melanckolye disseases In the legges are eight in each legge four vvherof the first is called Vena poplitis Vena Poplitis situated in the hockes or fovldinge of the knees is opened agaynst all disseases of the nethermost part of the bellye The second Saphena or mother vayne Saphena or Mother vayne vvhich vve opeÌ„ one the insyde of the legge vnder the anckle in all disseases of the kidnies of the vvombe to provoacke in the vvoemen ther monthlye sicknes or mestruousnes in all runninge of the raygnes and in Venus botches or as vve call them in lattin Bubones The third is the Schiaticke vayn vvhich externallye demonstrateth her selfe above the aÌ„ckle vvhich is only opened agynst the dissease called Sciatica The vayn Sciâ—tica The kidnye vayne agaynst all payne and doloure of the hippes and flanckes The fourth is the mediane or kidnyevayne situated belovve the foote and is phlebotomized agaynst all disseases of the kidnyes Amongst all the other vvhich are most coÌ„monlye opened are those three vvhich in the foulding of the arme are phlebotomized to vvit the head vayn Basilica the mediaÌ„ Basilica or liver vayne is daungerous to be phlebotomised VVe must dilligeÌ„tlye coÌ„sider that vvhen vve make an inscisioÌ„ theriÌ„ that vnder the Basilica or Liver vayne lyeth an artery or great harte vayne vnder the Median a synnue or tendone of the muscle Biceps or both of these together but vnder the Cephalica is nether synnue artery or tendone sitvated Cephalica or head vayne is opened vvithout daunger vvherfore amoÌ„gst all other vaynes ther is none vvhich vvith lesse perril dauÌ„ger may be opened If so be that through mischauÌ„ce in opening of the vayne Basilica vve chauÌ„ced to hurte the artery vvhich ther vnder is sitvated as I have knoovvne to have chauÌ„ced vve must praeseÌ„tlye for the stoppinge and restrayninge of the bloode and to the curing of the arterye vvithout leavinge anye Aneurisma Remedye for a vvouÌ„ded arterye cleave a bean in tvvo peeces laye the one halfe of the beane one the apertione of the vayne vvith a coÌ„presse therone gentlye tyed vvithout visitinge of the same in thre or foure dayes or once offer to touch it If so be in the apertion of the mediane vve chaunced to pricke the subter situated synnue or tendone vve must then immediatly phlebotomize the patient in the other arme and vve must droppe in the vvounde of the pricked synnue a little hott oyle of Terpentin and a little vvoolle beinge dipped therin vppon the same therby to keepe the apertione aperte then lay a playster of Diacalcitheos rovvnde aboute the vvounded parte of the vvhole arme vvhich hath biÌ„ne liquefacted vvith oyle of roses and vineger Of the Arteriotomia or apertion of the Arterys or hartvaynes Chap 5. COncerning the Arteriotomia or apertione of the Arteryes the praedicessors auncient professors vveare vvont to effect it especialle behinde the eares in the temples of the heade agaynst all continuall rebellious fluxions Rheumes of the eyes in like sort alsoe agaynst all diseases of the heade vvhich have takeÌ„ ther originall froÌ„ hotte dampishe or subtile rheumes as yet novv a dayes vve doe but not vvho lye as they vveare vvonte to doe in openinge of the same for soe farre forth as if the Arterye be small they then cut her cleane a sunder they also cut a peece therof avvay both the endes are dravven invvardes vvher by shee as then bleedeth noe more And if the Arterye be greate violentlye beateth it is the surest vvay that vve tye her vnder above and then betvveen both those ligations cut her of but the thredes vvhervvith vve binde her must be stroÌ„g closly tyed because that through the continvall beatinge of the arterye the thredes looseÌ„ the arterye openeth if so be it be not stiflye bovvnde because that she should not chaunce to corrupt before the inscision be replete grovveÌ„ full of flesh vvher through the mouth of the foresayed artery is stopped Hovv vve vse novv adayes to to open an artery But novv a dayes vve only make a simple inscision in the artery in such a manner as vve make an apertion in the vaynes vvithout cutting of the same clean of having dravven as much blood therout as vve desire vve theÌ„ lay a litle playster of masticke on the apertion a litle compresse tyed theron rovvnd abovt the vvhole head as close as is possible I knovve right vvell that ther are some vvhich houlde this apertione of the arteryes verye suspecte because it caÌ„ hardlye be stopped agayne and in doinge this ther remayneth a cicatrice in those partes vvhich are situated rovvnde about the foresayed arterye before the same is fullye cured and ther throughe often times an Aneurisma caused vvhich is verye troublesome Aneurisma is a daungerous dissese and daungerous for the patient But I may vvith verity affirme it to be true that oftentimes I have seene opened the arteryes of the temples of the heade vvithout any of the foresayed accidentes beinge happened thervnto the vvhich I couÌ„cel the yonge Chyrurgiane to doe it onlye in this place because such an inscisione is more fitter lesse daungerouse theÌ„ the vvhole cuttings of and ligature of the same ⧠Of the swellinge Aneurisma and of the meanes howe to binde and cut of the same Chap. 6. Discription of the tumefaction Aneurisma THis tumefactione Aneurisma is caused most commonlye throughe the dilatation of an arterye vvhich only vve must vnderstande of the smalle Aneurismata beinge impossible that the arterye shoulde so dilate as it vveare vnshutt in the greate Aneurismata vvhich oftentimes vve see vvherfor vve vvill rather say and houlde vvith the opinione of the auncieÌ„t professors that Aneurisma is then caused vvheÌ„ as the bloode and the vitall spirites are repulsed out of the arteryes throughe the apertion or orificia of the same vvhich vve call Anastomosin or els vvhen as the tunicle of the arterye is burst it be ether throughe a vvounde or by anye other occasione as vve may se vvhen as the Chyrurgiane purposinge to opene the vayne in the elbovve by chauÌ„ce prickethe the arterye vvhich is theruÌ„der sitvated the skiÌ„ne vvhich is theroÌ„ lyinge cicatrizeth it selfe and the perforatioÌ„ of the artery through her coÌ„tinvalle reverberatioÌ„e tarrieth vncured opeÌ„ is not stopt or vvith anye carnall substance replete as beinge vnprofitable for anye vse in noe sorte can be bound so close as the arterye of the temples of the heade but throughe the blood vitalle spirites vvhich by degrees issue therout are congregatede vnder the skinne soe conseqventlye cause the svvelliÌ„g supposinge they verye vvell did knovve therin to be matter or any other slimye substance or viscositye for vvhich reason they have made an apertione therin vvhervppon a little time therafter death hath follovved because of the bloode and of the vitall spirites vvhich in
parte of his body as havinge tvvo heades four armes beinge dubble or els if ther be moe then one to vvitt tvvo three or four vvherof the one might praesent his arme an other his legge or anye other part all at one time Afther the infāt praesenteth himselfe the childebirth falleth easye or difficulte because that follovvinge the naturall Childebirth the childe allvvayes praesenteth first his heade havinge his armes stretched out alōgest both his sydes or vvhē it praesēteth it selfe vvith both the legges forvvarde vvherby it may easylye be plucked dravven out vvhen it praesenteth him one anye other manner it is as then not naturall but verye daungerouse vvherin vve must vse our remedyes as herafter shal be shevved The externall occasions Touchinge the externall occasiones they are violēt heate vvherthrough the strengthe forces of our bodyes are convicted contrarilye ther is great could vvherthrough all the conduictes are stopped as allsoe are those persons vvhich vve feare or hate The childe alsoe as longe as it lyeth drye the vvater as yet is not brokē out vvherthroughe it can have no passage because the vvayes passages are drye not slippery not smoothe as in the vvater streames vve may see that the stones through the slipperishenesse of the vvater The operatione are carryed avvay In like sort alsoe all sorrovve tribulatiō stoppeth occludeth the entrance of the vvombe as cōtrarilye the meane reasonable iucunditye openeth the same All these foresayed occasions must be cōpared vnto ther cōtraryes as if soe be that throughe the imbicilitye of the mother it be occasioned she must thē be conforted