from the belly of the Muscle may seeme to end in a ligament I will answer that it is the condition of every nervous part so to binde or fasten it selfe to another part of his owne kinde as to a stay so that it can scarse be pluckt from thence We see the proofe hereof in the Peritonaeum or Rim in the Epigastrium or lower part of the lower belly That which covers the Muscles of the Epigastrium is but one unlesse you had rather part it in two the right and the left distinguished by the interposition of the Linea Alba or white Line It is scituate betwixt the fat and Muscles for it is fastened above and below to these parts with fibers which in smallnesse and fitnesse exceed the Spiders web But by its vessells it participates with the three principall parts and is of a cold and dry temper The use of it is to containe the Muscles in their naturall vnion and to keepe them as much as in it lyes from putrifaction which may happen to them from pus or matter which is often cast forth of the simular parts into the empty spaces and distances of the Muscles Wherefore going about to separate the fat of the Epigastrium where thou must begin the dissection of mans body you must have a care that you hurt it not with your knife but that before you touch the Muscles see you artificially take it away that you may the more easily separate the Muscles lying under it distinguished by a manifest space at the white Line which is made by the meeting together of the proper coates of all those muscles CHAP. VIII What a Muscle is and how many differences there be thereof A Muscle is the instrument of voluntary motion and simple voluntary motion is performed six manner of wayes upwards downewards forwards backwards to the right hand and to the left but the compound one way which is circularly the which is performed by the continuall succession of the motion of the Muscles ingirting the part Such a Motion Falconers use when they stretch forth their hand and Lure their Hauke We have some parts which have motion without a Muscle but that motion is not voluntary such parts be the heart stomacke gutts both the bladders that is that of the Gall and that of the urine and diverse other which have the motions of attraction expulsion and retention by the meanes of the three sorts of fibers for they draw by the right expell by the transverse and retaine by the oblique The differences of Muscles which are many and diverse are taken from their substance originall insertion into the part which they move for me or figure holes or openings magnitude colour site kind of fibers their conjugation or connexion heads bellyes tendons opposition in action and office Some in substance are nervous venous arterious because they have manifest nerves veines and arteryes as the Midriffe the Intercostall and Epigastricke Muscles and many more and that for their difference from other Muscles into which neither nerve nor veine or Arteryes are manifestly inserted although secretly they admit them all for sense and motion life and nourishment such are the Muscles of the wrest the wormy muscles of the hands and feet for if there be any nerves observed in them they are very small Some had rather make the difference of Muscles thus that some of them are fleshy some nervous others membranous From their Originall some arise from the bones as these which move the hands armes and Leggs others from gristles as the Muscles of the throat others from membranes which invest the tendons as the wormy Muscles of the hands and feet others from ligaments as the Extenders of the fingers others from other muscles as the two lower Muscles of the yard which proceed from the Sphincter Muscle of the fundament Others have no originall as the membrane which we call the fleshy pannicle assumes flesh in certaine places and degenerates into a Muscle such are the Cremaster or hanging Muscles of the testicles the large Muscles of the face and if you please the Midriffe as that which is composed of two coates the one in compassing the ribbs and the Peritonaeum hath flesh in the midst betweene the two membranes And moreover some Muscles have their originall from one onely bone as these which bend and extend the Cubite others arise of many bones as the oblique descending the Dorsall and many Muscles of the necke with arise together from many spondyls and sides of spondyls There be others according to the opinion of some men both from the bones and gristles of the Pubis at the right or direct Muscles of the Epigastrium yet by their favour I thinke otherwise Because by the Anatomicall and received axiome A Muscle is there thought to take his beginnings from whence he receives a nerve but these Muscles take a nerve from the intercostall muscles wherefore their originall ought to be referred to the sides of the brest blades as shall be shewed in due place From their insertion arise these differences some are inserted into a bone as those which move the head Armes and Legs others into a gristle as those of the Throtle eyelids nose and the obliqueascendant muscles of the Epigastrium some into a bone and gristle both as the right muscles of the Epigastrium and the Midriffe some into the skin as the muscles of the lips others into the Coates as the muscles of the eyes others into Ligaments as the muscles of the yeard But these differences following may be drawne both from their insertion and originall For some muscles arising from many parts are inserted into some one part as divers of these which move the arme and the shoulder which arising from many spondiles are inserted into the bone of the shoulder and the shoulder blade Others arise from one part and insert themselves into more as those which arise from the bottome of the shoulder blades are extended and inserted into some eight or nine of the upper ribbs to helpe respiration and the benders and extenders of the fingers and toes Others arising from many bones are inserted into as many as some of those which serve for respiration to wit those which we call the hinder Saw-muscles and the Semispinatus which sends a tendon into all the ribbs Others have their originall from many bones and end in gristles of the seven ribbs as those two which lye under the Sternon Moreover also these differences of muscles may be drawne from the originall and insertion that some proceed from bones and are inserted into the next bone to helpe and strengthen the motion thereof as the three muscles of the Hip others arise from an upper bone are not inserted into the next but into some other as the long muscles Some are named from the part they move as the temporall muscles because they move the temples others from their office as
meate by concoction turned into bloud Sleepe fitly taken much helpes the digestion of the parts because in the time of rest the heat being the worker of all concoction is carryed backe to them together with the spirits Neither doth sleepe only give ease to the wearyed members but also lessens our cares and makes us to forget our labours The night is a fit time to sleepe and to take our rest in as inviting sleepe by its moisture silence and darknesse For the Heat and Spirits in the thick obscurity of night are driven in and retained in the center of the body as on the contrary by the daily and as it were friendly and familiar light of the Sun they are allured drawne forth into the superficies and outward part of the body from whence they leave sleeping and begin to wake Besides also which makes not a litle to that opportunity and benefit which wee looke for from sleepe the night season suffices for the worke of just and perfect concoction Which is one reason amongst many that sleep on the day time may be hurtfull For wee are wakened from our sleepe by the heat and spirits called forth to the skinne either by the light or noise on the day time before that the concoction which was begun be finished But that sleepe cannot but be light which comes without necessity of sleeping Wherefore the concoction being attempted but not perfected the stomacke is filled with crudities distended with acide or soure belchings and the braine troubled with grosse vapours and excremcâ—titious humidities From whence proceeds paine and heavines of the head and store of cold diseases But although sleepe on the night time be wholsome yet it is fit that it be restrained within the limits of an indifferent time For that which exceeds hinders the evacuation of excrements both upwards and downewards but in the meane time the heate which is neuer idle drawes from them some portion or vapour into the veines principall parts and habite of the body to become matter for some disease We must measure this time not by the space of houres but by the finishing the worke of concoction which is performed in some sooner than in other some Yet that which is longest is perfected and done in seaven or eight houres The ventricle subsiding and falling into its selfe and its proper coats and the urine tinctured yeallow gives perfect judgment thereof For on the contrary the extension of the stomacke acide belching paine of the head and heavines of the whole body shew that the concoction is unperfect In sleeping we must have speciall care of our lying downe for first we must lye on our right side that so the meat may fall into the bottome of our stomacke which being fleshy and lesse membranous is the hotter and more powerfull to assimulate Then a litle after we must turne upon our left side that so the Liver with its Lobes as with hands may on every side embrace the ventricle and as fire put vnder a Kettle hasten the concoction Lastly towards morning it will not be unprofitable to turne againe upon our right side that by this scituation the mouth of the stomacke being opened the vapoures which arise from the elixation of the Chylus may have freer passage Lying upon the backe is wholy to be avoided for from hence the Reines are inflamed the Stone is bred Palsies Convulsion and all diseases which have their originall from the defluxion into the spinall marrow and to the Nerves taking beginning from thence To lye upon the belly is not unprofitable for such as have used to lyeso if they be not troubled with defluxions into the eyes for so the humor will more easily flow into the part affected But thus the worke of concoction is not a litle furthered because by that forme of lying not onely the inward heate is contained and gathered together about the ventricle but the encompassing warmenesse of the soft feathers of the bed aides and assists it Neither are the Dreames which we have in our sleepe to be neglected for by the diligent consideration of these the affections and superfluous humors which have cheife power in the body are marvailously knowne For those who have raging Choler running up and downe their bodyes while they sleepe all things to them appeare bright shining fiery burning full of noyse and contention Those who abound with Phlegme dreame of floods snowes showers and inundations and falling from high places Those who are Melancholy dreame of gapings and gulfes in the earth thicke and obscure darknesse smokes caves and all blacke and dismall things But those whose bodyes abound in blood dreame of mariages dances embracings of women feasts jests laughter of orchards and gardens and to conclude of all things pleasant and splendent Also we must observe how the Patient doth after sleepe whether more lively and cheerefull or more heavy for by the opinion of Hippocrates Cum labor à sommo est laethalem collige morbum Sinprosit somnus nihil hinc laethale timendum est Paine sleepe ensuing an ill disease doth show But if sleepe profit bring no harme from thence will flow And as sleepe so watching if it exceede measure is hurtfull for it hurts the temperature of the braine weakens the senses wastes the spirits breeds crudities heavinesse of the head falling away of the flesh and leanenesse over all the body and to conclude it makes ulcers more dry and so consequently rebellious difficult to heale and maligne There are many other things may be spoken of sleepe and watching but these may suffice a Chirurgion CHAP. XVII Of Repletion and Inanition or Emptinesse THere are to bee short two sorts of Repletion or of all excesse one is of a simple qualitie without any defluxion or societie of any humor as appeares in distempers without matter the other is of quantitie and masse the body being distended with too much meate or too great quantitie of humors from whence proceed an infinite number of diseases They call the Repletion of meates satietie or fulnesse and it is of two kinds the one which is called Repletion or Fulnesse to the vessels the other Repletion to the strength Wee judge of satietie to the vessels by the distention and swelling of the veines and intrailes as the stomacke Wee call satietie to the strength when the body is loaded with more meates than it can well beare But also there is a double Repletion of humors For either it is of some one humor or of all the humors they call this by a peculiar name Plethora For Galen defines Plethora an equall excesse of all the humors For if at any time he define a Plethora to be an excesse of bloud onely then verily by the name of bloud he understands an equall comprehension of the foure humors as it is taught in Physicke schooles The Repletion which is caused by some one humor is termed by
and guts by its two orifices with the braine by its nerves with the liver and spleene by its veines with the heartâ—… its arteries and with all the naturall parts by its common membrane The temper of the ventricle in men of good habite is temperate because it is almost composed of the equall commixture of sanguine and spermaticke parts or according to Galens opinion it is cold of its selfe and by the parts composing it and hot by the vicinitie of the bowels But in some it is hotter in others colder according to the diverse temper and complexion of diverse bodies That stomacke is to bee thought well tempered that powerfully drawes downe the meate and drinke and embraces and retaines them so drawne untill by concoction and elixation they shall be turned into a juyce like creame which the Greekes call Chylos and lastly which doth strongly send from it and repell the excremâ—nts of this first concoction The stomacke is knowne to be hotter by this that it better concocts and digests course and hard meates as beefe hard egges and the like than soft â—… digestion which it corrupts and turnes into belchings For so a young 〈…〉 sooner burnt than well rosted at a great fire The stomacke which is colder 〈…〉 much meate but is slow in concocting them especially if they be cold and 〈◊〉 of digestion which for that cause quickly turne sowre The action of a well conditioned stomacke is twofold one common another proper The common is to attenuate mixe and digest the meates taken in at the mouth for the nutrition of it selfe and the whole body after the liver hath performed its dutie which before it be done the ventricle onely enjoyes the sweet pleasure of the Chylus and comforts its selfe against the heate and impuritie of the adjacent parts wherefore it is called the worke-house of concoction Its first action is to attract retaine and assimulate to it selfe that which is convenient but to expell whatsoever shall be contrary either in quantitie or qualitie or in the whole substance It hath two orifices one above which they commonly call the stomacke and heart the other lower which is called the Pylorus or lower mouth of the stomacke The upper bends to the left side neere the backe bone it is farre more large and capacious than the lower that so it may more commodiously receive meates halfe chewed hard and grosse which Gluttons cast downe with great greedinesse it hath an exquisite sense of feeling because it is the seate of the appetite by reason of the nerves incompassing this orifice with their mutuall embracings whereby it happens that the ventricle in that part is endued with a quicke sense that perceiving the want and emptinesse of meate it may stirre up the creature to seeke foode For albeit nature hath bestowed foure faculties on other parts yet they are not sensible of their wants but are onely nourished by the continuall sucking of the veines as plants by juice drawne from the earth This orifice is seated at the fifth Vertebra of the chest upon which they say it almost rests Yet I had rather say that it lies upon the twelfth Vertebra of the chest and the first of the loines for in this place the gullet perforates the midriffe and makes this upper orifice The lower orifice bends rather to the right side of the body under the cavitie of the liver It is farre straiter than the upper lest any thing should passe away before it bee well attenuated and concocted and it doth that by the helpe or assistance of as it were a certaine ring like to the sphincter muscle of the fundament which some have thought a glandule made by the transposition of the inner and fleshie membrane of the ventricle into that which is the outer of the guts I know Columbus laughes at this glandulous ring but any one that lookes more attentively shall perceive that the Pylorus is glandulous The stomacke in its lower and inner side hath many folds and wrinckles which serve to hold and containe the meates untill they be perfectly concocted In the ventricle wee observe parts gibbous and hollow the hollow is next to the liver and midriffe the gibbous is towards the guts Now we must note that the ventricle when it is much resolved or loosed may slide downe even to the navell neare the bladder the which wee have observed in some bodies dissected after their death The third and fourth Figure The first figure shewes the fore-side of the stomacke and gullet A. sheweth the orifice of the gullet cut froÌ„ the throate B. the straight and direct course of the gullet from A. to B. C. how the gullet above the first racke bone of the chest from B. to C. inclineth to the right hand D. his inclination to the left hand from C. to D. EE the two glandules called the Almonds set close to the gullet in the end of the throate called also Paristmia Antiades Tonsilla and Salviares glandulae FF Another glandulous body in the midst of the gullet about the fifth racke bone from which place the gullet gives place to the great arterie somewhat declining to the right side Vesalius Lib. 5 Cap. 3. and Columbus Cap. vlt. lib. 9. write that those Glandules are filled with a certaine moisture with which the gullet is moistened that the meates may slide downe more easily into the stomacke as through a slippery passage No otherwise than the Glandula prostata filled with a kind of grosse and oily moisture smooth the passage of the urine that so it may flow through it with a more free and lesse troubled course G. the connexion of the gullet with the stomack where the upper orifice of the stomack is fashioned H. the lower orifice of the stomacke called Pylorus I. K. the upper part of the stomacke at I. the lower at K. LL. the foreside of the stomacke P. the gut called Duodenum T. V. the right and left nerves of the sixth paire encompassing about the gullet and the uppermost left orifice of the stomacke The second Figure sheweth the backe parts of the Ventricle and Gullet A. EE FF G. H P. TV. shew the like parts as in the former From C. to D. the inclination of the stomacke to the left hand M. N. O. the backeside of the stomacke M. sheweth the prominence of the left side N. of the right O sheweth the docke or impression where it resteth upon the racke bones Q. R. the passage of the bladder of the gall into the Duodenum at R. S a glandulous body growing under the Duodenum bearing up the vessels X. Y. a nerve on the left side creeping up to the top of the stomacke and so running out to the liver CHAP. XV. Of the Guts THe Guts thc instruments of distribution and expulsion are of the same substance and composure with the stomacke but that the site of the coates of the stomacke is contrarie to those of
