fourth is that it serves for a wall or bulwarke to the entrailes which lye and rest upon it on the inside And because we have fallen into mention of Ligaments it will not be amisse to insert in this place that which ought to be knowne of them First therefore we will declare what a Ligament is then explaine the divers acceptions thereof and lastly prosecute their differences Therefore a Ligament is nothing else than a simple part of mans body next to a bone and Gristle the most terrestriall and which most usually arises from the one or other of them either mediatly or immediatly and in the like manner ends in the one of them or in a Muscle or in some other part whereby it comes to passe that a Ligament is without blood dry hard and cold and without sense like the parts from whence it arises although it resemble a Nerve in whitenesse and consistence but that it is somewhat harder A Ligament is taken either generally or more particularly in generall for every part of the body which tyes one part to another in which sense the skin may be called a Ligament because in containes all the inner parts in one union So the Peritonaum comprehending all the naturall parts and binding them to the backe-bone so the membrane inuesting the Ribbs that is the Pleura containing all the vitall parts thus the membranes of the braine the nerves veines arteryes muscles membranes and lastly all such parts of the body which bind together and conteine other may be called Ligaments because they binde one part to another as the nerves annexe the whole body to the braine the Arteries fasten it to the heart and the veines to the liver But to conclude the name of a Ligament more particularly taken signifies that part of the body which we have described a little before The differences of Ligaments are many for some are membranous and thin others broad othersome thicke and around some hard some soft some great some little some wholy gristlely others of a middle consistence betweene a bone and a gristle according to the nature of the motion of the parts which they binde together in quicknesse vehemency and slownesse We will shew the other differences of Ligaments as they shall present themselves in dissection CHAP. XVII Of the Muscles of the Necke THe Muscles of the necke as well proper as common are in number twenty or else twenty two that is ten or eleven on each side of which seven only move the head or the first vertebra with the head the other 3 or 4 the necke it self Of the 7 which move the head with the head the first Vertebra some extend erect it others bend and decline it others move it obliquely but all of them together in a successive motion move it circularly and the like judgement may be of the Muscles of the Necke The fourth Figure of the Muscles This Figure sheweth the cavities of the middle and lower bellies the bowels being taken out but most part of the bones and muscles remaining AB The first musclebending the necke called Longus C C The second bender of the necke called Scalenus D D D D The outward intercost all muscles E E E E The inner intercostall muscles F F F The second muscle of the chest called serratus maior G The first muscle of the shoulder-blade called sâ—rratus minor separated from his originall H The first muscle of the arme called Pectoralis separated from his originall I The second muscle of the arme called Deltoides K The bone of the arme without flesh L The first muscle of the cubite called Biceps M The second muscle of the cubit called Brachiaus N The clavicle or coller-bone bent backward O The first muscle of the chest called subclavius P The upper processe of the shoulder-blade Q The first muscle of the head called obliquus inferior R The second muscle of the head called Complexus S The fourth muscle of the shoulder blade called Levator TV The two bellies of the fourth muscle of the bone Hyois X X a a The fist muscle of the backe whose originall is at a a. Y Y b b c c The sixt muscle of the thigh called Psoae whose originall is at c c and tendon at b b. Z Z The seaventh muscle of the thigh d the holy bone o o o the holes of the holy bone out of which the nerves doe issue e A portion of the fist muscle of the thigh arising from the share-bone f the share-bone bared k the ninth muscle of the thigh or the first circumactor The fifth Figure of the muscles in which some muscles of the head Chest arme and shoulder-blade are described I The processe of the shoulder-blade called the top of the shoulder O The fourth muscle of the arme or the greater round muscle to which Fallopius his right muscle is adjoyned which some call the lesser round muscle Q Q The sixt muscle of the arme or the upper blade-rider X The second muscle of the shoulder-blade or the Levator or heaver Z the second muscle of the chest or the greater Saw muscle Y the fifth muscle of the chest or muscle called Sacrolumbus αβ His place wherein he cleaveth fast to the longest muscle of the backe γγ the Tendons of the muscle obliquely inserted into the ribs ΔΔ the first paire of the muscles of the head or the Splinters Ch. 8. 9 their length whose beginning at 8 and insertion at 9. 10 11. the sides of this muscle 12 that distance where they depart one from the other 13 the two muscles called Complexi neare their insertion Φ the second muscle of the backe or the Longest muscle Ω the fourth muscle of the backe or the Semi-spinatus δ the shoulder-blade bare p A part of the transverse muscle of the Abdomen The sixth Figure of the muscles shewing some of the muscles of the Head Backe Chest Shoulder-blade and Arme. A D the second paire of the muscles of the head or the two Complexi the first part is at A D. B C. the second part E F the third part rising up under G and inserted at F. G the fourth part of this muscle or the right muscle of the head according to Fallopius which Vesalius made the 4. part of the 2. G G Betwixt the ribs the externall Intercostall muscles L the originall of the 2. muscle of the backe M His tendons at the racke-bone of the necke The upper O the fourth muscle of the arme or the greater round muscle O O the lower the 6 muscle of the chest or the Sacrolumbus hanging from his originall Q the sixt muscle of the arme or the upper Bladerider inverted V the third ligament of the joynt of the arme X the fourth muscle of the shoulder-blade or the heaver Z the second muscle of the Chest or the greater Saw-muscle 〈◊〉 the 3. muscle of the necke called Transuersalis Ï€ the 4. muscle of the necke called Spinatus
Σ the first muscle of the backe or the Square muscle Φ the 2. muscle of thebacke or the Longest whose originall is at L and his tendons at the Vertebrae at M M. Ω the fourth muscle of the backe called Spinatus δ the backe of the shoulder-blade flaied The seventh Figure of the muscles shewing some muscles of the head and Chest the Trapezius or table-Table-muscle being taken away as also of the blade and arme A The prominent part of the fourth muscle of the chest called Serratus posticus superior Δ the first muscle of the head called splenius E E the insertion of the second muscle of the head called Complexus I the coller bone bared M the backpart of the second muscle of the arme called Deltois ζH His backward originall θ His implantation into the arme N N the fourth muscle of the arme called Latissimus s μ His originall from the spines of the rack-bones and from the holy bone 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 the connexiou of this muscle with the hanch-bone which is led in the inside from μ to 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 the place where it lieth upon the lower angle of the Basis of the shoulder-blade O the 4. muscle of the arme called Rotundus maior e some muscles of the backe