givinge her a little vvyne or Hipocras conforting ioyinge her in her necessitye as much as is possible if soe farr forth as the passage be to narrovve or anguste to exsiccate or dry or els to much shrūcke vve must then endevore vvith decoctiones vvith vvarme infusions vvith pingvefactiōs to soften moystē make supple the same If then ther be anye carnositye vvhich in terrupteth the passage therofe vve must depose detrude the same one the one syde or if ther be a stone in the entrāce of the bladder vve must thrust the same on highe if soe be the Childe othervvise praesent it selfe thē it should as first vvith the heade vve must then turne it in the best sorte vve maye or if it thrust one arme or legge out vve must not thervvith dravve it out but must gentlelye retrude it backe agayne agayne bringe it into his place or if ther be more thē one child vve must dilligently consider hovve vve ought to take hould therone notinge that vve doe not take the one by the foote and the other by the foote soe both at once plucke thē vvherfore vve must thrust one foote on highe dravve tovvardes him the foote of that vvhich is next Hovv vve ought to situate the vvoman most rediest vnto the passage But before vve come to the manuall operatiō vve must first of al situate the vvomā convenientlye although ther be divers māners of situationes for some sett thē in a stoole others set thē leanīge on a table or one the edge of a bedd vvith the legges separated the one from the other others set them one theire knees yet the best fittest vvay is one a bedde causinge the vvomā to lye one her backe thvvarte over the bedde close to the edge ther of vvith cushēs or pillovves vnder her backe to rest her heade therō layinge her heeles close to her buttockes vvhich must lye alsoe somvvhat exalted and the hippes spanned the one frō the other vvhich of tvvo vvoemē must so in that sorte be helde least that she doe not chaūce to dravve shutt them together the vvomā lyinge in this sorte the Chirurgian as then may the easyer obtayn his vvill and com close vnto her to drive detrud the child tovvarde the entrance of the vvombe The vvomā beinge thus setled or layed the Chyrurgiā must lay one the knees one the belly of the vvomā a cleane linnē clothe partly to be an opercle or coveringe to the vvoman partlye ther through to be freed from the externall ayre thē he must gentlely thrust his hande being annoyncted vvith freshe butter vvith Sallatoyle or vvith hogges suct in to the entrance of the vvombe first of all cōsideringe vvhether the childe be alive or deade hovv it is thereī disposed or turned vvhether also ther be more thē one tvvo or thre children a fore hādes hovve soever it be situated The child must vvith his heade be dravvne out or vvith the feete if it be possible or disposed ether alive or deade curved or croocked if it be possible vve must dravve the heade first out but if not vvith both the legges dravvinge the same aeqvally dovvnevvardes cause one of the armes to be stretched out alōgest the syde of the heade because ther throughe may be hindered that the bodye beinge therout the vvombe doe not chaunce to shutt the necke of the Childe be not therin inclosed vvhich through the arme vvhich lyeth stretched out by his heade shal be praevented hindered If so be the one foote praesenteth it selfe the other tarrye therī vve must tye the foresayed foote vvith a ribbon gentlye thrust in agayn the foresayed foote sufferinge the end of the ribbon to hange out and inqvire seeke after the other foot thrustinge the hande alongst by the foresayed foote legge vntill such time as vve feele the buttocke of the other foote then reducinge your hande close to the buttok shall immediatlye finde the other foote vvhich gētlely you must bring forevvardes dravvinge by the ribbō the other foote vvil come forth agayn vvhich having thē both aeqvally together must gētly dravvē thē out vvith the rest of the vvhole bodye of the child by this means vve may knovv vvhether they be both the legges of one child on this māner dravving out the same first the one then the other Signes of a deade Childe in his mothers bodye But if so be the Childe be deade it vvill not as then stirre it selfe in the feelinge also therof it vvill be coulde vvhenas vve thrust the fīger in the mouth therof it stirreth nether lippes nor tunge to suck The mother as then hath a stinckinge breath hollovve eyes and a svvollen bellye vve therfore out of all these foresayed tokens perceavinge the Childe to be dead vve must then dravve it out as already vve have sayed vvith the feet forvvardes As farre forth therfore as if the Childe had one arme or one Legge hanging forth of the vvōbe it vveare impossibleto reduce the same agayne into his former sitvation because that throughe the bodye of the Childe the entrance of the vvombe is stopped vve must then plucke the foresayed arme or legge dravve it to the ioyncte of the shoulder or of
Dura mater Vaynes vvhich burst vvithin the braynes as vvell of those vvhich passe throughe the sutures as througe anye of the other smalle holes internallye are situated vvith in the braynes might come to breake out of the vvhich ther vvill issue bloode vvhich therafter cōgealeth and vvith great payne changeth in to matter vvith manye other fearfull accidents In this dissease theris all vvayes payne about that vayne vvhich is burst and if soe be vve chaunce to open in this place the skinne the bone there vnder hath a pale and deade Coloure but it is a difficult matter to iudge and knovve it vvherfore consideringe often times of the impossibilitye to doe anye remedye or cure therine by vvant of knovvledge death suddaynlye ensueth theron The vvhich Hippocrates reciteth of the daughter of Nerius A historye must of the daughter of Nerius described through Hippocrates vvhich vvas but 20. yeares oulde vvho in playinge beinge smitten on the bone Bregma vvith an outstreched arme of one of her playfellovves strayghtvvayes vvithout anye respiringe is fallen into a Vertiginem vvho as soone as she vvas brought into the house is fallen into a violent ague vvith payne in the heade and rednes of face one the seaventh day she voyded a goblet fulle of reddishe matter filthylye stinckinge out of her right eare by the vvhich she seemed to be somevvhat lighted and easyed but vvhen the ague agayne returned vnto her she vvas then vvholye abashed and allmost lay vvithout anye reason or vnderstandinge vvith Spasmo in her right cheeke or syde of the face vvithout beinge able to speake vvherone the foresayed Spasmus hath possessed the vvhole bodye vvith shakinge qviveringe vvith the tonge tiede and vvith irremoveable eyes and dyed on the ninthe daye ⧠What Fractures of the heade we ought to trepane and wherfore we must trepane them Chap. 3. We ought not at all times to trepane ALthoughe that in all fractures and fissures of the sculle the yōghe Chyrurgians take ther light or refuge strayght vnto trepaninge it is notvvithstādinge better that in the firste vve trye vvith playsters and vvith manye other remedyes and inventions therto constituted and ordayned consideringe one the consequence and importāce of the foresayed Fracture vvhether it be needfull or necessarye to take avvay anye parcell or peece of bone consideringe the excellentie and vvorthines of the braynes vvhich are such vvorthye partes vvherfore vve must vviselye and dilligentlye consider and marke vvhether the vvounde give a goode digestione forth of her and purifieth her selfe and vvhether there beginne in the vvounde to grovve anye redde pomgronate Kernell vvise fleshe or vvhether the ague vvhich consideringe the suppuratione in the vvounde be abated or asvvaged or hath left him vvhich soe in tollerablye vexed and tormented him vvhether his apetite be agayne restorede and vvhether the patient reasonablye taketh rest or sleepe vvithout havinge anye troublesome accidente chaunce vnto him vvherbye vve might suspecte that the membrane called Dura mater or the braynes are molested affected or suffer any payne ether throughe a splinter or throughe anye bloode or throughe anye matter vvhich might be come and situated it selfe therone And the matter luckylye ominouslye procedinge The fissures recollecte then selves sōtimes vve may continue the fore sayed remedyes and the vse therofe because that sometimes by this meanes the fissures are replenished filled vp vvith some obdurate substance