the guts For that which is the innermost coate of the stomacke is the outermost of the guts and so on the contrary The figure of the guts is round hollow and capacious some more some lesse according to the diverse bignesse But for the quantitie of the guts some are small some great more or lesse according to the varietie of bodies But they are sixe in number for there be three small the Duodenum the Iejunum or emptie gut and the Ilion Three great the Blind the Collicke and the Right gut All which have had their names for the following reasons the first because it is extended the length of twelve fingers like another stomacke without any turning or winding of which greatnesse it is found in great bodied men such as were more frequenly to be met withall in Galens time than in this time of ours in which this gut is found no longer than seven eight or nine fingers at the most The cause of this length is that there may be a free passage to the gate veine comming out of the liver as also to the artery and nerve which runne into it For seeing that this gut may sometimes rise to the top of the liver it would possesse the space under the bladder of the gall with which it is often tinctured if it had any revolutions that way which is the passage for such like vessels Others give another reason of this figure which is that there should bee nothing to hinder the easie and fit distribution of the perfectly concocted Chylus to the liver The second is called Iejunum or the empty gut not because it is absolutely so but because it containes little in comparison of the other There is a triple cause of this emptines the first the multitude of the meseraick veines and arteryes which are about it whereupon there is a greater and quicker distribution of the Chylus The second is the vicinity or neighbourhood of the liver strongly drawing the Chylus conteined in it the third is the flowing downe of the cholericke humor from the bladder of the Gall into it which ever and anon by its acrimony cleanses away the filth and by continuall flowing sollicites it to expulsion The third is called Ileon because it lyes betweene the Ilia or flankes it differs nothing from the rest in substance and magnitude but in this one thing that there is more matter contained in it than in the rest by reason of the paucity of the vessels terminated in it that it is no marvell that there can be no exact demonstration made of them The fourth is called Caecum or the Blind because it hath but one passage to send out and receive in the matter This gut hath a long and strait production which according to the opinion of some though altogether erroneous often falls downe into the Scrotum in the rupture or relaxation of the Rim of the Belly for that production in the lower belly strongly stickes to the Peritonaeum or Rim which hinders such falling downe But Galen seemes by such a blind gut to haue meant this long and narrow production and certainely so thinkes the common sort of Anatomists but here Vesalius justly reprehended Galen Wherefore Sylvius that he might free Galen of this fault would haue us by the blind gut to understand the beginning of the collicke gut The fift is called Colon or collicke gut because it is greater and more capacious than the rest The sixt and last the Right gut by reason of the rightnes or straightnes of the passage This in beasts especially hath a certaine fatnesse in it to make the passage slippery and lest the gut should be exulcerated in the passage by the sharpenesse of hard and acrid excrements The site of these guts in thus The Duodenum upon the backebone bends to the right hand the Ieiunum possesses a great part of the upper umbilicall region diffuses it selfe into both sides with windings like to these of the gut Ileum even to the flankes The gut Ileon is situate at the lower part of the umbilicall region going with many turnings and windings even to the hollownesses of the holy-bone above the bladder and side parts of the Hypogastrium which they call the flankes The Blind bends to the right hand a little below the kidney above the first and fourth Vertebra of the loines The Colon or Collicke gut is crooked and bent in the forme of a Scythian bow filling all the space from the blind gut below the right kidney even to the hollownes of the liver and then it goes by the gibbous part of the stomacke above the small guts even to the hollownesse of the spleene from whence sliding under the left kidney with some turnings it is terminated upon the Vertebra's of the loines By all which turnings and windings of the collicke gut it is easie to distinguish the paine of the stone of the kidneies which remaines fixt in one certaine place from the collicke wandring through these crooked passages we mentioned The right gut tends with an oblique site towards the left hand upon the holy bone even to the very fundament They have all one and a common connexion for they are all mutually joined together by their coats because there is but one way from the gullet even to the fundament but they are joyned to the principall parts by their nerves veines and arteries But a more proper connexion is that where the Duodenum on the upper part of it is joyned with the Pyloâ—us but on the lower part to the Ieiunum and the parts lying under it by the coate of the Peritonaeum The Ieiunum or emptie gut is ioyned to the Duodenum and Ileon The Ileum with the emprie and blind guts The blind with the Ileon and Colon and with the right side of the backebone where it is tied more straitly The Colon with the blind and right guts and in his middle part with the kidneies and the gibbous part of the stomacke whereby it comes to passe that being distended with wind in the collike it overturnes and presses the stomacke and so causes vomiting Lastly the right gut is annexed with the collicke gut and fundament At the end whereof there is a muscle fastened of figure round and circular called the Sphincter arising from the lower Vertebra's of the holy bone and rump by the benefit of which as of a dore or gate the excrements are restrained at our will lest man borne for all honest actions without all shame in every time and place should be forced every where to ease his belly For such as have lost the benefit of this muscle by the palsy have their excrements goe from them against their wills There is a body situate at the end of the right gut of a middle substance betweene the skinne and flesh as it were arising from the mixture of them both like the extremities of the lippes of the same use
gate veine plainely under its orifice descends to the fundament there to make the Haemorrhoidall veines CHAP. XXI Of the Vena Porta or Gate-veine and the distribution thereof THe gate-veine as also all the other veines is of a spermaticke substance of a manifest largenesse of a round and hollow figure like to a pipe or quill It is composed of its proper coate and one common from the peritâ—naeum It is onely one and that situate in the simous or hollow part of the lâ—ver from whence it breakes forth or rather out of the umbilicall veine into the midst of all the guts with which it hath connexion as also with the stomacke spleen sphincter of the fundament and Peritonaeum by the coat which it receives from thence It is of a cold and dry temper The Action of it is to sucke the Chylâ—â— out of the ventricle and guts and so to take and carry it to the Liver untill it may carry back the same turned into blood for the nutriment of the stomaeke spleen and guts This Gate veine comming out of the simous part of the liver is divided into sixe branches that is 4 simple and two compound againe divided into many other branches The first of the simple ascends from the fore part of the truncke to the bladder of the Gall by the passage of the Choller and are marked with g. g. with a like arterye for life and nourishment and this distribution is knowne by the name of the Cystica gamellae or Cysticke twins The second is called the Gastrica or stomack veine arising in like manner from the fore part of the truncke is carried to the Pylorus and the simous or backe part of the stomacke next to it The third is called Gastrepiplois the stomacke and kall veine which comming from the right side of the gate veine goes to the gibbous part of the stomacke next to the Pylorus and the right side of the kall The fourth going forth from behind and on the right hand of the gate veine ascends above the roote of the Meseraicke branch even to the beginning of the gut Ieiunum along the gut Duodenum from whence it is called Intestinalis or the gut-veine And these are the foure simple branches Now we will speake of the compound The first is the spleenicke which is divided after the following manner For in its first beginning and upper part it sends forth the Coronalis or crowne veine of the stomacke which by the backe part of the stomacke ascends into the upper and hollow part thereof to which place as soone as it arrives it is divided againe into two branches the one whereof climbs up even to its higher orifice the other descends downe to the lower sending forth by the way other branches to the fore and backe parts of the stomacke These engirt on every side incompasse the body of the ventricle for which cause they are named the crowne veines I have sometime observed this comming forth of the truncke a little above the orifice of the splenicke branch But this same splenicke branch on its lower part produces the branch of the Haemorroidall veines which descending to the fundament above the left side of the loines diffuses a good portion thereof into the least part of the collicke gut and the right gut at the end whereof it is often seene to be divided into five Haemorrhoidall veines sometimes more sometimes lesse Sylviâ—â— writes that the Haemorrhoidall branch descends from the mesentericke and truly we have sometimes observed it to have beene so Yet it is more sutable to reason that it should descend from the splenicke not onely for that we have seene with our eyes that it is so but also because it is appointed by nature for the evacuation of the excrementitious melancholike humor But this same splâ—â—ick branch out of the middle almost of its upper part produces the third branch going to the gibbous part of the stomacke and the kall they terme in the greater middle and left Gastrepiplois But on the lower part towards the spleene it produces the simple Epiplois or kall-veine which it diffuses through the left side of the kall Moreover from its upper part which touches the liver it sends forth a short branch called vas breve or venosum to the upper orifice of the ventricle for stirring up the appetite Wee have oftentimes and almost alwayes observed that this veinie vessell which Galen calls vas breve comes from the very body of the spleene and is terminated in the midst of the stomacke on the left side but never peirces both the coates thereof Wherefore it is somewhat difficult to find how the melancholy juyce can that way be powred or sent into the capacitie of the stomacke Now the splenicke branch when it hath produced out of it those five forementioned branches is wasted and dispersed into the substance and body of the spleene Then followes another compound branch of the vena porta called the mesentericke which is divided into three parts the first and least whereof goes to the blind gut and to the right and middle part of the collicke-gut divided into an infinite multitude of other branches The second and middle is wasted in the Ileon as the third and greater in the Ieiunum or empty gut It is called Mesentericke because it is diffused over all the Mesentery as the splenicke is in the spleen And thus much wee have to say of the division of the gate veine the which if at any time thou shalt find to be other-wise than I have set downe you must not wonder at it for you shall scarce â—inde it the same in two bodies by reason of the infinite varietie of particular bodies which as the Philosophers say have each their owne or peculiar gifts Our judgement is the same of other divisions of the vessels Yet wee have set downe that which wee have most frequently observed CHAP. XXII Of the originall of the Artery and the division of the branch descending to the naturall parts THose things being thus finished and considered the guts should be pulled aaway but seeing that if we should do so we should disturbe and loose the division of the artery descending to the naturall parts therefore I have thought it better to handle the division thereof before the guts be pluckt away Therefore we must suppose according to Galens opinion that as all the veines come from the liver so all arteries proceede from the heart This presently at the beginning is divided into two branches the greater whereof descends downewards to the naturall parts upon the spine of the backe taking its beginning at the fifth vertebra thereof from whence it goes into the following arteries The first called the intercostall runnes amongst the intercostall muscles and the distances of the ribs and spinall marrow through the perforations of the nerves on the right and left hand from
by the expulsive faculty they endeavoure to expell that which is troublesome and so free themselves of present and future dangers CHAP. XXIIII The manner of taking out the Guts WHen the Guts are to be taken out you must begin with the Right Gut And you must divide it being first straitly tyed in two different places at a just distance about foure fingâ—is from the end with 〈…〉 betweene the two ligatures Thâ—â— you must shâ—… proper coats and fibers and that common one which it hath from the Peritonaeum This being done you must in like manner binde the truncke of the gate veine as neere the originall as you can that so all his branches being in like manner tyed there may be no feare of effusion of blood you must doe the like with the Caeliacke Arterye at the left kidney and in the lower Mesentericke which descends to the Right gut with the Haemorrhoidall veines This being done pul away the guts even to the Duodenum which being in like manner tyed in two places which ought to be below the insertion of the Porus Cholagogus or passage of the Gall that you may shew the oblique insertion thereof into that gut for the obliquity of its insertion is worth observation as that which is the cause that the Gall cannot flow backe into its bladder by the compression of this Gut from below upwards Then all these windings of the Guts may be taken away from the body CHAP. XXV The Originall and distribution of the deseendent Hollow veine BEcause the rest of the naturall parts do almost all depend upon the descendent Hollow veine therefore before we goe any further we will shew its originall and distribution We said before that all veines proceeded from the Liver but yet in divers places For the gate veine goes out of the hollow part and the Hollow veine out of the Gibbous part of the liver which going forth like the body of a tree is divided into two great branches the lesser of which goes to the vitall and animall parts and the extremities of these parts as we shall shew in their place The greater descending from the backe part of the Liver above the Vertebra's of the loines to the parts beneath goes in the manner following The first division thereof is to the membranes of the reines which come from the Peritonaum Wherefore there it produces the Venaeadiposae or fatty veines so called because they bring forth a great quantity of fat in those places Of these fatty veynes there is a diverse originall for the right doth oftentimes arise from the right emulgent because it is higher but the lesse comes from the very truncke of the hollow veine because the emulgent on that side is lower and you shall scarse see it happen otherwise The second being the Kidney or Emulgent veines go to the Reines Which at their entrance or a little before is devided into two branches like as the Artery is the one higher the other lower and these againe into many other through the substance of the Kidneys as you may learne better by ocular inspection than by booke They are thick and broad that the serous humor may without impediment have freer passage Their originall is different for the right Emulgent often times comes forth of the Hollow veine somewhat higher than the left that seeing their office and duty is to purge the masse of blood from the chollericke and serous humor that if any part thereof slide by the one it may not so scape but fall as it were into the other Which certainly would not have happened if they had bin placed the one just opposit to the other For the Serous or wheyish humor would have stayed as equally ballanced or poised by reason of the contrariety of the action and traction or drawing therof But we must remember that in dissecting of bodies I have oft times found in such as have beene troubled with the stone seven Emulgent veines and so many arteries foure from the left side comming from diverse places of which the last came from the Iliacke three from the right hand likewise in diverse places The third division is called the spermaticke or seed veine it goes to the Testicles the originall thereof is thus that the right arises on the fore part of the trunck of the hollow veine but the left most commonly from the emulgent Besides you shall sometimes finde that these have companions with them to the right emulgent but to the left another from the hollow veine in some but on one side in others on both But also I have sometimes observed the left emulgent to proceed from the sperâ—… or seed veine The forth because it goes to the loynes is called Lumbaris which in his originall and insertion is wholy like the Artery of the loines But there are 4 Lambares or Loine veines on each side that is one in each of the 4 spaces of the 5 Vertebras of the loines The fift division makes the Iliacae until passing through the Peritonaeum they take the name of Crurall veines These are first divided into the Musculous so called because they goe to the oblique ascendent and transverse muscles and to the Peritonaeum Sometimes they have their originall from the end of the Trunck And then the same Iliacae are devided into the Sacrae or holy which goe to the spinall marrow of the Holy bone through those holes by which the nerves generated of this marrow have their passage Thirdly the Iliacae are divided into the Hypogastricae so called because they are distributed to all the parts of the Hypogastrium or lower part of the lower belly as to the right Gut the muscles therof the musculous skin in which place they often make the externall Haemorrhoidall ordained for the purging of such blood as offends in quantity as those other that is the inward Haemorrhoidall which descend to the right Gut from the Gate veine by the spleenicke branch serves for cleansing of that which offends in qualitie to the bladder and the necke thereof even to the end of the yard to the wombe and even to the necke of the wombe and utmust parts of the privities from whence it is likely the courses breake forth in weomen with child and virgins But this same veine also sends a portion of it without the Epigastrium by that perforation which is common to the share and haunch bones which strengthened by meeting of the other internall Crurall veine descends even to the Hamme but in the meane time by the way it is communicated to the muscles of the thigh called Obturatores and other parts within Fourthly the Iliaca produce the Epigastrica which on both sides from below ascend according to the length of the right muscles spreading also by the way some branches to the oblique and transverse muscles and also to the Peritonaum Fiftly these Iliacae produce the Pudendae or veines of the
the entrance of the hollow veine into the heart the lesse at the entrance of the veinous and of the great Artery with which parts they both have connexion We have formerly declared what use they have that is to break the violence of the matters and besides to bee stayes or props to the Arteria venosa and great Arterye which could not sustaine so rapid and violent a motion as that of the Heart by reason of their tendernesse of substance Of the ventricles of the Heart THe ventricles are in number two on each side one distinguished with a fleshy partition strong enough having many holes in the superficies yet no where pearcing through The right of these ventricles is the bigger and incompassed with the softer and rarer flesh the left is the lesser but is engirt with a threefold more dense and compact flesh for the right ventricle was made for a place to receive the blood brought by the hollow veine and for distributing of it partly by the vena arteriosa into the Lungs for their nourishment partly into the left ventricle by sweating through the wall or partition to yeild matter for the generation of the vitall spirits Therefore because it was needfull there should be so great a quantity of this blood it was likewise fit that there should be a place proportionable to receive that matter And because the blood which was to bee received in the right ventricle was more thicke it was not so needfull that the flesh to containe it should be so compact but on the contrary the arterious blood and vitall spirit have need of a more dense receptacle for feare of wasting and lest they should vanish into aire and also lesse roome that so the heat being united might become the stronger and more powerfully set upon the elaboration of the blood and spirits Therefore the right ventricle of the heart is made for the preparation of the blood appointed for the nourishment of the Lungs and the generation of the vitall spirits as the lungs are made for the mitification or quallifying of the Aire Which works were necessary if the Physicall Axiome bee true That like is nourished by like as the rare and spongious lungs with more subtle blood the substance of the heart grosse and dense with the veinous blood as it flowes from the Liver that is grosse And it hath its Cororall veines from the Hollow veine that it might thence drawe as much as should be sufficient But the left ventricle is for the perfecting of the vitall spirit and the preservation of the native heat Of the Orifices and Valves of the Heart THere be foure Orifices of the heart two in the right as many in the left ventricle the greater of the two former gives passage to the veine or the blood carried by the hollow veine to the heart the lesser opens a passage to the vena arteriosa or the cholerick blood carryed in it for the nourishment of the lungs The larger of the two other makes a way for the distribution of the Artery Aorta and the vitall spirit through all the body but the lesser gives egresse and regresse to the Arteria venosa or to the aire and fuliginous vapours And because it was convenient that the matters should bee admitted into their proper ventricles by these orifices by the Diastole to wit into the right ventricle by the greater orifice and into the left by the lesser and because on the contrary it was fit that the matters should be expelled by the systole from their ventricles by the fore-mentioned orifices Therefore nature to all these orifices hath put cleaven valves that is to say sixe in the right ventricle that there might bee three to each orifice five in the left that the greater orifice might have three and the lesser two for the reason we will presently give These valves differ many wayes first in action for some of them carry in matter to the heart others hinder that which is gone out that it come not back againe Secondly they differ in site for those which bring in have membranes without looking in those which carry out have them within looking out Thirdly in figures for those which carry in have a pyramidall figure but those which hinder the comming back againe are made in the shape of the Roman letter C. Fourthly in substance for the former for the most part are fleshy or woven with fleshy fibers into certaine fleshy knots ending towards the point of the heart The latter are wholy membranous Fiftly they differ in number for therebe only five which bring in three in the right ventricle at the greater orifice and two in the left at the lesser orifice those which prohibite the comming back are sixe in each ventricle three at each orifice Lastly they differ in motion for the fleshy ones are opened in the Diastole for the bringing in of blood and spirit and contrary wise are shut in the systole that they may containe all or the greater part of that they brought in The membranous on the contrary are opened in the systole to give passage forth to the blood and spirits over all the body but shut in the Diastole that that which is excluded might not flow backe into the Heart But you shall observe that nature hath placed onely two valves at the Orifice of the Arteria Venosa because it was needfull that this Orifice should bee alwayes open either wholy or certainely a third parte thereof that the Aire might continually be drawne into the heart by this orifice in inspiration and sent forth by exspiration in the contraction of the heart Whereby we may gather this that there is but one third part of that Aire we draw into the heart in breathing sent forth againe in the forme of vapour in exspiration because nature would have but one third part of the orifice to ly open for its passage out Therefore the exspiration or breathing out and the systole of the heart and arteryes is shorter than the inspiration so that we may truely say that the inspiration or drawing the breath in is equally so long as the exspiration is together with the rest which is in the middest between the two motions CHAP. XII Of the Distribution of the Vena arteriosa and the Arteria venosa HAving hitherto shewed the originall of each of the vessels of the Heart we must now speake of their distribution The Vena arteriosa or the arterious veine and the arteria venosa or the veinous arterie each proceeding out of his proper ventricle that is the right and left are divided into two large branches one of which goes to the right and the other to the left hand the one lying crosse wayes over the other the veine alwaies riding over the arterye as you may understand better by the sight of your eyes than by reading of bookes These branches at their