doe here offer themselves P the fift muscle of the arme called Superscapularis Inferior Q the sixt muscle of the arme called Superscapularis Superior S the beginning of the third muscle of the arme called Latissimus V the third muscle of the blade called Rhomboides 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 X His originall from the spines of the rackebones 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 His insertion into the basis of the shoulder-blade χ the fourth muscle of the blade called Levator * A part of the oblique descendent muscle of the Abdomen The eight Figure of the muscles especially of those of the Chest Head and Shoulder-blade the Trapezius Latissimus and Rhomboides being taken away A The fourth muscle of the chest or the upper and hinder Saw-muscle B the 5 muscle of the chest or the lower and hinder Saw-muscle a b A membranous beginning of the muscle of the Abdomen descending obliquely downe from the spine of the backe C the first muscle extending the Cubit at c his originall is from the necke of the arme and from the lower basis of the blade at d. E the originall of the fourth muscle of the bone hyois from the blade G G the outward intercostall muscles I the Clavicle or coller-bone bared N the upper the second muscle of the arme called Deltois char 4 5 the beginning of this muscle N the third muscle of the arme or the broad muscle separated O the fourth muscle of the arme or the lower Super-Scapularis or bladerider 1 2 3. Char. His originall at the basis of the shoulder-blade at 1 2 and his insertion into the joynt of the arme at 3. Q the sixt muscle of the arme or the upper Super-Scapularis X the fourth muscle of the blade called Levator or the heaver Z the second muscle of the Chest or the greater saw-Saw-muscle 7 7 Char. the ribs 〈◊〉 the sixt muscle of the chest or the muscle called Sacrolumbus 〈◊〉 the first muscle of the head or the splinter E E the second muscle of the head or the insertion of the muscles called complexei Φ the second muscle of the backe or the longest muscle Ω the fourth muscle of the backe called Semispinatus Wherefore when the first oblique moves the head obliquely forwards the second puls it packe by the first Vertebra this with his associate of the other side may be truly termed the proper muscles of the neck because they belong to no other part whereas it is contrary in other muscles But we must note that the head according to Galens opinion hath two motions one directly forwards and backwards as appeares in beckning it forwards and casting it backwards the other circular The first in Galens opinion is performed by the first Vertebra moved upon the second the second by the head moved upon the first Vertebra for which he is reproved by the latter Anatomists who teach that the head cannot be turned round or circularly upon the first Vertebra without putting it out of joynt The ninth Figure of the muscles shewing the muscles of the Head and Necke A B the third paire of the Muscles of the head called Recti Maiores C the Mammillary processe D the transverse processe of the first rackebone E the processe of the 2 rackebone of the necke F G the fourth paire of muscles of the head called Recti Minores H I the fift paire of muscles of the head called Obliqui Superiores K L the sixt paire of muscles of the head called Obliqui Inferiores X the fourth paire of muscles of the shoulder-blade Λ the second muscle of the necke called Scalenus which Falopius maketh the eight muscle of the chest Î the fourth muscle of the necke called spinatus Σ the first muscle of the backe called Quadratus Φ the second muscle of the backe called Longissimus a the sinus or bosome of this muscle whereby it giveth way unto the third muscle of the backe called Sacer. b His Originall ψ the third muscle of the backe called Sacer. γ His Originall δ His end Ω the fourth muscle of the backe called Semispinatus 〈◊〉 His upper end under the fourth muscle of the necke After the shewing of these muscles we must come to three or foure of the necke â—f which number two which some reduce to one extends another bends and the â—…st moves side wayes and all of them with a motion succeeding each other turne it â—…bout as we said of the muscles of the head The first of these which extend taking â—…s originall from the sixe transverse processes of the sixe upper racke-bones of the â—…acke or rather from the root of the oblique ascends directly to the spine of the second Vertebra of the necke and the oblique processe thereof some call it the Transâ—…versarius that is the transverse-muscle This if you desire to take it away it is best first to separate it from the spine then to turne it upwards to the transverse processes â—nlesse you had rather draw it a little from its partner and companion in that place where their originals are distinct seeing it is the last and next to the bones Marvell not if you finde not this distinction of their originall so plaine and manifest for it is commonly obscure For the muscle Spinatus as it most commonly comes to passe arising from the roots of the seven upper spines of the backe and the last of the necke is inserted into other spines of the necke so that it might easily be confounded with the former by Galen The third bends the necke and arising within from the body of the five upper Vertebrae of the back though with a very obscure originall specially in leane bodies it
when it comes almost to the midst of the Cubit presently or a little after it is divided into two large branches the one of which alongst the wand the qther alongst the Cubite is carryed into the hand on the inside under the Ring For both these branches are distributed and spent upon the hand after the same manner as the branches of the internall Axillary veine that is having sent by the way some little shoots into the parts by which they passe at the length the branch which descends by the Wand of the remainder therof bestowes two sprigs upon the Thumbe on each side one two in like manner on the fore finger and one on the midle the other which runs alongst the Ell performes the like office to the litle and the midle or ring finger as you may see by dissection CHAP. XXIIII Of the Nerves of the Necke Backe and Arme. NOw we should handle the sinewes of the Arme but because these proceed from the Nerves of the Necke and Backe I thinke it fit therefore to speake something of them in the first place Therefore from the Necke there proceed seven paire of Nerves the first of which proceeds from the nowle bone and the first Vertebra of the necke as also the first paire of the Backe from the last Vertebra of the Necke and the first of the Chest But all these Nerves are divided into two or more branches of the first paire that is to say on each side goe the one to the small right muscle ascending from the first racke-bone of the necke to the nowle bone the other to the long muscle on the foreside of the necke The branches of the second paire are distributed some with a portion which they receive from the third paire over all the skin of the head the two others go as well to the muscles which are from the second Vertebra to the backe part of the head and from the same to the first Vertebra as also to the long muscle before mentioned One of the third paire of Sinewes is communicated to the head as we said before but others to the Muscles which extend or erect the head and the Necke there is also one of these distributed into the neighbouring â—â—de muscle and part of the long The nerves of the fourth paire go one to the muscles aswel of the neck as the head to the broad muscle the other after it hath sent some portioÌ„ therof into the long muscle the side muscles of the necke it descends with