scarifye but once notvvithstandinge must apply the boxes tvvo or three times after other theron vvhich beinge finished and havinge vviped and dryed the parte vve must then apply one the scarlficatione the Cerotum Galeni or els the Vnguentum Rosarum THE SEAVENTH TREATISE OF THE OPEratione of Chyrurgerye Contayninge sixe Chapters Of the Caries or of the corruptione rottinge of bones Chap. 1. Of the fistles of the Privityes or fundamente Chap. 2. Hovv vve ought to dravve forth Childrene out of their mothers bodye vvhich of themselves can not be borne Chap. 3. VVherfore the externalle partes or ioynctes of the bodye must be extirpatede as Armes and Legges vvheraboutes the same must in the fore sayed ioynct be done Chap. 4. Hovv vve ought to effect the extirpation or dissection of any ioynct restraynge the bloode after vve shalle have layed dovvne the patient Chap. 5. Hovv vve ought to extirpate the spoylede superflvous fingers hovv vve shall separat those fingers vvhich are combinede grovven together Chap. 6. Of the Caries and corruptione of the bones Chap. 1. Disctiption of the naturall bones The bones are as vvell subiected vnto all māner of disseases as is the fleshe THe bones not being spoylede corrupt are of natur vvhyt smooth solide They are accordinge to the sayinges of aunciente Chyrurgianes and our dayly experience subiected vnto all evell dispositions vvhich the flesh is subiected vnto yea allso vnto apostematiōs Celsus avouchethe that all bones vvhich have any impedimēt are ether hurte corrodede corrupted burst broken crushed plettered or out of ioyncte VVe may praeiudice the bones to be altered To knovv the corrupted bones throughe sight or polluted throughe our sight feelinge matter and impuritye vvhich therout issueth vvhē vve perceave it to be yellovv or purple and at the last blacke as verye learned lye discretlye the sayed Author vvriteth first the corrupted bone vvaxeth fattye then blacke Through feelinge or putilaginous that is corroded vvhen as in touchinge vvith the privet or searchinge irō vve feele the bone to be rugged and not playn and the privet entereth therin as if it vveare a peece of corrupted vvorme eaten vvoode especially vve knovvinge the same not to have binn bared of his fleshe
Playster of Betonica This foresayed threde or Seton vve must suffer it to continue therin as longe as it shal be needfull as vve have sayed of the Fontanelles As concerninge the transforation A transforation applyed in the Scrotum vvhich in the navle or in the Scrotū may be applyed it vvil be sufficient vvhen vve take the Scrotum the extreamest end of the navle so perforate the skinn being doubled vvith a reasonable greate or grosse needle vvhich must be threded vvith a vvoollen cotten or silcke thred and applyinge therone the selfe same remedyes of the vvhich vve have in the transforatione of the necke rehearsed THE NINTHE TREATISE OF THE OPERATIone of Chyrurgerye wherin is discoursede and handelede of the Ligatures or vvindinges circumvolutions of the convenience or the situation of the partes Contayning sixe Chapiters VVhat the Ligamentes or Circumvolutiones are theire matter qualitye forme and quantitye Chapit 1. The Kindes and differences of the Ligamentes Chap. 2. Rules and generall instructions vvherone vve must consider in all circumvolutiones and Ligamentes Chap. 3. Hovve vve ought to tye the Ligament and agayne make loose the same Chap. 4. Hovve vve must ligate and tye the broken Armes Legges and Hippes Chap. 5. Of the placinge and situatione of those partes one the vvhich the operatione is set one vvorke and imployed Chap. 6. ⧠What the Ligamentes or Circumvolutiones are their matter quallitye forme and quantitye Chap. 1. HAvinge therfor spoken treaated of the combinationes and sutures vvherthrough al vvoūdes divisione or separatiō of the vvhole is inserted combined together agayne and the lippes or edges of the foresayed vvoundes are kept close together shutt vve vvil novve treacte and handle of the Ligamentes or bindinges of the vvounded partes vvherin vve ought to consider vvhat their matter theire qualitye forme quantitye differences are What Ligamentes are hovve vve ought to vvind and agayne vnvvinde the same The vvindinge therfore or dressinge of a vvounde is nothing els then a vvindinge aboute or circumvolution of the Ligatures vvhich is as much to say vvith a broade and longe ligamēt vvhervvith not onlye the vvounded parte butt allsoe the fin itimate and circumiacent partes are involved and circumvestede by this meanes to restore them to theire Former estate and naturall beinge Matter of the Ligamentes Those Ligamētes accordinge to the affirmations of aunciēt Chyrurgiās are of divers matter as of Linnen vvoolle or Lether the linnen Ligamentes are the most commonest of all the other vvhich at that time they vsed vvhen as they vvoulde stifflye compresse bringe close together anye parte they vsed vvoollen rovvlers in the fractures vvith vvoundes gentlye in that sort to retayne together the broken bones to cause noe payne or inflammatione at all Hippocrates vsed the Ligamentes of lether Hippocrates in the fractures of the Nose the nethermost chavv bone But of vvhat matter soever vve make thē they must not be too much vvorne out because that they may be strōge enough to be dravvn close together stretche stifflye out Farther more they must be even and smoothe nether must they have any silvages nether must it have anye harde seames must be cut aright the threde accordinge the length of the linnen not cōtradictorily because they may tye smoothe and evenlye vvithout the one syde beinge hardre tyed then the other as oftentimes it chaunceth vvhen the rovvler is cutt contradictorryelye It is right trevve that the ligature vvhervvithe after Phlebotomye vve tye the arme yeeldeth it selfe better beinge so cutt but it chaunceth heerin because in that place it yeeldeth it selfe better for the bending of the arme Touching their qvallity they must be cleane vvhyte leaste that throughe their impuritye they be a hinderance or interruption vnto the parte because by that meanes they may the better receave the humidityes as Oxicrate vvyne or any such like vvherin vve chaunce to madifye vvett them They must allso be fine light because throughe their ponderousnes they doe not overburthen the parte suscitate provoke payne cause inflāmation Thirdly they must be softe flexible because through the obduratnes therof they might chaunce to hurte that parte Fourthlye of līnen vvhich must be verye vvhyte not to closely vveaved because so they ar more better to be placede the matter the evaporationes might the easier therthroughe transpire vvhich being therin occluded cause inflāmatione itchinge Forme figure of the Ligamentes Concerning their forme figure vve muste knovve that these foresaede Ligamentes or rovvlers are ether rovvled vp or involved sīplelye or dubblelye vnto the middest of the foresayed ligature of an aeqvalle latitude in all places as are those vvhich vve vse in the fractures of the Armes Hippes Legges In like sorte allso in the vvoundes vlcerations of the same partes The dubble ligament or rovvler is ether of on peece of linnen on the endes beinge diverselye cutte or on an other place in other endes as are the ligamēts of the Head vvhich are cutte into foure or sixe endes And in foure endes for the Scrotum Or in the ligament vvhich is sovved together made of divers peeces as are those vvhich are vsed for the flancks for the Brestes for the Testicles for the Fundament that especiallye vve desirīge to spare be chairye of the linnen And as much as concerneth their longitude latitud that cosisteth on the consideratione iudgement of the Chyrurgiane vvhich before hand must see the figure knovve it must therby allso be able to knovve the conformatione sitvatione of the parte the diversitye of the dissease for vvhen as vve are vrgede to make a greate circumvolutione vve must then consider on the length make it as long as is reqvired cōsideringe the breadth vve must make thē accordinge to the longitude latitude of the dissease The Ligamēt must bē broader then the dissease so that the foresayde ligament must be greater thē the dissease because vvith on circūvolutione doe not onlye involve the vvounde but allso both the endes therof as vvell on the one syde as the other for if so be the ligamente vveare smalle he must thē crushe the dissease vvherthrough greate payne and inflammatione might becausede And to speake of the qvantitye of the foresayed ligamentes Quantitye of the Ligamētes that is nothinge els then the meane and measure vvhich vve must vse and observe ether in stifly or loosely bynding as in respect of the persone For as the one man is grosser more corpulent then the other so ther are also disseases vvherof the one is more paynfull then the other vvherfore vve muste consider that the ligament be nether too stifly nor loosely tyed for all ligatures vvhich are too stiflye bovvnde cause payne concursione of humors vvith inflāmations yea somtimes allso a Gangraena And those ligamentes vvhich are too loose they are profitable for nothinge cause that the restauratede partes vvhich
