vse of the Cauteryes and to what disseases and one what places they must be applyed Chap. 2. IT may rightvvell be sayed that nature hath shevved vnto vs The invētiō of the cauteryes is dimonstrated vnto vs through nature the inventione of the Cauteryes fōtanelles For as sōtimes the partes being overladē vvith to manye humors ether theire tartnes or venoumousnes are troubled they in the end discharge vnburthen themselves in some parte of the body of that vvhich molesteth thē as in one of the Armes or legges causinge ther to ther solace and ease some excoriatione or apertione So that the Physitiones Chyrurgianes to helpe heerin the nature have there throughe fovvnde out the vse of the Cauteryes Fontanelles effectinge by their arte that vvhich nature oftentimes throughe her ovvne commotione thervnto endevoreth to doe vvherfore vve alsoe vse the Cauteryes as oftentimes as vve desire to make any derivatione revulsione interceptione or evacuatione of anye matter the vvhich ether consideringe her qvantitye or qvallitye or vvith both of them together might in anye sorte be occasione of any harme VVe alsoe vse them not onlye vvhen as vve desire to transpire and cause to evaporate any venoumouse vapours but also vvhen vve vvould cause anye concurrent matter to exsiccate consume endevoringe to dravve the same from vvithine externally as vvell through the extractione vvhich it heer maketh as through the vlceratiō vvhich therafter remayneth as throughe certayn little open fistles or small rūninge issues vvhervvith vve dravv the matter from invvardes outvvardes ther to evacuate the same and cause to digresse from the one place to the other Cauteryes are profitable sayeth Galen Hippocrates in all corrosive ambulative vlcerationes agaynst fluxions of the eyes in the tumor Aegylops Vtilitye of the cauteryes vvhen as the fore arme is suncke and discended vnder the Armepittes In the Sciatica payne of the hippes for they retracte dravve backe the humors vvhich trouble in that place hinder those partes In the Gangraena in the extirpatione of the mēbres to stench stoppe the bloode soe forth in all fluxions of blood in all other internal disseases vvhat soever as in the Consumptione in vlcerations of the Breste Albucasis and in the Dropsye Abucasis avoucheth the Cauteryes generallye to be profitable in all disseases and sicknesses vvhich take their originall of any matter or vvithout matter They are also profitable and commodiouse for all bitinges stinginges of anye venoumouse creature in the Carbuncles and Venus botches becaus through theire heat they consume the venoumousnes of the humors annihilate them and out of the depth dravve thē vpvvardes They are alsoe verye profitable in al criticke Apostemations vvhich are could vvaterye and vvhich are verye slovve in maturatione because that throughe theire caliditye they opitulate and helpe to ripen the could toughe humors vvhich are in that parte They are alsoe goode agaynst all corruptione of bones because they exsiccate the venoumousnes of the same and consume it and cause the corrupted bones to separate from the sovvnde VVe may applye thē on all partes of our bodye and especiallye beinge needfulle to make anye apertione to give issue and passage to any matter or vapoure vvhich therine is assembled Ther are some vvhich have applyed the cauteryes one the vpper part of the head In vvhat partes the Cauterye must be applyed about the sagittal suture vvher she ioyneth her self vvith the Coronalle suture VVhich vvith great and good successe I have seē to be done of Mr. Pare Mr. Pare agaynst the Hemicraniam or payn of the one syde of the heade and agaynst manye other sortes of inveterated paynes of the heade because that through such an apeatione manye and divers humours vapours vvhich are congregated in the heade by this meanes are exhalated allso agaynst the fallinge sicknes to give transpiratione to some venoumouse humor vapoure vvhich are often times the occasion of this dissease Agaynst shortnes of breath and difficultye of breathinge vvhich have takē their originall of the superfluitye of humors and descende out of the heade dovvnevvardes to the brest ther hinder molest the partes of the brest and bringe vvith them the shortnes of breath and oftentimes allsoe are cause of vlceratiōs in the brest through corruptiō and putrifyinge of some pituitous humours also in the Ophthalmia or inflammation of the eyes vvhich is ther throughe caused through any fluxiō vvhich is sēt through the vaynes vvhich lye scattered in the Pericranio soe runne to the externall tunickle of the Eye Agaynst reddnes of the face Agaynst payne in the teeth of the Eyes in the Sqvinancie in manye other disseases vvhich come in the mouth and in the throte VVe Cauterize alsoe the Eyeliddes vvhich are relaxated in like sorte also the Cilia vvhich sticke in the Eyes and allso in those vvhich in number are to manye Alsoe in the Arteryes of the temples of the Heade The tumefactiō Aegylops the Polipus and Ozena the cleaved lippes the Ranula the Teeth and the pallate of the mouth vvhen it hangeth to lōge also the Almōdes The Thorax or Brest on divers