a portion of the fift and sixt paire to the Midriffe One of the branches of the fift paire is bestowed on the hinde muscles of the necke and head the other upon the longe muscle and Midriffe the third is communicated to the Levatores or Heaving muscles of the Arme and shoulder One of the Nerves of the sixt paire goes to the hinde muscles of the Necke and head another to the Midriffe the third with a portion of the seventh paire of the necke and of the first and second of the Chest goe to the Armes and heaving muscles of the shoulder-blade One of the branches of the seventh paire runs to the broad muscle and to the neighbouring muscles both of the necke and head another encreased with a portion of the fift and sixt paire of the necke and a third joyned to the second and third paire of the Chest descending into the Arme goe to the hand But you must note that the Muscles which take their originall from many Vertebrae whether from above downwards or from below upwards admit Nerves not onely from the Vertebrae from whence they take their originall but also from them which they come neere in their descent or ascent There passe twelue conjugations of Nerves from the Rack-bones of the Chest The first entring forth from betweene the last Racke-bone of the necke and the first of the Chest is divided that is on each side each Nerve from his side into two or more portions as also all the rest Therefore the branches of this first conjugation goe some of them to the Armes as we said before others to the muscles as well these of the Chest as others arising there or running that way The branches of the second conjugation are distributed to the same parts that these of the first were But the branches of all the other conjugations even to the twelfth are communicated some to the intercostall muscles running within under the true ribs even to the Sternon and under the bastard ribs even to the right and long muscles and the Costall Nerves of the sixt conjugation are augmented by meeting these intercostall branches by the way as they descend by the roots of the Ribs Other particles of the said Nerves are communicated to the muscles as well of the Chest as spine as the same Muscles passe forth or runne alongst by the Vertebrae from whence these nerves have either their originall or passage forth Having thus therefore shewed the originall of the Sinewes of the Arme it remaines that we shew their number and distribution Their number is five or sixe proceeding from the fifth sixth and seventh Vertebra of the necke and the first and second of the Chest The first of which not mixed with any other from the fifth Vertebra of the necke goes to the Muscle Deltoides and the skin which covers it The other 4 or 5 when they have mutually embraced each other not onely from their first originall but even to the shoulder where they free themselves from this convolution are distributed after the following manner The first and second descending to the Muscle mentioned a litle before and thence sometimes even to the hand is by the way communicated to the Muscle Biceps and then under the said Muscle it meets and is joyned with the third Nerve Thirdly it is communicated with the Longest muscle of the Cubite in the bending whereof it is divided into two branches descending alongst the two bones of the Cubit untill at last borne up by the fleshy pannicle it is spent upon the skin and inner side of the hand The third lower than this is first united with the second under the Muscle Biceps then straight way separated from it it sends a portion thereof to the Arme which lyes under it and to the skin thereof lastly at the bending of the Cubit on the fore side it is mingled with the fift paire The fourth the largest of all the rest comming downe below the third branch under the Biceps with the internall Axillary veine and Artery is turned towards the outward and backe part of the Arme there to communicate it selfe to the Muscles extending the Cubit and also to the inner skin of the Arme and the exteriour of the Cubit the remainder of this branch when in its descent it hath arrived at the joynt of the Cubit below the bending thereof it is divided into two
of the cavities or fissures of thâ— Throttle What the necke is What to be considered in the vertebrae of the necke Which be the right processes of the vertebrae Which the transverse Which the transverse The connexions of the vertebrae of the necke The processe called the tooth By what articulation the head is bended backwards and forewards The Vertebrae of the Holy bone The manifold uses of the backebone What a Ligament is Why it is without sense What parts may be called Ligaments in a generall signification The differences of Ligaments properly so called Their number Which may be truly called the proper muscle of the necke The two motions of the head The Transversaâ—… The Spinatus The Lâ—… The Scalenus In what the Vertebrae of the necke and loines agree and disagree How the tenth Vertebrae of the backe may be said to be the middle of the spine The number of the muscles of the Chest The muscles dilating the Chest The muscles contracting the Chest The Subclavius is the first of the muscles dilating the chest Serratuâ— major Serratus posterior and superior The oblique ascendent of the lower belly The eleaven Intercostales externi 6. Intercartilaginei The Sacro-lumbus the first of those which contract the chest The oblique descendent the right and transverse of the Epigastrium Triangulus musculâ—s Intercostalcâ— incerni Intercartilaginei interni Muscles alwayes receive their nerves in their heads The midriffe The muscles of the loines They are three pairâ—… Trianguluâ— Semispinatu Sacer The description of the blade-bone or shoulder-blade The basis of the bladâ— The head of the shoulder-blade The spine of the blade The processes Acromion and Coracoides The muscles of the shoulder blade Rhomboides Levator Trapezius Latissimus Pectoralis What is meant by the hand in generaâ—l The differences of the hand from the site thereof Why the hand is devided into so many fingers Why the nailes are added to the soft flesh of the fingers Why the nailes grow continunally The Cephalicke vaine The median veine Howby opening the median veine you may draw more or lesse bloud from the head or liver The axillary is devided into The deepe axillary and outward axillary The Selvatella and Splenitica An Aontomicall Axiome The 7 paire of nerves of the necke The first paire The second paire The third paire The fourth paire The fift paire The sixt paire The seventh paire The 12. pairâ— of Nerves of the Chest The first paiâ—â— The second paire The otheâ— paires The Nerves vvhich are carryed to thâ— Armes The greatnesse and figure The Appendix of the Arme. The processes of the Arme The figure of the Arme. The originall and insertion of the pectorall muscle The Deltoides The Epomis or Scapularis What is ment by the Cubit What the Olecranum is The 2 bones of the Cubit The two Appendices of the wande The figure and fite of the wande The 2 Appendices of the bone of the Cubit The figure of the Cubit bone or Ell. The muscles moving the Cubite The Biceps or 〈◊〉 headed muscle The Brachiaus The Longus The Brevis What the Hand properly so called is What the Annulus oâ— Ring is The bones of the Aftervvrest The bones of the fingers When at the mailes are generated The ossa Sesamoid or Seed-bones Their use The museles of the Cubite The Supinatores The Carpitensores The Digitum-tensores The Obliquator externus The first of the Supinatores The second The upper of the Carpitensores The lower The greater of the Digitumtensores The lesser The Obliquator or Abductor externus The muscles of the inner part of the Cubit The Palmaris The Pronatores