great hast have rushed therout vvithout anye remedy hovve to restraygne them Novv perfectlye to knovve such a svvellinge and to discerne it from other tumefactiōs Signes of this tumefactiō vve must observe that in this tumefactione ther is a continuall reverberatiō the foresayed tumor beinge of one coloure vvith the skinne hovve great or smalle the inflatione be it is alsoe tēder and soft in the touchinge of the same glidinge avvay vnder the finger vvhen as vve depresse it yea and almost throughe the foresayed depressione vvholye vanisheth out of our sight considering the bloode of the vitall spirites vvhich through the foresayed depressiō are crushed in the arterye vvherfore they alsoe as passinge throughe a little apertiō vvhich violence do make a noyse or sovvnde vvhich havinge taken avvay and removed the finger immediatlye shoote agayne in ther foresayed concavitye as alsoe agayne in ther forth comminge of the foresayed angust apertione vve may heare a certayne sovvnde vvhich cōmonlye chaunceth vvhen as this Aneurisma is caused throughe an Anastomosis and not of anye vvounde because the Orificium beinge apert the vitall spirites as being most subtile are before the bloode driven out soe that the vvhole tumefaction is almost replete vvith vitall spirites But if soe be the Arterye be burste there as then issueth much bloode therout vvhich bringeth in the tumefaction more blood thē vitall spirites vvherfore alsoe it is more obdurate and harder and the sayed bloode coagulateth and therin rotteth and corrupteth As much as concerneth the curatione of this tumefactione it consisteth onlye Curation of Aneurisma in the bindinge of the foresayed arterye and especiallye the same beīge somvvhat thicke for they vvhich are greate and especiallye the arteryes of the necke the arme pittes or of the flanckes may or can in noe sorte be tyed because it is impossible to finde them make them bare and if vve allsoe make an inscisione therin ther then follovveth such a quantitye of bloode and of the vitall spirites that most commōlye the patient dieth vnder the handes of the Chyrurgiane That arterie vvhich is situated in the bendinge of the arme may easilye be cured Of an arterye vvhich of the Author vvas tyed above the Aneurisma as out af this subsequent historye vve may note My lorde of Maintenon desired me to visite the sonne of my lorde of Belleville vvhich throughe phlebotomy in the bendinge of his arme had gotten a little Aneurisma vvhich through continuance of time is grovven as greate as a fiste vvherin in the ende the bloode vvhich therin vvas included coagulated so that in the foresayed tumefaction Aneurisma ther came a corrupting and rottennes vvhich he one the out syde of the foresayed skinne of the svvellinge he espyede vvhich from the vitall and livinge coloure vvas chaunged into a blacke and purple coloure vvherebye alsoe ther vvas an apertione caused in the skinne To the remedyinge and curinge of the vvhich especiallye the superfluous effluxione of bloede vvhich might therof ensue the losse alsoe of the vitall spirites if soe be the apertiō as yet vveare dilated I as then councelled the Physitions and Chyrurgians to praevent farther evells that vve ought to tye binde the Arterye vvhich vvas situated and his place in the bending of the arme somvvhat higher then the Aneurisma to the vvhich opinion propositione in the end they all consented agreed The vvhich alsoe vvith happye successione of all causes vvas brought to passe in the praesence of the vvorpshipfull master Drovet Doctour of Physicke at Beauvais and of the Chyrurgiane dvvellinge at Avet vvhich vveare come thether to cure him On vvhat sorte the Aucthor tyed this Arterye First of all I cōsidered on the arterye in the vppermost and inner parte of the fore arme as shee from above descēdeth vnder the armpittes vnto the bēdinge of the arme three fingers bredth therabove on the vvhich place vvhen I had seene and fixede myne eyes therone I made an inscisione in the skinne according to the length therofe vvhich lay opened right above the Arterye vvhere by tacture vve might feele her vvhich vvhen I had found and discovered her I thrust a crooked needle thervnder vvherin vvas a strōg threde vvhere vvith I tyed the foresaeyde Arterye vvith a dubble knott this beinge done I took avvay and purifyed all the congealed or coagulated bloode all other impuritye out of the vvounde or svvellinge and have vvashed the same vvith Aqvavitae Remedye agaynst the putrefactione in the vvhich I mixed a little Aegyptiacum by this means to cleanse it the better from all putrefactions and the patient is vvithin a moneth therafter ensuinge vvholye cured and grovvne sovvnde vvith out retayninge any lamnes in his arm vvherin I my selfe have vvondered If soe be that in anye other externall parte there chaunced to come any Aneurisma into the Chyrurgians handes he must then knovv that allvvayes for certayntye he shall finde the arterye in her vppermost parte or discover and bare her soe bynde and tye her vvith out anye more ceremonies ⧠Of the Cirsotomia that is of the manner howe we ought to cutt of the varices Chap. 7. Discriptione of a Varice VArices or burstene vaynes are troublesome because of ther greatnes their extracting thicknes and their gibbositye above ther nature property VVherfor ether because they cause payne and hinder the actione of that parte or els because they soacke in some certayne vlceratione vvith some humiditye vvherby she can not be cured vve are vrged to open them and cut themof Curation of a Varice or els vvith some actuall cauterye to cauterize them soe consume and bringe them to nought To vvhich purpose the auncient professors Councell of the auncient professors for the curinge of the Varices have ordayned that vve should cut out and cleane take avvay those vvhich lye croockedlye and dubbelye foulded in divers rovvnde revolutions or els lye intangled the one vvith the other But before vve proceede to such an operatione it is necessarye that first of all vve bath that part vvith hott vvater to cause the grosse bloode somvvhat to separate and vvexe or grovve subtile and the vaynes to svvel and exalt themselves But the most gentlelest remedye is that vvhich daylye vve vse vvhich is the simple apertione and inscisione of the foresayed Varices at one tvvo or thre places as if vve intended to phlebotomize makinge the apertion somvvhat greater and larger therin because of the grosse melancholicke bloode vvhich vve desire to let therout Throughe vvhich foresayed apertione vve extracte as much bloode as vve suppose to be goode and sufficient or els as much as the patient cā abide one vvhich foresayed apertione vve must lay compresses vvhich therone vve must binde as vve are commonlye vsed to doe one the vaynes vvhē as vve have phlebotomised prohibitinge the patient not to stirre or goe vvhich sayed Varices if so be they chaunced to svvell agayn
vse of the Cauteryes and to what disseases and one what places they must be applyed Chap. 2. IT may rightvvell be sayed that nature hath shevved vnto vs The invētiō of the cauteryes is dimonstrated vnto vs through nature the inventione of the Cauteryes fōtanelles For as sōtimes the partes being overladē vvith to manye humors ether theire tartnes or venoumousnes are troubled they in the end discharge vnburthen themselves in some parte of the body of that vvhich molesteth thē as in one of the Armes or legges causinge ther to ther solace and ease some excoriatione or apertione So that the Physitiones Chyrurgianes to helpe heerin the nature have there throughe fovvnde out the vse of the Cauteryes Fontanelles effectinge by their arte that vvhich nature oftentimes throughe her ovvne commotione thervnto endevoreth to doe vvherfore vve alsoe vse the Cauteryes as oftentimes as vve desire to make any derivatione revulsione interceptione or evacuatione of anye matter the vvhich ether consideringe her qvantitye or qvallitye or vvith both of them together might in anye sorte be occasione of any harme VVe alsoe vse them not onlye vvhen as vve desire to transpire and cause to evaporate any venoumouse vapours but also vvhen vve vvould cause anye concurrent matter to exsiccate consume endevoringe to dravve the same from vvithine externally as vvell through the extractione vvhich it heer maketh as through the vlceratiō vvhich therafter remayneth as throughe certayn little open fistles or small rūninge issues vvhervvith vve dravv the matter from invvardes outvvardes ther to evacuate the same and cause to digresse from the one place to the other Cauteryes are profitable sayeth Galen Hippocrates in all corrosive ambulative vlcerationes agaynst fluxions of the eyes in the tumor Aegylops Vtilitye of the cauteryes vvhen as the fore arme is suncke and discended vnder the Armepittes In the Sciatica payne of the hippes for they retracte dravve backe the humors vvhich trouble in that place hinder those partes In the Gangraena in the extirpatione of the mēbres to stench stoppe the bloode soe forth in all fluxions of blood in all other internal disseases vvhat soever as in the Consumptione in vlcerations of the Breste Albucasis and in the Dropsye Abucasis avoucheth the Cauteryes generallye to be profitable in all disseases and sicknesses vvhich take their originall of any matter or vvithout matter They are also profitable and commodiouse for all bitinges stinginges of anye venoumouse creature in the Carbuncles and Venus botches becaus through theire heat they consume the venoumousnes of the humors annihilate them and out of the depth dravve thē vpvvardes They are alsoe verye profitable in al criticke Apostemations vvhich are could vvaterye and vvhich are verye slovve in maturatione because that throughe theire caliditye they opitulate and helpe to ripen the could toughe humors vvhich are in that parte They are alsoe goode agaynst all corruptione of bones because they exsiccate the venoumousnes of the same and consume it and cause the corrupted bones to separate from the sovvnde VVe may applye thē on all partes of our bodye and especiallye beinge needfulle to make anye apertione to give issue and passage to any matter or vapoure vvhich therine is assembled Ther are some vvhich have applyed the cauteryes one