and callositye vvhich agreeth and may be likened vnto the callositye or cicatrice of other bones Sometimes onlye the first table of the sculle breaketh and renteth vvithout pearcinge or penetratīge the Diploe Diploe is the porositye betvveene the botables Some times allsoe is the fore sayed diploe crushed plettered and broken yet the seconde tablē safe and illaese or vnburte vvherfore as then it is not necessarye to detecte and make bare or to trepane the membrane Dura Mater yea and as then vve may perceave the manner as it vveare of a splinter of the sculle therin lyinge erected The fracture at sometimes alsoe is soe greate vvith such a huge quantitye of massacred and crushed bones vvhich lye halfe and halfe separated or els for the most parte cleane beaten theroute that vve may playnlye vvith our eyes behoulde the membrane Dura mater soe that the bloode vvhich driveth therone may verye easylye flovve out of the vvounde in like forte allsoe may the remedies therin easyly be applyed To the vvhich fractures the trepane is nothīge behoovinge or nedefull And if so be in anye sorte you perceave anye skilfers or splinters by the vvhich that membrane might be pricked or crushed you must take them verye easylye therout It happeneth alsoe some times not onlye in the little children but in aged poeple The bones of the yonge Childrene are bēt invvardlye alsoe in vvho me the bones are soe thinne and tender that vvith anye rude blovve they are invvardlye bente as vve see a tinne or a copper potte to be brused vvithout the externall skinne beinge anye vvhere externally hurte To the vvhich disease of the bones vve must onlye take our refuge flight vnto our extractive dravvinge plasters vvherbye that the depressede bone might by anye meanes be elevated and heaved agayne into his right place Hippocrates comprehendethe in verye Shorte vvordes in his blooke De Locis in homene The opinione of Hippocrates tou the vvhole cure of the fractures of the sculle demonstratinge those vnto vs vvhich vve ought to trepane The opinione of Hippocrates touchinge the curinge of fractures or not As farre forthe therfore sayeth he as if the bone be broken or massacred ther is as thē noe perrille or daunger at all vvith moysteninge medicamentes must it be cured and helped vvhich quiet and take a vvay the inflammatione soften and mollyfye the bone because that vvithout payne vve might take the brokē peeces of bone therout but insomuch as the bone onlye chaūcede to be burst it is then verye daungerous must of necessitye be trepaned because that the matter vvhich distilleth throughe the rente or fissure one the membrane doe not in anye sorte corrupte and rott the foresayed subiacent or subiectede membrane for as vvithout havīnge anye issue agayne shee come to sincke throughe this angustnes and narrovvnes as then she causeth an ague and somtimes allsoe distemperatenes of minde vvherfore vve must needes trepane and make a large apertione because that the sanious matter may not onlye have an entrance but an issue alsoe vvhen as vve doe not in anye sorte suspecte that the membrane Dura mater sufferethe any thinghe or is in any sorte crushed or pricked vvith anye peeces of the brokē bones that ther is noe matter runne therone by the vvhich she might be troubled it is not thē necessarye that vve trepane or open the sculle For vvhat occasione vve ought to trepane The Chyrurgiane is constrayned to vse the trepane for divers occasions and
figure of the inscisione it is effected in three sundrye sortes and fashons vvherof the first is made overthvvarte the secōd accordinge vnto the length of the vayne vvherthroughe the vayne is cleft or splitted not pricked the thirde is the meane betvveene them both vvhich vve may vvell call the contradictorye apertione because cōtradictorilye shee is made Three formes of inscisions in phlebotomye VVe make the apertione overthvvarte vvhen as vve are not minded to reiterate the phlebotomy for vvhē vve bende the ellbovve thē both the endes of the vayne ioyne together agayne This figure or forme is necessarye vvhen as vve desire to make a large apertione VVe must make the apertione sydelonge or contradictorye vvhen vve purpose to iterate the phlebotomye and vve makinge the apertione in this manner verye seldome or never misse the vayne and vvhich is more it is better for the circumstantes and standers by vvhen the bloode in this manner issueth therout That inscisione vvhich is made accordinge to the lēgth of the vayne is verye expedient vvhen vve intende to renue the bloode lettinge that not onlye the same day but one the next day alsoe because that vvhen vve bende the elbovve both the labia or lippes of the vayn do separate devide themselves But in vvhat forme soever vve make the inscisione The vayne must be inscided in her middle yet notvvithstādinge the vayne must be pearced in the middle vvithout vvholye cuttinge a sunder of the same Because her lippes might chaunce to be inverted invvardes and the bloode could not resulte out of the apertione but runne dovvn a longe by the arme or both the endes of the vayne are dravvē invvardes vvithout deliverāce of anye blood from her or at the least in the first very little ⧠Wheron we ought to marke after the thruste apertione of the vayne and when the bloode issueth therout Chap. 3. Although the vayne be vvel opened yet shee droppeth throughe the afrightednes of the patiēt WE may knovve that the vayne most commōlye is vvell opened as easily vve may perceave by the bloode vvhen as in the firste it rousheth and as it vveare leapeth out in great haste but immediatly altereth vnto droppinge vvhich throughe the afrightinge of the patient is caused for vvhich reason the bloode is dravven invvardes VVhich vvhen it chaunceth vnto vs vve must vvith patiēce abyde and vnbinde it somvvhat and incourage the patient causinge him to move his fingers turne Grosse bloode doth nothinge but droppe and crush the same in his hande The apertione in the vayne is sometimes ample enoughe but because the bloode is grosse it can not issue out therat to the vvhich end vve must put a little oyle therine vvhich to that purpose is verye profitable If soe be therfore the Chyrurgyane in absence of the physitione findeth the patiēt verye feeble and yet notvvithstandinge follovvinge the rule ordinance of the physitione is verye necessarye to be vvell phlebotomized vve must them doe it providentlye that althoughe at the first vve have not dravvne soe much blood as the sicknes or dissease reqvireth vve must then some certayne hovvres therafter agayn renue the phlebotomye for the seconde time and if it be needfull yet once agayne for the thirde time vvithout over charginge of the patient vvith to great phlebotomye at one time It might alsoe chaūce that before vve could detracte such a qvantitye of the patiēt as vvas ordayned and reqvired the patient might chaunce to be debilitated and in daunger to fall in great fayntnes sovvndinge vvheron the Chyrurgiane must dilligentlye consider as he may easyly perceave it vvhen the patiēt vvaxeth pale and oppressed at his harte his puls diminishinge vvhen the bloode runneth dovvne by his arme What vve ought to doe vvhē vve perceave the fayntinge to approch the patient VVhich vvhen it chaunceth the Chyrurgian must then immediatlye sease the bleedinge layinge his thumbe one the apertione of the vayne lay the patiente on his backe vvith his heade one a cushen sprincklinge could vvater in his face and give him a little vvyne in his mouth and cause him to smell at some vineger and then have a little patience vntill that agayne he reviveth comme to himselfe for as soone as he shal be come to his former strength agayne vve may as thē finishe the phlebotomye The patiēt lying fiat on his backe cā verye vvel suffer phlebotomye Some ther are vvhich in anye sorte can not indure phlebotomye hovv lovve soever they sitt althoughe it vveare on the bed or althoughe vve cōtinually helde vineger before ther nose or gave them vvyne to drincke yet notvvithstandinge they lyinge prostrate on the bedd vvith ther heade reasonable highe they can as thē verye vvell suffer and abyde the foresayed phlebotomye althoughe vve dravve a goode qvantitye of blood from them As of late I my selfe have knovvne to happen in an honorable and coragious gentleman After that vve have detractede a reasonable qvantitye of blood out vve must then dissolve and make