small branches into the spinall marrow through the holes by which the nerves passe and also into the membranes ligaments gristles bones and neighbouring muscles Eightly the Musculosa or musculous which also ariseing out of the Subclavis is devided into two other branches the one whereof goeth upon the brest to the paps nourishing the foremost muscles wherefore in a bastard pleurisie Cupping glasses may be fitly applied in this place The other branch descends to the upper muscles of the chest but specially to that which is called Latissimus The tenth is the Axillaris The eleventh the Humeralis of which wee will treat in their place The twelfth and last is the Iugularis properly so called which is twofold the internall and externall The internall being the lesser doth presently on both sides from this very beginning ascend by the sides of the Aspera Arteria or weazon even to the mouth and skull yeilding nourishment to the parts by which it passes as to the next membranes and nerves But when it comes to the basis of the Cranium it is divided into two branches the greater whereof going back along the basis of the Cranium to the hind part thereof sending abranch to the long muscle scituate upon the oesophagus it enters the Cranium with the small Carotides through the hole of the nerves of the sixth conjugation where they become one common vessell The lesser sending a slippe to the organe of hearing by the hole called Cacum or the blind also enters the Cranium and is spent in the thicker meninx nere to the hole of the third and fourth conjugation of nerves The externall Iugular veine being greater and fairer most commonly simple yet sometimes double either presently at his beginning or a little after ascends superficially on both sides of the neck between the broad muscle or fleshy pannicle being there easie to be discerned and other muscles scituate at the sides of the neck into which as also into the skin it sends certaine branches for nourishment The Figure of the hollow veine whole and freed from the rest of the body A The trunke of the hollow veine the lower AA At this place of the Liver is seated the left part of the veine and distributeth branches to the left side B Sheweth how the trunke of the hollow veine in the chest to give way to the heart is curved or bowed to the right hand Betwix A. and B. that part of the hollow veine which is betwixt the gibbous side of the Liver and the Midriffe C. the left midriffe veine called Phrenica sinistra from which surcles doe run in a man unto the pursse of the heart for the midriffe and it doe grow together D The orifice of the hollow veine which groweth unto the heart E the crown-veine called coronaria which like a crowne compasseth the basis of the heart and sprinkleth his surcles on the outside therof as far as to the cone or point F F The trunke of the veine Azygos or non parill descending along the right side of the racke-bones unto the loynes GG the lower intercostall veines to the branches of the veine Azygos which go unto the distances betwixt the ribs afford surcles unto the muscles which lye upon the ribs the racke-bones the membranes of the chest H the division of the hollow vein into two subclavian trunks neare the Iugulum under the brest-bone ll the subclavian branch tending on either side unto the arme called by some Axillaris K the upper intercostall veine which commonly sendeth three slips unto the distances of the upper ribs unto which the first intercostall veine sent no branches LL the descending mammary veine this descendeth under the brest-bone unto the right muscles of the Abdomen affoordeth surcles to the distances of the griftles of the true ribs to the Mediastinum the muscles that lye upon the breast and the skin of the Abdomen M the coniunction of the mammary with the Epigastricke vein ascending about the navill under the right muscles N the veine of the necke called Ceruicalis ascending toward the Scull which alloweth surcles to those muscles that lye upon the neck O the veine called Muscula which is propagated with many surcles into the muscles that occupy the lower parts of the necke and the upper parts of the chest P Thoraeica superior the upper chest veine which goeth to the muscles lying uppon the chest to the skinne of that place and to the dugges Q the double Scapularis distributed into the hollow part of the shoulderblade and the neighbour muscles so also betwixt P and R sometimes small veines doe reach unto the glandules that are in the arme-holes R Thoracica inferior running downward along the sides of the chest and especially distributed into the muscle of the arme called Latissimus S the inner Iugular veine which entreth into the Scull after it hath bestowed some surcles uppon the rough artery T the externall Iugular veine V. the division of this veine under the root of the eare X. a branch of the externall Iugular which goeth into the inside of the mouth and is diversly divided into the parts therein contained Y. the exterior branch distributed near the Fauces into the muscles of the chops and the whole skinne of the head Z. a portion of the branch y reaching unto the face a ae the veine of the fore-head a. a portion of it creeping through the temples ae * a propagation that goeth unto the skin of the Nowle or Occiput a a. the veine called Cephalica or the externall veine of the arme which others call Humeraria b. Muscula superior a propagation of the Cephalica veine which goeth unto the backward muscles of the necke Betwixt b. and d. on the backeside jssueth a branch from the Cephalica which passeth unto the outside of the blade and a portion thereof runneth betwixt the flesh and the skin d. d a veine from the Cephalica which attaineth unto the top of the shoulder and is consumed into the muscle that elevateth or lifteth up the arme and into his skin e e. a small veine from the Cephalica dispersed through the skin and the muscles of the arme f. the division of the Cephalica into three parts g. the first branch runneth deep unto the muscles which arise out of the externall Protuberation of the arme h. the second branch which goeth to make the median veine i. i. the third branch running obliquely above the wand and the outside of the arme k. from this branch certaine circles are divided into the skin the chiefe whereof is marked with k. l. the third branch at the wrist which is joyned at l with the branch of the Basilica marked with x. m. the Basilica which on the right hand is called Hepatica on the left hand Lienaris n. o. a branch of the Basilica going to the heads of the muscles of the cubit at n and to the muscles themselves at o. p a notable branch of the
called the median veine because it arises from two branches and is seated betweene them They usually open this median veine in the diseases of the head and liver which require Phlebotomy but if it shall not be sufficiently manifest when you judge it must be opened for a generall evacuation of the whole body you may cut one of these branches by whose concourse it is made which you shall think the fitter and because each branch drawes from the next parts according to the straightnesse of the fibers rather than from the opposite side if you would evacuate the head and liver equally by opening either of these branches it is convenient that opening that branch for example which comes from the Cephalicke you presently lay your thumbe upon it untill you suppose you have drawne a just quantity of bloud from the liver by the Basilica or liver veine which done you may take off your thumbe and suffer the bloud to follow freely by the open branch of the Cephalicke untill you have drawne as much bloud as you shall judge requisite otherwise you will draw it but from one part to wit the head So you shall evacuate it onely from the liver if you open the branch which comes from the Basilica and concurs to the generation of the median Moreover when there is neede to open the Basilica and it shall be no where conspicuous the Cephalicke or median being easie to be discerned at the same time you may in stead thereof open the median or if it be not to be found the Cephalicke pressing but the trunke thereof with your thumbe as we said before lest the head should be evacuated in stead of the liver You may doe the same in the Basilica if when there shall be necessitie to open the Cephalicke it shall not appeare Most of those which at this day open a veine in stead of the median open that branch of the Basilica which ascends together with the Cephalicke to make the median But you must understand that the median descends betweene the two bones of the cubit even to the end thereof and then devided into many branches it is at length spent on the backe of the hand behinde the thumbe the fore and middle fingers or the afterwrest Sometimes it runs backe into the following branch and then at the wrest it departs from it to be bestowed upon the forementioned parts The other branch of the Cephalicke which we may call the fore and outward Cephalicke descending directly downe to the midst of the wand thence wanders overthwart into the hinde part of the arme where encreased with a branch from the Basilica it is distributed over all the backe of the hand which with the median it nourishes But the branches of these veines doe so run through the forenamed parts that by the way they yeeld them necessary provision CHAP. XXII The Description of the Axillary veine THe Axillary arising at the insertion of the pectorall muscle or a little higher after it hath produced the two Thoracicae it is devided under the tendon of that muscle into two faire branches that is to say into the inner deepe Axillary and the skinne or outward axillary The deepe or inner having still for his companion in his descent the axillary artery and the nerves of the third conjugation after it hath produced the small externall musculous of the arme it goes into the bending of the elbow where running somewhat deepe with the artery and nerve into the muscles of the cubite it is devided into three other branches of which one descending with the wand slides under the ring into the inner side of the hand and hath bestowed two small branches on the thumbe two others on the fore and one upon the middle finger so that all of them ascend by the sides of these fingers the other descending with the artery as the former alongst the cubite sends branches to the rest of the fingers like as the former The third goes on the foreside betweene the two bones even to the wrest and the square muscle But you must note that the veines of which we now treate doe not onely make these devisions mentioned by us but infinite others besides as well in the parts which they goe to as also in the inner muscles of the hand which they nourish And thus much of the internall and deepe axillary veine For the externall or skin Axillary which first appeares under the skinne especially in leane bodies a little above the inward production of the arme it is devided in that place into two branches the one whereof descending to the bending of the arme meets and is united with the Cephalike branch sooner or later that so it may produce the median as we formerly mentioned The other branch having sent forth many shoots of a different length and thicknesse as well into the skinne as into the other neighbouring parts descending alongst the lower side of the bone of the cubite properly so called is at length spent upon the fore and outward Cephalicke branch which we said descended alongst the wand and thus united they runne over all the hand where in the right hand betweene the middle and fore finger they make the Salvatella but in the left in the same place they produce the Splenitica But alwayes remember if in dissection you finde any thing otherwise than wee have delivered it that the distribution of the vessels is so various especially in the hands that there can no certaine rule be delivered thereof CHAP. XXIII The Distribution of the Axillary Artery THe Axillary artery from the first originall which is presently after the two Thoracica descending betweene the muscle called Biceps or the two headed muscle and the Brachiaeus with the deepe axillary veine distributes a large branch amongst the outward muscles of the arme which extend the cubite and is spent in the externall muscles of the same which arise without from the productions of the arme And this is called the Ramus Musculus or Musculous branch as also the veine that accompanyes this Arterye Then this Arterye when it comes to the bending of the cubite thrusting it selfe into the muscles bending the fingers communicates certaine branches to the parts pertaining to the dearticulation of the cubit with the shoulder and other parts there situate as it did in the upper parts by which it descended hither Verily it may it may be a generall rule that every vessell sends or bestowes certaine portions thereof by the way to all the parts by which it passes But if you should aske why I have not prosecuted these productions I would answer I never intended to handle other than large and faire branches of vessels by rash incision of which there may happen danger of death or a disease For it would be both an infinit and needles busines to handle all the small divarications of the veines arteryes and nerves Therfore this Artery sunke into these muscles
rebellious and untractable as that which contemnes milde remedies and becomes more fierce by acride and strong the paine feaver and all the symptomes being encreased from whence the powers are dejected the wasting and consumption of the body followes and lastly death Yet if it be small and in a part which may suffer amputation the body being first purged and bloud drawne the strength of the Patient not disswading it will be convenient to use the hand and to take hold of and cut away whatsoever is corrupt even to the quicke that no feare of contagion may remaine or be left behind The amputation finished the bloud must not be preseÌ„tly stopped but permitted to flow out in some measure yea verily pressed forth all about it that so the veines swollne with blacke and melancholicke bloud may be disburdened When you have taken a sufficient quantity of bloud the place must be scared with an actuall cautery For that will strengthen the part affected draw forth the venenate quality and also stay the defluxion Then must you apply mitigaâ—… medicines procure the falling away of the Eschar To conclude that which remâ—… must be performed according to the cure of other ulcers Now we know and â—…stand that all the Cancer is cut away and all the malignity thereof extinct when â—…lcer casts forth laudable matter when that good flesh begins to growâ—… little â—…ittle like to the graines of a Pomeganate the pricking paine and â—…e symptomes being asswaged Yet the cure of an ulcerated Cancer which shall possesse the lips may be more happily and mildly performed no causticke medicine being applied after section so also that scarse any deformity will be left when it is cicatrized Which new and never formerly tried or written of way as farre as I know I found and performed in a man of fifty yeares old Doctor Iohn Altine a most learned Physition being called to Counsell Iames Guillemeaâ—… and Master Eustachius the Kings Chirurgions and Iohn Le Ieune the Duke of Guise his most worthy Chirurgion being present The way is this The Cancer must be thrust through the lips on both sides above and below with a needle and threed that so you may rule and governe the Cancer with your left hand by the benefit of the threed least any portion thereof should scape the instrument in cutting and then with your Sizers in the right hand you â—…ut it off all at once yet it must be so done that some substance of the inner â—…the lippe which is next to the teeth may remaine if so be that the Cancer be not growne quite through which may serve as it were for a foundation to generate flesh to fill up the hollownesse againe Then when it hath bled sufficiently the sides brinkes of the wound must be scarified on the right and lift sides within and without with somewhat a deepe scarification that so when we would draw together the sides and lips of the wound by that manner of stitching which is used in an hare-lippe we may have the flesh more pliant and tractable to the needle and threed The residue of the cure must be performed just after the same manner as we use in hare-lips of which we shall treate hereafter CHAP. XXX Of the Topicke medicines to be applied to an unlcerated and not ulcerated Cancer WE at the beginning use repercussive medicines such as are the juyces of Nightshade Plantaine Henbane Lettuce Sorrell Houseleeke Water Lentill or Duckes-meate Knotgrasse Pomegranates and the like Also Oleum rosarum omphacinum the powders of Sumach Berberies Litharge Ceruse Burnt-lead Tutia Quicksilver and the like Of which you may compose Fomentations Liniments Ointments Cataplasmes Emplaisters Emplastrum Diacalcitheos dissolved with juice of Nightshade and oile of Roses is very fit for not ulcerated Cancers Pompholix or Tutia washed in juice of Nightshade or Plantaine is very good for ulcerated Cancers Besides this following medicine is very coÌ„mendable â„ž Lytharg cerus an â„¥ j terantur in mortario plumb cum oleo rosar donec reducantured consistentiam linimenti vel unguenti and there may be use of a resolving and repercassive ointment as â„ž plumbi usti loti pomphol thuris an Ê’ijss absinth pontic â„¥ ss olei rosarum â„¥ iij ceraeÊ’vj succi solani quantum sufficit ad unguenti crassitudinem They very much commend Theodorickes Emplaister to asswage the paine of ulcerated Cancers â„ž Olei ros cerae alb an â„¥ ijss succigranat solani an â„¥ ij cerusae lotae â„¥ j plumbi usti loti tuthiae praepar an â„¥ ss thuris mastich an Ê’ij fiat empl molle This following ointment I have often used with good successe â„ž Therciac veter â„¥ j succi cancrorum â„¥ ss succi lactucae olei rosar an â„¥ iss vitel ovorum sub cinerib coct ij camphor Ê’ss pistentur omnia in mortario plumb fiat unguentunâ— â„ž spum argent axungiae porei recentis cerae alb an lib. ss olei boni â„¥ viij vitel ovorum assat iiij fiat unguent servetur usui And when you will vse it mixe it with a little ointment of Roses I have also mitigated great paine by applying Leaches to an unulcerated Cancer in that part where the torment was most vehement by disburdening the part of some portion of the maligne humor which same thing I have done by application of young Whelpâ—… or Kitlings or Pidgions or Chickins cut long wayes and presently applied to the ulcer and now and then changed as soone as their heat seemes dissolved and â—…hers applied for the naturall heat in an anodyne or mitigating medicine Iohn Baâ—…â—heodosius in his Epistles writes that a cataplasme of the herbe Erysimum or Câ—…cke being beaten is very good to be applied to a Cancer not ulcerated but if the Cancerâ—…cerated â—…cerated he boiles this same herbe in Hydromel and so by injections and lotions â—…ses the ulcer and mitigates the paine If the Cancer affect the wombe the patient feeles the pricking of the paine in the groines above the pecten and in the Kidneyes is often troubled with a difficulty of making water but when it is ulcerated it poures forth filth or matter exceeding stinking carion-like and that in great plenty the filthy vapour of which carryed up to the heart and braine causes often swounding Now to mitigate the paines of such like places the following medicines are of good use â„ž Mucag. semin lini foenugr extract in aqua rosar plantaginis quod satis est Of this being warme make a fomehtation â„ž Rad. Atheae lb ss coquatur in hydromelite pistetur traijciatur addendo olei rosar parum fiat Cataplasma Also you shall make divers pessaries according to the different kinds of paine also make injections of the juice of Plantaine Knotgrasse Lettuce Purslaine mixed together and agitated or laboured in a leaden mortar wiâ—… oyle of Roses for this kinde of medicine is commended by Galen in every kinde of