the vpper part of the head In vvhat partes the Cauterye must be applyed about the sagittal suture vvher she ioyneth her self vvith the Coronalle suture VVhich vvith great and good successe I have seē to be done of Mr. Pare Mr. Pare agaynst the Hemicraniam or payn of the one syde of the heade and agaynst manye other sortes of inveterated paynes of the heade because that through such an apeatione manye and divers humours vapours vvhich are congregated in the heade by this meanes are exhalated allso agaynst the fallinge sicknes to give transpiratione to some venoumouse humor vapoure vvhich are often times the occasion of this dissease Agaynst shortnes of breath and difficultye of breathinge vvhich have takē their originall of the superfluitye of humors and descende out of the heade dovvnevvardes to the brest ther hinder molest the partes of the brest and bringe vvith them the shortnes of breath and oftentimes allsoe are cause of vlceratiōs in the brest through corruptiō and putrifyinge of some pituitous humours also in the Ophthalmia or inflammation of the eyes vvhich is ther throughe caused through any fluxiō vvhich is sēt through the vaynes vvhich lye scattered in the Pericranio soe runne to the externall tunickle of the Eye Agaynst reddnes of the face Agaynst payne in the teeth of the Eyes in the Sqvinancie in manye other disseases vvhich come in the mouth and in the throte VVe Cauterize alsoe the Eyeliddes vvhich are relaxated in like sorte also the Cilia vvhich sticke in the Eyes and allso in those vvhich in number are to manye Alsoe in the Arteryes of the temples of the Heade The tumefactiō Aegylops the Polipus and Ozena the cleaved lippes the Ranula the Teeth and the pallate of the mouth vvhen it hangeth to lōge also the Almōdes The Thorax or Brest on divers places somtimes shallovvly sōtimes to the cōcavity of the fores yed Brest the inferior parte of the Belly the Scrotum or genitalles especiallye the hippe agaynst the Sciatica the bone vnder the knees on the insyde of the legge Some ther are vvhich sett five cauteryes one the heade of those vvhich vve suppose to be infected vvith the lazarye Cauteryes for such as are troubled vvith the lazary VVherof vve must set the first cautery one the Coniunctiō of the sagitalle suture vvith the Coronalle The secōde above the forheade vvheare the hayre ceaseth The third in the Necke The other tvvo the Ossa Petrosa above the eares somvvhate aftervvarde tovvarde the end of the Lamdoidalle Suture to avoyde the end of the temporalle muscle to vvitt one one the right syde an other on the left syde All vvhich Cauteryes are applyed to separate those humors vvhich cause the nose to exulcerate and the internalle part of the mouth in those vvhich have the lazarye and vvhich externallye have theire face corroded deformed fearfull to behoulde These Cauteryes are applyed one some because vve shoulde not see that they have binne cauteriyed onlye behinde in the necke and one both the Armes ⧠Of the Potentialle Cauteryes how we ought to make them Chap. 3. The potētiall Cauterye and the matter therof THe potētiall Cauteryes are those vvhich through theire intollerable extream heate being vvith their forces set to vvorke together vvith the benefites of our naturall caliditye burne as it vveare a fyer in that parte vvherone they are applyed leavinge behinde them an Escara or crust Of the vvhich the matter of the Corrosive is in great number and hot vnto the fourth degree Amōgst the vvhich ther ar
vvhich are made of freshe milcke vvher in vve must contunde some yolckes of Egges oftentimes reiteratinge of the same and thē vsinge the absterginge clisteryes vvhich gentlelye vvil purifye the intestines VVe make also divers other of divers fashons formes vvher vnto this shall serve for an example of one rum Rosar rub Tapsibarbati Furfuris Hordei ana P.j. fiat decoctio in Lacte in colatura ad lib. j. vel ad quartastres dissolve oleiras colati Sacchari albi ana ℥ ij Syrupirosar siccarū ℥ ij fiat Clyster additis duobus ovorum vitellis VVe may vse this clister reiterate the same as often as vve perceave it to be necessarye but vvhen vve must vse some astringent Clisterye vvhich vve may not doe vnles that the repeccating humors be cleanlye purged out and then vve may vse this subseqvent clisterye or anye other such like rum Furfuris macri paleae Hordei tapsi Barbati Centinodiae Chamemillae summitatū Anethi ana M j. fiat decoctio in aqva Chalibeata velin Lacte vstulato in colatura ad lb j. vel ad quartes tres dissolve syr rosar siccarum vel mirtillorum ℥ ij Vitellorum ovorū iij. pulveris Mastiches sang draconis ana ℥ iij. fiat Clyster VVe may also cōstitute exordinate to this end divers Sundrye potiones Electuaryes also the Kindes of Diacorallum nature of a Harte fine Bolus sealed earth iuyce of Berberis Ribes conserve of Roses The Empiricke medicamētes vvhich the Methodicall Physiciones doe so disdayne esteeme of little vvorth are those vvhich vve throughe experience throughe the divturnall vse have fovvnde to be most excellēt vvhich being vsed vvith iudgemēt are not vvholye to be disdayned seinge that Galen testifyeth that the Physition must be established one tvvo fundamētes or foundations to vvitt on the reason on the experiēce vvherof the Reason is as it vveare the Soule of the same vvhich measureth ponderateth all thinges and the Experience the body as a providēt tutor Schoolmaster Experiēce teacheth vs that the Rubarbe on vvhat manner soever vve administre the same but especiallye the infusione therof is verye commodious profitable in this dissease as in like sorte also is the Spiritus Vitrioli vvith Rose-vvater vvithe Plantinevvater also beinge administred vvith Cynamomevvater Ther is a sugerye dulcor or svveetnes extracted out of Leade vvhich never deceaved the hope of the right vvorshipfull Mr. Duion Mons r. Duion an expert Phisition vvhich is a verye experte learned Physition vvherof I have attayned the best of this discours The Tincture of Coralle and of yellovve Ambre extractede vvith Aquavitae is in his operation admirable also Crocus Martis Flos sulfuris being administred vvith cōserves of the betryes of the Cornus Cōserve of Roses Marmalade Citronpeelinges vvith manye other such like thinges are all together verye commodiouse Because amongst naturall thinges I knovv nothing that exsiccateth more oppugneth it selfe more agaynst all corruptiones And to conclude ther are an innumerable sortes of remedyes vvhich vve must so compounde that they may have one similitude or one Analogye vvith the dissease Finallye vve must in an extreame Dysenteria for the last remedye endevoure to mitigate the payne vvith Narcoticall thinges as is the Oleum Iusqviami Mandragora the could seedes the Philounium Reqvies Nicolai manye othes such like compositiones vvhich are vnto this dissease vsed vvhich may not be administred thē vvith great iudgment and advice had therone The end of this Treatise of the Dysenteria or Bloodyeflixe An Apologye for the Chirurgians wher throughe is apparantlye evidentlye demonstrated shewed which be the occasions or causes of death in divers sundry wounded Persons although notwithstandinge their woundes weare smalle wher by the Chyrurgians may be liberated excused from all calumnes sclaunders wher with falsely they are accused reproched THe common discourses of Chyrurgery are novve adayes farre more meane idle more fabulouse vncertayne thē the Nativityes of the Goddes the Historyes of the Giantes or the doctrines of the Philosophicall stone yea a thousand other phantasticall sommationes Ther is but one experte Chyrurgiancinal Fraunce dreames There is novvadayes in all Fraunce but one expert Chyrurgiane vvhome everye potentate and great Lorde endevoureth to retayn by them vvherthrough they are vvont to say I have the best expertest Chyrurgian vvhich is living vvherfore they also laude extoll him to have a million of knackes vvhich vveare never before herde or knovvne The one boasteth that his Chyrurgiā in a verye shorte time hath cured one vvhich hath binn shott clean throughe his head althoughe the very substāce of the Braynes Divers fictions Lyes issued therout the other stedfastlye affirmeth that his Chyrurgiane hath agayn imposed the Eye of a man vvhich frō the earth he tooke vp vvithout beinge deprived of his sight in that Eye or els that he cut of a peece of ones Liver or Milte yet hath praeserved the life of the man Farthermore an other vvill bouldlye periure himselfe say that they are but nugationes Childrens play for his Chyrurgian to cure a harqueboushed or shotten vvounde of the Harte the Liver the Milte the Blather and the stomacke and the Intestins and of the great vaynes yea is noe more molested thervvith thē vveare the Sould lours of Iulius Caesar vvhich never interrogated hovv forcible strong theire enimies vveare but vvheare they vveare nether one vvhat place of the Citye the breach vvas bartered but vvhether īdeed it vve are shott or not Comparasion So that novvadayes the Chyrurgianes also doe not anye more aske nether doe any more endevoure to knovv the nature the conditiō the necessity the vse or the vvorthines or excellencye of the vvounded partes but aske only vvhether the man be vvouded althoughe all the ossicles of his Legge vveare crushed yet vvithī the space of 14. dayes at the farthest vvith theire vvater of shottē vvoundes they are able to cure them although I my selfe doe not disdayne the same the same beinge administred vsed vvith discretton And breefly to cōclude each lord supposeth that he hath by him an Hippocrates an Aesculapius a Podalirus a Machaon Out of vvhich ignorāce persuasion as not to knovve vvhat vvoundes are mortalle or curable vvhat vvoūdes are little or greate vvhich are of an easy or difficulte resanation ther must then necessarilye heerout follovve that vvhēas any body seemeth to be little hurt dyeth vnder the hādes of a most expert Chyrurgiā ether because of the greatnes of the vvound through any vnhealthfullnes of the bodye through any concursione of humours or els because of any vnexpected accidentes he is then vvithout all compassione blamed disdayned and diffamed notvvithstandinge all his greate paynes or dilligence accordinge to the arte he in curinge of the foresayed Patient hath done that because they are ignorant of the causes of