The Carpiflexores The Digitum-flexores The Sublimis Digitumflexor The profundus Digitum-flexor The number of the muscles of the inside of the hand The Thenar The Hypothenar The externall Abductor of the thumbe The Lumbrici The Interosses The number of the muscles of the whole taken in generall The diverse acception of the Legge The thigh The legge or shanke The foote The division of the foote The Instep The top of the foote The toes The beginning of the Crurall veine The two branches thereof By what veines the matter causing those tumors called Bubones flows downe Where and in what diseases the Sapheia must be opened To what places and by how manifold devisions the internall branch of the crurall veine goes Ischiadica Vena Muscâ—la 〈◊〉 Poplitea 〈◊〉 Suralis venaâ— Ischiadica maior muscula The five conjugations of the nerves of the loines Where the testicles have their nerves The conjugations of the nerves proceeding through the holybone An Anatomis call axiome Of how many bones the Ossa Ilium consist What the Os Ilium strictly taken is What theline lippe brow and rib of the Os Ilium are The Os Ischium or huckle-bone The Os pubis or share-bone The descript of the thigh-bone The two appendices of the thigh-bone The two processes of the thigh-bone make the two Trochanters Whence the marrow becomes partaker of sense Their number The two flexores The three Tensores Three Intromoventes The movers of the buttocks The two Obturatores What the Paiella or whirle bone of the knee is The use thereof What and how many bones the legge hath The legge-bone What Diaphysis is The Perone fibula or shinne-bone Their number The Longus The Membranosus The Rectus The two Vasti The Crurcus The three Internall The Biceps or two-headed muscle The Popliteus or ham muscle Their number The bones of the Instep The Astragalus it s three connexions and their use It s three processes The description of the Calcaneum or Câ—… Why a fracture of the heele is so dangerous Hippocrates Sect. 3. lib. de fracturis The Os Scaphoidos or boate-like-bone The Os Cuboides or Die-bone The Ossa innominata or namelesse bones The bones of the foote or Pedium The bones of the toes The Seed-bones of the foote The twofold use of the feete Their number Musculus Peronaus Tibiaeus anticus The Toestretcher is two-fold The 6 hinde muscles The 2 Gemeli or Twins muscles Yn what place the kibes breed The Plantaris The Soleus The Tibiaeus Posticus The Digitum-flexor two-fold Their number The Abductor of the Toes or Pediosus The Flexor superior The muscle equivalent to the Thenar The 4 Lumbrics The descripâ—â—on of the upper and loâ—… Interosses The bones of the face 15. The teeth 32. The bone Hyoides The bones of the spine 34. 2 Coller-bones The Ribs 24. The bones of the Sternon 3. The bones of the whole arme 62. The bones of the whole leg 66. What the Sceletos is The bones are composed two manner of wayes 2 Sorts of Articulation What Diarthosis and Synarthrosis are 3. Sorts of Diarthrosis What Enarthrosis is What Arthrodia What Cephale is What Corone is What Cotyle is What Glene is What Ginglymos 3 Kinds of Synarthrosis What a Suture is What Gomphosis is What Harmonia is What Symphyasis is Synchondrosis Syneurosis The things signified by word Nerve Synsarcosis The â—8 of the Laâ—…x
assaults by somewhat yeelding to their impression no otherwise than soft things opposed against cannon shot Wee will prosecute the other differences of gristles in their place as occasion shall be offered and required CHAP. II. Of the containing and contained parts of the Chest THe containing parts of the chest are both the skinnes the fleshie pannicle the fat the breasts the common coate of the muscles the muscles of that place the forementioned bones the coate investing the ribbes and the Diaphragma or midriffe The parts contained are the Mediastinum the Pericardium or purse of the heart the heart the lungs their vessels Of the containing parts some are common to all the body or the most part thereof as both the skins the fleshie pannicle and fat Of which being we have spoken in our first Booke there is no neede now further to insist upon Others are proper to the chest as its muscles of which we will speake in their place the brests the forementioned bones the membrane investigating the ribs and the Diaphragma or midriffe Wee will treate of all these in order after we have first shewed you the way how you may separate the skinne from the rest of the chest Putting your knife downe even to the perfect division of the skinne you must draw a straite line from the upper part of the lower belley even to the chinne then draw another straight line overtwhart at the collar bones even to the shoulder-blades and in the places beneath the collar-bones if you desire to shunne prolixitie you may at once separate both the skinnes the fleshie pannicle the fat and common coate of the muscles because these parts were shewed and spoken of in the dissection of the lower belley Yet you must reserve the brests in dissecting of the bodies of women wherefore from the upper parts of the breasts as artificially as you can separate onely the skin from the parts lying under it that so you may shew the Pannicle which there becommeth fleshie and musculous and is so spred over the necke and parts of the face even to the rootes of the haires CHAP. III. Of the Breasts or Dugges THe Breasts as wee said when we spoke of the nature of glandules are of a glandulous substance white rare or spongious in maides and women that doe not give sucke they are more solid and not so large Wherefore the bignesse of the Dugges is different although of a sufficient magnitude in all Their figure is round somewhat long and in some sort Pyramidall Their composure is of the skinne the fleshie pannicle glandules fat nerves veines and arteries descending to them from the Axillaris under the Sternon betwixt the fourth and fifth and sometimes the sixth of the true ribbes And there they are divided into infinite rivelets by the interposition of the glandules and fat by which fit matter may be brought to be changed into milke by the facultie of the dugges Wee will speake no more of the nature of glandules or kernels as having treated of them before onely we will add this that some of the glandules have nerves as those of the brests which they receive from the parts lying under them that is from the intercostall by which it comes to passe that they have most exquisit sense Others want a nerve as those which serve onely for division of the vessels and which have no action but onely use They be two in number on each side one seated at the sides of the Sternon upon the fourth fifth and sixth true ribs Wherefore they have connexion with the mentioned parts with their body but by their vessels with all other parts but especially with the wombe by the reliques of the mamillary veines and arteryes which descend downe at the sides of the brest-blade in which place these veines insinuating themselves through the substance of the muscles are a litle above the navill conjoined with the Epigastricks whose originall is in some sort opposite to the Hypogastrickes which send forth branches to the wombe By the meeting of these it is more likely that this commerce should arise than from other and those almost capillary branches which are sometimes seene to descend to the wombe from the Epigastrick They are of a cold and moist temper wherefore they say that the blood by being converted into milke becomes raw flegmaticke and white by the force of the proper flesh of the dugs Their action is to prepare nourishment for the new borne babe to warme the heart from whence they have received heat and to adorne the brest By this you may know that some