the blisters are raised they must be annointed againe that so the water may by little and little flow so long untill all the humor be exhausted and the patient restored to health Galen writes the Husbandmen in Asia when they carried wheat out of the country into the city in Carrs when they will steale away and not be taken hidde some stone juggs fild with water in the middest of the wheat for that will draw the moisture through the juggs into it selfe and increase both the quantitie and weight When certaine pragmaticall Physitions had read this they thought that wheat had force to draw out the water so that if any sicke of the Dropsie should be buried in a heape of wheat it would draw out all the water But if the Physition shall profit nothing by these meanes he must come to the exquisitely chiefe remedy that is to Paracentesis Of which because the opinions of the ancient Physitions have beene divers we will produce and explaine them Those therefore which disallow Paracentesis conclude it dangerous for three reasons The first is because by powring out the contained water together with it you dissipate and resolve the spirits and consequently the naturall vitall and animall faculties another opinion is because the Liver wanting the water by which formerly it was borne up thence forward hanging downe by its weight depresseth and draweth downewards the Midriffe and the whole Chest whence a drie cough and a difficulty of breathing proceede The third is because the substance of the Peritonaeum as that which is nervous cannot be pricked or cut without danger neither can that which is pricked or cut be easily agglutinated and united by reason of the spermatique and bloudlesse nature thereof Erasistratus moved by these reasons condemned Paracentesis as deadly also he perswaded that it was unprofitable for these following reasons viz. because the water powred forth doth not take away with it the cause of the Dropsie and the distemper and hardnesse of the Liver and of the other bowels whereby it comes to passe that by breeding new waters they may easily againe fall into the Dropsie And then the feaver thirst the hot and drie distemper of the bowels all which were mitigated by the touch of the included water are aggravated by the absence thereof being powred forth which thing seemeth to have moved Avicen and Gordonius that he said none the other said very few lived after the Paracentesis but the refutation of all such reasons is very easie For for the first Galen inferres that harmefull dissipation of spirits and resolving the faculties happens when the Paracentesis is not diligently and artificially performed As in which the water is presently powred forth truly if that reason have any validity Phlebotomy must seeme to be removed farre from the number of wholesome remedies as whereby the bloud is powred forth which hath farre more pure and subtile spirits than those which are said to be diffused and mixed with the Dropsie-waters But that danger which the second reason threatens shall easily be avoided the patient being desired to lie upon his backe in his bed for so the Liver will not hang downe But for the third reason the feare of pricking the Peritonaeum is childish for those evils which follow upon wounds of the nervous parts happen by reason of the exquisite sence of the part which in the Peritonaeum ill affected and altered by the contained water is either none or very small But reason and experience teach many nervous parts also the very membranes themselves being farre removed from a fleshie substance being wounded admit cure certainely much more the Peritonaeum as that which adheres so straitly to the muscles of the Abdomen that the dissector cannot separate it from the flesh but with much labour But the reason which seemes to argue the unprofitablenesse of the Paracentesis is refelled by the authority of Celsus I saith he am nor ignorant that Erasistratus did not like Paracentesis for he throught the Dropsie to be a disease of the Liver and so that it must be cured and that the water was in vaine let forth which the Liver being vitiated might grow againe But first this is not the fault of this bowell alone and then although the water had his originall from the Liver yet unlesse the water which staieth there contrary to nature being evacuated it hurteth both the Liver and the rest of the inner parts whilest it either encreaseth their hardnesse or at the least keepeth it hard and yet notwithstanding it is fit the body be cured And although the once letting forth of the humor profit nothing yet it make way for medicines which while it was there contained it hindered But this serous salt and corrupt humor is so farre from being able to mitigate a Feaver and thirst that on the contrary it encreaseth them And also it augmenteth the cold distemper whilest by its abundance it overwhelmes and extinguisheth the native heate But the authority of Caelius Aurelianus that most noble Phisition though a Methodicke may satisfie Avicen and Gordonius They saith he which dare avouch that all such as have the water let out by opening their belly have died doe lie for we have seene many recover by this kind of remedy but if any died it happened either by the default of the slow or negligent administration of the Paracentesis I will adde this one thing which may take away all error of controversies we unwisely doubt of the remedy when the patient is brought to that necessity that we can onely helpe him by that meanes Now must we shew how the belly ought to be opened If the Dropsie happen by fault of the Liver the section must be made on the left side but if of the Splene in the right for if the patient should lie upon the side which is opened the paine of the wound would continually trouble him and the water running into that part where the section is would continually droppe whence would follow a dissolution of the faculties The Section must be made three fingers bredth below the Navell to wit at the side of the right muscle but not upon that which they call the Linea Alba neither upon the nervous parts of the rest of the muscles of the Epigastrium that so we may prevent paine and difficulty of healing Therefore wee must have a care that the patient lie upon his right side if the incision be made in the left or on the left if on the right Then the Chirurgion both with his owne hand as also with the hand of his servant assisting him must take up the skinne of the belly with the fleshie pannicle lying under it and separate them from the rest then let him divide them so separated with a Section even to the flesh lying under them which being done let him force as much as hee can the devided skinne upwards towards the stomacke that when the wound which
is a further danger least the arme should totally loose its motion If the wound be upon the joynt of the elbow the arme shall be placed and swathed in a middle posture that is which neither too straitly bowes it nor holds it too stiffly out for otherwise when it is cicatrized there will be an impediment either in the contraction or extension When the wound is in the wrist or joynts of the fingers either externally or internally the hand must be kept halfe shut continually mooving a ball therein For if the fingers be held straight stretched forth after it is cicatrized they will be unapt to take up or hold any thing which is their proper faculty But if after it is healed it remaine halfe shut no great inconvenience will follow thereon for so hee may use his hand divers wayes to his sword pike bridle and in any thing else If the joynts of the Hip be wounded you must so place the patient that the thigh bone may be kept in the cavity of the hucklebone may not part a haires breadth therefrom which shal be done with linnen boulsters and ligatures applyed as is fitting and lying full upon his backe When the wound shal begin to cicatrize the patient shall use to moove his thigh every way least the head of the Thigh-bone sticke in the cavity of the huckle-bone without motion In a wound of the knee the legge must be placed straight out if the patient desire not to be lame When the joynts of the feete and toes are wounded these parts shall neither be bended in nor out for otherwise he will not be able to goe To conclude the site of the foote and legge is quite contrary to that of the arme and hand CHAP. XL. Of the wounds of the Ligaments THe wounds of the Ligaments besides the common manner of curing these of the Nerves have nothing peculiar but that they require more powerfull medicines for their agglutination desiccation and consolidating both because the Ligamentall parts are harder and dryer and also for that they are voyd of sence Therefore the foresaid cure of Nerves and joynts may be used for these wounds for the medicines in both are of the same kinde but here they ought to be stronger and more powerfully drying The Theorie and cure of all the symptomes which shall happen thereupon have beene expressed in the Chapter of curing the wounds of the nervous parts so that heere we shall neede to speake nothing of them for there you may finde as much as you will Wherefore here let us make an end of wounds and give thankes to God the author and giver of all good for the happy processe of our labours and let us pray that that which remaines may be brought to a happy end and secure for the health and safety of good people The end of the tenth Booke OF VVOUNDS MADE BY GVN SHOT OTHER FIERIE ENGEINES AND ALL SORTS OF VVEAPONS THE ELEVENTH BOOKE The Preface I Have thought good here to premise my opinion of the originall encrease and hurt of fiery Engines for that I hope it will be an ornament and grace to this my whole treatise as also to intice my Reader as it were with these junckets to our following Banquet so much savouring of Gunpouder For thus it shall bee knowne to all whence Guns had their originall and how many habits and shapes they have acquired from poore and obscure beginnings and lastly how hurtfull to mankind the use of them is Polydore Virgill writes that a Germane of obscure birth and condition was the inventor of this new engine which we terme a Gun being induced thereto by this occasion He kept in a mortar covered with a tyle or slate for some other certaine uses a pouder which since that time for its chiefe and new knowne faculty is named Gunpouder Now it chanced as hee strucke fire with a steele and flint a sparke thereof by accident fell into the mortar where upon the pouder suddainly catching fire casts the stone or tyle which covered the mortar up on high he stood amazed at the novelty and strange effect of the thing and withall observed the formerly unknowne faculty of the pouder so that he thought good to make experiment thereof in a small Iron trunke framed for that purpose according to the intention of his minde When all things were correspondent to his expectation he first shewed the use of his engine to the Venetians when they warred with the Genoveses about Fossa Clodia in the yeare of our Lord 1380. Yet in the opinion of Peter Messias their invention must have beene of greater antiquity for it is read in the Chronicles of Alphónsus the eleaventh King of Castile who subdued the Isles Argezires that when he beseiged the cheefe Towne in the yeare of our Lord 1343. the beseiged Moores shot as it were thunder against the assailants out of Iron mortars But we have read in the Chronicles written by Peter Bishop of Leons of that Alphonsus who conquered Toledo that in a certaine sea fight fought by the King of Tunis against the Moorish King of Sivill whose part King Alphonsus favoured the Tunetans cast lightning out of certaine hollow Engines or Trunkes with much noise Which could be no other than our Guns though not attained to that perfection of art and execution which they now have I thinke the deviser of this deadly Engine hath this for his recompence that his name should be hidden by the darkenesse of perpetuall ignorance as not meriting for this his most pernicious invention any mention from posterity Yet Andrew Thevet in his Cosmography published some few yeares agone when hee comes to treate of the Suevi the inhabitants of Germany brings upon the authority credite of a certaine old Manuscript that the Germane the inventer of this warlike Engine was by profession a monke and Philosopher or Alchymist borne at Friburge and named Constantine Anclzen Howsoever it was this kind of Engine was called Bombarda i a Gun from that noise it makes which the Greekes and Latines according to the sound call Bombus then in the following ages time art and mans maliciousnesse added much to this rude and unpolisht invention For first for the matter Brasse and Copper mettalls farre more tractable fusible and lesse subject to rust came as supplies to Iron Then for the forme that rude and undigested barrell or mortar-like masse hath undergone many formes and fashions even so farre as it is gotten upon wheeles that so it might run not onely from the higher ground but also with more rapide violence to the ruine of mankinde when as the first and rude mortars seemed not to bee so nimbly traversed nor sufficiently cruell for our destruction by the onely casting forth of Iron fire Hence sprung these horrible monsters of Canons double Canons Bastards Musquits feild peices hence these cruell and furious beasts Culverines Serpentines Basilisques Sackers Falcons Falconets and divers
for this indication let each one perswade himselfe thus much That the part must be bound up in that figure wherein wee would have it remaine Now for that indication which is drawne from the disease if there be a hollow ulcer sinuous and cuniculous casting forth great store of Sanies then must you begin the ligature and binding from the bottome of the sinus and end at the orifice of the ulcer and this precept must you alwayes observe whether the sinus be sealed in the top bottome middle or sides of the ulcer For thus the filth therein contained shall bee emptied and cast forth and the lippes of the ulcer too farre separated shall bee joyned together otherwise the contained filth will eate into all that lyes neare it increase the ulcer and make it uncurable by rotting the bones which lye under it with this acride sanies or filth But some Ligatures are remedies of themselves as those which performe their duties of themselves and whereto the cure is committed as are these which restore to their native unitie those parts which are dis-joyned others are not used for their owne sakes but only to serve to hold fast such medicines as have a curative facultie This kinde of Ligature is eyther yet a doing and is termed by Hippoc. Deligatio operans or else done and finished and is called Deligatio operata for the first that the Ligature may be well made it is fit that it be close rowled together and besides that the Surgeon hold it stiffe and strait in his hand and not carelesly for so he shall binde up the member the better Also he must in the binding observe that the ends of the Rowler and consequently their fastning may not fall to bee on the affected or grieved part for it is better that they come above or below or else on the side besides also he must have a speciall care that there be no knot tyed upon the same place or upon the region of the backe buttocks sides joynts or backe part of the head or to conclude in any other part upon which the Patient uses to leane rest or lye Also on that part where wee intend to sow or fasten the Rowlers you must double in their ends that so the fastning or suture may be the stronger otherwise how close soever they shall be wrapped or rowled about the member yet will they not remaine firme especially if they be of a great breadth For the second kinde of Ligature to wit that which is already done and finished the Surgeon the performer thereof must consider to what end it was done and whether he hath performed it well and fitly as also neatly and elegantly to the satisfaction both of himselfe and the beholders For it is the part of a skilfull Workeman everie where handsomely and rightly to performe that which may so be done In fractures and luxations all dislocations of bones as also in wounds and contusions you must beginne your bandage with two or three windings or wraps about upon the place and that if you can more straitly than in other places that so the set bones may be the better kept in their places and that the humors if anie be alreadie fallen thither may by this strait compression be pressed forth as also to hinder and prevent the entrance in of any other which may bee readie to fall down But in fractures as those which never happen without contusion the blood flowes and is pressed forth of its proper vessels as those which are violently battered and torne which causes sugillation in the neighbouring flesh which first lookes red but afterwards black and blue by reason of the corruption of the blood poured forth under the skinne Wherefore after these first windings which I formerly mentioned you must continue your rowling a great way from the broken or luxated part he which does otherwise will more and more draw the blood and humors into the affected part and cause Impostumes and other maligne accidents Now the blood which flowes goes but one way downwards but that which is pressed is carried as it were in two pathes to wit from above downwards and from belowe upwards Yet you must have a care that you rather drive it backe into the body and bowels than towards the extremities thereof as being parts which are uncapable of so much matter and not furnished with sufficient strength to suffer that burden which threatens to fall upon it without danger and the increase of prenaturall accidents But when this masse and burden of humors is thrust backe into the bodie it is then ruled and kept from doing harme by the strength and benefit of the faculties remaining in the bowels and the native heat CHAP. III. Of the three kindes of Bandages necessarie in fractures TWo sorts of Ligatures are principally necessarie for the Surgeon according to Hippocrates by which the bones aswell broken as dislocated may be held firme when they are restored to their naturall place Of these some are called Hypodesmides that is Under-binders others Epidesmi that is Over-binders There are sometimes but two under-binders used but more commonly three The first must first of all bee cast over the fracture and wrapped there some three or foure times about then the Surgeon must marke and observe the figure of the fracture for as that shall be so must he vary the manner of his binding For the ligature must be drawne strait upon the side opposite to that whereto the luxation or fracture most inclines that so the bone which stands forth may be forced into its seat and so forced may be the more firmely there contained Therefore if the right side be the more prominent or standing forth thence must you beginne your ligation and so draw your ligature to the left side On the contrarie if the left side be more prominent beginning there you shall goe towards the opposite side in binding and rowling it Here therefore would I require a Surgeon to be Ambidexter .i. having both his hands at command that so he may the more exquisitly performe such variety of ligations But let him in rowling bend or move this first ligature upwards that is towards the bodie for the former reasons But neyther is this manner of ligation peculiar to fractures but common to them with luxations for into what part soever the luxated bone flew then when it is restored that side must be bound the more loosely and gently whence it departed and that on the contrary more hard unto which it went Therefore the ligature must be drawne from the side whereunto the bone went so that on this side it bee more loose and soft and not straitly pressed with boulsters or rowlers that so it may be more inclined to the side opposite to the luxation If the ligation be other-wise performed it succeeds not well for the part is relaxed and moved out of its naturall seat wherefore there will be no small
or mortification but too loose is unprofitable for that it doth not contain the parts in that state we desire It is a signe of a just ligation that is neyther too strait nor too loose if the ensuing day the part be swolne with an oedematous tumor caused by the blood pressed forth of the broken place but of too strait ligation if the part be hard swolne and of too loose if it bee no whit swolne as that which hath pressed no blood out of the affected part Now if a hard tumor caused by too strait binding trouble the patient it must presently bee loosed for feare of more grievous symptomes and the part must be fomented with warme Hydraeleum and another indifferent yea verily more loose ligature must be made in stead thereof as long as the paine and inflammation shall continue in which time and for which cause you shall lay nothing upon the part which is any thing burdensome When the patient beginnes to recover for three or foure dayes space especially if you find him of a more compact habit and a strong man the ligature must be kept firme and not loosed If on the third day and so untill the seventh the spires or windings be found more loose and the part affected more slender then wee must judge it to be for the better For hence you may gather that there is an expression and digestion of the humors causing the tumor made by force of the ligation Verily broken bones fitly bound up are better set and more firmely agglutinated which is the cause why in the place of the fracture the ligation must bee made the straiter in other places more loosely If the fractured bone stand forth in any part it must there be more straitly pressed with boulsters and splints To conclude the seventh day being past we must binde the part more straitly than before for that then inflammation paine and the like accidents are not to bee feared But these things which we have hitherto spoken of the three kindes of Ligatures cannot take place in each fractured part of the body as in the chaps collar-bones head nose ribs For seeing such parts are not round and long a Ligature cannot be wrapped about them as it may on the armes thighes and legges but only bee put on their outsides CHAP. VI. The uses for which Ligatures serve BY that which wee have formerly delivered you may understand that Ligatures are of use to restore those things which are separated and moved forth of their places and joyne together those which gape as in fractures wounds contusions sinewous ulcers and other like affects against nature in which the solution of continuitie stands in neede of the helpe of Bandages for the reparation thereof Besides also by the helpe of Bandages these things are kept asunder or separated which otherwise would grow together against nature as in Burns wherein the fingers and the hams would mutually grow together as also the arme-pits to the chests the chin to the breast unlesse they be hindered by due Ligation Bandages doe also conduce to refresh emaciated parts wherefore if the right legge waste for want of nourishment the left legge beginning at the foote may bee conveniently rowled up even to the groine If the right arme consume binde the left with a strait Ligature beginning at the hand and ending at the arme-pit For thus a great portion of blood from the bound-up part is sent back into the vena cava from whence it regurgitates into the almost emptie vessels of the emaciated part But I would have the sound part to bee so bound that thereby it become not painefull for a dolorifick ligation causes a greater attractation of blood and spirits as also exercise wherefore I would have it during that time to bee at rest and keep holy-day Ligatures also conduce to the stopping of bleedings which you may perceive by this that when you open a veine with your launcet the blood is presently stayed laying on a boulster and making a ligature Also Ligatures are usefull for women presently after their delivery for their womb being bound about with Ligatures the blood wherewith their womb was too much moistened is expelled the strength of the expulsive facultie being by this means stirred up to the expulsion thereof and it also hinders the empty wombe from being swolne up with winde which otherwise would presently enter thereinto This same Ligature is a helpe to such as are with childe for the more easie carrying of their burden especially those whose Childe lyes so farre down-wards that lying as it were in the den of the hippes it hangs betweene the thighes and so hinders the free going of the mother Therefore the woman with childe is not only eased by this binding of her wombe with this Ligature which is commonly termed the navill Ligature but also her childe being held up higher in her wombe she hath frâ—eâ—r and more liberty to walke Ligatures are in like sort good for revulsion and derivation as also for holding of medicines which are layd to a part as the necke breast or belly Lastly there is a triple use of Ligatures in amputation of members as armes and legges The first to draw and hold upwards the skinne and muscles lying under it that the operation being performed they may by their falling downe againe cover the ends of the cut-off bones and so by that meanes helpe forwards the agglutination and cicatrization and when it is healed up cause the lame member to move more freely and with lesse paine and also to performe the former actions this as it were cushion or boulster of musculous flesh lying thereunder The second is they hinder the bleeding by pressing together the veines and arteries The third is they by strait binding intercept the free passage of the animall spirits and so deprive the part which lyes thereunder of the sense of feeling by making it as it were stupid or num CHAP. VII Of Boulsters or Compresses BOulsters have a double use the first is to fill up the cavities and those parts which are not of an equall thicknesse to their ends Wee have examples of cavities in the Arme-pits Clavicles Hams Groines and of parts which grow small towards their ends in the armes towards the wrests in the legges towards the feet in the thighes towards the knees Therefore you must fill these parts with boulsters and linnen cloathes that so they may be all of one bignesse to their ends The second use of boulsters is to defend and preserve the first two or three Rowlers or Under-binders the which we sayd before must be applyed immediately to the fractured part Boulsters according to this two fold use differ amongst themselves for that when they are used in the first mentioned kind they must be applied athwart but when in the latter long-wayes or down-right You may also use Boulsters lest the too strait binding of the Ligatures