thinges The iudgement must be provident lye given VVe must thefore suspeÌ„de our iudgemeÌ„t and keepe it in secrete for a season vvithout givinge anye absolute reporte the first daye because that the good or badde signes caÌ„ not soe sone reveale and disclose themselves vve must alsoe coÌ„sider that all vvoundes must have ther originalle ther increasinge and there estate and duringe this time seeke by all meanes possible to represse the vntemperatenes vvhich is fallen into the vvounded parte throughe the blovve throughe the external ayre vvhich striveth vvith nature agaynst the vvhich nature strengthenethe and fortyfyeth her selfe to expell and drive avvay the foresayed vntemperatenesse duringe the vvhich time vve can not certaynlye knovve vvhich of theÌ„ shall obtayne the victorye theÌ„ onlye some time therafter vvhenas the foresayed vntemperatenesse maketh her selfe knovvne throughe anye signes vvhich shee revealeth in the concurringhe humors because nature throughe certayne sygnes doth demonstrate that shee hath obtayned victorye and is become the mistresse of that vnteÌ„peratenesse These signes and tokeÌ„s are especiallye knovvne by the matter afore haÌ„d and because that the purulence or matter is not engendred the first daye it necessarilye follovveth that on the first daye vve give not anye absolute reporte of a vvounde but must first consider vvhether it is bent because that nature one the dayes of Crisis demonstrateth her selfe by the vvhich vve may iudge of the end of the sicknes The first and certanest daye of the Crisis is the seventhe for the fourth is not indeede the day of the Crisis but vvel the demonstratinge day of the seaventh vvhich is the vpright and trevve day of the Crisis After the seventh follovvethe the eleventh of the vvhich the seaventh is the demonstratinge daye then the fourteenth daye follovveth after that the tvventithe and then the last is the fortithe For if that before the fortith daye vve perceave noe badd signes it is then evideÌ„t and playne enoughe that the vvounde vvilbe easylye cured It is best therfore that vve doe not reporte or give anye iudgement before the seaventh day be passed by in vvhich time WheÌ„ that the reporte must be done the accideÌ„tes beginne to reveale theÌ„se 〈◊〉 â—her on as theÌ„ vve must have a specia◠〈◊〉 â—de and care vvhether ther be more good then badde accideÌ„tes afore haÌ„des or the contrarye vve must consider one these signes three manner of vvayes For they reveale themselves ether in the qualitye of the bodye of the vvounded parte or in the livinge and vitalle in the animaele or naturalle actions Or in the excremeÌ„tes vvhich are common or in the vvhole bodye alsoe in the particulare excrementes vvhich the vvoundes reiecte and repelle from them The signes vvhich reveale themselves in the qvalitye of the bodye are considered vvhen vve regarde on the figure and one her coloure the animaele and spirituale actions consiste in the stirringe in feelinge and in reason The vitall or the livinge actions consist in the pulse and the naturalle actions coÌ„siste in the appetite in the digestinge and in the expellinge and drivinge forth of the excrementes The common excrements of the vvhole bodye are the filthynes of the Nose the teares out of the Eyes spittle out of the mouth or the substaÌ„ce and filthye matter of the guttes the vrine or that vvhich vve opvvards parbrake The particulare excrementes are filthe matter aÌ„d the bloode in vvhich excrementes vve must marke and note the quantitye the consistence colour smelle and sometimes alsoe one the taste seinge that if ther be more goode that is soe much the better vve must alsoe note that throughe the actioÌ„s vve may best iudge of the forces Havinge thus therfore togethere considerede and noted all these thinges the Chyrurgiane shal be able to geve his sentence and reporte certaynlye ether of lyfe or of deathe of lamnes or criplenes THE FIRSTE TREATISE OF THE OPERATIon of Chyrurgerye wherin is discoursede and handelede of the meanes and vvay hovv te extracte and dravve forth anye alienate thinge out of the bodye contayninge five Chapters Of the profite and necessitye that commeth to dravve all alienate thinges out of the bodye Chap. 1. Hovv the Chyrurgiane convenientlye and fitlye extractinge and dravvinge forthe the bullet ought to consider marcke theire diversityes and in vvhat partes or places they lodgeor are collocated Chap. 2. VVe ought to extracte and dravve forthe the pellet or anye other thinges if it by anye meanes be possible at the first dressinge And praemeditate one the meanes hovv vve shoulde best and convenientest effect the same Chap. 3. After vvhat manner vve shal dravve forthe those bulletes vvhich sticke faste in the bones Chap. 4 That the Chyrurgiane ought not to be too curious in extractinge or dravvinge forthe of the bullet Chap. 4. ⧠Of the necessitye and vtilitye of the extractione or drawinge forth of all strange thinges Cap. 1. The excellentie of Chyrurgerye AMongste all operatioÌ„s of Chirurgerye the aunciente Chyrurgians of oulde times have especiallye coÌ„sidered one the haÌ„dlinge vvher vvith all vve most convenientlye and aptlye drevve forth out of maÌ„s bodye all maÌ„ner of straunge alienate thinges as are Bullets Arrovves and all other sortes of vveapons or all peeces of brokene bones and many other such like things as beinge moste necessarye for this foresayed operatione It is a Chyrurgiane full of crafte That out of the bodye can plucke shafte An excellent similitude And even as in the vvarrelike affayres those Capitaynes are esteemed to be moste couragious and valiant vvhich one the suddayne can beste discerne and knovve ther enimyes and allure and as it vveare dravve them forth to their ovvne furtherance to battayle oras in chasinge those hunters are esteemed fittest and expertest vvhich suddaynelye can discover or disclose the harboure of the persecuted deere and knovveth hovv he may vvith al foresight chase the same Even so have the Physitions alsoe had those Chyrurgians in greate estimatioÌ„ vvhich first of all have founde out that parte of mans bodye in the vvhich the bulletes or Arrovves or anye other alienate thinges have binne hidden and lodged and vvhich have hadde knovvledge science fitlye convenientlye to dravve them therout consideringe that throughe there continuance in the same above al thinges they are cleane contrarye vnto vs vnsufferable as that vvhich is deade livinge so it is a hinderance vnto vs and especialye to that parte vvherin the foresayede vveapon stickethe and that as vvel of it selfe because that it vvholye hinderethe the curinge of the vvounde or else because it bringethe to gether manye heavye accidentes the vvhich is cause of lamnesse or criplenesse in the vvounded parte or els causeth the health vvhich vve suppose to have gotten not to be perfecte and sure but is subiecte vnto a farre vvorse returne renueinge of the same Yet for all that I knovve some vvhich are cured Some meÌ„ are curede contayninge the bullet in the bodye in the
retayne the Dura Mater and administer life and nurture vnto her But if it soe chaunced that the fracture chaunced to be one the suture vve must then applye the trepane on both the sydes of the suture vvith out in the least touchinge of her for if soe be vve trepane but on the one syde onlye and not at the other syde of the suture it vveare then impossible that the bloode or matter should have at that hole anye issue or passage the membrane beinge betvvixt them both nether may vve trepane on the fontanelle or openinge of the heade in yonge Children because that ther tendere imbicillitye as yet is notable to suffer and abyde the trepane The inferior or descending partes of the sculle are not convenient or fitt to be trepaned because the braynes throughe ther ponderousnes might chaūce to sincke therout or the membranes throughe the apertione might chaunce to be extruded But if soe be vve vveare vrged ther vnto vve must make but a verye smalle apertione VVe ought in noe vvyse to trepane the temples of the heade We may not trepane the temples of the heade because vve shoulde not hurte the temporalle muscle consideringe divers synnues arteryes and vaynes vvhich are therin divided and entermingled throughe the vvhich there might be caused to greate payne fluxione of bloode agues Spasmus and the patient might chaunce to dye Because that ther vnder the bone called Os petrosum is situated and that consideringe the movinge and stirringe in the temporall muscle vvhich happeneth in speakinge or eatinge the vvoūde might be farre more daungerous and Hippocrates alsoe sayeth that the inscisione of the same muscle might be cause of a greate and villanouse distortione out of the vvhich one the same syde a Paralisis on the other a cōvulsione of synnues might chaunce to ensue Nether ought vve to trepane that parte of the sculle a little above the eye brouvves because in this place ther is a greate concavitye fylle of ayre and vvhite slimye mye humiditye of nature in that place cōstituted ordayned to paepare the ayre vvhich ascēdeth