places somtimes shallovvly sōtimes to the cōcavity of the fores yed Brest the inferior parte of the Belly the Scrotum or genitalles especiallye the hippe agaynst the Sciatica the bone vnder the knees on the insyde of the legge Some ther are vvhich sett five cauteryes one the heade of those vvhich vve suppose to be infected vvith the lazarye Cauteryes for such as are troubled vvith the lazary VVherof vve must set the first cautery one the Coniunctiō of the sagitalle suture vvith the Coronalle The secōde above the forheade vvheare the hayre ceaseth The third in the Necke The other tvvo the Ossa Petrosa above the eares somvvhate aftervvarde tovvarde the end of the Lamdoidalle Suture to avoyde the end of the temporalle muscle to vvitt one one the right syde an other on the left syde All vvhich Cauteryes are applyed to separate those humors vvhich cause the nose to exulcerate and the internalle part of the mouth in those vvhich have the lazarye and vvhich externallye have theire face corroded deformed fearfull to behoulde These Cauteryes are applyed one some because vve shoulde not see that they have binne cauteriyed onlye behinde in the necke and one both the Armes ⧠Of the Potentialle Cauteryes how we ought to make them Chap. 3. The potētiall Cauterye and the matter therof THe potētiall Cauteryes are those vvhich through theire intollerable extream heate being vvith their forces set to vvorke together vvith the benefites of our naturall caliditye burne as it vveare a fyer in that parte vvherone they are applyed leavinge behinde them an Escara or crust Of the vvhich the matter of the Corrosive is in great number and hot vnto the fourth degree Amōgst the vvhich ther ar
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
The superioure parte of the foote G Metatarsos L Metatarsus vvhervnto the toes are adioyninge z The Anckles G Sphyra L Malleoli The Declaration of the Characters which are compraehēded one the posteriore parte of the bodye The superiour part of the head G Coryphe Mesocranion L Vertex The hinder parte of the heade G Inion L Occiput Occipitium The place vvhere vve applye the Cauteryes agaynst surdity tovvardes the mamillare productions The Nape of the Necke on vvhich place allsoe vve apply the Cauteryes that vvhich is compraehended betvveene the foresayede D vnto a H is callede the Backbone G Rachis L Spina dorsi * The Necke G Auchyn Deires Opisthocranion L Cervix It is the place vvherin vve applye the Seton or in the place therof tvvo Cauteryes E The place vvheron vve applye the boxes G Epomis L Summitas humeri the superioure parte of the shouldre F That vvhich is collocatede betvveene these tvvo lettres is called the Backe G Metaphrenon Noton L Dorsum Tergum That vvhich is comprisede betvveene the lasté F a G Osphis Ixis L Lumbi The bone Sacrum G Hieron Platy L Os Magnum Sacrum Latum vvhich is contaynede betvveen I and a H. The Cropion or Rumpe G Coccyx L Cauda k The Shouldre blade G. Homoplata L Spatula L The right situatione and collocatione of the Kidnyes M The beginninge of the Muscle Delthoide H That vvhich is compraehendede betvvixte these tvvo letters is called the forearme G Olenos L Cubitus The Elbovve G Olecranon L Cubitus Q The fiste vvhich is contaynede betvveene these tvvo lettres G Carpos L Brachiale R The fore most parte of the fiste vvhich is cōpraehendede betvveene these tvvo characters G Metacarpion L Postbrachiale S The Haunches or Hippes G Ischia L Coxoe On this place is the right combinatione the collocatione of the heade of the bone in the Hippe vvheron vve must apply the remedyes agaynste the Scià tica * The Buttockes G Gloutoi L Nates L The crassitude of the Hippe L Femen V The externalle parre vvhere the membranouse muscle is collocatede X The Hockes G Ignya L Poplex vvhere vve opē the Popleticalle Vayne Y The Calfe of the legge G Castrocnemion L Sura Z The greate Tendone of the Heele ω The Heele G Pterna L Calx ΠThe plante or sole of the Foote G Pedion L Planta pedis the concavity therof G Coilon podos Vola pedis Declaratione of the Characters contaynede in the firste and seconde figure of the externalle Vaynes which we vse to Phlebotomize Demonstratethe the Vayne in the Foreheade In the seconde figure the Vayne Pupis The Temporalle Vayne in each figure The Eare vayne The Eye or ocullare vayne The Iugulare or organicke vayne of the Arabians callede Guides f In the 1 and 2 figure the Cephalicke shouldre vayne g In the first seconde figure the Basilica Hepatica the liver vayne i L 4 The Mediane but the right mediane is that vvhich is notede vvith L and 4. 