loose the ligature and crush out the bloode of the vayne least that the bloode chaunce to congeale therine and coagulate and soe exulcerate and if soe be ther appeerede anye little parcell of pingvedity or fat vve must thē gentlye thrust it in agayne vvith the heade of a pinne and not cutt it of and then vvipe of the blood vvhich cleaveth is dryed or exciccated to the arme lay a little cōpresse one the apertion vvhich is madefyed in coulde vvater and vvinde the ligature tvvice or thrice aboute the elbovve like a borgondian crosse vvithout tyinge both the endes fast before you have caused the patient to bende his arme to laye the ligature therafter The Ligatione of the elbovve after phlebotomye This ligatione may not be to stiflye bovvnde because the cicatrice by this meanes may qvicklye be sitvatede on the apertione of the vayne The arme beinge thus fouldede together if so be the patiente be able to vvalke he must vveare his arme before on his breste in a scarfe if so be he lye on his bedde he must gently lay the same besyde him vvith out much movinge of the foresayed arme nether must he lye therone for ther have binne some vvhich in ther sleepe have hadde ther armes violentlye to bleede vvith great daunger of ther lives Hovv vve may stopp restraygne blood The bloode issueth sometimes vvith such violence out of some partes of our bodye that vvith noe cōpresses or ligatures vve can restraygne the same vvhich happeninge vve are thē constrayned to lay above one the toppe of the apertione the one halfe of a greate beane and the compresse therone and in this sort bind it together Ther remayneth somtimes a nigreditye or blacknes Daunger that happeneth to phlebotomye viriditye or greenes about the apertione but therof ensueth noe evell vnles anye other accident chaunced thervnto VVhen as therfore vve
desire to renue the phlebotomy To renue the phlebotomye vve must then lay one the inscisione saulted oyle because that hindereth the curinge of the vvounde and the sault keepeth the blood from coagulation vvherthroughe the apertione of the vvounde is stopped And if soe be the vvounde vveare soe stopped that the bloode vvould difficultlye issue therout vve must not then rigerously stretch out the arme vvhich the patient hath carried on his brest dubbed nether depresse the vayn vvith to great violence to get the bloode therout Because such violēce might cause great payn and inflammatione To renue the phlebotomye but vve must rather vvith a small privett or searching iron remove that blood vvhich therin is exciccated dryed or rather once agayne make an inscisione after that vve have bovvnde the arm somvvhat higher then the elbovve as before vve have sayed Hovv vve ought to open the vaynes or arteryes of the tēples of the head VVhen as vve desire to make an apertione in the vaynes or arteryes of the temples of the head of the foreheade or vnder the tunge vve must then cause the patient gentlye to vvring about his neck a table naptkīne or a tovvell therby to cause the bloode to ascēde on high the vaynes to svvel vvhich vve intend to open Hovv vve ought to open the vaynes of the handes feete And vvhen as vve desire to open the vaynes of the handes or feete vve must bath them in vvarme vvater because throughe caliditye vvarmethe of the vvater the foresayed vaynes might erect themselves the bloode the vayne beinge opened might the better issue out therof ⧠Of the number of vaynes arteryes which commonlye vse to be opened in mans bodye Chap. 4. THe aunciēte professors of Chyrurgerye have observed certayne vaynes vvhich in mans bodye must be opened accordinge as everye divers dissease shall reqvir vvherof the Chyrurgiane must not onlye knovve ther situatione ther divisione or separatione but alsoe the names of the sam because that he doe not mistake the one from the other Vayne of the foreheade They vvhich most commonlye are opened are 41. vvherof ther are in the heade 17 een the first vvherof is called the vayne of the foreheade vvhich is situated in the middest of the foreheade and is opened vvhen as vve have anye inveterated payn in the occipitialle partes of the heade to trouble molest vs. The seconde is called Vena Pupis Vena Pupis vvhich is situated right in the middest of the occipitialle or hinder partes of the heade this vayne is opened agaynst the soporiferousnes payne of the heade vvhich is situated in the foreheade The temporall vayne The thirde is called the temporalle or vayne of the tēples vvherof in each syde ther is on vvhich in divers brāches ascēdeth in the temples of the heade vve open those vaynes agaynst the superfluous lachrimation of the eyes agaynst vehemēt payne in the eares agaynst the Hemicrania vvhich onlye commeth in on syde of the heade Eeare vayne The fourth is called the eare vayne one eache syde one have ther place situatione behinde the eares this vayne is opened agaynst surditye Eye vayn payne vlceration of the eares The fifth is the eye vayne the vvhich in the greate corner of the eye close by the nose vve may perfectlye see shee is opened agaynst all disseases of the eyes eyeliddes The sixt is Nosevayn the nosevayne vvhich hath her place in the middest of the end of the nose betvveene the tvvo grisles or cartilages shee is opened agaynst the heavines of the head agaynst all reumes of the eyes eyeliddes The seaventh Lippevayne is the lippe vayne vvherof one each syde are tvvo in the internall partes of the opermost and nethermost lippe vve opē them agaynst all tumors excrescenses of fleshe agaynst all vlceratiōs of the mouth agaynst the vehement rednes of the face The eight is called Ranularis vena Ranularis vvhich is situated vnder the tunge one each syde on vve make therin an apertion agaynst the Sqvinantie agaynst the incensione of the Almondes of the pallate more other disseases of the throte The ninth is very publique lyinge in the necke and is called the Iugularis Iugularis vayne of the Arabians Gvides on each syde of the necke one Shee may very conveniētlye be opened agaynst tht Sqvinantye agaynst all rheumes of the throte vvhich bringe vs into greate angustnes and trouble In the armes are sixe in every arme three vvhich in the fouldinge of the armes are phlebotomized The first is the head vayn Headvayne Cephalica vvhich is situated highest most outvvardlye in the arme vvhich vve opē agaynst the payn of the heade eyes eares payne svvellinge of the throte The second is the nethermost in the insyde of the arme is called Basilica Basilica being the foundatione of both the other vaynes and is also called Hepatica or liver vayne Hepatica or Liver vayne VVe open this vayn agaynst the stoppinge of the Liver agaynst all inflāmations of the vvhole bodye all disseases vvhich are situated vnder the heade The thirde is the Mediane The Mediane or Mediana as vvell concerninge her situatione as originall because shee taketh her beginninge out of the Heade Liver vaynes as also considering her conditions because vve open her as vvell for all disseases vvhich are situated in the vpper as vndermost partes of our vvhole body and ther trouble and molest vs. In the handes vve have sixe in each hande three Eye vayn in the hande The first descendeth a longest the Metacarpion of the hande and passethe betvvixt the thumbe the first finger vve call her allsoe the heade vayne or the eye vayne VVherfore shee is onelye opened agaynste payne in the heade eyes The seconde is called Salvatella Salvatella or Liver vayn betvvixt the little thirde finger shee is phlebotomized agaynst the yellovve gaundise in all disseases of the liver on the right hande and one the left agaynst all disseases of the milte vvherfore of som in the left hande shee is called the miltvayne Blacke vayne The thirde is alsoe called the Mediane Blacke and Common vayne descendeth by the finger called Medicus Blacke vayne or thirde finger vvhich vayne vve may open vvhen vve can finde nether of the other tvvo In the belly are tvvo in each syde of the bellye one Vena Illiaca vvhich vve call Venam Illiacam or Titillarem demonstratethe her selfe betvveen the hippes the flanckes She vvhich is opened in the right syde agaynst the Dropsye and other disseases of the Liver shee vvhich lyeth in the left syde agaynst the disseases of the Milt In the fundament or privityes of a mā are one each syde tvvo the one vvherof vve calle the Hemorrhoidalle vayne Hemorrhoidall vayne is onlye opened in