vp to the braynes the vvhich indeed is vvorthye to be knovvne observed because that the Chyrurgiane might not in anye sort be deceaved takinge the foresayed concavitye to be a depressione of the bone vvhich needes must be trepaned if it so chaunced that anye of these foresayed partes vveare brokē as are the temples of the heade vve ought then to applye the trepane a little above the tēporall muscle Vve may not trepane that bone above the eyebrovves if soe be that the part or portione of the sculle be broke a little above the eyebrovves vve must as then make choyse of that parte of bone vvhich boundeth on the fracture as above in the fooreheade it is right true that if so be the foresayed bones vveare depressed and crushed that as thē vve ought to elevate them and if they be cleane separated vve as then must plucke them out in like sorte as vve must doe in the sutures The sutures and temples of the heade may sometimes be trepaned Yet consideringe all this vve are oftētimes compelled constrayned to trepane in all places of the scull The vvhich a renoumned experte Chyrurgiane called Andreas a cruce confesseth often times to have done vvithout anye daunger And I dare my selfe bouldlye affirme that I in the yeares of 1591 1592 have my selfe trepaned and have seene others trepane in the foresayed prohibited places as one the sutures and one the temples of the heade Notvvitstandinge I vvould councell the yonge Chyrurgiane that in as much as is possible he avoyde eschevve the trepaninge of these places but rather make choyse of anye other parte vvhich parte may be a little descendinge because havinge made the apertione the bloode the matter all impuritye might therout have ther free passage Consideringe in the dayes vvhich goe before and vvhich conseqventlye follovve after the trepaninge on the singularitye and vvorthines of tvose partes vve must commaunde the afflicted and vvounded persone that in all thinges he vvilbe sober and observe a good diet both in etinge and drinckinge abstayninge especiallye from vvine and phlebotomye as much as is needfull because that the humors shoulde not concurre vnto the vvoūded parte and that alsoe vve keepe his heade vvarme vvith light coveringes of the heade because coulde is a greate enymye vnto the braynes all synuis he partes ⧠What qvantitye or vvhat bignes of the bone in trepaninge vve must take out Chap. 5. WE must in the firste accordinge vnto the quantitye Hovv greate the apertione must be for to trepane and bignes of the bone vve purpose to take out make an apertioin the skinne denudate the foresayed sculle Therfore if so be ther be noe vvounde nor anye apertione and the skinne externallye as yet vnhurte this shall as thē be the convenientest apertione vvhich vvith handes may be made vvhich vve shall make vvith tvvo crossevvyse overthvvarte inscisiones in such a forme as this in the margine demonstrateth vnto you or els in forme of a borghondiane crosse vvhich in his middle praesenteth four corners In somuch therfore as if the hurte have made a vvounde and inscisione in the skinne vve must suffise our selves thervvith vvith such as it is if soe be she be thervnto fit and apt making an other transversall inscisione namelye overthvvarte the vvounde because these tvvo as then may present one But if soe be the vvounde be verye ample large vve must as then onlye cutt the skinne one the one syde begīninge the same in the middle of the vvounde because soe the vvounde may present this letter T in the vvhich vvilbe but tvvo corners These foresayed inscisions are cenvenientest done for the inflammations The inscisione must be done before the inflammatione But if soe be vve perceave the vvounde to be large enoughe to give place vnto the trepane or anye other instrumente vvhatsoever vvhervvith vve might endevoure and seeke to elevate and restore agayn the broken or depressed bones in so much as if ther be anye vve must thervvith content our selves exstendinge the foresayed vvounde at the first vvith linte vvith little plumaceoles therof being made and therin crushed on allsydes corners of the vvounde But in vvhat sorte or fashone soever vve make our inscisione in the skinne vve must allvvayes note that vve doe not suffer anye portione of the Pericranium to remayne one the sculle vvhich vnder the skinne decketh and covereth the vvhole sculle because if so be the foresayed membrane Pericranium vveare per happes torne vvith the teeth of the trepane might be the cause of greate inflammatione payne and agues vvher fore it is better that vve cleane and vvholye separate it from the sculle vvhich beinge done vve must then damme stoppe vp the vvounde vvith vvhite linte by the vvhich the next day ensuinge vve shall finde the vvounde vvide open
in there place tye them vvith a gouldē vvyer as is before rehearsed or els vve may set other teeth in ther places vvhich are by art made of Ivory Looke afore in the figure or formes or of any other matters as here before vve have set dovvne the figures and discriptions therof The Frenche Chirurgerye THE SIXTE TREATISE OF THE OPERATIone of Chyrurgerye Contayninge nine Chapiters Of that vvherone vve must consider before vve make an apertion in avayne Chap. 1. Hovv vve ought to phlebotomive or open avayne Chap 2. VVherō vve ought to cōsider after vve have opened the vayne vvhē shee bleedeth Chap 3. Of the number of vaynes arteries vvhich are vsed most cōmonlye to be opened Chap. 4. Of the apertione of the Arteries Chap. 5. Of Anevrisma or broken arterye hovve vve ought to make an inscisione therin after vvhat manner vve ought to binde them Chap. 6. Of the Cirsotomia vvhich is hovv vve ought to make our inscision in the Varices or bursten vaynes Chap. 7. Of horseleeches and of ther vse and hovv vve ought to applye them Chap. 8. Of boxes and hovve vve must applye and vse them Chap. 9. ⧠Wheron we must consider when as we desire to open a vayne or phlebotomize Chap. 1. Intentione porpose of the aucthor MYe purpose and intent is not in this place to discrib vnto you vvhat sicknesses reqvire phlebotomye in vvhat age in vvhat time or season of the yeare in vvhat countrye in vvhat cōstitutiō of the body it must be done of vvhat occasione namelye especiallye vvhether it be for anye simple evacuation or for anye deprivatione or derivatione or for any revulsione In like sorte alsoe in vvhat vayn vve ought to make the apertione vvhat qvantitye of bloode vve ought to detracte out of the same in vvhat sorte and hovv much at one time hovve often after the other or in vvhat time of the sicknes vve must make the apertione in the vayne But my purpose and meaninge is onlye to shevve hovv vve ought to opē a vayne vvheron vve must thinck dilligentlye consider before vve make the apertione therin after vve have opened her vvherone vve ought to not vvhē the blood issveth out of the same This doinge shall the Chyrurgiane be noe lesse vvorthye of prayses because he cā verye excellentlye phlebotomize then the physitione is prayse vvorthye by his perfect knovvledge vvhether the patiēt have neede of phlebotomy or not Why phlebotomye is difficulte daūgerous For although that it seemeth to be a smalle sciēce to phlebotomize aright very vvel yet notvvithstandinge is it oftentimes a difficulte matter verye daūgerouse because the vaynes ar situated somtimes close to the Arteryes yea alsoe thervppen as alsoe are the synnues Accidentes vvhich are caused take ther originall of ther hurtinge of anye vayne synnue arterye or tendone the tēdones If soe be therfore vve chaunce vvith the lancet to hurte a Tendone therafter most commonlye issueth a Spasmus or a Gangrene and mortificatione vvherthroughe the patiēt pitifullye ruefullye and vvith great torment endeth his lyfe If ther be then any arterye touched opened shee verye difficultlye vvil be cured vvherby the patiēt bleedeth to death vvhē as vve descide a vayne qvite asunder both the endes therof are immediatlye retracted and dravvne invvardes the one end this vvay the other end that vvaye soe that vnder the fleshe both of the endes are lost noe bloode cā possibly issve therout if shee be then vvith to great timorousnes feare pricked the skinne onlye vvhervvith shee is covered is as thē inscided the vayn not opened or els if shee be onlye pricked vvith the poyncte of the lancet the bloode as thē issveth therout droppingevvyse and the subtilest bloode onlye cometh out vvher cōseqvently therafter she exvlcerateth Sometimes alsoe lyeth the vayne occulted soe deepe in the fleshe that vve can not vvith the lācet finde thē vvithout great paynes yea also although vve espye them yet throughe there perpusillitye rotūditye they avoyde eschevve the poyncte of the lācet hovv accute subtile soever the same be Soe that ther are oftētimes divers occasions vvherfore phlebotomye is difficulte vvhich to an other vvhich never hath done it seemeth to be very easye Before the Chyrurgian maketh his apertiō in the vayne if soe be the patiēt be restringed bovvnde in his belly hath in a lōge time not bīne at stool vve must thē first of all cause him to vse a Clistere because throughe the phlebotomye the vaynes beīge evacuated emptied doe not attracte dravve vnto thē out of the guttes or entralles any corrupted rottē humors vvherbye anye of the vvorthyest partes might be offende hindered Nether is phlebotomye expediēt Wheron vve ought to cōsider before phlebotomye vvhen as the stomacke is burthened ether vvith anye cruditye of vndigested meat or drincke or vvith anye other viscositye vvhatsoever as also it is vvholye dissvvaded to doe after anye greate evacuatione or anye other occasione vvherby the patient might be debilitated as is superfluous parbrakinge a great laske great