5 In the first and seconde figure the Heade or oculare Vayne 6 The Salvatella of the Arabians Seynale or Syelen The Mediane or Blacke Vayne Q The Iliaqve vayne or Titillatis in Latine n In the seconde figure the Popliticalle vayne V V p p The Saphena T q q The Sciaticke Vayne R The Crutalle vvhich maketh the Saphena noted vvith R in the seconde figure The Sciaticalle vayne vvhich also noteth the Sciaticalle vayne in the externalle anckle P A A Demonstrate the internalle anckle vayne O B B The externalle anckle vayne * f * f The Heele 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 Demonstration of all the externalle vaynes Declaratione of the Characters contaynede in the Table of Instrumentes wher with we extracte and drawe out the Bulletes and all other vnnaturalle and alienate thinges forth of the bodye Demonstratethe such an Instrumente vvhich consideringe the figure similutude is in Latinne called Rostrum Lacerti it is very necessary to extracte a bullet out of the body vvhen they lye therin plettered or els to dravve out of the vvound any smalle peeces of bones The foresayed A noteth only vnto vs the Pipe therof The vice or meanes vvherby this foresayed Instrumente is opened shutte agayne as much and as little as pleaseth the Chyrurgiane The little Iron rodde vvhich openeth shutteth the foresayed Efts bille for vve dravvinge the same tovvardes vs it shutteth and thrusting the same frō vs it openeth D The Dilatorye behoulder or Enlarger in Latine Dilatorium or Speculum This Instrumente is internally concavouse dentified or toothede to retayne hould that fast vvhich shal be ther betvveene it may be vsed for tvvo purposes first of all to dilate enlarge the vvounde vvhether it be ether to vue the botome therof or els to bring any other Instrumente therin vvhervvith vve vvoulde dravve anye thinge out of a vvounde secondlye it is also of it selfe commodiouse to dravve anye alienate thinge out of a vvounde The chayned bullete A little Chayne c Certayne parcels of Mayle dubbletes E The Cranes bille In Latine Rostrum Gruinum The springe to Keepe open the same leaste that the Chyrurgian might be hindered in the opening therof because he shoulde allvvayes be preparede to shutte the same as soone as vve perceave any thing to be betvveene the same The Bullete vvhich must be dravvne out H The Ganders bille In Latine Rostrum anserinū It is also callēd Rostrum latum the broade bille the extremitye end therof is also dentified toothede because he shoulde the surer retayne the Bullet The bullete vvhich is betvveene the teeth The soundinge Iron or Esprovette vvhich may be vsede also for a Needle to make a Seton is verye conveniente to sound serche for bulletes and all other alienate thinges in a vvounde as also vve may make thervvith any Seton the same beinge needefulle some ther are vvhich ar made of tvvo peeces becaus it should so be more portable This foresayed searching Iron is called in Latine Astilla tētoria Radiolus Explorator in G it is callede Mele Galen calleth it Thaumatiche Mele and Hippocrates Ischyri The Bulletdravver or Grounde dravver vvithout his canulle This Grounde dravver is verye acute on his end becaus the bullet might sticke fast therone it is called in Latine Terebellum simplex The vise vvhervvith he is fastened in the pipe or canulle vvhervvith he is boarede into the bulette vvithout any great violence or force The Pipe or Canulle vvith the hādefastening ther of In Latine Canula simplex The hādle through the vvhich vve thrust the Groūde dravver The Bullet dravver vvith his canulle on vvhose end the bullet is fastened to be dravvne out We vse this Instrumente vvhen the bullet is fastened in any bone vvhē the same vvith violence must be dravven therout is in Latine called Terebellum torculatum cum Canula The vise vvhich entereth into her case notede vvith Π. The vise vvhich is in ternallye occulted An other
other badde accidentes vntil the Fifteenth day and the moderne and ionge professors vntill the hundred the day The Iurists or lavvyers have constituted and ordayned fifteene dayes for the iudgement of the vvoundes of the Heade to knovve of a certayntye vvhether the patient by occasione of that vvoūde came to dye or not or by reasone of his ovvne faulte or by any other occasione Because therfore that the yonger Chyrurgiane shall not be over rashe in givinge of his iudgement leaste he come te glyde and falle into anye badde reportes or in anye repraehensione As much as appartayneth vnto me I have knovvne some vvhich have continued in a verye good estate vnto the thirteenth fourteenth or vntill the fifteenth day and then have fallen into agues and manye other accidentes by the vvhich they in the end chaūced to dye VVee must alsoe note that all naughtye and badde accidents most of all publishe themselves at the full Moone more then at other times because as then all maner of moysture grovveth and increaseth more then in the decreasinge of the Moone alsoe more in the sommer then in the VVinter The signes and tokens of the deadlye fractures of the sculle are agues in the VVinter The signes of the deadly fractures of the sculle before the fourteenthe daye and in the sommer before the seaventhe day Item a naughtye and badde colloure of the vvounde little matter of the same mortificatione of that vvhich is inflamed slimye or viscouse consistence of that vvhich is corrupted drieth ariditye in the skinne of the heade as it is in a peece of pouldrede fleshe vvith a brouvvne leadishe and blacke colloure vvhich signifyeth the beginninge of the corruptinge and putrifyinge of the sculle vvhich thē vvaxeth ravve as vve may see vvhen it is rotten and grovvne blacke vvheras before