mens shoulders or two standing posts The fifth with a Ladder The sixth with an Instrument called an Ambi. Wee will describe these sixe waies and present them to your view CHAP. XXII Of the first manner of setting a Shoulder which is with ones fist FIrst let one of sufficient strength placed on the opposite side firmly hold the Patient upon the joynt of the Shoulder lest he move up and downe with his whole bodie at the necessarie extension working and putting it in then let another taking hold of his arme above the elbow so draw and extend it downe-wards that the head thereof may be set just against its cavitie hollowed in the blade-bone Then at last let the Surgeon lift and force up with his fist the head of the bone into its cavitie Here this is chiefly to be observed that in fresh luxations especially in a bodie soft effeminate moist and not over corpulent that it sometimes comes to passe that by the only meanes of just extension the head of the bone freed from the muscles and other particles wherewith it was as it were intangled will betake it selfe into its proper cavitie the muscles being by this meanes restored to their place and figure and drawing the bone with them as they draw themselves towards their heads as it were with a sudden gird or twitch wherefore in many whilest we thought no such thing it sufficed for restitution only to have extended the arme But if the Luxation bee inveterate and the hand cannot serve then must the Patients shoulder be fastned to a Poste with the forementioned Ligature or else committed to ones charge who may stand at his backe and hold him fast Then the arme shall presently be tyed about a little above the elbow with a fillet whereto a cord shall be fastened which being put or fastened to the Pulley shall be drawne or stretched forth as much as need shall require Lastly the Surgeon with a towell or such like Ligature fastened about his necke and hanging down and so put under the Patients arme-pit neare to the Luxation shall raising himselfe upon his feete with the whole strength of his necke lift up the shoulder and also at the same time bringing his arme to the Patients breast shall set the head of the shoulder-bone forced with both his hands into its cavitie as you may see by this ensuing figure An expression of the first manner of putting a Shoulder into Joynt Then must you cover all the adjacent parts with a medicine made ex farina volatili bolo armenio myrtillis pice resina alumine beaten into powder and mixed with the white of an egge Then must the hollownesse under the arm be filled with a clew of Woollen or Cotton yarne or a linnen cloth spred over with a little oyle of Roses or Myrtles a little vinegar and unguentum rosatum or infrigidans Galeni lest it sticke to the haires if there be any there The part must afterwards be bound up with a ligature consisting of two heads of some five fingers breadth and two ells long more or lesse according as the bodie shall require The midst thereof shall be put immediately under the arme-pit and then crossed over the lame shoulder and so crossing it as much as shal be fit it shall be wrapped under the opposite arme And lastly the arme shall be layd upon the breast and put in a scarfe in a middle figure almost to right angles so that by lifting up the hand hee may almost touch his sound shoulder lest the bone newly set may fall out againe neyther shall the first dressing be stirred untill foure or five daies be past unlesse the greatnesse of some happening symptome divert us from this our purpose CHAP. XXIII Of the second manner of restoring a Shoulder that is with the heele when as the Patient by reason of paine can neither sit nor stand THe Patient must be layd with his backe on the ground upon a Cover-lid or Mat and a clew of yarne or leathern-ball stuffed with tow or cotton of such bignesse as may serve to fill up the cavitie must be put under his arm-pit that so the bone may straight-wayes the more easily be forced by the heele into its cavitie Then let the Surgeon sit beside him even over against the luxated shoulder and if his right shoulder be luxated he shall put his right heele to the ball which filled up the arme-pit but if the left then the left heele then let him forthwith draw towards him the Patients arme taking hold thereof with both his hands and at the same instant of time strongly presse the arme-pit with his heele Whilst this is in doing one shall stand at the Patients backe who shall lift up his shoulder with a towell or some such thing fitted for that purpose and also with his heele presse downe the top of the shoulder-blade another also shall sit on the other side of the Patient who holding him shall hinder him from stirring this way or that way at the necessary extension in setting it as you may see it exprest by the following figure The expression of the second manner of restoring a Shoulder CHAP. XXIV Of the third manner of restoring a Shoulder SOme one who is of a competent height and strength shall put the sharpe part of the toppe of his shoulder under the Patients arme-pit and also at the same time shall somewhat violently draw his arme towards his owne breast so that the Patients whole bodie may as it were hang thereby In the meane time another for the greater impression shall lay his weight on the luxated shoulder shaking it with his whole bodie Thus the shoulder drawne downe-wards by the one which stands under the arme-hole and moved and shaken by the other who hangs upon it may bee restored into its seat by the helpe of the Surgeon concurring therewith and with his hand governing these violent motions as the following figure shews The figure of the third manner of putting a Shoulder into Joynt CHAP. XXV Of the fourth manner of restoring a dislocated Shoulder YOu must take a perch or piece of Wood somewhat resembling that which the Water-bearers of Paris use to put on their shoulders some two inches broad and some sixe foote long in the midst hereof let there bee fastened a clew of yarne or ball of sufficient bignesse to fill up the cavitie of the arme-hole Let there be two pins put in one on each side of the ball each alike distant there-from with which as with stayes the shoulder may be kept in and upon the ball that it slip not away from it Let two strong men taller than the Patient eyther by nature or art put this perch upon their shoulders then let the Patient put his arme-pit upon that place where the ball stands up the Surgeon must be ready to pull his hanging arme downe-wards Thus the Patient shall as it were hang on the perch with his shoulder and so
the warmness of the water and in the time of fomenting For too long fomenting resolves the blood that is drawne But that which is too little or short a space drawes little or nothing at all after the fomentation hot and emplastick medicines made of pitch turpentine euphorbium pellitory of Spaine sulphur and the like shall bee applyed They shall bee renued every day more often or seldome as the thing it selfe shall seeme to require These medicines are termed Dropaces whose forme is thus â„ž picis nigrae ammoniaci bdelii gummi elemi in aqua vitae dissolutorum an â„¥ ii olei laurini â„¥ i. pulveris piperis zinziberis granorum paradisi baccarum lauri et juniperi an â„¥ ii fiat emplastrum secundum artem extendatur super alutam It is also good to binde about the opposite sound part with a ligature yet without pain as if the right arme shall decay for want of nourishment the left shall bee bound beginning your ligation at the hand and continuing it to the Arme-pit If this mischance shall seaze upon the right leg then the left shall be swathed up from the sole of the foote to the groine For thus a great portion of the bloud is forced back into the vena cava or hollow veine and from this being distended and over full into the part affected and gaping with the vessels almost empty besides also it is convenient to keepe the sound part in rest that so it may draw the lesse nourishment and by that meanes there will bee more store to refresh the weake part Some wish also to bind up the decaying member with moderate ligation for thus say they the bloud is drawne thither for when as wee intend to let blood by opening a veine with a lancet we bind the arme Also it is good to dip it into water somewhat more than warme and hold it there untill it grow red and swell for thus bloud is drawne into the veines as they find which use to draw blood of the saphena and salvatella Now if when as these things and the like bee done the lame part grow hot red and swollen then know that health is to be hoped for but if the contrary happen the case is desperate wherefore you need attempt nothing further Furthermore there is sometimes hardnesse left in the joints after fractures and dislocations are restored It is fit to soften this by resolving the conteined humor by fomentations liniments cataplasmes emplasters made of the roots of Marsh-mallowes briony lillies line seed fenugreek seed and the like and also of gums dissolved in strong vineger as Ammoniacum bdelium opopanax labdanum sagapenum styrax liquida and Adeps anserinus gallinaceus humanus oleum liliorum and the like Also you must wish the patient to move the part ever now and then every day yet so that it be not painefull to him that so the pent up humour may grow hot bee attenuated and at length discussed and lastly the part it selfe restored as farre as art can perform it for oft times it cannot be helped any thing at all For if the member be weake and lame by reason that the fracture happened neere the joint for the residue of his life the motion thereof useth to bee painefull and difficult and oft times none at all especially if the Callus which grows there be somewhat thick and great and lastly if the joint it selfe shall bee contused and broken by the stroake as it oft-times happens in wounds made by Gun-shot The End of the sixteenth Booke OF DIVERS OTHER PRETER NATURALL AFFECTS WHOSE CURE IS COMMONLY PERFORMED BY SURGERY THE SEVENTEENTH BOOKE CHAP. I. Of an Alopecia or the falling away of the haires of the head AN Alopecia is the falling away of the haire of the head and sometimes also of the eye-browes chin and other parts the French commonly call it the Pelade Phisicians terme it the Alopecia for that old Foxes subject by reason of their age to have the scab are troubled oft times with this disease This affect is caused either through defect of nourishment fit to nourish the haires as in old age through want of the radicall humidity or by the corruption of the alimentary matter of the same as after long fevers in the Lues venerea leprosie the corruption of the whole hody and all the humours whence followeth a corruption of the vapours and fuliginous excrements or else by the vitious constitution of the pores in the skin in rarity and constriction or density as by the too much use of hot oyntments made for colouring the hair or such as are used to take off haire therefore called Depilatoria or by the burning of the skin or losse thereof having a scarre in stead thereof by reason of whose density the haire cannot spring out as by too much laxity the fuliginous matter of the haire stayes not but presenly vanisheth away The Alopecia which comes by old age a consumption burne baldnesse leprosie and a scald head is uncurable that which admits of cure the cause being taken away is helped Wherefore if it proceed from the corruption of humours let a Phisician bee called who as hee shall thinke it fit shall appoint diet purging and phlebotomie Then the Surgeon shall shave off that haire which is remaining and shall first use resolving fomentations apply Leaches and Horns to digest the vicious humour which is under the skin then shall he wash the head to take away the filth with a lye wherein the roots of Orris and Aloes have been boyled Lastly hee shall use both attractive fomentations and medicines for to draw forth the humour which is become laudable in the whole body by the benefit of diet fitly appointed But if the Alopecia shall happen through defect of nourishment the part shall bee rubbed so long with a course linnen cloth or a figge leafe or onions untill it waxe red besides also the skin shall bee pricked in many places with a needle and then ointments applied made of Labdanum pigeons dung stavisager oile of bayes turpentine and waxe to draw the bloud and matter of the haires If the haire be lost by the Lues venerea the patient shall be annointed with quicksilver to sufficient salivation To conclude as the causes of this disease shall be so must the remdies be fitted which are used CHAP. II. Of the Tinea or scalde Head THE Tinea let me soterme it in Latine whilst a fitter word may be found or a scald head is a disease possessing the musculous skin of the head or the hairy scalpe and eating thereinto like a moth There are three differences thereof the first is called by Galen scaly or branlike for that whilst it is scratched it casts many branlike scales some Practitioners terme it a dry scall because of the great adustion of the humour causing it Another is called ficosa a fig-like scall because when it is dispoyled of the crust or
of paine we must not presently run to Tooth-drawers or cause them presently to goe in hand to plucke them out First consult a Physician who may prescribe remedies according to the variety of the causes Now here are three intensions of cureing The first is concerning diet the other for the evacuation of the defluxion or antecedent cause the third for the application of proper remedies for the asswaging of paine The two former scopes to wit of diet and diverting the defluxion by purging phlebotomie application of cupping glasses to the necke and shoulders and fcarification doe absolutely belong to the Phisitian Now for proper and to picke medicines they shall be chosen contrary to the cause Wherefore in a hot cause it is good washing the mouth with the juice of Pomgranats plantaine water a little vineger wherein roses balaustiae and sumach have beene boyled But such things as shall be applyed for the mitigating of the paine of the teeth ought to bee things of very subtle parts for that the teeth are parts of dense consistence Therefore the ancients have alwaies mixed vineger in such kind of remedies ℞ rosar rub sumach hordei an m. ss conquassatiʒii santalorum an ʒi lactucae summitatum rubi solani plantaginis an m. ss bulliant omnia in aquae lib. iiii pauco aceto ad hordei crepaturam Wash the mouth with such a decoction being warme You may also make Trochisces for the same purpose after this manner ℞ sem hyoscyami sandarachae coriandri opii an ʒss terantur cum aceto incorporentur formentur que trochisci apponendi dentibus dolentibus Or else ℞ seminis portulacae hyoscyami coriandri lentium corticis santali citrini rosar rub pyrethri camphorae an ʒss Let them all bee beaten together with strong vineger and made into trochisces with which being dissolved in rose water let the gums and whole mouth bee washed when need requireth But if the paine bee not asswaged with these you shall come to narcoticks which may stupefie the nerve as ℞ seminis hyoscyami albi opii camphorae papaveris albi an quantum sufficit coquantur cum sapa et denti applicentur Besides you must also put this following medicine into the eare of the pained side ℞ opii castorei an ℈ i. misceantur cum oleo rosato It hath sometimes availed in swolne and distended gums being first lightly scarified to have applied leaches for the evacuation of the conjunct matter as also to have opened the veines under the tongue or these which are behind the eares For I remember that I by these three kindes of remedies asswaged great paines of the teeth Yet there bee some who in this affect open not these veines which are behind the eares but those which are conspicuous in the hole of the eare in the upper part thereof Paine of the teeth arising from a cold cause and defluxion may be helped by these remedies boyle rosemary sage and pellitory of Spaine in wine and vinegar and adde therto a little aqua vitae in this liquor dissolve a little treacle and wash your teeth therewith Others mingle Gum ammoniacum dissolved in aqua vitae with a little sandar acha and myrrhe and lay it to the pained tooth after Vigoes counsaile Mesue thinkes that beaten garlicke carryed in the right or left hand asswages the paine as the teeth ake upon the right or left side But I being once troubled with grievous paine in this kinde followed the counsaile of a certaine old woman and laid garlicke rosted under the embers to my pained tooth and the paine forthwith ceased The same remedy used to others troubled with the like affect had like successe Moreover some thinke it availeable if it bee put into the auditory passage Others drop into the eares oile of castoreum or of cloves or some such other chemicall oile It is good also to wash the teeth with the following decoction ℞ pyrethriʒss menthe et rutae an p. i. bulliant in aceto and with this decoction being warme wash the teeth Some like fumes better they make them of the seeds of Coloquintida and mustard and other like they take the smoake by holding their mouths over a funnell Other some boile pellitory of Spaine ginger cinamon alume common salt nut megs cipresse nuts anise and mustard seeds and euphorbium in oxycrate and in the end of the decoction adde a little aqua vitae and receive the vapour thereof through a funnell as also they wash their teeth with the decoction and put cotton dipped therein into the eare first dropping in a little thereof Some there are which affirm that to wash the teeth with a decoction of Spurge is a very good and anodyne medicine in the tooth-ach I have oft times asswaged intolerable paines of the teeth by applying vesicatories under the eare to wit in that cavity whereas the lower jaw is articulated with the upper for the veine artery and sinew which are distributed to the roots of the teeth lye thereunder Wherfore the blisters being opened a thinne liquor runnes out which doth not onely cause but also nourish or feed the disease But if the tooth be hollowed and that the patient will not have it puld out there is no speedier remedy than to put in caustick medicines as oile of vitrioll aqua fortis and also a hot iron for thus the nerve is burnt insunder and loseth its sense Yet some affirm that the milky juice that flowes from Spurge made into a paste with Olibanum and amylum and put into the hollowed tooth will make it presently to fall away in peeces When the Gums and Cheekes are swollen with a manifest tumour then the patient begins to be somewhat better and more at ease For so by the strength of nature the tumor causing the paine is carryed from within outwards But of what nature soever the matter which causeth the paine be it is convenient to intercept the course thereof with Empl. contra rupturam made with pitch and mastick and applyed to the temple on that side where the tooth aketh CHAP. XXVI Of other affects of the teeth THe teeth are also troubled with other preternaturall affects For sometimes they shake by relaxation of the gums or else become corrupt and rotten or have wormes in them or else are set on edge For the first the gummes are relaxed either by an externall or primitive cause as a fall or blow or else by an internall or antecedent as by the defluxion of acrid or waterish humours from the braine or through want of nourishment in old bodies If the teeth grow loose by the meanes of the decaying gums the disease is then incurable but you may withstand the other causes by the use of such things as fasten the teeth shunning on the contrary such as may loosen them Therefore the patient must not speake too earnestly neither chaw hard things If they become loose by a fall or