abstinence continualle vigilatione and great conversation vvith vvoemen VVhē as therfore the Chyrurgiane in the absence of the Physition hath on all these foresayed thinges dilligentlye cōsidered he must as then deferre the phlebotomye And if it soe chaunced that anye persone to praevent any dissease desired to be phlebotomized he must then cause it to be done vvhē as he is best of courage as beinge freede from all care of sorrovve of ire and besyde all this vve must not phlebotomize anye persone vvhich is to timorouse fearfull of phlebotomye because the afrightednes the feare causeth the bloode to vvithdravve it selfe tovvardes the internall partes of the bodye Hovve vve shoulde convenientlye phlebotomize And the patiēt as yet beinge lustye strōg vve must then cause him to sit in a stoole but if soe he be feeble debile is subiected vnto fayntnes sovvndīge as those are vvhich are of a hott nature vve must in the first let him suppe in a soft dressed egge or a morsell of breade sopped in vvyne then cause him to lye one the bedde halfe sittinge vpright stuff him vnder vvith cushēs as if he sate And above all vve must dilligentlye note that the light of the ayre or shining of the candle doe rightlye shine one the vayne because that through the shaddovv therofe the knovvledg of the vayne of the place vvhere she must be pearced be not vanished out of your sight then must the Chyrurgiane vvith his right hande take the right hand of the patient or vvith his left hande the left hāde of the patiēt out of the vvhich he meaneth to dravve the blood out depressinge the arme sōvvat dovvn vvardes and then vvith his left hand or vvith a vvarmed table naptkinne rubbe the insyde of the arme vvher he
nether hath binn of the ayre illuminated because that sometimes the altered bone for that it hath a longe vvhile lyen bare is grovvē to be soe harde thicke thar vvithout greate paynes vve can not fasten therō vvith the grating iron through the matter vvhich is thinne Through the matter subtile cleere faetide stinckinge blackishe vvhen as rovvnd aboute the vlceration especiallye is regenerated a tender viscouse flesh vvher through the vlceration can not be cicatrized although shee be cicatrized therafter redubleth herforces breacketh open agayne Occasion of the corruption of the bones Such alteration procedeth of some cōcurrēt humors that descēde on the bared bones as appeareth vvhen they are through soackede vvith any pestiferouse humors or els because they are of their flesh pellicle or mēbrane Periostio denudatede and barede vvherthrough they corrupte vvaxe drye for vvant of blood vvhervvith they shoulde be nourished or els because they are to full of humiditye moysture throughe the purulēt matter vvhich cōtinuallye theron distilleth corrodeth ether because they are to much ānoyncted vvith oyle to much fatty salves therō applyed vvherby the vlceration is corrupted putrified Or because she is polluted vvith the matter of the vlceratione vvhich supernaturallye from above is descēded theron distilled VVhēas therfore for certaynty vve knovve that ther is putrefactiō rottēnes in the bone vve must then doe our devoyr to knovv hovv lardge profovvnd the same is because therby vve may the surer knovv hovv vvith moste conveniēce vve shoulde remove abolishe the same cause therin a separatione because it is necessarye that the vivificēt parte expelle drive from it the mortified or els the mortifiede allso cause mortificatione in the vivificent partes Magnitude of the putrefactiō Concerninge the magnitude thereof vve may discerne it through the sight vnlesse it be operted vvith any viscoufe or slimye flesh vve supposing doubtinge to be more putrefactione of bones that is patefiede evidente vnto vs throughe the circumiacent partes of the vlceraration vvhich as then are purple coloured through the spongiouse flesh through the elevatione of the edges of the vlceratione throughe the diuturnalle continuāce of the same in one estate Hippocrates For as Hippocrates affirmeth In the venomouse vlcerations vvhich for the space of a yeare have continuede or longer it can not othervvise be but necessarilye in the bone vnder the fleshe of the vlceratione must needes be a corruptione putrefaction a corrosione some peeces therof come out the Cicatrises also vvill continually be cōcavouse hollovve To cure the putrefacted bones VVe therfore certaynlye knovvinge this vve muste as then dilate the vlceratiō denudate the bone dilligentlye marck hovv large the foresayede putfactiō is vvhich muste be effectede vvith causticke medicamentes by the vvhich the spongiouse fleshe mvst be cōsumede accordinge as the foresayede vlceratiō reqvireth Celsus councelleth vs that firste vve make an inscisione in the skīne to denudate the bone if so be the putrefaction of the bone be greater then the vlceratione discidinge cuttinge of all the flesh rovvnde aboute vnto the sovvnde bone touchinge the depth of the putrefactione of the bone vve may knovve it throughe the privet or searchinge iron vvhen as vve feele theron the vvhich pearcinge deep or not deep in the same shevveth vnto vs that the foresayede corruptione of bone is great or smalle But if vv see the bone to be blacke dry as it happeneth bereft of blood the privet thē vvill not enter therin vvherfore the depth of such a corruptione can so certaynly be knovven as through the perforative Trepane or els through the little groūd dravver vvherevvith vve must perforate the foresayede bone through vvhich perforatione of bone vve easily shalle perceave vvhether the bone be blacke vvhyte or redde vvhether ther issuethe bloode out or not if it be so it is then a signe that the putrefaction of the bone is not deep And if so be vve perceave the perforated bone to be blacke it is then a token that the putrefactione is deepe because the corruptione of the bone pearceth so deepe vvhen vve perceave that the bone is vvhyte redde so farre is it then incorruptede To the vvhich Caries or corrupting of bōes vve muste vse the actualle Cauterye or els allso the potentialle or the Raspatorium If so be the corruptione of the bone penetrateth not verye deepe Hovv lōg vve ought to raspe vve muste then grate the foresayed bone vvith a peculiare Raspatorye in raspinge of the same stifly crush therō that vve may qvicklye penetrate through the corruptione the operatione vvih all festinatione be effectede done All daūger beinge novv passed vve perceavinge the bone to be vvhyte smooth pure solide it is then sufficient For it is impossible that the foresayede corruptione of bones may have an end as long as vve doe not liberat free the same by one meās or other from all daūger corruptiō VVhen vve perceave in raspinge the bone to give bloode from it it is then a signe that all corruptione is therout and that the bone is vvell disposed because that no corrupte or alterede bones vvill give from thē any bloode This beinge done vve as then vse the poulder of Aristolochiae of Mirrha of Ireas of Aloe to liberate the foresayed bone frō al corruption praevente the same to be anye more putrefacted and corrupted If vve suppose that the Raspatorium be not sufficient enough to remove the foresayed corruption as vvhē she is deeply corroded invvardes The fyer is the surest remedye to repel all corruptions out of the bōes vvhen as ther is a peculiare corruptiō imprinted in the bone the same alsoe being fatt oylye if so be the patient vveare not timorouse of the fyer the afsuredest remedye as then is that vve cauterize the foresayed coruption vvith an actuall Cauterye vvhich conforteth that parte and consumeth all venoumouse humors vvith all festinatione causeth the corrupted bones to separate causeth little or noe payn at all because the foresayed bone is insensible and doth not communicate his vnhemence vnto the other circumiacent partes VVhen as therfore Māner hovv to apply the Cauterye vve desire to vse it accordinge to the depthe greatnes of the coruption or Caries vve must therin vse a meane of applyinge the foresayed Cauteriū on the bone to vvitt vntill through the porositye of the bone ther commeth out a frothye matter noe lōger for if vve helde it lōger theron it should through his great callidity throughe the exsiccatinge vertues therof not onlye consume the humeditye of the putrefaction of the bone but alsoe the naturall humiditye moysture through vvhich occasiō the fleshe ingendreth increaseth betvveene the sovvnde the corrupte bones This doinge nature in a certayne time