it vvas even and smoothe Finallye vve see therin a pale and yellovvishe colloure to vvitt vvhen the foresayede bone is vvholye corrupted rotten throughe the purulent matter vvhich vvas suncke to the grovvnde of the vvounde and vvas there gathered together The patient beginneth to rage he hath little pimples one his tonge he getteth alsoe convulsione of synnues one the contrarye syde of the vvounde some fal inte an Apoplexia vvheron follevvethe deathe The Practitioners of our times have observed in all vvoundes vvhether allreadye therin vveare a Paralisis or els therafter happened thervnto and onethe contrarye syde a Convulsione or somtimes also in the vvounded part a Convulsione and in the other syde a Paralisis sometimes also in both the partes ether a Cōvulsione or Paralisis and somtimes one each syde ether a Convulsione or a Paralisis vvithout the contrarye syde beinge in anye sorte thervvith infected The goode signes of healinge in the fractures of the Heade after that it is trepanede or els after that the brokē parcells of bones are taken out of the Heade are these namelye vvhen that the Membrane of the Braynes hath her naturalle colloure and her naturalle motione stirringe vvhen the engendringe and grovvinge Fleshe is redde VVhen that the patient may easylye turne aboute his Necke and alsoe easylye vvagge his lovver chavve bone But in somuch as the Membrana hath noe stirringe Badde signes and is blacke leadishcolourede lividouse or vvith anye other badde coloure taynted defylede Then the patient ragethe vomiteth exceedinglye falleth into a Paralysis or in Spasmo if that the Fleshe of the vvounde be leadishe colourede the necke the chavvebone bothe of thē stād stiffe all these are verye bad signes And vvhē the vvoōde is at a good estate thē beginneth the fleshe of the Membrane or of the sculle to grovve and to vvax dubble and filleth all the voyde places vvith fleshe that have binne open betvveene the bones yea somtimes covereth even as it vveare vvith pomgranate Kernells the scull it selfe ⧠The tokens howe to knowe which partes of the bodye are wounded Cap 3. TTe vvoundes most commonlye are knovven by ther first aspecte alsoe sometimes the place of the vvoūde certifyeth vnto vs vvhat partes are internallye vvounded But seinge that it often times chauncethe that these vvoundes ' vvhich to our estimatione be not profounde or deepe penetrate vnto the internall partes vve vvil heere therfore recite the signes by the vvhich vve may knovve vvhat internall partes vvithin the bodye aré vvoūded because ther by vve may knovve vvhether the patiēte may be cured of them or not Signes vven the braynes are hurt If soe be that the Braynes or else ther Membrane is vvoūded thē ther issueth bloode out of ther Noses vvith some alsoe out at there Eares commonlye ther follovveth a vomitinge of choler some lye almoste out of the memorye beside thēselves that althoughe you call crye vnto them they give noe ansvvere others seē in ther faces as if they vveare afrighted feared some turne and vvinde there eyes this vvay and that vvaye as if they vveare touched stricken by Gods hāde the thirde or the fifth daye most commōlye they fall into madnes Phrenesie other gette the Spasmū before they dye some there are vvhich plucke the medicamētes from there Heades soe that the vvounde commeth to lye bare vvaxeth coulde VVhē as the backe bone is hurte Sygnes vvhē the backe bone is hurte or vvoūded thē beginnethe the patiēt to be feéble lame in his synnes or else he getteth cōvulsione of synues vvhich is called Spasmus leeseth the sence of feelinge somtimes the patiēt can nether retayne his vrine Sperma or Stole but of it selfe departeth from him If the Harte be vvoūded Signes vvhē the harte is vvoūded ther issueth out of the vvounde greate store of blacke dence or thicke bloode especiallye vvhen the right side of the Harte is hurte But vvhen the left syde of the Harte is hurte then issuethe out of the vvounde fine subtile redde bloode the pulse of the patiēt is verye debile feeble variable is verye pale coloured in his face The coulde svveate in all his bodye bursteth out and hath a verye vnsaverye smelle evē as vve may note in other sicknesses of longe cōtinuance His handes and feete beginne to be coulde out of the vvhich present death ensueth VVhē the Lunges are hurte thē breatheth the patiēt vvith greate difficvltye The vvounds of the Lungs divers times reiterateth dravveth anevve his breath as if he there by sought indevoured to doe him selfe som solace cōforte he voydeth of ten times through his mouth frothye bloode throughe the vvoūde fayre redde vitalle bloode vvith peepinge hissinge breathe he endevoureth for the most parte to lye one his vvoūded syde others often times erecte them in ther bed vvith out anye occasione Some lyinge one the vvounded syde can speeke but turninge thēselves one ther sovvnde syde are quite deprived of there speeche sometimis they are bloesinge in ther faces sometime cleane pale and at the
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