too short it cannot cover the glans This happens either by nature to wit by the first conformation or afterwards by some accident as to those whom religion and the custome of their nation bids to be circumcised The cure is thus The Praepuce is turned up and then the inner membrane thereof is cut round and great care is had that the veine and artery which are there betweene the two membranes of the Praepuce be not cut in sunder Hence it is drawn downward by extension untill it cover the glans a deficcative emplaster being first put between it and the glans lest they should grow together Then a pipe being first put into the urinary passage the praepuce shall be there bound untill the incision be cicatrized This cure is used to the Jewes when having abjured their religion full of superstitions for handsomnesse sake they would cover the nut of their yard with a praepuce and so recover their cut off skinne CHAP. XXXII Of Phymosis and Paraphymosis that is so great a constriction of the praepuce about the Glans or Nut that it cannot be bared or uncovered at Pleasure THe prepuce is straitened about the Glans two waies for it either covers the whole nut so straitly encompasses the end therof that it cannot be drawne upwards and consequently the nut cannot be uncovered or else it leaves the Glans bare under it being fastened so stiffely to the roots thereof that it cannot bee turned up nor drawn down or over the Glans The first manner of constriction is termed Phymosis the latter Paraphymosis The Phymosis happens either by the fault of the first conformation or else by a scarre through which occasion the praepuce hath growne lesser as by the growing of warts Now Paraphymosis is often occasioned by the inflammation of the yard by impure copulation for hence ulcers breed betweene the praepuce and Glans with swelling and so great inflammation that the praepuce cannot bee turned backe Whence it is that they cannot bee handled and cured as you would and a gangrene of the part may follow which may by the contagion bring death to all the body unless it be hindred prevented by amputation but if a scar be the cause of the constriction of the praepuce the patient being plac'd in a convenient site let the praepuce be drawne forth and extended and as much as may be stretched and enlarged then let the scarre be gently cut in three or foure places on the inner side with a crooked knife but so that the gashes come not to the outside and let them be an equall distance each from other But if a fleshy excrescence or a wart shall be the occasion of this straitnesse and constriction it shall be consumed by the same remedies by which the warts of the wombe and yard are consumed or taken off But when as the praepuce doth closely adhere to the Glans on every side the cure is not to be hoped for much lesse to be attempted CHAP. XXXIII Of those whose Glans is not rightly perforated and of the too short or strait ligament bridle or Cord of the yard SOme at their birth by evill conformation have not their Glans perforated in the middle but have only a small hole underneath toward the bridle ligament of the yard called the cord Which is the cause that they do not make water in a strait line unlesse they turn up their yard toward their belly neither by the same reason can they beget children because through this fault of conformation the seed is hindred from being cast directly into the wombe The cure is wholly chirurgicall and is thus performed The praepuce is taken hold of and extended with the left hand but with the right hand the extremity thereof with the end of the Glans is cut even to that hole which is underneath But such as have the bridle or ligament of the yard too short so that the yard cannot stand straight but crooked and as it were turned downewards in these also the generation of children is hindred because the seed cannot be cast directly and plentifully into the wombe Therefore this ligament must be cut with much de xterity and the wound cured after the manner of other wounds having regard to the part Children also are sometimes borne into the world with their fundaments unperforated for a skinne preternaturally covering the part hinders the passage forth of the excrements those must have a passage made by art with an instrument for so at length the excrements will come forth yet I have found by experience that such children are not naturally long lived neither to live many dayes after such section CHAP. XXXIV Of the causes of the stone THE stones which are in the bladder have for the most part had their first originall in the reines or kidneys to wit falling down from thence by the ureters into the bladder The cause of these is twofold that is materiall and efficient Grosse tough and viscide humours which crudities produce by the distempers of the bowels and immoderate exercises chiefly immediately after meat yeeld matter for the stone whence it is that children are more subject to this disease than those of other ages But the efficient cause is either the immoderate heate of the kidneys by meanes whereof the subtler part of the humors is resolved but the grosser and more earthy subsides and is hardened as we see bricks hardened by the sun and fire or the more remisse heat of the bladder sufficient to bake into a stone the faces or dregges of the urine gathered in great plenty in the capacity of the bladder The straightnesse of the ureters and urenary passage may be accounted as an assistant cause For by this meanes the thinner portion of the urine floweth forth but that which is more feculent and muddy being stayed behind groweth as by scaile upon scaile by addition and collection of new matter into a stony masse And as a weeke often-times dipped by the Chandler into melted tallow by the copious adhesion of the tallowy substance presently becomes a large candle thus the more grosse and viscide faeces of the urine stay as it were at the barres of the gathered gravell and by their continuall appulse are at length wrought and fashioned into a true stone CHAP. XXXV Of the signes of the stone of the Kidneys and bladder THE signes of the stone in the reines are the subsiding of red or yellow sand in the urine a certaine obscure itching at the kidneys and the sense of a weight or heavinesse at the loynes a sharp and pricking paine in moving or bending the body a numnesse of the thigh of the same side by reason of the compression caused by the stone of the nerves discending out of the vertebrae of the loynes of the thigh But when the stone is in the bladder the fundament and whole perinaeum is
pressed as it were with a heavie weight especially if the stone be of any bignesse a troublesome pricking pain runs to the very end of the yard and there is a continuall itching of that part with a desire to scratch it hence also by the paine and heat there is a tension of the yarde and a frequent and needlesse desire to make water and sometimes their urine commeth from them drop by drop A most grievous paine torments the patient in making water which he is forced to shew by stamping with his feet bending of his whole body and the grating of his teeth He is oft times so tormented with excesse of paine that the Sphincter being relaxed the right gut falleth downe accompanied with the swelling heate and paine of the Haemorrhoid veines of that place The cause of such tormentis the frequent striving of the bladder to expell the stone wholly contrary to the nature thereof whereto by sympathy the expulsive faculty of the guts and all their parts of the belly come as it were for supply The sediment of the urine is grosse viscid and oft-times like the whites of egs which argueth the weaknesse of the native heate not attenuating the juices The patient looketh of a pale and yellowish complexion and hollow eyed by reason of the almost continuall watching which is caused by the bitternesse of paine yet may it more certainely be knowne by putting in or searching with a Cathaeter Which to doe the patient shall bee wished to stand with his body somewhat stooping leaning against somewhat with his backe and holding his knees some foot asunder Then the Cathaeter being bigger or lesser as the body shall require and anointed with oyle or butter shall bee thrust with a skilfull hand into the passage of the urine and so into the capacity of the bladder But if the Cathaeter cannot come to that capacity the patient shall be placed in such a posture then shall he be layd upon his backe on a bench or the feet of a bed with his knees bended and his heeles drawn to his buttocks after which manner he must almost lie when he is to be cut for the stone as shall be shewen hereafter For thus the Cathaeter is more easily thrust into the bladder and shewes there is a stone by the meeting and obscure sound of the obvious hard and resisting body You must have sundry Cashaeters that they may serve for every body bigger and lesser and these must be crooked smooth and hollow When being thrust into the urenary passage which before unawares I omitted they come to the necke of the bladder they must not be thrust streight into the bladder but taking hold of the yard with the left hand they must bee gently thrust with the right directly into the bladder especially in men by reason of the length and crookednesse of the way which trends in the forme of this letter S. It is not so in women by reason of the shortnesse and straitnesse of the necke of the bladder It is fit your Cathaeters bee hollow or fistulous in manner of a pipe that they may receive a silver wiar or string that may hinder the grosse and viscide humour clotted blood or the like from stopping the further end of the Cathaeter through which the suppressed urine ought to passe be made But now assoon as we perceive that the Cathaeter is come into the capacity of the bladder the wiar must be drawn forth that so the urine may the freelier flow out by the hollownesse of the Cathaeter You may perceive the shapes of these instruments by this following figure The figure of Cathaeters and of a silver string or wiar CHAP. XXXVI Prognostickes in the stone WHen the stone is cast forth of the kidney whereas it bred by little and little and is so driven into one of the ureters that it wholly stop it yet thereupon there followeth no suppression of the urine for seeing nature hath made divers parts of our body double all the urine floweth into the other ureter But if they shall bee both stopped with stones there is no doubt but the urine will bee wholly supprest and death ensue by the suffocation and extinction of the native heat by the urine flowing back by the rivelits of the veines over all the whole body Such as have a small stone cast forth of their reines into the cavity of the ureters these untill this stone be fallen into the bladder have cruell paine with gripings with often desire to go to stoole and make water but oft-times do neither For such oft-times have their bellies distended with flatulencies an argument hereof is their continuall belching or breaking of wind But by sneesing coughing or any other concussion of the whole body a pricking paine is forthwith felt whereas the stone stops especially if it be either rough or have sharpe points like hornes This paine is communicated to the hip and thigh by sympathie and some have the stones drawne up as it were with great violence To these may bee added the Colicke cholericke vomiting and almost a generall sweat The stone in the kidnies is most commonly bred in such as are ancient by reason of the weaknesse of the expulsive faculty But the stone in the bladder happeneth to such as are more young because the native heat is more vigorous in such and strong and inordinate motions increase the strength of the expulsive facultie When the stone is in the bladder and the urine appeareth bloody it is the signe of a small as also a prickly and rough stone for thus it more casily entreth into the neck of the bladder and exulcerateth it being fleshy whence the blood commeth away with the urine and most cruell paine as of needles thrust into the flesh especially after labour and much exercise on the contrary a larger and more smooth stone will not cause such tormenting paine and it causeth a milkie water The shapes of stones bred in the kidnies are various according to the variety of the strainers through which they passe whilst they are bred Verily I have seen stones which represented the figure of grayhounds hogs and other creatures and things wholly contrary to mans nature by the production of their prickles and as it were branches Some are foure square others longish and like a finger other some of a round figure with many protuberancies like a pine apple kernell neither is the variety lesse in magnitude number and colour for some are yellowish others whitish red ash-coloured or some other like according to the various temper of the affected bodies The stones of cholerick and leane men usually concrete by preternaturall heat and drinesse but those of phlegmaticke or fat bodies of a certaine as it were congelation and obstruction of the passages A stone falling sometimes from the bottome of the bladder into the passage of the urine quite stops it up and thence followeth a totall
out of the ureter bladder and passage of the urine now will we briefly shew the manner of taking of greater stones out of the bladder which is performed by incision and iron instruments and I will deliver the practice thereof first in children then in men and lastly in women First therefore let the Surgeon take the boy upon whom it is determined the worke shall be performed under the arme holes and so give him five or sixe shakes that so the stone may descend the more downewards to the neck of the bladder The must you cause a strong man sitting upon a high seat to lay the child upon his backe with his face from himward having his hips lying upon his knees The child must lye somewhat high that he may breathe the freelier let not the nervous parts be too much stretched but let all parts be loose and free for the drawing forth of the stone Furthermore it is fit that this strong man the childs legges being bended backe wish the child that putting his legs to his hams that he draw them up as much as he can let the other be sure he keep them so for this site of the child much conduceth to well performing of the worke Then let the Surgeon thrust two of the fingers of his left hand as farre into the childs fundament as hee is able but let him with his other hand presse the lower belly first wrapping a cloth about his hand that so the compression may be the lesse troublesome and lest inflammation should happen rather by this meanes than by the incision Now the compression hath this use to cause the stone descend out of the bottome of the bladder into the neck thereof under the os pubis whither after it is arrived it must be there kept as it were governed by the command of your hand lest it should slide from that place whereto you have brought it These things thus done nothing now remaineth but that the Surgeon with a wound some two fingers breadth distant from the fundament cut through all the flesh even to the stone on the left side of the perinaeum But in the interim let him beware that he hurt not the intestinum rectum for it may and usually doth happen that whilest the stone is brought out of the bottome of the bladder to the neck thereof this gut is doubled in now if it bee cut with your incision knife it commeth to passe that the excrements may sometimes come out at the wound and the urine by the fundament which thing hath in many hindred the agglutination and consolidation of the wound yet in some others it hath done little harme because in this tender age many things happen which may seeme to exceed nature the incision being made the stone must bee plucked forth with the instrument here expressed Hookes to pull stones forth of childrens bladders The stone being drawne out a small pipe shall be put into the wound and there kept for some space after for reasons hereafter to bee delivered then his knees shall bee bound together for thus the wound will the sooner close and bee agglutinated The residue of the cure shall be performed by reducing the generall cure of wounds to the particular temper of the childs age and the peculiar nature of the child in cure CHAP. XLII How to cut men for the taking out of the stone in the bladder SEing wee cannot otherwise helpe such men as have stones in their bladders we must come to the extreme remedy to wit cutting But the patient must first be purged and if the case require draw somebloud yet must you not immediately after this or the day following hasten to the work for the patient cannot but be weakened by purging bleeding Also it is expedient for some daies before to foment the privities with such things as relaxe and soften that by their yeelding the stone may the more easily be extracted Now the cure is thus to be performed The patient shall be placed upon a firm table or bench with a cloth many times doubled under his buttocks and a pillow under his loynes back so that he may lie halfe upright with his thighs lifted up and his legs and heels drawn back to his buttocks Then shall his feet be bound with a ligature of three fingers breadth cast about his ankles and with the heads thereof being drawn upwards to his neck and cast about it and so brought downewards both his hands shall bee bound to his knees as the following figure sheweth The figure of a man lying ready to be cut for the stone The patient thus bound it is fit you have foure strong men at hand that is two to hold his armes and other two who may so firmely and straightly hold the knee with one hand and the foot with the other that he may neither move his limmes nor stirre his buttocks but be forced to keep in the same posture with his whole body Then the Surgeon shall thrust into the urenary passage even to the bladder a silver or iron and hollow probe annoynted with oyle and opened or slit on the out side that the point of the knife may enter thereinto and that it may guide the hand of the workman and keep the knife from piercing any farther into the bodies lying there-under The figure of this probe is here exprest Probes with slits in their ends He shall gently wrest the probe being so thrust in towards the left side and also he who standeth on the patients right hand shall with his left hand gently lift up his Cods that so in the free and open space of the left side of the perinaeum the Surgeon may have the more liberty to make the incision upon the probe which is thrust in and turned that way But in making this incision the Surgeon must be carefull that he hurt not the seame of the perinaeum and fundament For if that seame bee cut it will not be easily consolidated for that it is callous and bloudlesse therefore the urine would continually drop forth this way But if the wound be made too neare the fundament there is danger lest by forcible plucking forth of the stone he may break some of the haemorrhoide veins whence a bleeding may ensue which is scarce to be stopped by any meanes or that hee may rend the sphincter muscle or body of the bladder so that it can never be repaired Therefore it must be made the space of two fingers from the fundament according to the straightnesse of the fibres that so it may be the more easily restored afterwards Neither must the incision thus made exceed the bignesse of ones thumbe for that it is afterwards enlarged by putting in the Crowes beake and the dilater but more by the stone as it is plucked forth But that which is cut is neither so speedily nor easily healed up as that which is torne
sharpe feavers we open a veine to breathe out that bloud which is heated in the vessels and cooling the residue which remaines behind The fift is to prevent imminent diseases as when in the Spring and Autumne we draw bloud by opening a veine in such as are subject to spitting of bloud the squinancie pleurisie falling sicknesse apoplexie madnesse gout or in such as are wounded for to prevent the inflammation which is to be feared Before bloud letting if there bee any old excrements in the guts they shall bee evacuated by a gentle glyster or suppository lest the mesaraicke veines should thence draw unto them any impuritie Bloud must not be drawne from ancient people unlesse some present necessity require it lest the native heat which is but languid in them should be brought to extreme debility and their substance decay neither must any in like sort be taken from children for feare of resolving their powers by reason of the tendernesse of their substance rareness of their habit The quantity of bloud which is to be let must bee considered by the strength of the patient and greatnesse of the disease therefore if the patient bee weake and the disease require large evacuation it will bee convenient to part the letting of bloud yea by the interposition of some dayes The veine of the forehead being opened is good for the paine of the hind part of the head yet first we foment the part with warme water that so the skin may be the foster and the bloud drawne into the veines in greater plenty In the squinancie the veines which are under the tongue must be opened assant without putting any ligatures about the neck for feare of strangling Phlebotomie is necessary in all diseases which stop or hinder the breathing or take away the voice or speech as likewise in all contusions by a heavie stroake or fall from high in an apoplexie squinancie and burning feaver though the strength be not great nor the bloud faulty in quantity or quality bloud must not be let in the height of a fever Most judge it fit to draw bloud from the veines most remote from the affected and inflamed part for that thus the course of the humours may be diverted the next veines on the contrary being opened the humours may be the more drawne into the affected part and so increase the burden and paine But this opinion of theirs is very erroneous for an opened veine alwaies evacuates and disburdens the next part For I have sundry times opened the veines and arteries of the affected part as of the hands feet in the Gout of these parts of the temples in the Megrim whereupon the paine alwayes was somewhat asswaged for that together with the evacuated bloud the malignitie of the Gout and the hot spirits the causers of the head-ach or Megrim were evacuated For thus Galen wisheth to open the arteries of the temples in a great and contumacious defluxion falling upon the eyes or in the Megrim or head-ach CHAP. LX. How to open a veine and draw bloud from thence THE first thing is to seat or place the patient in as good a posture as you can to wit in his bed if he be weak but in a chaire if strong yet so that the light may fall directly upon the veine which you intend to open Then the Surgeon shall rub the arme with his hand or a warme linnen cloth that the bloud may flow the more plenitfully into the vein Then he shall bind the veine with a ligature a little above the place appointed to be opened and hee shall draw back the bloud upwards towards the ligature from the lower part and if it be the right arme he shall take hold thereof with his left hand but if the left then with his right hand pressing the veine in the meane time with his thumbe a little below the place where you meane to open it lest it should slip away and that it may bee the more swolne by forcing up the bloud Then with his naile hee shall marke or designe the place to be opened and shall annoint it being so marked with butter or oyle whereby the skin may be relaxed and the lancet enter more easily and therefore the section may be the lesse painefull He shal hold his lancet between his thumb and fore finger neither too neer nor too far from the point he shall rest his other three fingers upon the patients arme that so his hand may be the more steddy lesse trembling Then shall he open the vein with an incision agreeable to the magnitude of the vessell the indifferent thicknesse of the conteined bloud somewhataslant diligently avoiding the artery which lies under the basilica the nerve or tendon of the two-headed muscle which lyes under the Median veine But for the Cephalicke it may be opened without danger As much bloud as is sufficient being drawne according to the minde of the Physician he shall loose the ligature and laying a little boulster under hee shall with a ligature bind up the wounded part to stay the bleeding the ligation shall be neither too strait nor loose but so that the patient may freely bend and extend his arme wherefore whilest that is in doing he must not hold his arme streight out but gently bended otherwise he cannot freely bend it The figure of a Lancet to let bloud withall CHAP. LXI Of Cupping-glasses or ventoses CUpping-glasses are applyed especially when the matter conjunct and impact in any part is to be evacuated and then chiefly there is place for sacrification after the cupping-glasses yet they are also applyed for revulsion and divertion for when an humour continually flowes down into the eyes they may be applyed to the shoulders with a great flame for so they draw more strongly and effectually They are also applyed under womens breasts for to stop the courses flowing too immoderately but to their thighes for to provoke them They are also applyed to such as are bit by venemous beasts as also to parts possessed by a pestiferous Bubâ— or Carbuncle so to draw the poyson from within outwards For as Celsus saith a Cupping-glasse where it is fastned on if the skin be first scarified drawes forth bloud but if it bee whole then it draws spirit Also they are applyed to the belly when any grosse or thick windinesse shut up in the guts or membraines of the muscles of the Epigaâ—trium or lower belly causing the Collick is to bee discussed Also they are fastned to the Hypocondry's when as flatulency in the liver or spleene swels up the entraile lying thereunder or in too great a bleeding at the nose Also they are set against the Reines in the bottome of the belly whereas the ureters run downe to draw downe the stone into the bladder when as it stops in the middle or entrance of the ureter You shall make choice of greater and lesser Cupping-glasses according