Glandules have action others use and some both At the top of the dugs there are certaine hillockes or eminencies called tears or nipples by sucking of which the child is nourished through certaine small and crooked passages which though they appeare manifest to the sight whilest you presse out the milke by pressing the dug yet when the milke is pressed out they doe not appeare nor so much as admit the point of a needle by reason of the crooked wayes made by nature in those passages for this use that the milke being perfectly made should not flow out of its owne accord against the nurses will For so the seed is retained and kept for a certaine time in the Prostats CHAP. IIII. Of the Clavitles or Coller bones and Ribs IF we should handle these parts after the common order we should now treat of the Muscles of the Chest which move the arme and serve for respiration and which first offer themselves to our sight But for that they cannot be fitly shewed unlesse wee hurt the muscles of the shoulder blade and necke therefore I thinke it better to deferre the explanation of these muscles untill such time as I have shewed the rest of the contained and containing parts not onely of the chest but also of the head that having finished these we may come to a full demonstration of all the rest of the muscles beginning with those of the head which wee first meet with and so prosequuting the rest even to the muscles of the feet as they shall seeme to offer themselves more fitly to dissection that so as much as lyes in us we may shunne confusion Wherefore returned to our proposed taske after the foresaid muscles come the Collar bones the sternon and ribs But that these parts may be the more easily understood wee must first know what a bone is and whence the differences thereof are drawne Therefore a bone is a part of our body most terrestriall cold dry hard wanting all manifest sense if the teeth be excepted I said manifest sense that you may understand that the parts have a double sense of touching the one manifest such as resides in the flesh skin membranes nerves Teeth and certaine other parts the other obscure yet which may suffice to discerne the helping and hurting tactile qualityes such sense the
entrance of the lungs are divided into two other large branches and each of them goe to his peculiar Lobe of the lungs and these againe runne almost into infinite other branches dispersed in three places over the Lungs These vessels have acquired their names by reason of that transmutation of consistence whereby the composure of a veine degenerates into an arterye and that of an arterye into a veine for the commodity of life For this is a miracle of prudent nature to change the coats of the vessels of the lungs producing a veine which in its body should imitate an arterye and an arterye which should represent a veine For if the vena arteriosae should have retained its proper consistence the arterious blood which is carried by it from the heart to nourish the lungs might by reason of its subtility penetrate through and flow away by reason of the rarity of the veinous texture and so nature should never have attained her conceived end that is to nourish the Lungs by reason of the continuall motion of their contraction and dilatation For nourishment cannot be assimulated to the part unlesse it be put and cleave to it Wherefor it was fit that nature should make the body of this veine solid that it might be immoveable unshaken and stubborne in respect of a veine which by its softnesse would have been too obsequious and yeilding to the agitation of the Lungs that so it might have nourishment which might be diffused into all parts thereof and which might neither bee drawne by its Diastole nor driven back into the heart by its systole But the arterye hath the consistence of a veine that by that veinous softnesse according to the necessity of nature it might be the more readily contracted and dilated to bring the Aire in and carry the vapours forth of the heart Here wee meet with a difficulty which is by what way the blood is carried out of the right into the left ventricle of the heart Galen thinkes that there be certaine holes in the partition made for that purpose and verily there are such but they are not perforated Wherefore Columbus hath found out a new way which is that the blood is carried to the lungs by the vena arteriosa and there attenuated and carried from thence together with the aire by the Arteria venosa to the left ventricle of the heart this he writes truely very probablely Botallus in his treatise De Catarrho hath found out a third way to wit a veine which he calls Arteriarum nutrix that is The nurse of the Arteryes which creepes a litle above the Coronall to the right eare of the Heart and then goes into the left eare thereof But yet I am very much afraid that this veine observed by Botallus is that vessell observed by Fallopius whereby the Vena arterialis is joined to the Aorta by which all the vitall blood is carryed for the forming and nourishment of the lungs whilest the infant is yet in the wombe Of which also Galen makes mention but it had laine hid from his time to this day but that Fallopius raised up the memory of it againe CHAP. XIII The distribution of the ascendent Hollow veine THe Hollow veine riseing out of the gibbous part of the Liver and resembling according to Galen the body of a tree is divided into two notable branches but not of a like bignes For the greater by the hind part of the Liver upon the back bone and by the way receives certaine other branches from the substance of the Liver which entred not into the great trunck with the rest You may often see this descendent branch even to the backe bone upon which it lyes in this its descent covered with the substance of the liver so that it may seeme that branch proceeds not from that common trunck together with the ascendant although indeed it alwayes doth But the lesser branch ascends to the upper parts and is distributed after this manner following For first ariseing into the midriffe it bestowes two small veines upon it on each side one which from that part are called Phrenicae But from thence when it arrives at the right Eare of the Heart it makes the Coronales the Coronall or Crowne veines which compasse the basis of the heart in manner of a Crowne Thirdly entring somewhat more deeply into its right Eare in its greater part it produces the vena arteriosa Fourthly lifted up above the heart on the right side it produces the veine Azygos or sine pari that is without a fellow which descending to the fourth rib reckoning from above downewards nourisheth the intercostall muscles and also the membranes of the 8 lower ribs on both sides sending a branch into each of the muscles at the lower part of the rib which may bee sufficient for their nourishment Besides also oftentimes especially in little men this veine Azygos nourishes all the spaces between all the ribs by the like branches which it sends in the same manner to the foure upper ribs Moreover also this Azygos sometimes though but seldome is found double that is on each side one Here you must chiefly observe that this veine after it hath nourished the spaces between the lower ribs in its remainder descends under the Diaphragma and is joined on the left side to the Emulgent vein by which it is manifest how an Abscesse may be critically evacuated by the urine in a pleurisye But this same Azygos is more depressed on the right side and meets with the Venae lumbares but especially with one of them which goes downe to the thigh whereby Fallopius gathers that it is very convenient in the beginnings of Pleurisyes to open the vena poplitis the veine of the Ham. Fifthly above the Azygos when it is wanting there it sends forth the branch called Intercostalis to the other spaces between the upper ribs although this is sometimes seene to come from the Axillares which Sylvius calls the subclaviae Sixtly it brings forth the Mammariae so called because in their greater part they run to the dugs between the fourth and fifth ribs for the uses formerly mentioned men and women have on each side one of these comming from the Subclaviae They are sometimes found to proceed by a certaine common orifice from the hollow veine before it be divided into the Subclavian branches but it is rather in beasts than in men these veines descending by the sides of the sternon yeild nourishment to the 2 inner muscles of the chest to the 7 intercostall muscles of the true ribs to the sternon it selfe and to its ligaments and gristles as also to the Mediastinum and the upper part of the right muscles and the adjacent parts Seaventhly it produces the Cervicalis which on both sides through the holes of the productions of the Vertebra's of the necke ascends to the head sending many