thre foulde meanes to cure the Fistles of the fundament vve vvill not heere treate of anye thinges belonging vnto the medicamentes but onlye speake of the Chyrurgerye to the curing of this dissease the vvhich on a threefoulde manner is taught vnto vs as vvell in the curatione of the internalle as externalle Fistles to vvitt ether throughe ligature inscisione or through Cauterye Although Avicenna vvith more others are of opinione that vvith anye of these foresayed remedyes vve ought in noe sort to meddle ther vvith vnles they vveare too intollerable and molestiouse vnto the patiēt but that vvith cleane linnen vvith Cotten and vvith decent and convenient lavamentes vve ought to sustayne them But for all this not vvithstanding I vvill heere discribe vnto you our vse and customes of the auncient Chyrugians Novv therfore as vvell to cure the publiqve and patent Fistles as the occult and hidden vve must cause the patient conveniently to lye namelye that the patient must lye one his backe vvith his legges on highe retayning and houldinge the foresayed legges close vnto his belly and this is the maner and customes of ayncient Chyrurgians But vve novve a dayes cause the patiēt to stande on both his legges vvith his heade lyinge on a bedde disioyninge separatīge the foresayed legges vvyde the one frō the other vvhich alsoe of tvvo servantes or stāders by must soe be helde least that he agayne might chaunce to shut them The patient being thus situated tovvardes the light vve shall then thrust the middlemost finger of the left hande into the fundamente havinge vvith some certayne oyle anoyncted your finger and pared close your nayles and in our right hande vve must have a privet or searchinge irō in forme of a needle in the vvhich at the on end ther of must be a threde vvhich foresayed needle or Privet vve must thrust into the Orificium of the Fistle vntill vve sensibly feele the same on our finger and then vvith our finger recurvate the end of the foresayed needle neatlye conveniently reduce the same vnto the fundamēt and then dravve the same therout dilligentlye observinge that internally vve hurte or vvoūde nothinge Hovv vve must bind a publique or patent Fistle and the threde alsoe beinge passed throughe the fundament vve must then cut of the foresayed needle from the threde tye the endes of the foresayed threde both together dravvinge the same reasonable fast and close together and vvith a slidinge knott binde the same together because daylye vve might knitt the same closer and continuinge this same soe longe in this sorte vntill such time as vve shall have cutt avvay all the thred vvhich vvas remayninghe betvveene both the Orificia and both the apertions become to one and the threde conseqventlye vvithout anye more dissectione of the same shal be taken thereout But vve perceavinge the Fistle to have no issue in the concavitye the arsegutt and the needle doth not come out agaynst our finger beinge in the foresayed arsegutt and that ther as yet is some pellicle or membrane betvveene them both the needle havinge a reasonable sharpe acuitye or poyncte vve must thrust the foresayed threded needle or Privett bouldlye and audaciouselye therthroughe into the foresayed concavitye of the Arsegutt because vve might also dravv the foresayed thred therout as alreadye above vve have mētioned VVe must alsoe heere farther note that this privet or needle must ether be of goulde or silver because shee may the easyer internallye in the foresayed gutt be recurved VVe vse heervnto a silver plate vvhich thervnto expressely vve caused to be made as this same plate the foresayed Privett or needle before amōgst the figures of the instrumentes are also defigured and sett dovvne vnto vs. The threde must be of course thred the same being tvvisted thre or foure times dubble And because that vnto some the dissectione of this simple threde falleth somvvhat tediouse they annoyncte the same vvith some Causticke medicamētes Gvido Opinion of Gvido effecteth this dissection vvith a rescindent actuall Cauterye to praevent the same that it pearce noe deeper then it ought he thrusteth in the fiistle a hollovv Privett on the vvhich concavitye he vvith the foresayed Cauterye pearceth the skinne and in like sort alsoe cutteth throughe the fistle bringeth dirimateth avvay vvith it the callositye praeventeth also the fluxione of bloode It is surer to make an inscision in the fistle thē to tye it Others vvil not in anye sorte have the fistle cauterized nor bovvnde tyed but vvill only have that same to be inscided vvith a croocked lancett vvhich is betvveene both the Orisicia to vvitt of the fistle and the excrementall or arsegutt that alsoe vvhich internallye is grovven callouse they vvill have it to be crudifyed and made ravv or excoriated as vve are vsed to doe in the haremouthes yet daylye experience teacheth vs that the ligature is more certayne thē the inscisione vvherin vve neede not to take avvaye the callosity because it oftētimes chaūceth that vve endevoringe to remove and take avvay this callositye vve discide and cutt of any of the Fibres of the muscle Spincter vvhich beinge vvounded or hurte the patient ther after can in no sorte restraygne his stooles or excrementes