from all spices and all salted and spiced meats and all sharpe things wine especially that which is not allayed or mixed with water and carnall copulation with a man let her avoyd all perturbations of the minde but anger especially let her use moderate exercise unlesse it be the exercise of her armes and upper parts rather than the legges and lower parts whereby the greater attraction of the blood that must be turned into milke may bee made towards the dugges Let her place her childe so in the cradle that his head may be higher than all the body that so the excrementall humours may bee the better sent from the braine unto the passages that are beneath it Let her swathe it so as the neck and all the back-bone may be straight and equall As long as the childe sucketh and is not fed with stronger meat it is better to lay him alway on his backe than any other way for the backe is as it were the Keele in a ship the ground-worke and foundation of all the whole body whereon the infant may safely and easily rest But if hee lye on the side it were danger lest that the bones of the ribs being soft and tender not strong enough and united with slacke bands should bow under the waight of the rest and so waxe crooked whereby the infant might become crooke-backed But when he beginneth to breed teeth and to bee fed with more strong meat and also the bones and connexions of them begin to waxe more firme and hard hee must bee layed one while on this side another while on that and now and then also on his backe And the more hee groweth the more let him be accustomed to lye on his sides and as hee lieth in the cradle let him bee turned unto that place whereat the light commeth in lest that otherwise he might become poore-blind for the eye of its owne nature is bright and light-some and therefore alwaies desireth the light and abhorreth darkenesse for all things are most delighted with their like and shunne their contraries Therefore unlesse the light come directly into the childes face he turneth himselfe every way being very sorrowfull and striveth to turne his head and eyes that hee may have the light and that often turning and rowling of his eyes at length groweth into a custome that cannot bee left and so it commeth to passe that the infant doth either become poore-blind if hee set his eyes stedfastly on one thing or else his eyes doe become trembling alwaies turning and unstable if hee cast his eyes on many things that are round about him which is the reason that nurses being taught by experience cause over the head of the childe lying in the cradle an arch or vault of wickers covered with cloath to be made thereby to restraine direct and establish the uncertaine and wandering motions of the childes eyes If the nurse be squint-eyed she cannot look upon the childe but side-waies whereof it commeth to passe that the childe being moist tender flexible and prone to any thing with his body and so likewise with his eye by a long and daily custome unto his nurses sight doth soone take the like custome to looke after that sort also which afterwards he cannot leave or alter For those evill things that we learn in our youth do stick firmly by us but the good qualities are easily changed into worse In the eies of those that are squint-eyed those two muscles which do draw the eyes to the greater or lesser corner are chiefly or more frequently moved Therefore either of these being confirmed in their turning aside by long use as the exercise of their proper office encreaseth the strength soone overcomes the contrary or withstanding muscles called the Antagonists and brings them into their subjection so that will they nill they they bring the eye unto this or that corner as they list So children become left-handed when they permit their right hand to languish with idlenesse and sluggishnesse and strengthen their left hand with continuall use and motion to do every action therewithall and so bring by the exercise thereof more nutriment unto that part But if men as some affirme being of ripe yeers and in their full growth by daily society and company of those that are lame and halt doe also halt not minding so to doe but it commeth against their wills and when they thinke nothing thereof why should not the like happen in children whose soft and tender substance is as flexible and pliant as waxe unto every impression Moreover children as they become lame and crook-backt so doe they also become squint-eyed by the hereditary default of their parents CHAP. XXIII How to make pappe for children PAppe is a most meet foode or meat for children because they require moist nourishment and it must bee answerable in thickenesse to the milke that so it may not be difficult to be concocted or digested For pap hath these three conditions so that it be made with wheaten flower and that not crude but boiled let it be put into a new earthen pot or pipkin and so set into an oven at the time when bread is set thereinto to bee baked and let it remaine there untill the bread bee baked and drawne out for when it is so baked it is lesse clammy and crude Those that mixe the meale crude with the milke are constrained to abide one of these discommodities or other either to give the meale grosse clammy unto the child if that the pap be onely first boiled over the fire in a pipkin or skillet so long as shall bee necessary for the milke hence come obstructions in the mesaraike veines and in the small veines of the liver fretting and wormes in the guts and the stone in the reines Or else they give the child the milk despoiled of its butterish and whayish portion and the terrestriall and cheeselike or curdlike remaining if the pap be boiled so long as is necessary for the meale for the milke requireth not so great neither can it suffer so long boyling as the meale Those that doe use crude meale and have no hurt by it are greatly bound to nature for so great a benefit But Galen willeth children to bee nourished onely with the nurses milke so long as the nurse hath enough to nourish and feed it And truely there are many children that are contented with milke only and will receive no pappe untill they are three moneths old If the child at any time bee costive and cannot voide the excrements let him have a cataplasme made with one dramme of Aloes of white and blacke Hellebore of each fifteene graines being all incorporated in as much of an oxe gall as is sufficient and extended or spread on cotton like unto a pultis as broad as the palme of ones hand and so apply it upon the navell warme moreover this cataplasme hath also vertue to kill the wormes in the belly
if his hands bee forth already so that it may seeme hee may bee drawne forth easily that way yet it must not be so done for so his head would double backwards over his shoulders to the great danger of his mother Once I was called unto the birth of an infant whom the midwives had assayed to draw out by the arme so that the arme had been so long forth that it was gangrenate whereby the childe dyed I told them presently that his arme must bee put in againe and hee must bee turned otherwise But when it could not bee put backe by reason of the great swelling thereof and also of the mothers genitals I determined to cut it off with an incision knife cutting the muscles as neare as I could to the shoulder yet drawing the flesh upwards that when I had taken off the bone with a paire of cutting pincers it might come downe againe to cover the shivered end of the bone lest otherwise when it were thrust in againe into the wombe it might hurt the mother Which being done I turned him with his feete forwards and drew him out as is before sayd But if the tumour either naturally or by some accident that is to say by putrefaction which may perchance come bee so great that hee cannot bee turned according to the Chirurgions intention nor be drawne out according as hee lyeth the tumour must bee diminished and then hee must bee drawne out as is aforesaid and that must bee done at once As for example if the dead infant appeare at the orifice of the wombe which our mydwives call the Garland when it gapeth is open and dilated but yet his head being more great and puffed up with winde so that it cannot come forth as caused to bee so through that disease which the Greeks call Mucrophisocephalos the Chirurgion must fasten a hooke under his chinne or in his mouth or else in the hole of his eye or else which is better and more expedient in the hinder part of his head For when the scull is so opened there will bee a passage whereat the winde may passe out and so when the tumour falleth and decreaseth let him draw the infant out by little and little but not rashly lest he should break that whereon he hath taken hold the figure of those hookes is thus The forme of hookes for drawing out the infant that is dead in the wombe But if the breast bee troubled with the like fault the hookes must bee fastened about the chanell bone if there bee a Dropsie or a Tympany in the belly the hooks must bee fastned either in the short ribs that is to say in the muscles that are betweene the ribbes or especially if the disease doe also descend into the feete about the bones that are above the groine or else putting the crooked knife here pictured iâ—…he wombe with his left hand let him make incision in the childs belly and so get out all his entrals by the incision for when hee is so bowelled all the water that caused the dropsie will out But the Chirurgion must do none of all these things but when the child is dead and the woman that travelleth in such danger that shee cannot otherwise be holpen But if by any meanes it happeneth that all the infants members bee cut away by little and little and that the head onely remaineth behinde in the wombe which I have sometimes against my will and with great sorrow seene then the left hand being anoynted with oyle of Lillies or fresh butter must bee put into the wombe wherewith the Chirurgion must find out the mouth putting his fingers into it then with his right hand hee must put up the hooke according to the direction of the left hand gently by little little and so fasten it in the mouth eye or under the chin and when hee hath firmely fixed or fastened it hee must therewith draw out the head by little and little for feare of loosening or breaking the part whereon hee hath hold In stead of this hooke you may use the instruments that are here described which therefore I have taken out of the Chirurgery of Francis Dalechamps for they are so made that they may easily take hold of a sphaericall and round body with the branches as with fingers Gryphons Talons that is to say instruments made to draw out the head of a dead infant that is separated in the wombe from the rest of the body But it is not very easie to take hold on the head when it remaineth alone in the wombe by reason of the roundnesse thereof for it will slip and slide up and downe unlesse the belly be pressed downe and on both sides thereby to hold it unto the instrument that it may with more facility take hold thereon CHAP. XXVII What must bee done unto the woman in travell presently after her deliverance THere is nothing so great an enemy to a woman in travell especially to her whose child is drawne away by violence as cold wherefore with all care and diligence shee must bee kept and defended from cold For after the birth her body being voyde and empty doth easily receive the ayre that will enter into every thing that is empty and hence shee waxeth cold her wombe is distended and puffed up and the orifices of the vessels thereof are shut and closed whereof commeth suppression of the after-birth or other after purgations And thereof commeth many grievous accidents as hystericall suffocation painefull fretting of the guts feavers and other mortall diseases What woman soever will avoyde that discommodity let her hold her legges or thighes acrosse for in so doing those parts that were separated will bee joyned and close together againe Let her belly bee also bound or rowled with a ligature of an indifferent breadth and length which may keep the cold ayre from the wombe and also presse the bloud out that is contained in all the substance thereof Then give her some Capon broth or Caudle with Saffron or with the powder called Pulvis ducis or else bread toasted and dipped in wine wherein spice is brewed for to restore her strength and to keepe away the fretting of the guts When the secundine is drawne out and is yet hot from the wombe it must bee layd warme unto the region of the wombe especially in the winter but in the summer the hot skinne of a Weather newly killed must be laid unto all the whole belly and unto the region of the loynes But then the curtaines of the bed must bee kept drawne and all the windowes and doores of the chamber must bee kept shut with all diligence that no cold ayre may come unto the woman that travelleth but that shee may lye and take her rest quietly The Weathers skinne must bee taken away after that it hath lyen five or sixe houres and then all the region of her belly must bee annointed with the oyntment following â„ž
happen by the same cause that twinnes and many at one birth contrary to natures course doe chance that is by a larger effusion of seed than is required for the framing of that part that so it exceeds either in number or else in greatnesse So Austin tells that in his time in the East an infant was borne having all the parts from the belly upwards double but from thence downewards single and simple for it had two heads foure eyes two breasts foure hands in all the rest like to another child and it lived a little while Caelius Rhodiginus saith he saw two monsters in Italy the one male the other female handsomly neatly made through all their bodies except their heads which were double the male died within a few daies after it was borne but the female whose shape is here delineated lived 20. five yeers which is contrary to the common custome of monsters for they for the most part are very short lived because they both live and are born as it were against natures consent to which may be added they doe not love themselves by reason they are made a scorne to others and by that meanes lead a hated life The effigies of a maide with two heads But it is most remarkeable which Lycosthenes telleth of this woman-monster for excepting her two heads shee was framed in the rest of her body to an exact perfection her two heads had the like desire to eat and drinke to sleepe to speake and to doe every thing she begged from dore to dore every one giving to her freely Yet at length she was banisht Bavaria lest that by the frequent looking upon her the imaginations of women with childe strongly moved should make the like impression in the infants they bare in their wombes The effigies of two girles whose backes grew together In the yeere of our Lord 1475. at Verona in Italy two Girles were borne with their backes sticking together from the lower part of the shoulders unto the very buttockes The novelty and strangenesse of the thing moved their parents being but poor to carry them through all the chiefe townes in Italy to get mony of all such as came to see them In the yeere 1530. there was a man to bee seene at Paris out of whose belly another perfect in all his members except his head hanged forth as if he had been grafted there The man was forty yeeres old and hee carried the other implanted or growing out of him in his armes with such admiration to the beholders that many ranne very earnestly to see him The figure of a man with another growing out of him The effigies of the horned or hooded monster At Quiers a small village some ten miles from Turine in Savoy in the yeere 1578. upon the seventeenth day of January about eight a clocke at night an honest matron brought forth a childe having five hornes like to Rams hornes set opposite to one another upon his head he had also a long piece of flesh like in some sort to a French-hood which women used to wear hanging downe from his forehead by the nape of his necke almost the length of his backe two other pieces of flesh like the collar of a shirt were wrapped about his necke the fingers ends of both his hands somewhat resembled a Haukes talons and his knees seemed to be in his hammes the right leg and the right foot were of a very red colour the rest of the body was of a tawny colour it is said he gave so terrible a scritch when he was brought forth that the Midwives and the rest of the women that were at her labour were so frighted that they presently left the house and ran away When the Duke of Savoy heard of this monster he commanded it should be brought to him which performed one would hardly think what various censures the Courtiers gave of it The shape of a monster found in an egge The monster you see here delineated was found in the middle and innermost part of an egge with the face of a man but haires yeelding a horrid representation of snakes the chinne had three other snakes stretched forth like a beard It was first seene at Autun at the house of one Bancheron a Lawyer a maide breaking many eggs to butter the white of this egge given a Cat presently killed her Lastly this monster comming to the hands of the Baron Senecy was brought to King Charles the ninth being then at Metz. The effigies of a monstrous childe having two heads two armes foure legs In the yeere 1546. a woman at Paris in her sixt moneth of her account brought forth a childe having two heads two armes and foure legges I dissecting the body of it found but one heart by which one may know it was but one infant For you may know this from Aristotle whether the monstrous birth bee one or more joined together by the principall part for if the body have but one heart it is but one if two it is double by the joyning together in the conception The portraiture of Twinnes joyned together with one head In the yeere 1569. a certaine woman of Towers was delivered of twinnes joyned together with one head and mutually embracing each other Renatus Ciretus the famous Chirurgian of those parts sent mee their Sceleton The effigies of two girles being Twinnes joyned together by their fore-heads Munster writes that in the village Bristant not farre from Wormes in the yeere 1495. he saw two Girles perfect and entire in every part of their bodies but they had their fore-heads so joined together that they could not be parted or severed by any art they lived together ten yeeres then the one dying it was needfull to separate the living from the dead but she did not long out-live her sister by reason of the malignity of the wound made in parting them asunder In the yeere 1570. the twentieth of July at Paris in the street Gravilliers at the signe 〈◊〉 the Bell these two infants were borne distering in sexe with that shape of body â—â—at you see expressed in the figure They were baptized in the Church of St. Nichlas of the fields and named Ludovicus and Ludovica their father was a Mason his nâ—me was Peter German his surname Petit Dieu i little-God his mothers name was Mathea Petronilla The shape of the infants lately borne at Paris The figure of two girles joyned together in their breasts and belly In the yeere 1572. in Pont de See neare Anger 's a little towne were borne upon the tenth day of July two girles perfect in their limbs but that they had but foure fingers apiece on their left hands they clave together in their 〈◊〉 parts from their chin to the navell which 〈◊〉 but one as their heart was also but one their 〈◊〉 was divided into foure lobes they lived haâ—â— an houre and were baptized The figure of a child with two heads and the body as bigge as one