the hippe Hovv vve ought to dravve forth a deade Childe then discide cut of the same in the foresayed ioncte And if so be the heade did first repraesent it selfe vve must then thrust both our fingers into the mouth therof in place of a hoocke tovvardes the roofe and so as gentlye as is possible dravve the same tovvardes you If soe be the belly therof be svvollene or hath to greate a heade and the same fulle of vvater vve must then vvith our finger a little crush theron because the aquosity might soacke therout and the svvollen partes by this meanes be diminished and vnsvvollen if soe be that our handes vveare not sufficient to dravve out the Childe or to finde the belly to let out the sayed Aquosity vvhich ether is retayned in the heade in the Brest or in the bellye vve must then gently vvith our right hande bringe therin a little curved and croocked knife vvhich vvithin the curvednes therof is sharpe and cutttinge the acuitye or povncte therof being closely inclosed betvvixt his fingers After vvhat fort vve may dravve forth the aquositye out of a deade Childes bodye vvhich he must houlde verye close together vvhervvith vve must make an inscisione ether in the Heade in the Breste or els in the Belly by this meanes to dravve forth the vvater vvhich is therin cōtayned And then vve must take a hook vvhich on the same fashon as is afore sayed vve must bring therin vvherof vve must fasten the poyncte ether in the eyes or in the mouth or in the Clavicles vvheron vve must then dravve as violentlye as the cause reqvireth to be done dilligentlye cōsideringe that the hooke breack not through let his houlde goe through the violente pluckinge of the same doe not chaūce to hāge take houlde in the VVombe to the vvhich intēt vve must vvith as much iudgemēt cōsideration dravve the same as is possible onlye vvith one hande vvhich muste be vvithin the VVombe Novv if the Childe be so thick so grosse A monstruouse Childe that vvholy to dravv it out is impossible for vs or els if it be a Monster or tvvo Childrene faste together vve must as then by parcels dravve them out cuttinge the Heade thereof in peeces then plucke out first the the one peece then the other then the Brest the Armes and the legges allvvayes makinge that it be cut in the ioynctes vvithout breakinge any bones for although they be tender yet the splinters therof might chaunce to hurte the vvombe soe that it is allvvayes the surest vvay vve cutt of the Armes and legges in their ioynctes It chaūceth also sōtimes that vve dravvinge forthe the Childe by the legges that onlye the head tarrieth therin vvhich therafter vvithout great difficulty vve cā not get it out thē vvith extreame daunger because the same rovvleth vp and dovvne in the concavitye of the vvōbe this therfor being happened ther must as then a servant or one of the standērs bye vvhich is experimented in such affayers sittīg one the left syde of the vvoman crushe vvith both his handes one the bellye of the vvomā beinge covered vvith a vvarme cloth on this manner to depresse dovvnevvardes the heade of the childe and ther in that place to contayne and keepe the same Hovv vve may dravve forth the heade of the deade childe as yet remayninge in the vvōbe And the Chyrurgiane vvhich sitteth on the right syde of the vvoman must vvith his light hande bringe the hoocke therin as is already sayed vvhich he must faftē in the heade ether in the eyes in the mouth or in the apertione of the heade dravve the same by little little therout as if as yet the vvhole bodye remayend therin If soe be the foresayed head vveare to great vve must then in like sorte alsoe cutt the same in peeces and dravv therout the peeces first the one then the other The Childe beinge dravven therout vve must dilligentlye consider that vve doe not breake a sunder the navell because it may serve for a conductor leader vvhich vve must allvvayes feelinge the same and suffering it to glide throughe our right hande must follovve vntill vve be come to the matrice vvhervvith the Childe vvas covered in the foresayed vvōbe hauinge found the same vve must gentlye rovvnde about separate her vvher vve finde her to befastened then dravve her forth vvith al the cōgregrated blood therī if therbe anye least that there it might chaunce to putrifye havinge thus finished all this the vvoman as then shall ioyne and shutt her hippes together agayne and must then circumligate the bellye as is required and necessarye In this forerehearsed daunger is oftentimes incident vnto the vvoman a farre more lamentable and pitiful accident to vvitt a discendinge and sinckinge do vvnvvardes of the vvombe vvhich betvveen the hippes sincketh out throughe the vvhich the vvoman can not goe The māner to elevate agayn the suncke discēded Matrice If soe be therfore this chaunced vve must gentlye and easilye by degrees thrust in agayn the same as vve have sayed of the guttes or entralles being sunck out vvherof vve must cause the disseased and sicke vvoman to keepe her bedde some certayn cōtinuance of time vvith her buttockes a little exalted and if soe be the Matrice in her risinge chaunced agayn to sincke out vve must then agayn thrust in the same And to praevent her that she doe not agayne sincke out of the bodye vve must thē thrust in the Matrice a Pessarium like a rovvnde Apple vvhich must have a hole in the middle therofe as heer before amongest the instrumentes vve may see it defigured vnto vs vvher vve shall alsoe finde the forme the figure the manner of vsinge the same ⧠VPpon what occasione the externall partes as Armes and legges are and must be extirpated or cutt of and in what place it must be done Chap. 4. When vvhye the externall part must be saved of THe externalle membres of mās bodye as are Armes legges are cutt or savved of vvhen as they are sqvised plettered and brokē the Vaynes Arteryes Synues vvholy be lacerated cutt of Or els vvhen they concerninge any externalle occasione are hurte or indammaged vvherby they sōtimes vvholy come to be mortifyed that suddaynlye or els somtimes alsoe by degrees so that somtimes ther ensueth such a Gangraena or mortification that not only the fleshe all the other mollifyed partes of the foresayed ioyncte doe mortify corrupte but alsoe the Bones themselves soe that ther is noe hope at all of any health then onlye throughe the extirpatione of the same fearinge least that the foresayed Gangraena shoulde farther infect pollute all the circumiacent partes vvherethroughe the patient might suddaynlye chaūce to dye Notvvithstandinge the Chyrurgiane may not in anye forte aproch vnto his exstreame last remedye before he have tryed all other remedyes to ease
povvnde of Potashes An other vvhich vvith all expeditiō can be made Sal alcali pulverizated very smalle foure ovvnces commone ashes of vvoode tvvo povvnde infuse heer in 15 povvnde of common vvater let it stande soacke three or foure hovvres then seeth it a little if you take it to be convenient and then let it stande purifye or sincke and then let is straygne throughe a Felte heerof you may make goode Cauteryes Allthoughe that vve have all these foresayed thinges in a readines An observatione in seethinge of the saulte to the Cauterye therof to make a lye or lixivye vnles that you ebulliate your sault verye short drye it vvill as then have noe great forces vvill qvicklye be liqvefacted agayn dissolved Therfor to seeth a right your lye you shall infuse it in a Basen let her there seethe and ebulliat or evaporate till such time as shee be verye thicke like vnto honye mixe stirre it vvell together vvith an iron Spatula and then the foresayed sault vvill somtimes present divers colours as blevve by little little vvill grovv thicker yet not vvithstandinge vve must yet make greater fyer thervnder Liqvefactinge fyer vvith violente flames as if it vvear a liqvefactīge fyer because the foresayed sault might be melted and liqvefacted as Butter chaunged into vvater of the vvhich you must take a little on your Spatula lay it on a stone if soe be it immediatly vvex harde it is thē a signe that it is sufficientlye sodden For if soe be as then you keepe it longer one the fyer it vvill as then burne agayne be chaunged into ashes as beinge needfull that there be some humiditye therby to keepe it in his vvonted thicknes vvhich beinge done you must then remove your Basen from the fyer vvith the Spatula take out the sault or your Cauterye therout vvhilest as