It may seeme admiraculouse strange vnto some that I vvrite that the fistle may be cured throughe the ligature onlye vvithout removinge the callositye because it seemeth oppugnant vnto reason because all combinatione healinge together is caused throughe the ioyninge or touching of vveake thinges together yet I dare affirme that all those vvhich I have seen tyed have bin perfectlye and sovvndlye cured vvithout in any sort to have touched or removed the callositye Novv to come to the operation of the hidden fistles havinge situated the patient as before is sayed vve must then applye therin the Speculum Ani opening the fundamēt thervvith vvith the least payn vve cā as vvyde as is possible allvvayes annoynctinge the foresayed Speculum vvith oyle throughe the vvhich sayed apertione the Orisicium of the vlceratione may appeare be apparēt vnto vs be-tvvixt vvhich concavityes or braunches vve must thrust in a privet vvhich must be of a reasonable thickenes or crasitude like vnto a small little needle vvherevvith vve are vvonted to make our stitches vvhich must be blunte in the one end must vvith a threede be threded vvhich foresayed needle or privet vve must thrust vnto the bottome or grovvnde of the fistle vvhich penetrateth vnto the skinne as vve easily may feele vvith our finger on the vvhich vvith the croocked lancet vve must make an inscision the needle beinge in this sorte passed through the Speculū Ani beinge taken avvay vve must then dravve out the needle and cutt her from the thred and tye bothe the endes therof together Other say vve ought besides the privett internallye to make an inscisione throughe the vvhol Fistle vnto the other hole
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
27 Chap. describeth Not because of the signe vvhich remayneth in the Cauterized parte that is because of the little Vlceratione vvhich remayneth therin vvhen as the Escara is fallen therout Soe that this vvorde Cauterium in properlye being vnderstoode can noe othervvise be vnderstoode then a little Vlceratione in anye externall parte of the bodye vvhich throughe the art of the Chyrurgiane is made therin throughe some comburent adustive medicamentes to give issve passage to some certayne matter of some dissease VVherfor the differēces of these Cauteryes The differences of the Cauteryes not properlye taken or Vlcerationes are as it vveare dravvne from their place being vvheron they are applyed also from theire efficient cause The essence beinge of these Cauteryes cōsisteth in theire forme figure vvherfor some ther are vvhich be rovvnde some contradictorye others right great smalle deepe or not deed All the vvhich have but one onlye apertiō or sometimes also tvvo is thē called a transforatione or Seton And also of all other places vvheron they may be possiblelye applyed as on the Heade in the Necke Armes Legges finally in all partes of the bodye vvherone they might be applyed vvhē onlye the agilitye or actione of the parte can not ther through be hindered or hurte Of their efficiēt cause vvhich is takē out of the diversitye of the matter vvhich is applyed one anye parte of the bodye or ingendred in the same The matter vvhich continuallye is applyed on the bodye actuallye combureth Actuall Cauterye or potentiallye vvherfore they are called actuall or potentialle Cauteryes That vvhich in our body is ingendred can come through any sharpe corrodent or bitinge humors vvherthroughe the skinne is corroded bitten throughe exulcerated of vvhich vlceratione may be effected made a Cautery or fontanelle vvhich may be called actuall Cauterye Differences of the cauteryes simply taken Heere of vve may coniecture and suppose that the Cauteryes fontanelles vveare invented follovving nature therin ther throughe to give passage to that vvhich is contrary opposite vnto her vvherof she is perturbated molested it be ether in quallity or in qvantitye as heerafter vve vvill farther speake of And as touchīg the Cauteryes vvhich vve call instrumentes their principalle especiall difference is taken of theire substance forme figure of theire tarditye slovvnes or festinatione of adustion of theire depth shallovvnes of the manner of theire applicatione touching theire matter or substance because they actually in deede doe combure burne or potenciallye they are therfore called actuall or potencialle Cauteryes The substance of the actual cauteryes The forme of those vvhich actuallye burne is almost innumerable vvhich are made hott glovvinge The antique auncient Chyrurgians have commonlye made theire Cauteryes of mettles as of gould of siver of Iron of copper Archigenes Archigenes hath cauterised the lachrimall fistles vvith liquefacted leade vvhich through a little pipe he dropped therin They vveare of opinion that the cauteryes of gould caused lesse payne Substāce of the cauteryes vvhich the auncient Chyrurgians vsed vveare farre more easyer to be suffered that alsoe the Cauterized place shoulde not avoyde soe much matter and the adustiō is not soe daungerouse because gould amongest all other mettles is the moste temperate vvherfore it burneth not so violently as Iron because