the reduplication of the Dura mater deviding the fore-part of the braine that so joined and united they may make the torcular the third ascendent is distributed upon the backe part and basis of the lower jaw to the lippes the sides of the nose and the muscles thereof and in like manner to the greater corner of the eyes to the forehead and other parts of the face and at length by meeting together of many branches it makes in the forehead the veine which is called vena recta or vena frontis that is the forehead veine The fourth ascending by the glandules behind the eares after it hath sent forth many branches to them is divided into two others one whereof passing before and the other behind the eare are at length spent in the skinne of the head The fifth and last wandring over all the lower part of the head going to the backe part thereof makes the vena pupis which extended the length of the head by the sagitall suture at the length goeth so farre that it meets with the vena frontis which meeting is the cause that a veine opened in the forehead is good in griefes of the hinder parts of the head and so on the contrary But wee must observe that in the Cranium of some the vena pupis by one or more manifest passages sends some portion thereof to the inner part of the head so that the vena pupis being opened may make revulsion of the matter which causeth the internall paines of the head CHAP. XIIII The distribution of the nerves or sinewes of the sixth coniugation BEcause the Distribution of the arteries cannot be well shewed unlesse wee violate those nerves which are carried over the Chest therefore before we shew the distribution of the arteries we will as briefely as we can prosecute the distribution of these nerves Now the sixth conjugation brings forth three paire of nerves for passing out of the skull as it comes downe to the Chest it by the way sends forth some branches to certaine muscles of the necke and to the three ascendant muscles of the Larinx on each side of the Sternon and upon the clavicles Then the remainder descending into the Chest is divided on each side into these three paire The first paire makes the Ramus costalis The second the Ramus recurrens The third paire the Ramus stomachicus The Ramus costalis or costall branch is so called because descending by the roots of the ribs even to the holy bone and joyning themselves to these which proceede from each of the Vertebra's of the spine they are carried to all the naturall parts The Recurrens or recurrent is also called because as it were starting up from the chest it runs upwards againe but these two Recurrent nerves doe not run backe from the same place but the right from below the artery called by some the axillarie by others Subclavian and the left from beneath the great artery descending to the naturall parts But each of them on each side ascending along by the weazon even to the Larinx and then they infinuate themselves by the wings of the Cartilago scutiformis and Thyroydes into the proper muscles which open and shut the Larinx By how much the nerves are nearer the originall to wit the braine or spinall marrow they are by so much the softer On the contrary by how much they are further absent from their originall they are so much the harder and stronger which is the reason that Nature would have these recurrent nerves to runne backe againe upwards that so they might be the stronger to performe the motions of the muscles of the Larinx But the Stomachicus or stomacke-branch is so called because it descends to the stomacke or ventricle For this branch descending on both sides by the sides of the gullet sends many branches from it into the inner substance of the lungs into the coate thereof into the Pericardium and heart and then comming into the upper orifice of the stomacke it is spent in many branches which folded after divers manners and wayes chiefely makes that mouth or stomacke which is the seate of the Animall apetite as they terme it and hunger and the judger of things convenient or hurtfull for the stomacke But from thence they are diversely disseminated over all the body of the ventricle Moreover the same branch sends forth some small branches to the liver and bladder of the gall giving each part by the way so much sense as should be sufficiently necessary for it Here you must note the stomacke branch descends on each side one knit to the gullet and by the way they divide themselves into two branches each of which goes to the opposite side that it may there joine itselfe to the nerve of that side To which purpose the right is carried above the gullet the left below it so that these two stomaticke become foure and againe these foure presently become two CHAP. XV. The division of the Arteries THe Artery arising forth of the left ventricle of the heart is presently the two Coronall arteries being first spred over the substance of the heart divided into two unequall branches The greater whereof descends to the lower parts being distributed as we formerly mentioned in the third Booke and 22. Chapter The lesser ascending to the upper parts is againe divided into two other unequall branches the lesser of which ascending towards the left side sends forth no artery from it untill it arive at the first rib of the Chest where it produces the subclavian artery which is distributed after the manner following First it produces the intercostall and by it imparts life to the three intercostall muscles of the foure upper ribs and to the neighbouring places Secondly it brings forth the Mammillary branch which is distributed as the Mammillary veine is Thirdly the Cervicalis which ascends along the necke by the transverse productions to the Dura mater being distributed as the vena cervicalis is Fourthly passing out of the Chest from the backe part of the Chest it sends forth the musculosa whereby it gives life to the hinde muscles of the necke even to the backe part of the head Fiftly having wholy left the Chest it sends forth the two Humerariae or shoulder arteries the one whereof goes to the muscles of the hollow part of the shoulder blade the other to the joint of the arme and the muscles situate there and the gibbous part of the shoulder blade Sixthly and lastly it produces the Thoracica which also is two fold for the one goes to the fore muscles of the Chest the other to the Latssimus as we said of the veine the remnant of it makes the Axillaris of that side The other greater branch likewise ascending by the right side even to the first ribbe of the Chest makes also the subclavian of that side which besides those