yet it be hott least that it cleave therone to harde vvherof yon must then make great or little Trociskes vvhich immediatly you must put into divers little glasses violles least that through the ayre they chaunce to be altered and chaunged and stoppe the same very close Hovv vve must praeserve the cauteryes vse thē vvhensoever it shall please you And to praevent that the Escara of the cauteryes or ruptoryes be not to harde a certayne frende of mine for certayntye imparted vnto me that in the end of the ebullitione of your lixivye vvhen shee is aboute the thicknes of hony vve infuse thervnto a little Aquavitae or spanishe vvyne or els anye other stronge vvyne as Malmasye And to make them soe that they shoulde not cause anye great payne vve must as thē adde vnto it a little Opium vvhich is liqvefacted in Aquavitae but I never tryed it The manner howe we ought to applye these Cauteryes Chap. 4. NOvv therefore condecentlye to applye all cauteryes as vvell actuall VVheron vve ought to consider in the application of the Cauteryes as Potentiall vvithout expectinge therin anye reproche vve must first of all cōsider one those vvhich are able to tollerate them In vvhat places they may be best sett and applyed one vvhat manner vve may applye them for commonlye the vvithered leane personnes can not tollerate them vnles it vveare one the heade because their bodyes are nothing els then Membranes Vaynes Synnues vvherthrough sōtimes greate payn might be caused or anye vayn or Artery might chaūce to be through corroded one al vvhich thinges vve must note vvhen as vve must applye anye Cauteryes vve must also consider one the nature of the Patient Divers considerations for a strong grosse bodye as a Labourers or countrye clovvne may farre more easyer tollerate suffer a Cauterye then a tender delicate bodye or of a vvoman nether can anye obdurate parte as is the skinne of the heade soe easylye be corroded through as anye other soft or tender parte vvherfore vve must houlde the Cauterye longer one the one place then one the other A little actuall Cautery or a little parcell of a potētiall Cautery vvil vvorke as forciblye one a tender softe bodye as a great cauterye vvould doe one a strong grosse and obdurate bodye If soe be it be a replete corpulēt bodye or an vnhealthsame bodye vve must then first of al Phlebotomize or purge the same because in the cauterized partes ther chaūce not to come anye concursione of humors VVhen vve desire to applye anye Cauteryes or make any Fontanelles vve must consider that vve apply them not one any synnuishe parte nether on the endes or beginninges of any muscles nether any greate Vayne Arterye or Synnue Places vvheron vve apply the Cauteryes VVe applye them most commonlye on the Heade one the Armes and one the legges betvvixte all corners of the heade for the curinge of divers disseases vvhich heere before vve have recited the aunciente Chyrurgiās have made theire choyse of that place vvhere the Sagittalle suture ioyneth and vniteth her selfe vvith the Coronalle vvhich place is like vnto a threfould vvay of the heade the vvhich plase because vve should not misse of the same is shevved vnto vs of Albucasis To vvitt that vve cause the Patient to put forth the one of his handes Hovv vve shall finde in the heade the place vvheron vve must applye the Cauterye and lay the end therof vvhich is the vvriste or bēdinge of the hande one the originall beginninge of his Nose betvveene both his Eyes and thē stretch forth his middlemost or longest finger tovvardes the crovvne or superior parte of his heade one that place vvhere as the foresayed finger shall have his endīg ther vve must apply the Cautery because that ther is the place vvhere the sagitall suture vniteth her selfe vvith the Coronall suture if so be throughe the applicatiō of this cauterye vve desire to doe anye vtilitye profite vve must thē suffer the same to penetrate vnto the bone for by this meanes the bone being denudated it vvill exfoliate peele through the vvhich the apertione continueth the longer open VVherfore divers after they have applyed the potēciall cautery the next day follovvinge have cutt of the Escara doe applye theron an actuall cautery vvithout any daunger as oftentimes I have seene to be done of Mr. Paré VVe may applye alsoe cauteryes of corrosives in the posterior partes of the Heade in the end of the suture lambdoide behind vnder the Eare therthroughe to avoyde the muscle Crotaphite To the surer findinge of the vvhich place therfore vve must cause the patiente to opē shut his mouth and soe to feele the motion of the sayed muscle Mons r. Martel chosen ordinarye Chyrurgian to the kinge vvhich vvas an experte man he applyed cauteryes behinde the Eares in the cōcavity vvhich is situated behinde the little flappe of the Eare called Fibra Cauterye in the Fibra and that agaynst all
inveterate disseases of the Eyes vvherof he certifyed me to have allvvayes had ominouse and happye successe vve allsoe sometimes applye the Cauteryes in the Necke in the hollovvnes or concavousnes therof but vve must consider that they doe not penetrate to deep least that vve chaunce to adust or corrode the eight small musckles of the Heade vvhich are in this place situated vvhich might cause daungerouse accidentes as I oftentimes have knovvne to chaunce The most commonest novve in vse Meanes hovv fittlye to applye the Cauterye on the Arme. is to apply the Cauteryes one the armes vvhere most curiouslye vvith greate care vve must make electione of the place the most fittest place is in the middest of the arm tovvardes the inner syde therof right betvveē the brachialle musckle the musckle Biceps close to the syde of the heade vayne And convenientlye to make choyse of this place vve must lay the first finger one that place stiffelye crushinge the same vvith the other hande foulde shutt the elbovve agayne strech him out allso lift vp the Arme because through this motione of the Arme vve might perceave vvhether there be noe synnue or Tendone situated thervnder to vvitt vnder your finger vvhether you finde in that place noe concavity or interstitiū of muscles vvhich is verye fitt for a Pease or little pellet to be therine to keepe open apert the foresayed Cauterye havinge novv vvith your finger fovvnde out the most fittest place vve must there applye the Cauterye Meanes hovv to apply the cauteryes convenientlye on the legge And touchinge the same vvhich vve desire to apply one the legges the most cōveniētest place ther vnto is tvvo or thre fingers breadth belovve the knees vvhere vve are vsed to tye our garters vvhether it be internallye or externallye one the legge But those that are much vsed to ride on horsebacke also to cause better abscessione of humors vvherthrough the Sciatica is caused for thē it is better to apply them in the externall partes of the legges in like sorte alsoe for vvoemen Admonitione in the applycation of the actuall Cauteryes Havinge therfore vvell dilligentlye considered on the fittest places and those vvhich are also the surest you must thē first race avvay the hayre if at the least ther be any VVhich being finished vve must then situate the Patient on a convenient place beinge helde of some other persone if soe be it be needfull thē you shall take your Cautery vvhich must be proportioned fashoned according alsoe vnto that parte vvhich you intende to cauterise and must be glovvinge redd hott or at the least as hott as is required because your operatione may at one time be finished if it by anye meanes be possible vvhich accordinge as shal be required you must imprint the same deepe or shallovve in that parte consideringe taking heede that in noe sorte you chaunce to hurte the circumiacent or finitimate parte thervnto to the praeventing vvherof ther are invented founde out divers defensions for the foresayed Cautery as certayn pipes little cases being composed and made of Iron least that vve shoulde chaūce to combure the finitimate approximate partes vvhether it vveare throughe the faulte of the patient or els throughe temerousnes timorousnes of the Chyrurgian as in other places vve more at large have spokē of alsoe therby have placed the discriptione of the foresayed Cauteryes For the reiterated Cauteryes Beinge therfore necessary oftentimes to reiterate the Cauterye as in any great Gangraena or in any Carie of legges vve must then cover the approximate places thervnto