27 Chap. describeth Not because of the signe vvhich remayneth in the Cauterized parte that is because of the little Vlceratione vvhich remayneth therin vvhen as the Escara is fallen therout Soe that this vvorde Cauterium in properlye being vnderstoode can noe othervvise be vnderstoode then a little Vlceratione in anye externall parte of the bodye vvhich throughe the art of the Chyrurgiane is made therin throughe some comburent adustive medicamentes to give issve passage to some certayne matter of some dissease VVherfor the differēces of these Cauteryes The differences of the Cauteryes not properlye taken or Vlcerationes are as it vveare dravvne from their place being vvheron they are applyed also from theire efficient cause The essence beinge of these Cauteryes cōsisteth in theire forme figure vvherfor some ther are vvhich be rovvnde some contradictorye others right great smalle deepe or not deed All the vvhich have but one onlye apertiō or sometimes also tvvo is thē called a transforatione or Seton And also of all other places vvheron they may be possiblelye applyed as on the Heade in the Necke Armes Legges finally in all partes of the bodye vvherone they might be applyed vvhē onlye the agilitye or actione of the parte can not ther through be hindered or hurte Of their efficiēt cause vvhich is takē out of the diversitye of the matter vvhich is applyed one anye parte of the bodye or ingendred in the same The matter vvhich continuallye is applyed on the bodye actuallye combureth Actuall Cauterye or potentiallye vvherfore they are called actuall or potentialle Cauteryes That vvhich in our body is ingendred can come through any sharpe corrodent or bitinge humors vvherthroughe the skinne is corroded bitten throughe exulcerated of vvhich vlceratione may be effected made a Cautery or fontanelle vvhich may be called actuall Cauterye Differences of the cauteryes simply taken Heere of vve may coniecture and suppose that the Cauteryes fontanelles vveare invented follovving nature therin ther throughe to give passage to that vvhich is contrary opposite vnto her vvherof she is perturbated molested it be ether in quallity or in qvantitye as heerafter vve vvill farther speake of And as touchīg the Cauteryes vvhich vve call instrumentes their principalle especiall difference is taken of theire substance forme figure of theire tarditye slovvnes or festinatione of adustion of theire depth shallovvnes of the manner of theire applicatione touching theire matter or substance because they actually in deede doe combure burne or potenciallye they are therfore called actuall or potencialle Cauteryes The substance of the actual cauteryes The forme of those vvhich actuallye burne is almost innumerable vvhich are made hott glovvinge The antique auncient Chyrurgians have commonlye made theire Cauteryes of mettles as of gould of siver of Iron of copper Archigenes Archigenes hath cauterised the lachrimall fistles vvith liquefacted leade vvhich through a little pipe he dropped therin They vveare of opinion that the cauteryes of gould caused lesse payne Substāce of the cauteryes vvhich the auncient Chyrurgians vsed vveare farre more easyer to be suffered that alsoe the Cauterized place shoulde not avoyde soe much matter and the adustiō is not soe daungerouse because gould amongest all other mettles is the moste temperate vvherfore it burneth not so violently as Iron because it is not soe cōdensated of substance vvherfore in like sorte alsoe the Cauteryes vvhich are made of Copper doe not soe closely burne or cauterize as those vvhich are made of Iron because the copper is not so solide of matter vvherfore vve desiring strōgelye violentlye to cauterize vve must take such cauteryes vvhich are made of the condēsest A kinde of spongiouse matter full of dust grovvinge on the moūtaynes vvhervvith vve vse to stench bloode most firmest matter substance Somtimes have also the aunciēte professors as Hippocrates recited to have cauterized vvith tentes vvhich they dipped in ebullient seethīge oyle or vvith drye incended puffes as vve call them or vvith the root Aristolochiae being madefyed in seething oyle or vvith the rootes of Strutium as Caelius Aurelianus Dioscorides and Attilus vvhich have cauterized vvith incended Goates dunge Aetius hath cauterised the corrupted gummes Aurelianus Dioscorides Attilus Aetius Albucasis Guido vvith ebullient oyle vvhich he applyed theron vvith vvolle beinge therin madefyed Albucasis in like sorte hath cauterized the hollovve and concavouse teeth vvith seethinge butter Guido hath cauterised the bones vvith liquefacted Brimstone to vvitt of the Caries Soe that out of all these vve may sufficientlye vnderstande that vve may make as manye sortes of cauteryes as there are substances vvhich may be incended The foresayed cauteryes Differences of the cauteryes cōcerninge their figures especiallye those vvhich are made composed of any mettle are also differinge in their figures the one from the other For everye cauterye must be proportioned accordinge to the dissease and that vvheron vve vvill apply the same so that some are like heades of great nayles triangled others rovvnde like vnto a buttō others cutting some not dislike vnto a halfe moone and others circlevvyse As vve may behoulde and see the circles of Albucasis other in forme of a rapersblade as Celsus discribeth ther vvith to cauterize the fissures in the lippes They are alsoe differinge the one from the other in theire depthe or shallovvnes for vve neede somtimes to cauterize the skinn only as Hippocrates vvilleth vs to doe in the paynes of the shoulders VVe must alsoe sometimes cauterize the fleshe as in the Sciatica Cauteryes to cauterize deepelye Some times also to the bone and crushe the same reasonable close thervnto as vve must doe vvhen as vve must cauterise above on the heade vve must sometimes cauterize into the concavity of the bodye as vvhen vve must cauterise into the brest to let ther out any matter somtimes vve doe but only scorche or singe above one the place And because that amongest the cauteryes Differences of the cauteryes taken out of theire actione considering the matter vvherof they are composed ther be some vvhich are quicly heated and some vvhich continue longer hott then others even soe ther are some vvhich consideringe theire pōderousnes or levitye tarditye or festinatiō ether in violence or payn of theire operation are differinge the one from the other The Cauteryes are alsoe differing Difference in numbre in theire numbre for at somtimes vve applye but one somtimes tvvo thre four yea alsoe fifteen at one time as Aetius cōmandeth vs to the curing of the vlcerations of the Brest They differ alsoe in theire manner of applicatione for some are applyed alone Differēce taken out of the manner of the applycation others in little pipes vvhich at one ende are aperte and opē or have any appertiōs or vvindovves in the sydes therof Of the Invention and of the
the vvounded or hurte entralies not so pungent and sharp but somvvhat more surde and benumde The occasione of the bloodyeflixe is the venoumouse puissance and force Occasion cause of the Dysenteria Dynamis of the acute saulte and mordicant humoures vvhich beinge as it vveare on the iournye to descende right to the guttes but they come recurvared in form of this lettre S. as in the situatione they must passe by manye recurvationes cōcavityes vvher they cleaving fast first of al crudifye and excoriate the foresayed guttes in the end throughe theire acuitye corrode the same as is the cholericke humiditye the melancholycke humors and the saulte Petuita the vvhich is ether ingēdred internally in the guttes or els congregate together in other place are soe driven that vvay as it happeneth commonlye in the Pestilentialle agues in Causo colliqvanti Phthisi Athrophia in the Cacochimia in the inflammatione and in the colliquation of the vvorthyest partes The humors are also irritated and provoacked through causticke and venoumouse medicamentes as throughe the Coloquintida Scammonia or throughe the Sublimated poulder of a Diamante Ravve fruicte causeth the Bloodyflixe Also through anye viciouse acute grosse cibaryes and those vvhich are apte vnto corruptione or els is not sufficientlye dressed Alsoe throughe any fruicte as by cherryes Blackecherryes Plumbes Peatches Coucoumbres Milions such like vvhich vve call Hotatij Fructus vvhich more throughe the constitutione of the ayre vvhich ether is to moyste and pluviouse or raynye to coulde or to hott in others through intemperature and other inordinate victitatione or debacchatione by the vvhich it inseparablelye happeneth as vvell in the VVinter as in the Summer that this dissease of the bloodyeflixe afflicteth man kinde It is right true that this dissease Indicati◠hovv vve may easilye or difficultlye attayn to the Bloodyeflixe oftentimes reagneth in the Prime or vernall time of the yeare and especially in the Harvest or Autumne in the vvhich time the humors doe most impeach hurt vs vvith the qvallityes Havinge observed all these thinges vve must consider one the quantitye and quallitye of the dissease as on the greatnes of the vlceratiō and the superfluitye of bloode and one the greate corrosione and one the violence of the dissease therbye to iudge vvhether the dissease vvith anye facilitye difficulty or impossibilitye may be repelled and cured VVe esteeme the cure of the Dysenterya to be of more facilitye the same beinge in the great guttes or intestines Caecum Colon Rectum thē it being in the smalle entralles Duodenum Ieiunum and Ileum VVe take also the same to be lesse daungerouse in yonge persons and in the men then in yonge children and vvoemen In a longevalle or longe continuing Dysenterye it is a badde signe vvhē the appetite is departed yet a farre more vvorse signe vvhē as ther are associated vnto the same Agues or Imflammationes They vvhich are of most experiēce may iudge of this poyncte As is that vvhich is caused out of anye Apostemation beinge burst out of the Liver or of the Milte vvhich verye rarelye happeneth and yet more rare out of the pulmonicalle Apostemationes vvherof the matter disgorgeth it selfe in the left ventricle of the Harte and soe into the Artery called Aorta the truncke or body of all other Arteryes frō thence into the Vaynes of the Mesentery vvhich are extēded to the entralles the vvhich passage or vvay vve can not then throughe imagination compraehend and vvhich is very obscure And if soe be ther follovved any peculiare thinge therout besides the causticke and venoumouse matter it might thē inferre fearefull daungerouse accidentes to the hart of the Patiēt vvhich is the vvelspring of lyfe the onlye originall of vitall spirites vvhich are diffused over the vvhole body are occasione of the actione motione also all other agilityes of the bodye The evomitiō of the choloricke humors in the beginning of the dissease doe beare vvitnes alsoe