next to the first passing entire forth of the skull imparts some small branches to certaine muscles of the neck and throttle and then descending into the chest it makes the recurrent nerves and dispersed over all the parts of the two lower bellyes it passes even to the bladder and testicles as wee shewed in the former booke The seventh is inserted and spent upon the muscles of the bone Hyois the tongue and some of the throtle to give them motion it passes forth of the skull by the hole of the nowle bone at the extuberancies thereof CHAP. IX Of the Rete Mirabile or wonderfull Net and of the Wedge-bone THe Animall spirit is made of the vitall sent from the heart by the internall sleepy Arteryes to the braine For it was requisite that it should be the more elaborate because the action of the Animall is more excellent than that of the vitall nature hath framed a texture of Arteryes in many places running crosse one another in the forme of a Net diverse times doubled whereupon it had the name of the wonderfull Net that so the spirit by longer delay in these Labyrinthean or maze-like turnings might be more perfectly concocted and elaborate and attaine to a greater fitnesse to performe the Animall functions This wonderfull Net scituate at the sides of the Apophyses clinoides or productions of the wedgebone is twofold that is divided by the pituitary Glandule which is scituate betweene the said Apophyses Clinoides having the wedgebone lying under them next to the Crassa Meninx being perforated on the right and left side next to which lye bones as rare as a sponge even to the Pallate by which the Phlegme is purged by the mouth and nose and therehence I thinke that spattle flowes which such as have a moist braine continually spit out of their mouth The Eight figure of the braine A The Braine B The Cerebellum or after braine C A processe of the brain but not that which is called Mammillaris D D The marrow of the backe as it is yet within the skul E The Mammillary processe or instrument of smelling F The opticke nerve G The coate of the eye into which the opticke nerve is spread H The nerve that moveth the eye or the second payre I The third conjugation or the harder and lesser branch of the nerves of the third conjugation brought forward K The fourth conjugation or the greater and thicker nerve of the third payre bending downward L A branch of the nerve marked with I which goeth to the fore-head M Another branch of the nerve I reaching to the upper jaw NN A nerve proceeding from the branch I intexed or woven with the coat of the nose O The nerve of the temporall muscle issuing from the branch I. P A nerve contorted of the nerves K and b. Q A nerve proceeding from the branch K to the sockets of the upper teeth R A nerve creeping from the nerve K to the lower jaw S. A surcle of the branch R offered to the lower lip TT Other surcles from the branch R attaining to the lower teeth VV A branch of the nerve K diffused into the coate of the tongue X X The fourth paire of sinews which goe into the coat of the pallat Y The fifth paire of sinews which are the nerves of hearing a the membrane of the eare unto which that fifth nerve goeth b c two small branches of the fifth conjugation uniting themselves with the nerve P. à the eight conjugation or a nerve of the fifth paire attaining unto the face ee the sixt paire of nerves f A branch from the nerve e reaching to the muscles of the neck g Small branches derived unto the throttle or larynx h the byfurcation of the nerve into two branches iii An inner branch hanging to the rackbones and strengthning the intercostall nerves and is therefore called Intercostalis kk Surcles of the utter branch going to the heads of the muscles to the breast-bone and to the coller-bones l m branches of the right nerve l making the right Recurrent nerve m n the insertion of the recurrent sinews into the muscles of the larinx o p branches of the left nerve making the left recurrent sinew p. qq branches from the sixt conjugation going to the coate of the lungs r small nerves of the heart and of the purse thereof called the Pericardium as also some approaching to the coats of the lungs s nerves on either side sent to the stomack t the right stomacke nerve going to the left orifice of the stomack u u the left stomack nerve going to the right orifice of the stomack x a nerve from the branch u passing into the hollownes of the liver y the nerve belonging to the right side of the kell z the nerve belonging to the collick gut α a nerve creeping to the gut called duodenum and the beginning of the ieiunum or empty gut β a nerve implanted in the right side of the bottome of the stomacke γ a nerve belonging to the liver and bladder of gall δ a nerve reaching unto the right kidney 〈◊〉 a branch reaching the Mesenterium and the guts ζ a branch sprinkled to the right part of the bladder η a branch going through the left part of the kel θα surcles derived to the collick gut and the kel χ small branches inserted into the spleen λλ a nerve approaching to the left side of the bottome of the stomack μ a branch belonging to the left side of the Mesentery and the guts ν a branch which attaineth to the left kidney ξ small nerves creeping through the left side of the bladder o the seven paire of finewes 〈◊〉 a branch derived from the sixt coniugation to the muscles which arise from the processe called Styloides 〈◊〉 a branch of the seaventh coniugation which goeth to the muscles of the tongue of the bone hyois and of the throtle or larinx 〈◊〉 A coniunction or coition of the 6. and 7. paire into one nerve These Apophyses clinoides are certaine productions of the Osbasilare or wedge-bone called the Saddle thereof between which as I said the pituitary glandule lies with part of the wonderfull net There is a great controversie amongst Anatomists concerning this part for Vesalius denies that it is in man Columbus admits it yet hee seemes to confound it with the Plexia Choroides Truely I have observed it alwayes after the manner as Sylvius alledges against Vesalius It remaines that we recite the perforations of the skull because the knowledge of these much conduces to the understanding of the insertions of the veines arteryes and nerves CHAP. X. Of the holes of the inner Basis of the Scull IN the first place are reckoned the holes of the bone Ethmoides then those of the optick nerves thirdly of the nerves moving the eyes Fourthly of that portion of the nerves of the fourth conjugation which goe to the temporall muscles Fifthly are reckoned these holes scarse visible
or Antagonist rests or keeps holieday that when that which is said to open the eye is imployed the opposite thereof resting the upper eye-lid should be drawne towards its originall as we see it happens in convulsions because the operation of a muscle is the collection of the part which it moves towards its originall Therefore seeing such a motion or collection appears not any where in the eye-lid I thinke it therefore manifest that all the motion of this upper eye-lid depends upon this broad muscle and that it alone is the author of the motion thereof The originall of this broad muscle is from the upper part of the Sternon the clavicles the shoulder blades and all the spines of the vertebra's of the neck but it is inserted into all these parts of the head which want haire and the whole face having diverse fibers from so various an originall by benifit of which it performes such manifold motions in the face for it so spreads it selfe over the face that it covers it like a vizard by reason of the variety of the originall and the production of the divers fibers of this muscle But I have not in the description of this muscle prosecuted those nine conditions which in the first booke of my anatomy I required in every