it is not soe cōdensated of substance vvherfore in like sorte alsoe the Cauteryes vvhich are made of Copper doe not soe closely burne or cauterize as those vvhich are made of Iron because the copper is not so solide of matter vvherfore vve desiring strōgelye violentlye to cauterize vve must take such cauteryes vvhich are made of the condēsest A kinde of spongiouse matter full of dust grovvinge on the moūtaynes vvhervvith vve vse to stench bloode most firmest matter substance Somtimes have also the aunciēte professors as Hippocrates recited to have cauterized vvith tentes vvhich they dipped in ebullient seethīge oyle or vvith drye incended puffes as vve call them or vvith the root Aristolochiae being madefyed in seething oyle or vvith the rootes of Strutium as Caelius Aurelianus Dioscorides and Attilus vvhich have cauterized vvith incended Goates dunge Aetius hath cauterised the corrupted gummes Aurelianus Dioscorides Attilus Aetius Albucasis Guido vvith ebullient oyle vvhich he applyed theron vvith vvolle beinge therin madefyed Albucasis in like sorte hath cauterized the hollovve and concavouse teeth vvith seethinge butter Guido hath cauterised the bones vvith liquefacted Brimstone to vvitt of the Caries Soe that out of all these vve may sufficientlye vnderstande that vve may make as manye sortes of cauteryes as there are substances vvhich may be incended The foresayed cauteryes Differences of the cauteryes cōcerninge their figures especiallye those vvhich are made composed of any mettle are also differinge in their figures the one from the other For everye cauterye must be proportioned accordinge to the dissease and that vvheron vve vvill apply the same so that some are like heades of great nayles triangled others rovvnde like vnto a buttō others cutting some not dislike vnto a halfe moone and others circlevvyse As vve may behoulde and see the circles of Albucasis other in forme of a rapersblade as Celsus discribeth ther vvith to cauterize the fissures in the lippes They are alsoe differinge the one from the other in theire depthe or shallovvnes for vve neede somtimes to cauterize the skinn only as Hippocrates vvilleth vs to doe in the paynes of the shoulders VVe must alsoe sometimes cauterize the fleshe as in the Sciatica Cauteryes to cauterize deepelye Some times also to the bone and crushe the same reasonable close thervnto as vve must doe vvhen as vve must cauterise above on the heade vve must sometimes cauterize into the concavity of the bodye as vvhen vve must cauterise into the brest to let ther out any matter somtimes vve doe but only scorche or singe above one the place And because that amongest the cauteryes Differences of the cauteryes taken out of theire actione considering the matter vvherof they are composed ther be some vvhich are quicly heated and some vvhich continue longer hott then others even soe ther are some vvhich consideringe theire pōderousnes or levitye tarditye or festinatiō ether in violence or payn of theire operation are differinge the one from the other The Cauteryes are alsoe differing Difference in numbre in theire numbre for at somtimes vve applye but one somtimes tvvo thre four yea alsoe fifteen at one time as Aetius cōmandeth vs to the curing of the vlcerations of the Brest They differ alsoe in theire manner of applicatione for some are applyed alone Differēce taken out of the manner of the applycation others in little pipes vvhich at one ende are aperte and opē or have any appertiōs or vvindovves in the sydes therof Of the Invention and of the
must then beginne from belovv the legge or Arme vpvvardes vvhich is the most farthest from the originall of the Vaynes and supernallye end the same to vvitt about the Harte the Liver vvhich are the originalls of all Vaynes Arteryes heerby to repell the humors vvhich are in that parte to praevent that there concurre noe more vnto that place As farre forth therfore as if that parte be rugged and vnsmoothe as is that Legge vvhich is farre more thicker in the Calfe therof then in the lovvermost partes therof vve must thē frō palme to Palmebreadthe a little more thē half throughe cutt the same and fovvlde both sydes cōtradictorilye the one to the other soe looslye sovve the same by vvhich meanes the sayed Ligament is made to be recurvated and croockedlye vvounde like a Bovve Having therfore stifflye rovvled op this foresayed ligature or rovvler An attractive Ligature vve may thervvith as smoothlye vvind involve a Legge vvithout makinge therin anye inaeqvalitye or furrovves causing that syde vvhich vvas cut of thē agayn sovved aeqvallye to agree vvith the thīnest parte the vvhol parte vvhich is the longest to agree vvith the greatest parte Above these tvvo foresayed Kindes differēces of Ligamentes vve may as yet adde thervnto a thirde Kinde The vvhich vve call an attractive Ligamēt vvhich vve may vse vvhen vve desire to retracte anye bloode nourishment or anye other vitall Spirites into that parte the vvhich the parte of it selfe can not dravve attracte vnto it because her attractive forces are debilitated very much feebled The secōde kinde of Ligament above rehearsed