of the daunger follovvinge The bloody flixe vvhich is caused out of any melācholicke humors is esteemed to be vvithout anye hope The convulsiō of synnues the Hickough the parbraking are forerunners as it vveare embassadoures of death In like sorte allsoe vvhen vve espye a blacke spott behinde the left eare as bigge as a Vetche vvherbye is great alteratione that allso is a signe of Death as Hippocrates vvithnesseth vnto vs. If soe be this dissease through negligēce or through malice or aulteration or by any other meanes came to be inveterated the Patient as then vvill vvholye consume vvexe so feeble that vvithout great difficultye he shall not be victor therof This therfor is the cause or occasiō the species kindes of this dissease the afflicted opressed parte beinge aperte and knovvne vve must novv proceede to the resanatione of the same The finall end of the curatione is ether generalle or specialle The generall end is to be noted ether on the dissease or on the Physitione as on both the especiallist most principall personages vvhich acte and sett forth the Historye of this dissease In all the kindes of Dysenteria Cure of the Dysenteria the patient must keepe himselfe reposed and quiet because all vlcerationes desire to be quietlye kepte and in ease Notvvithstandinge Hippocrates in his third boocke de Diaeta councelleth that vve shoulde cause the Patient vvhich hath the bloodye flixe to vvalke alsoe cause him to stirre his bodye vvherby he meaneth that vve ought to doe the same before the foresayed Dysenteria become because of the Prophylactica therthroughe to prevent the procreatiō of all badde humors to defend the same out of the intestines cause them to vvithdravve themselves into other externall partes of the bodye Farthermore the patient must allvvayes retayne his stooles as longe as he possibly may or can vvithout constraygninge himselfe thervnto The Chyrurgian must first of al consider on the vse of the astringent medicamentes What astringent medicamētes the Patient must vse vvhich before repast or comestion are vsed for he cōtayninge the viandes or cibaryes they helpe also to the digestiō of the same but by the astringent thinges I vnderstande meane vvhich are reasonablelye fortifyinge and confortative and those vvhich are helpefulle to the concoctione For it vveare the greatest absurdest error of the vvorlde if soe be in the first especiallye in an vnhealthfulle bodye to vse violent stopping astringent medicamētes for it vveare nothinge els thē to shutt keepe our enimye or theefe vvithin doores VVherfore his viandes or meate drincke What his meates drinckes must be must onlye be Diureticke astringent causinge to voyde vrine because through the vrine especially all aquositye of the blood is evacuated but if so be you perceave that the great toughenes of the acute sharp adusted Pituita or aquosity vvhich is verye retardatelye expelled
his deathe allvvayes persuade themselves A foolish persuasiō that if the Patiēt had binne in handes of theire Chyrurgiane he vvithout al doubte had not dyed although that theire Chyrurgian have experimented tried little or nothinge at all and is vvholy inexperte so that by continuance of time vve finde thē to doe or vvorck noe more miracles thē a common or lay man and also vvith noe more certayntye doctrine nor experience and oftentimes in their practise beinge at theire vvittes or councels end are constrayned to sue for succoure ayde of their companions or partakers Because therfore that in conseqvente times heerafter these fellovves should not vndeservedlye reape such honoure the aunciente Chyrurgianes might liberate free thēselves from all calumnes of beinge ignorāt vvhich is layed to their charge and to reqvite and resolve the opinions of those mighty and potētat Lordes vvith reason because therafter they doe no more blame and sclaunder the Chyrurgianes I vvill heere breeflye recite Some vvoundes are esteemed to be small vvhich indeede are great and daungerous the occasions of Death causinge them playnlye and evidently to vnderstāde that ther are some vvhich of a vvoūd vvhich vve esteeme to be but small and of little regarde doe notvvithstanding dye yet of expert learnede men the same vvas esteemed and accounted for a perillouse vvounde And contrarilye some are cured of great vvoundes vvhich indeede vve esteeme to be but smalle and of little regarde and vvhich vvith all facilitye may be cured They can not cure all men Notvvithstandinge beinge impossible for the Chyrurgiane hovv erudite experte soever he be to cure all men althoughe at sometimes they be vvoundede vvith verye smalle vvoundes Novv therfore to returne to our discourse What is required to the resanatione of vvoundes vve must first of all knovve that to cure a vvoundede parte to restore agayne that person into his former accustomed estate of health thervnto are many thinges reqvired vvhich I heere normallye rightlye vvill prosecute First of all ther is the integrity force vigore of the vulneratede hurte parte or membre As evidentlye doe demonstrat vnto vs the aucthoritye reasone and experience For accordīg to the opinione and sentence of divine Hippocrates It is nature vvhich cureth all sicknesses and disseases sect 5. Epid. 6. The vvounded partes are infeebled ether cōsidering the nature of their first conformation or throughe any accidentes chauncinge to the dissease or els because of any hurtes or shottes vvhich happen vnto the same vve may throughe their nature knovve thē vvhen as the head is to little for as then it is vvhole inconveniēt Or els to grosse and so vaste and ponderouse that becaus of the dissease the patiēt is not able to beare vp the same right on his shoulders If so be it be perfectlye and completly rounde for in such a Heade is ether vvanting the anterioure A Heade noughtily formed or the posterioure future or both of thē together vvhich are the suspiracles through the vvhich nature disburseth her selfe of all superfluityes vvhich beinge therin contaynede they retardate the curatione of the vvounde And if it soe chaunced that the Heade of your vvounded vveare indecently formed the vvound seeminge to be small allthough indeede noe Capitalle vvoundes are to be esteemed smalle and the curation therof be tardife and the Patiente chaunce to dye therof vve ought not as then in anye sorte to attribute the faulte vnto the Chyrurgiane but to the badde formatione of that parte vvhich is hurte or vvounded VVe must alsoe vnderstande the same of the Breaste vvhich being anguste stricte sufficiently demonstrateth vnto vs that the harte and the naturall calor of the same are very feeble be cause the domicille of the harte the Lūges is to angustlye formed vvhich might be the cause that if any body being vvounded in such an angust stricte breaste shall vvith great difficulty receave agayn his health because the natural caliditye being in these partes feeble lāguide shall not be able to surmount the Accidentes vvhich ordinarilye happen vnto such partes as difficulty of respiratiō through the oppression of the effuded blood in that part vvhich cā not be digested nor expelled ether by the Mouthe or through the vvoūd that for vvante of naturall caloure vvhich cōmonly in such a stricte anguste Breast is very smalle Abadde formed Backe or Backebone The like may also be sayed of the Back of the Spina Dorsi or Backebone vvhich being sōvvhat to lōg as those vvhich cōtumeliouslye diridingly vve call Elevenribbes because they have such huge and vaste long sydes vvherof vve neede not doubt but that such a Back or Backcbone is farre more debile then others therfore more apte and prone to receave anye vnnaturall humiditye vvherfor also in such vvoūdes there happē great fluxiōs betvveen the Muscles the skinn betvvixte the distāces of the same becaus of the great quātity of excremētes vvhich have theire accourse out of the Braynes other partes of the body vvherby betvveē the Muscles the distāces of the same there sincke manye superfluous humors vvhich by consequēce of time are chaūged into some venoumouse humiditye matter through the vvhich vve are sōtimes cōstrayned to make some great apertione vvhich require a long continuance of time to the mūdifyinge therof vvholy to be cured yea sōtimes also aulter chaūg into fistles becaus of the tendernes softenes of the part vvhich cā not be shut nether through ligamentes reserated or cōpressede as an arme or legg Hippocrates hath observed noted that betvvixte feeble A notable sentence diseased fleshe ther alvvayes descēdeth sīcketh a vvaterishe humudity vvhich easily can corrupt The small thinne Hippes vvhich are baddly formede Hern fashoned hippes legges vvherof vve commonlye say they goe one VVayghtes are vnder and above all most of aequall crassititude and thicknes cōtrary to those vvhich vve saye to be hipped legged or have a payere of goode stedfast stiltes vnder thē vvhich are vvel proportioned vvher of daylye experience teacheth vs that to our greate greefe and sorrovve that such persons ether being vvoūded in hippes in the legges or in the feete are subiecte vnto many and divers accidentes the vvoundes alsoe difficult to be cured mūdifyed Legges vvhich are of a difficulte resanatiō in the vvhich oftētimes above the ordinary fluxiōs therin engēdreth proude fleshe novve being as it vveare almost readye to be Cicatrizede can very difficultely be brought thervnto being cicatrized through anye small occasion bursteth open agayn And if so be the bones be offended or brokē as then the Ioyncte most commonlye consumeth and vvithereth the health very retardately can be agayne restored Novv all this vvhich hath binn sayed The most truest assuredst signe of the imbicilitye of any part is