vvher vve intend to Cauterize vvith Compresses beinge madefyed in Plantine-vvater or anye other humiditye yea also vestite the edges of the vlcerationes vvith plasters of Infrigidans Galeni or els vvith some linnen cloutes beinge madefyed and dipped in anye distilled Aquosityes or vvaters Novv beinge sufficientlye Cauterized vve must then by all meanes indevoure to qualifye ease the payne and doloure therof to cause the Escara to separate To ease the payn and Separate the Escara vvhich must be effected throughe anye vvarme and moyst remedyes vvhich is aequallye proportioned vvith our humiditye calidity because through the humiditye or moyster therof it may soacke through the Escara and also the finitimate partes therof vvhich are obdurated drye because throughe the caliditye therof it might suscitate and dravve vnto him the naturalle caliditye out of the internall partes of the body into the externall partes of the same by this meanes expel that frō him vvhich is mortifyed combured Amongst all remedyes there is none better thē that vvhich is made of Oyle of Egges of insulsed and freshe Butter of Venetiane Terebebentine addīg in the end thervnto a little poulder of Ireas Aristolochiae and a little Beanemeale vvherthroughe alsoe all the purulente matter vvhich hangeth therone as lime and an Escara is purifyed Some vse a Digestive made of yolckes of Egges of oyle of Roses of Terebītine But that is not soe necessary as the formest because it doth not soe califye coagulating as the yolcke of an Egge is vvonted to doe and alsoe immediatlye vvaxeth drye and exsiccated The potentiall Cauterye Hovv vve must applye the potential Cauterye vvhich maketh an Escara or scabbe being as it vveare a Vicarius of the actvall is in this manner follovvinge applyed VVe must first of all make a playster of Diacalcitheos or some such like as greate as a large peece of tvvelve pence in the middest vvher of vve must cut a little hole as great as the nayle of ones little finger or a little greater accordinge to the bignes as vve desire to have the apertione and if you desire to have the apertion somvvhat longe you must then alsoe make the hole in the plaster somvvhat longe then lay the same on that place vvhich vve desire to open And in the hole of the foresayed plaster vvherthroughe vve perceave the skinn denudated lay your potenciall Cauterye or Corrosive vvhether it be greate or smalle accordinge as you desire to make the apertion great or little deepe or shallovv VVhich being done vve must lay therō a smalle dubbled clovte vvhich must be sōvvhat greater thē the Cautery The cauterye maketh a farre greater Escara then the hole of the Plaster thervvith to cover the same and theron as yet an other playster vvhich must be a little broader then the firste and one this plaster an other cōpresse vvhich must be of tvvo fingers breadthe and agayn theron an other vvhich must be yet greather and then tyinge the same vvith a ligature acordīg as the parte shal thē be requiring The Cauterye therfore having done his operatiō vvhich most commonlye in the space of tvvo hovvres is finished if so be the sayed cauterye be stronge violent enoughe vve must as then take it of and presently to cause the Escara
Playster of Betonica This foresayed threde or Seton vve must suffer it to continue therin as longe as it shal be needfull as vve have sayed of the Fontanelles As concerninge the transforation A transforation applyed in the Scrotum vvhich in the navle or in the Scrotū may be applyed it vvil be sufficient vvhen vve take the Scrotum the extreamest end of the navle so perforate the skinn being doubled vvith a reasonable greate or grosse needle vvhich must be threded vvith a vvoollen cotten or silcke thred and applyinge therone the selfe same remedyes of the vvhich vve have in the transforatione of the necke rehearsed THE NINTHE TREATISE OF THE OPERATIone of Chyrurgerye wherin is discoursede and handelede of the Ligatures or vvindinges circumvolutions of the convenience or the situation of the partes Contayning sixe Chapiters VVhat the Ligamentes or Circumvolutiones are theire matter qualitye forme and quantitye Chapit 1. The Kindes and differences of the Ligamentes Chap. 2. Rules and generall instructions vvherone vve must consider in all circumvolutiones and Ligamentes Chap. 3. Hovve vve ought to tye the Ligament and agayne make loose the same Chap. 4. Hovve vve must ligate and tye the broken Armes Legges and Hippes Chap. 5. Of the placinge and situatione of those partes one the vvhich the operatione is set one vvorke and imployed Chap. 6. ⧠What the Ligamentes or Circumvolutiones are their matter quallitye forme and quantitye Chap. 1. HAvinge therfor spoken treaated of the combinationes and sutures vvherthrough al vvoūdes divisione or separatiō of the vvhole is inserted combined together agayne and the lippes or edges of the foresayed vvoundes are kept close together shutt vve vvil novve treacte and handle of the Ligamentes or bindinges of the vvounded partes vvherin vve ought to consider vvhat their matter theire qualitye forme quantitye differences are What Ligamentes are hovve vve ought to vvind and agayne vnvvinde the same The vvindinge therfore or dressinge of a vvounde is nothing els then a vvindinge aboute or circumvolution of the Ligatures vvhich is as much to say vvith a broade and longe ligamēt vvhervvith not onlye the vvounded parte butt allsoe the fin itimate and circumiacent partes are involved and circumvestede by this meanes to restore them to theire Former estate and naturall beinge Matter of the Ligamentes Those Ligamētes accordinge to the affirmations of aunciēt Chyrurgiās are of divers matter as of Linnen vvoolle or Lether the linnen Ligamentes are the most commonest of all the other vvhich at that time they vsed vvhen as they vvoulde stifflye compresse bringe close together anye parte they vsed vvoollen rovvlers in the fractures vvith vvoundes gentlye in that sort to retayne together the broken bones to cause noe payne or inflammatione at all Hippocrates vsed the Ligamentes of lether Hippocrates in the fractures of the Nose the nethermost chavv bone But of vvhat matter soever vve make thē they must not be too much vvorne out because that they may be strōge enough to be dravvn close together stretche stifflye out Farther more they must be even and smoothe nether must they have any silvages nether must it have anye harde seames must be cut aright the threde accordinge the length of the linnen not cōtradictorily because they may tye smoothe and evenlye vvithout the one syde beinge hardre tyed then the other as oftentimes it chaunceth vvhen the rovvler is cutt contradictorryelye It is right trevve that the ligature vvhervvithe after Phlebotomye vve tye the arme yeeldeth it selfe better beinge so cutt but it chaunceth heerin because in that place it yeeldeth it selfe better for the bending of the arme Touching their qvallity they must be cleane vvhyte leaste that throughe their impuritye they be a hinderance or interruption vnto the parte because by that meanes they may the better receave the humidityes as Oxicrate vvyne or any such like vvherin vve chaunce to madifye vvett them They must allso be fine light because throughe their ponderousnes they doe not overburthen the parte suscitate provoke payne cause inflāmation Thirdly they must be softe flexible because through the obduratnes therof they might chaunce to hurte that parte Fourthlye of līnen vvhich must be verye vvhyte not to closely vveaved because so they ar more better to be placede the matter the evaporationes might the easier therthroughe transpire vvhich being therin occluded cause inflāmatione itchinge Forme figure of the Ligamentes Concerning their forme figure vve muste knovve that these foresaede Ligamentes or rovvlers are ether rovvled vp or involved sīplelye or dubblelye vnto the middest of the foresayed ligature of an aeqvalle latitude in all places as are those vvhich vve vse in the fractures of the Armes Hippes Legges In like sorte allso in the vvoundes vlcerations of the same partes The dubble ligament or rovvler is ether of on peece of linnen on the endes beinge diverselye cutte or on an other place in other endes as are the ligamēts of the Head vvhich are cutte into foure or sixe endes And in foure endes for the Scrotum Or in the ligament vvhich is sovved together made of divers peeces as are those