VVe vvill somvvhat alsoe speake of that ligament vvhich of it selfe is for noe vse profitable but accidentallye cureth throughe his continuāce of the remedyes vvhich are applyed vnto the dissease vvherfore vve may call it the retentive Ligament vvherin vve must consider thre especiall thinges First in vvhat disseases it is commodious Secondly on hovve manye fashones it may be composed made Thirdly Ligamēt for the dissease lastelye hovve vve ought to vse the same Touchinge the first vve ether vse the same consideringe the parte or the Dissease vvhich can tollerate noe other Consideringe the Dissease as anye vvounde or vlceratione accompanied associated vvith anye great payne or inflammatione or vvhen vve disire an Apostematione to be matured Consideringe the parte as vvhen a vvounde is in the Heade in the Necke in the Bellye or in the Testicles vvhich partes cā not indur to be stiffly tyed or bovvnd therfore neede noe ligatione but only to retayne the remedyes therone because that the other stiffe ligatures bringe vvith them great discommoditye Concerninge the seconde poyncte Ligamēt for the parte The retentive Ligamēt must have tvvo three or four endes accordinge to the forme situatione of the parte vvhich vve vvoulde dresse Touching the thirde poyncte that must be begunne in the dissease ended on the other syde of the same ⧠Of the Rules generall Instructions wheron we must consider in all Rowles Ligatures Chap. 3. THerfore convenientlye Tvvo thinges to be considered vvhen as decentlye vve desire to vvinde anye parte decentlye to vvinde or involve anye parte or mēbre vve must note cōsider on tvvo especiall thinges vvherof the first is the vvounded parte vvhich vve vvill vvinde the seconde is the aegritude or dissease Touching therfore the disseased parte vve take this for a generall Rule that shee must be tyed that in such a forme figure as vve vvil have her to cōtinue lye For if soe be vve vvind a foulded curvated parte vvhich therafter must be situated right and extented ther vvill as then conseqventlye insue such or the like Accidentes to vvitt that the Ligature vvill dissolve loosen that ther vvilbe caused great payn doloure in the parte because the Muscles Vaynes Arteryes Synnues the verye bones alsoe have an other situatione beinge erected extended then vvhen as they are recurved and croocked As in exāple If soe be a broken Legge Example being recurved soe on that manner be circumligated vvounde vvhich ought othervvyse to be tyed beinge stretched extended right forthe vvithout doubte all the Ligature vvill goe loose vvhen as vve desire to extende the same out of the vvhich vvill follovve great payn because the brockē Bones Vaynes Arteryes Synnues Muscles doe not as thē keepe the same place as they have done the parte beinge bovvnde tyed Contrarilye vve desiringe to dresse a fracture in an Arme he must then be shutt foulded together for if soe be vve dresse him beinge extended vvhē as therafter he shal be recurved bended then the Bones in therre lyinge vvith the other partes be turned into some other fashone vvherthroughe the Ligature vvil in one place be loosened in another spāned vvhich also suscitateth payne in that parte For it must necessarilye follovve that vvhen as a tyed parte be chaunged and then ether shutt bended or extended thē there are some of the Muscles extended crushed as in the rotunditye in the abbreviatione others vveackened vnited And vvhē they are exrected they must needes then be crushed throughe the Ligature out of the vvhich must necessarily follovve intollerable payne because of the Compresse vvhich in ferreth vvith it in that parte great fluxiones other accidentes mischaunces The dissease Novv for as much as cōcerneth the dissease vve must circumligate involve an Arme or a broken Legge vvith a vvounde on an other manner and fashon then a Fracture vvith out vvoūde on an other fashon a Legge vvhich hath but a simple Vlceratione then a Legge vvhich hath a concavouse or Fistulouse vlceratione And a Ioyncte vvhich is full of payne must one an other manner be tyed then that vvherin is noe payne Decētlye to vvind Therfore cōvenientlye decentlye to ligate or vvinde the Ligature must be right closely rovvled vp because vve may houlde him the faster stedyer in the hāde vvithout stirring or glidinge this vvay or that vvaye as he might chaunce to doe the same not being stiffly rovvled vp because that throughe his hardenes he may the better be handled conduced so that all ligationes farre cōvenienter more decēt to more contentment of the Patient and the circumstantes or standers by may be effected then other vvyse vvhē as the Ligature is layed dubble croocked curved vneven ⧠Howe we ought to tye the Ligament agayne make loose the same Chap. 4. Wherone vve ought to consider in the fasteninge of the ligature THe Chyrurgiane must cōsider note that ther be no seames knottes or anye vnevennes in the Ligament vvhich might chaūce to crushe the vvound and the Ligatione alsoe being finished consideringe that the end of the Ligature be not fastened one the vvounde nether one anye place vvher ther is any payne for vnles vvith