breast with warme water and with the moisture thereof looseth the skinnes of blacke greene and yellow frogges laid upon it and stucke together with glew made of bole armenick the white of an egge and flower and these being thus fetched off he found her breast perfectly sound The beggar being cast for this into prison confessed that shee was taught this tricke by a beggar that lay with her who himselfe also by putting about his legge an oxes Milt and perforating it in sundry places that so the forementioned liquor might drop out counterfeited an ulcer of a monstrous bignesse and malignity covering the edges of the Milt on every side with a filthy cloath This beggar was diligently enquired after but could not bee found and so shee was whipped and banished Within lesse than a yeere after there came into the same city another notable crafty companion who presently taking up the church doores laid open his wares to wit a Kercher with some small pieces of mony lying thereon a wooden Barrell and Cliquets wherewith he would evernow and then make a great noise his face was spread over with great thicke pustles being of a blackish red colour and made with glew like those that have the Leprosie this his ghasty look made him to be pitied by all men which was the cause that every one gave him mony Then my brother came somewhat nearer him and asked him how long hee had beene troubled with this so cruell disease hee answered with an obscure and hoarse voice that hee was borne a Leper from his mothers wombe and that his parents both died of this wicked disease so that their members fell away piece-meale Now hee had a woollen swathe about his chapps wherewith having his left hand under his cloake hee so straitened his chapps that much blacke blood rose into his face and made him so hoarse that he could scarce speake yet hee could not conteine himselfe but that in speaking hee ever now and then slackened the swathe with his hand the freelier to draw his breath which when my brother had observed suspecting some cozenage he obtained leave of the Magistrate to search and examine the man whether hee were truely leprous or no. First therefore he tooke away his swathe or rowler that was about his necke then washed his face with warme water so that the counterfeit glewed pustles were dissolved and his face free from all tainture shewed it selfe of a good and naturall colour and shape Then he laid bare his whole body and diligently viewed each part and found no signe of a leprosie one or other Which when the Magistrate once heard he made him to bee put in prison and to be thrice whipped through the streets of the city with his barrell hanging before him and his cliquets behind him adding thereto the punishment of perpetuall banishment It happened that as hee was whipped the third market day the people cryed out to the hang-man in jest that he should not feare to lash him soundly for being leprous he could not feele it the executioner incited by this cry of the people did so belabour him that the wretch died of his whipping within a short while after having a just reward for his wickedness For these impostors besides that they live like drones feigning this or that disease and so being idle enjoy the fruits of others labours they also divers times conspiring together take away the lives and goods of honest and substantiall citizens and other people for there are some of them that in an evening as men that have no habitation desire lodging for a night and it being granted them they when as the master of the house and his family are asleepe open the doores to their comrades men as wicked as themselves and kill and carry away all they can Certainly we may justly affirme that this crafty begging is the mother and schoole of all dishonesty for how many acts of bawdry and poisoning every where corrupt the wells and publicke fountaines how many places have beene burnt under the shew of begging where can you get more fit spies where more sit undertakers and workers of all manner of villany than out of the crew of these beggars Some of them there are who besmeare their faces with soot layed in water so to seeme to have the Jaundise But you may at the first sight find out the deceit by the native whitenesse of the utter coat of the eye called Adnata which in such as truely have the Jaundise useth to bee died and overcast with a yellowish colour also you may be more certaine thereof if you wet a cloath in water or spittle and so rub the face for the adventitious yellownesse will quickly vanish and the true native colour shew it selfe Some there bee who not content to have mangled and filthily exulcerated their limbes with causticke herbs and other cauteries or to have made their bodies more swolne or else leane with medicated drinks or to have deformed themselves some other way but from good and honest Citizens who have charitably relieved them they have stollen children have broken or dislocated their armes and legges have cut out their tongues have depressed the chest or whole breast that with these as their owne children begging up and downe the country they may get the more reliefe pitifully complaining that they came by this mischance by thunder or lightning or some other strange accident Lastly they part the kingdome amongst themselves as into Provinces communicate by letters one to another what newes or new quaint devises there are to conceale or advance their roguery to which purpose they have invented a new language onely knowne to themselves so to discourse together and not bee understood by others We here vulgarly terme it Canting Dr. Flecelle a Physitian of Paris entreated me to beare him company to his country house at Champigny foure miles from Paris Where as soone as wee arrived and were walking in the Court there came presently to us a good lusty well flesht manly woman begging almes for St. Fiacre sake and taking up her coat and her smocke shee shewed a great gut hanging downe some halfe a foot which seemed as if it had hanged out of her fundament whereout there dropped filth like unto pus which had all stained her legges and smocke most beastly and filthy to looke upon Flecelle asked her how long she had beene troubled with this disease she answered that it was foure yeeres since she first had it Hence he easily gathered that she plaied the counterfeit for it was not likely that such abundance of purulent matter came forth of the body of so well flesht and coloured a woman for she would rather have been very leane and in a consumption Wherefore provoked with just anger by reason of the wickednesse of the deceit he run upon her and threw her downe upon the ground and trod her under his feet and hit her divers blowes
of the wound is received of the Chirurgion according to the civill Law It is recorded in the workes of ancient Physitions that wounds may bee called great for three respects The first is by reason of the greatnesse of the dissolved unitie or resolution of Continuity and such are these wounds which made by a violent stroake with a backe-sword have cut off the arme or legge or overthwart the breast The second is by reason of the dignitie or worthinesse of the part now this dignity dependeth on the excellencie of the action therefore thus any little wound made with a bodkin knife in any part whose substance is noble as in the Braine Heart Liver or any other part whose action and function is necessary to preserve life as in the Weasant Lungs or Bladder is judged great The third is by reason of the greatnesse and ill habit or the abundance of ill humors or debility of all the wounded body so those woundes that are made in nervous parts and old decayed people are sayd to be great But in searching of wounds let the Chirurgion take heede that he be not deceived by his probe For many times it cannot goe into the bottome of the wound but stoppeth and sticketh in the way either because he hath not placed the patient in the same posture wherein he was when he received his hurt or else for that the stroake being made downe right slipt aside to the right or left hand or else from below upwards or from above downewards and therefore hee may expect that the wound is but little and will be cured in a short time when it is like to bee long in curing or else mortall Therefore from the first day it behooveth him to suspend his judgement of the wound untill the ninth for in that time the accidents will shew themselves manifestly whether they be small or great according to the condition of the wound or wounded bodyes and the state of the ayre according to his primitive qualities or venomous corruption But generally the signes whereby we may judge of diseases whether they bee great or small of long or short continuance mortall or not mortall are foure For they are drawne either from the nature and essence of the disease or from the cause or effects thereof or else from the similitude proportion and comparison of those diseases with the season or present constitution of the times Therefore if wee are called to the cure of a greene wound whose nature and danger is no other but a simple solution of Continuity in the musculous flesh we may presently pronounce that wound to be of no danger and that it will soone be cured But if it have an Vlcer annexed unto it that is if it be sanious then we may say it will be more difficult and long in the curing and so we may pronounce of all diseases taking a signe of their essence and nature But of the signes that are taken of the causes let this bee an example A wound that is made with a sharpe pointed and heavie weapon as with an halbeard being stricken with great violence must be accounted great yea and also mortall if the accidents be correspondent But if the patient fall to the ground through the violence of the stroake if a cholericke vomiting follow thereon if his sight faile him together with a giddinesse if blood come forth at his eyes and nosthrills if distraction follow with losse of memory and sense of feeling we may say that all the hope of life remaineth in one small signe which is to be deduced from the effects of the wound But by the comparing it unto the season that then is and diseases that then assault mans body wee may say that all those that are wounded with gunshot are in danger of death as it happened in the schirmishes at the seige of Roan and at the battall of Saint Denis For at that time whether it were by reason of the fault of the heavens or ayre through the evill humors of mans body and the disturbance of them all wounds that were made by gunshot were for the most part mortall So likewise at certaine seasons of the yeare we see the small pockes and measels breake forth in children as it were by a certaine pestilent contagion to the destruction of children onely inferring a most cruell vomit and laske and in such a season the judgement of those diseases is not difficult But you by the following signes may know what parts are wounded If the patient fall downe with the stroake if he lye senselesse as it were asleepe if he voyde his excrements unwittingly if he be taken with giddinesse if blood come out at his eares mouth and nose and if he vomit choller you may understand that the scull is fractured or pearced through by the defect in his understanding and discourse You also may know when the scull is fractured by the judgement of your externall senses as if by feeling it with your finger you finde it elevated or depressed beyond the naturall limits if by striking it with the end of a probe when the Pericranium or nervous filme that investeth the scull is cut crosse wise and so divided there from it yeeld a base and unperfect sound like unto a pot sheard that is broken or rather like unto an earthen pitcher that hath a cleft or rent therein But we may say that death is at hand if his reason and understanding faile him if he be speechlesse if his sight forsake him if he would tumble headlong out of his bed being not at all able to moove the other parts of his body if he have a continuall feaver if his tongue be blacke with drienesse if the edges of the wound bee blacke or dry and cast forth no sanious matter if they resemble the colour of salted flesh if he have an apoplexie phrensie convulsion or palsie with an involuntarie excretion or absolute supprâ—ssion of the Vrine and excrements You may know that a man hath his throate that is his weason and winde pipe cut First by the sight of his wound and next by the abolishment of the function or office thereof both wayes for the patient can neither speake nor swallow any meate or drinke and the parts that are cut asunder divide themselves by retraction upwards or downewards one from another whereof commeth sodaine or present death You may know that a wound hath peirced into the brest or concavity of the body if the ayre come forth at the wound making a certaine whizzing noyse if the patient breathe with great difficulty if he feele a great heavinesse or weight on or about the midriffe whereby it may be gathered that a great quantity of blood lyeth on the place or midriffe and so causeth him to feele a weight or heavinesse which by little and little will bee cast up by vomiting But a little after a feaver commeth and the breath is unsavory and stinking
upon the backe of his left hand the bignesse almost of foure fingers with the cutting of the Veines Arteries Nerves and part of the bones of that part whence it is that he will be lame of that hand howsoever carefully and diligently healed Now because by hurting the spinall marrow men become lame sometimes of a legge it is fit you know that the spinall marrow descends from the braine like a rivelet for the distribution of the Nerves who might distribute sense and motion to all the parts under the head wherefore if by hurting the spinall marrow the patients armes or hands are resolved or numme or wholy without sense it is a signe these Nerves are hurt which come forth of the fifth sixth seaventh vertebrae of the necke But if the same accidents happen to the thigh legge or foote with refrigeration so that the excrements flow unvoluntarily without the patients knowledge or else are totally supprest it is a signe that the â—inewes which proceed from the vertebrae of the loynes and holy-bone are hurt or in fault so that the animall faculty bestowing sense and motion upon the whole body and the benefit of opening and shutting to the sphincter muscle of the bladder and fundament cannot shew its self in these parts by which meanes suddaine death happens especially if there be difficulty of breathing therewith Being to make report of a child killed with the mother have a care that you make a discreete report whether the childe were perfect in all the parts and members thereof that the judge may equally punish the author thereof For he meriteth farre greater punishment who hath killed a child perfectly shaped and made in all the members that is he which hath killed a live childe than he which hath killed an Embryon that is a certaine concretion of the spermaticke body For Moses punisheth the former with death as that he should give life for life but the other with a pecuniary mulcte But I judge it fit to ex emplifie this report by a president I A. P. by the Iudges command visited Mistris Margaret Vlmary whom I found sicke in bed having a strong feaver upon her with a convulsion and effluxe of blood out of her wombe by reason of a wound in her lower belly below her navill on the right side penetrating into the capacity of her belly and the wombe therein whence it hath come to passe that she was delivered before her time of a male childe perfect in all his members but dead being killed by the same wound piercing through his scull into the marrow of the braine Which in a short time will be the death of the mother also In testimony whereof I have put my hand and seale The manner how to Embalme the dead I Had determined to finish this my tedious worke with the precedent treatise of Reports but a better thought came in my head which was to bring man whose cure I had undertaken from his infancie to his end and even to his grave so that nothing might be heere defective which the Chirurgion might by his profession performe about mans body either alive or dead Verily there hath scarse ever beene a nation so barbarous which hath not onely beene carefull for the buriall but also for the Embalming or preserving of their dead bodyes For the very Scythians who have seemed to exceede other nations in barbarousnesse and inhumanity have done this for according to Herodotus the Scythians bury not the corpes of their King before that being embowelled and stuffed full of beaten Cypresse frankincense the seedes of Persly and Annise hee be also wrapped in cearcloathes The like care hath also possessed the mindes of the Ethiopians for having disburdened the corpes of their friends of their entrails and flesh they plaistered them over and then having thus rough cast them they painted them with colours so to expressâ— the dead to the life they inclosed them thus adorned in a hollow pillar of glasse that thus inclosed they might be seene and yet not anoy the spectators with their smell Then were they kept the space of a yeere in the hands of their next kindred who during this space offered and sacrifized to them The yeare ended they carryed them forth of the Citty and placed them about the walls each in his proper vault as Herodotus affirmes But this pious care of the dead did farre otherwise affect the Aegyptians than it did other nations For they were so studious to preserve the memory of their ancestors that they embalmed their whole body with aromaticke oyntments and set them in translucent Vâ—nes or glasse Colls in the more eminent and honoured part of their houses that so they might have them dayly in their sight and might be as monuments and inciters to stirre them up to imitate their fathers and Grandâ—ires vertues Besides also the bodyes thus embalmed with aromatick balsamick oyntments were in steed of a most sure pawn so that if any Aegyptian had neede of a great sum of money they might easily procure it of such as knew them their neighbours by pawning the bodye of some of their dead parents For by this meanes the creditour was certaine that he which pawned it would sooner loose his life than break his promise But if all things so unhappily succeded with any so that through poverty he could not fetch home his pawne againe but was forceâ— to forgoe it he was so infamous amongst all men during the rest of the life as one banished or forlorne and loosing his freedome he shall become a servant yea scorned and reviled of all men he should be accounted unworthy to enjoy the light and society of men And certainely the Aegyptians understanding the life which we heere lead to be of short continuance comparison being made with that which wee are to live after the separation of the soule from the body they were more negligent in building their houses they dwelt in but in raring the pyramides which should serve them in steed of sepulchers they were so beyond reason sumptuous and magnificent that for the building of one of these edifices so renowned over all the world which King Cheopes begun a hundred thousand men were every 3 moneths for twenty yeeres space there kept at worke it was five furlongs and being square each side was 800. foot long and so much in height Almost all the peeces of marble went to the building thereof were thirty foote long engraven and carved with various workemanship as Herodotus reports But before the bodyes were committed to these magnificent Sepulchers they were carryed to the Salters and Embalmers who for that purpose had allowance out of the publicke stocke These besmeared them with Aromaticke and balsamicke oyntments and sowed up the incisions they made then strewed them over with salt and then covered them with brine for 70. dayes which being expired they washed them being taken thence and all the filth being taken off they
make Now I beleeve it was per Diapedesin or Anastomosin that is to say by the apertion of the mouthes of the vessells or by their porosities the poore little wrastler was buryed I tooke leave of Messieurs de Rohan de Laval and Estamps Monsieur de Rohan gave mee a present of fifty double duckets and an ambling horse and Monsieur de Laval another for my man and Monsieur de Estamps a Diamond of thirty Crownes and so I returned to my house at Paris The Voyage of Parpignan 1543. A Little while after Monsieur de Rohan tooke me with him poste to the campe of Parpignan being there the enemy made a Sally forth and came and inclosed three peeces of our Artillery where they were beaten back to the gates of the Citty which was not done without hurting and killing many and amongst the rest de Brissâ—c who was then chiefe master of the Artillery received a musket shot upon the shoulder returning to his Tent all the others that were hurt followed him hoping to be drest by the Chirurgions that ought to dresse them Being come to his Tent and layd on his bed the bullet was searched for by three or foure the most expert Chirurgions of the Army who could not finde it but sayd it was entred into his body In the end hee called for me to see if I were more skilfull than them because he had knowne me before in Piedmount by and by I made him rise from his bed and prayed him to put his body into that posture as it was then when hee received his hurt which he did taking a javelin betweene his hands as he held the Pike in the skirmish I put my hand about the wound and found the bullet in the flesh making a little tumor under the Omoplate having found it I shewed them the place where it was and it was taken out by Master Nicholas Lavernaut Chirurgion to Monsieur the Dolphin who was the Kings Lievtenant in that army yet notwithstanding the honour remained to me for finding of it I saw one thing of great remark which is this that a souldier in my presence gave to one of his fellowes a stroake with an Halbard upon the head penetrating even to the left ventricle of the braine without falling to the ground Hee that strooke him said he had heard that he had cheated at Dice and that he had drawne a great summe of money and that it was his custome to cheate I was called to dresse him which I did as it were for the last knowing well that he would quickly die having drest him he returned all alone to his lodging which was at least two hundred paces distant I bid one of his companions send for a Priest to dispose of the affaires of his soule he helpt him to one who stayd with him to the last gaspe The next day the patient sent for mee by his shee friend in a boyes apparell to come to dresse him which I would not doe fearing hee should die under my hands and to put it off I sayd I must not take off the dressing till the third day by reason hee would die though hee were never touched The third day hee came staggering and found me in my Tent accompanied with his wench and prayed mee most affectionately to dresse him And shewed me a purse wherein he had an hundred or sixscore peeces of Gold and that he would content me to my desire for all that yet notwithstanding I left not off to deferre the taking off his dressing fearing least hee should die at the same instant Certaine Gentlemen desired me to goe dresse him which I did at their request but in dressing him he died under my hands in a Convulsion Now this Priest accompanied him untill death who seazed upon the purse for feare least another should take it saying hee would say Masses for his soule Moreover hee furnisht himselfe with his cloathes and with all the rest of his things I have recited this History as a monstrous thing that the Souldier fell not to ground when he had received this great stroake and was in good senses even till death Soone after the Campe was broken for divers causes the one because we were advertized that foure companies of Spaniards were entred into Parpignam the other that the Plague begun much in our Campe and it was told us by the people of the countrey that shortly there would bee a great overflowing of the Sea which might drowne us all and the presage which they had was a very great winde from Sea which arose in such manner that there remained not one Tent which was not broken and overthrowne for all the strength and diligence that could be given and the Kitchins being all uncovered the winde raised so the dust and sand which salted and poudred our meate in such sort that wee could not eate it so that wee were constrained to boile it in pots and other vessells well covered Now we did not uncampe our selves in so good time but that there were many Carts and Carters Mules and Mule drivers drowned in the Sea with great losse of baggage The Campe broken I returned to Paris The voyage to Landresy 1544. KIng Francis raised a great Army to victuall Landresy on the other side the Emperour had no lesse people yea much more that is to say eighteene thousand Germans tenne thousand Spaniards sixe thousand Wallons tenne thousand English and a matter of thirteene or foureteene thousand Horse I saw the two Armies neare one another within Canon shot and it was thought they would never part without giving battaile There were some certaine foolish Gentlemen who would approach the enemies Campe certaine shot was made at them and some dyed at the place others had their Legges or Armes carried away The King having done what hee desired which was to revictuall Landresy retired himselfe with his Army to Guise which was the day after All Saints one thousand five hundred forty foure and from thence I returned to Paris The Voyage of Boulogne 1545. A Little while after we went to Boulogne where the English seeing our Army left the Forts which they had that is to say Moulambers the little Paradise Monplaisir the fort of Shatillon the Portet the Fort Dardelot One day going through the Campe to dresse my hurt people the enemies who were in the Tower of Order shot off a peece of Ordinance thinking to kill two horsemen which stayd to talke one with another It happened that the Bullet passed very neare one of them which threw him to the ground and t' was thought the said Bullet had toucht him which it did not at all but onely the winde of the said Bullet in the midst of his coate which went with such a force that all the outward part of the Thigh became blacke and blew and had muchadoe to stand I drest him and made him divers Scarifications to evacuate the contused blood which the winde of the said Bullet