vvhich are vsed for the flancks for the Brestes for the Testicles for the Fundament that especiallye vve desirīge to spare be chairye of the linnen And as much as concerneth their longitude latitud that cosisteth on the consideratione iudgement of the Chyrurgiane vvhich before hand must see the figure knovve it must therby allso be able to knovve the conformatione sitvatione of the parte the diversitye of the dissease for vvhen as vve are vrgede to make a greate circumvolutione vve must then consider on the length make it as long as is reqvired cōsideringe the breadth vve must make thē accordinge to the longitude latitude of the dissease The Ligamēt must bē broader then the dissease so that the foresayde ligament must be greater thē the dissease because vvith on circūvolutione doe not onlye involve the vvounde but allso both the endes therof as vvell on the one syde as the other for if so be the ligamente vveare smalle he must thē crushe the dissease vvherthrough greate payne and inflammatione might becausede And to speake of the qvantitye of the foresayed ligamentes Quantitye of the Ligamētes that is nothinge els then the meane and measure vvhich vve must vse and observe ether in stifly or loosely bynding as in respect of the persone For as the one man is grosser more corpulent then the other so ther are also disseases vvherof the one is more paynfull then the other vvherfore vve muste consider that the ligament be nether too stifly nor loosely tyed for all ligatures vvhich are too stiflye bovvnde cause payne concursione of humors vvith inflāmations yea somtimes allso a Gangraena And those
all payne vvhich tvvo observationes are vvell agreinge the one vvith the other For all fashons vvhich cause noe payne that is the naturalle and accustomed figure and collocatione therof Euen as the paynefull and vnnaccustomed figure is agaynst nature so that the naturall and accustomed figure or fashō is vvholy vvithout payn vvhich happeninge the Patient must a longe continuance keepe his Ioyncte in that beinge because soe he shall feele noe or at the least verye small payne at all vvhich is verye cōmodiouse to the resanation of all vvoundes vlceratiōs Fractures also for all dislocatiōs as it is in like sort profitable for all other disseases vvhatsoever The aunciente Chyrurgians have called this forme of situatione the right and true collocatione because all the Vaynes Arteryes Synnues muscles as then are right nether are they extended nether lye they recurved The natural situatiō vvhich of the aūcient professors is called the right situation And althoughe that the Arme have binn anglevvyse collocated notvvithstāding vve esteeme it as then to lye right because that all the foresayed partes are accounted to lye right not extended nether recurved that this collocation of the Arme is naturalle as heere after vve vvill more largelye speake of An example of the situatiō of any disseased part And by degrees to specifye the situatione of each sundry parte vve vvil heere discribe some of them for an example vvhē as ther is any vvounde Apostemation or dislocation in any Ioyncte vve must then vvith all dilligence note the situation there of for through a badde situatione not onlye immediatly are caused many accidentes but after the sanatione therof the Ioynct sometimes tarryeth right out extended vvhich ought to have binne croocked or els abideth croocked vvher it oughte to be extēded or els combineth it selfe ioyneth vvith some other thinge vvhich ought to have binn separated seioyncte An excellent observation VVherfore if the vvounde be in the vppermost parte of the shoulder vve must then impose vnder the Armepites of the Patient a great linnē balle hange the arme one the Brest somvvhat beare out his elbovve because that the heade of the arme may be somvvhat elevated the separated partes may agayne be inserted the one vvith the other and so much the better be cured together agayne The contrarye vvherof must be observed if soe be that in the inferior parte be anye vvounde as vnder the Armepittes for the vvound beinge cured vve doe not lift vp somtimes the Arme let him fall dovvne agayn stirre him othervvayes vvithout causinge any payne and that the Arme is not helde from the Breste the Patient therafter because of the Cicatrice shall not be able to lift vp his Arme because through the same the Arme is grovven stiffe As therof vve have an example exemplifyed vnto vs of the throte in the Necke also of many and divers vvhich beinge vvounded or burned the cicatrice hath remayned so obdurated that they ther through have ether helde their Heades to much on high or to much stoupinge or hāging backvvarde or to much dependinge ether on the right or one the Leftsyde If so be that ther be an Apostemation The anglevvyse figure is the naturall forme of the Arme. in the Elbovve or els that the same be dislocated or vvounded vve must thē situat the Elbovve angle or cornervvyse for such aforme is very necessarye for the same natural accustomed vnto hī although the cornervvyse figure is that vvhich maketh an accute corner notvvithstāding vve meane therby through the anguled figure vvith the auncient Chyrurgians that vvhich hath his corner right but yet not so cleane and vvholy erected but that vvhich attaygneth somvvhat tovvard the rectitude so that it commeth somvvhat bluntlye and such a figure is not as yet truelye the meane betvveene the inflexione and the extensione but is the same vvhich yeeldeth her selfe tovvarde the extensione If soe be the Arme be inserted and combined vvith being able to be recurved or extēded vve may yet as then better and vvith more facilitye helpe him selfe then if he vveare vvholye recurved or vvholye extended VVe may alsoe observe the same in the hande The hand must be shutt for vve must keepe the fingers shutt halfe bended and if soe be the dissease vveare in one finger only it vveare then better that the same continued ether inflected or incurved thē that he vveare strayght for the property of the hande is to gripe and take houlde the vvhich shee can not effecte and bringe to passe then throughe the recurvatione of the same If soe be above in the Hippe ther chaunce to come an Apostemation or vvovnde The hippe must be stirred vve must then in the consolidatinge of the same observe that vvhich in the shoulder vve have seene as beinge necessarye to stirre the foresayed parte on divers fashons because the heade of the bone doe not insert it selfe and grovve fast in the panne VVe observe in the Ioyncture of the knees the contrarye for if so be The legge must be kept right that ther be a vvounde or an Apostemation or els in the finitimate parte the Patiēt must thē hould his legge right vvithout havinge the heeles dravven in tovvardes his buttockes as it in divers persons happeneth and that to the hinderance of the Patientes vvhen they are cured And vve must dilligentlye note that the legge be collocated as right as is possible and if so be by chaunce it laye recurved vve must then as gentlelye as is possible stretche and extende the same agayne othervvyse the patient beinge cured might chaunce to be mutilate and vvithout greate indecorū or deformity should not be able to goe as vve have knovvene the same to happē vnto tvvo great personages of our times Novv as concerninge the foote the Toes they must allsoe be extended and not recurved or inflected as vve have spoken of the hād fingers Discommoditye of having the Legge croocked For if soe be they cōtinued soe croocked the bodye as then shoulde not be able to rest or stayede theron Soe that the situation of the Arme is cōtrarye to the Hande to the Legge and to the Foote because the one must be recurvede or croocked and the other extended right out The end of the Frenche Chyrurgerye contayninge the manuall Operations Methodicalle discourse or rehearsall of the Originalles occasiones Signes Tokens Accidentes chaunces Prognosticationes and Remedyes agaynst the Bloodyeflixe or Dysenterye BY all other miserable and pitifulle disseases vvhich doe commonlye vexe and trouble the Entralles and runne through the same as is the Cholicke the restrictione or constipatione Ileus Lyenteria Diarrhea Tenasmus the vvormes many other such like yet me thincketh the Dysenteria or the Bloodye flixe of all these to be most intollerable Bloodyeflixe and most mortall And also amongst the Commonaltye amongst our Frenche Martiallistes or