part because I may seeme to have sufficiently declared them in the description of the muscles of the Epigastrium Wherfore hence forward you must expect nothing from me in the description of muscles besides their originall insertion action composition and the designation of their vessels CHAP. IIII. Of the Eye-lids and Eye-browes BEcause wee have fallne into mention of the Eye-lids and Eye-browes and because the order of dissection also requires it we must tell you what they are of what they consist and how and for what use they were framed by nature Therefore the Eye-browes are nothing els than a ranck of haires set in a semicircular forme upon the upper part of the orbe of the Eye from the greater to the lesser corner thereof to serve for an ornament of the body and a defence of the eyes against the acrimony of the sweat falling from the forehead But the Eye-lids on each side two one above and another below are nothing els than as it were certaine shuttings appointed and made to close and open the eyes when need requires and to containe them in their orbes Their composure is of a musculous skin a gristle and haires set like a pale at the sides of them to preserve the eyes when they are open chiefly against the injuries of small bodyes as motes dust such like These haires are alwaies of equall and like bignesse implanted at the edges of the gristly part that they might alwaies stand straight and stiffe out They are not thick for so they should darken the eye The gristle in which they are fastened is encompassed with the pericranium stretched so far before it produce the Coniunctiva It was placed there that when any part thereof should be drawne upwards or downewards by the force of the broad muscle or of the two proper muscles it might follow entirely and wholy by reason of its hardnes They call this same gristle especially the upper Tarsus The upper and lower eye-lid differ in nothing but that the upper hath a more manifest motion and the lower a more obscure for otherwise nature should have in vaine encompassed it with a musculous substance CHAP. V. Of the Eyes THe Eyes are the instruments of the faculty of seeing brought thither by the visive spirit of the opticke nerves as in an aqua-ducte They are of a soft substance of a large quantity being bigger or lesser according to the bignesse of the body They are seated in the head that they might overlooke the rest of the body to perceive and shum such things as might endanger or endamage the body for the action of the eyes is most quick as that which is performed in a moment which is granted to none of the other senses Wherefore this is the most excellent sense of them all For by this wee behold the fabricke and beauty of the heavens and earth distinguish the infinite varietyes of colours we perceive and know the magnitude figure number proportion site motion and rest of all bodyes The eyes have a pyramidall figure whose basis is without but the Cone or point within at the opticke nerves Nature would have them contained in a hollow circle that so by the profundity and solidity of the place they might be free from the incursions of bruising and hurtfull things They are composed of six muscles five coats three humors and a most bright spirit of which there is a perpetuall afflux from the braine two nerves a double veine and one artery besides much fat and lastly a Glandule seated at the greater angle thereof uppon that large hole which on both sides goes to the nose and that lest that the humours falling from the braine should flow by the nose into the eyes as we see it fares with those whose eyes perpetually weep or water by reason of the eating away of this glandule whence that affect is called the Fistula lachrymalis or weeping Fistula But there is much fat put between the muscles of the eye partly that the motion of the eyes might be more quick in that slipperines of the fat as also that the temper and complexion of the eyes and chiefly of their nervous parts might be more constant and lasting which otherwise by their continuall and perpetuall motion would be subject to excessive drynesse For nature for the same reason hath placed Glandules flowing with a certaine moisture neere those parts which have perpetuall agitation CHAP. VI. Of the Muscles Coats and humors of the Eye THere are sixe muscles in the eye of which foure performe the foure direct motions of the eye they arise from the bottome of the orbe and end in the midst of the eye encompassing the opticke nerve When they are all moved with one endevour they draw the eye inwards But if the upper only use its action it drawes the eye upwards if the lower downewards if the right to the right side if the left to the left side The two other muscles turne the eye about the first of which being the longer and slenderer arises almost from the same place from which that muscle arises which drawes the eye to the right side to the greater corner But when it comes to the utmost part of the inner angle where the Glandula lachrymalis is seated it ends in a slender Tendon there peircing through the middle membrane which is there as through a ring from whence it presently going backe is spent in a right angle towards the upper part of the eye betwixt the insertions of those 〈◊〉 muscles of the which one draws the eye upwards the other directly to the outward corner as it is
the diversitie of their composition Wherefore hence forward concerning the substance temper and other circumstances of such parts as we shall omit you may have recourse to those things which we have written in the Demonstration of the simple and simular parts of which these organicall are composed as if any should aske of what temper the Larinx is you shall answere of a colde dry and hot and moist because it consists both of a gristlely and fleshly substance Hee which reckons up all the parts of the mouth must not omit that gristlely and membranous body which arises from the roots of the tongue which that it might be more quicke for motion that is whereby it might be more easily erected and depressed for those things which are more soft doe continually slide away but those which are too hard cannot be bended it was convenient it should be neither too hard nor too soft that it might be erected whilest we breath but depressed when wee swallow It is a principall instrument of the voyce for it cannot be well articulated unlesse the way were straite Therefore it straitens that way and the passage of the gristles of the throttle but specially the Arytenoides it is alwayes moist by a certaine native and inbred humiditie wherfore if it happen to be dried by a fever or any other like accident the speach is taken away It is bound on both sides by the common membrane of the mouth to the sides of the Arytenoides even to the backe part thereof that so like a cover it may open and shut the orifice of the throtle that none of the meat and drinke in swallowing may fall into the weazon in such aboundance as may hinder the egresse and regresse of the aire For we must not thinke that this body doth so closely shut the orifice of the throttle but that some small quantitie of moisture alwayes runnes downe by the inner sides as the walles thereof to moisten the lungs other-wise Eclegma's should be of no use in the diseases of the Chest And because that this litle body is partaker of voluntarie motion therefore according to the opinion of some there are foure muscles bestowed upon it two which may open it and two that shut it on each side one The opening muscles descend from the roote of the bone Hyoides and in their insertion growing into one they are terminated in the roote of this body that is the Epiglottis in the backe part thereof The shutting muscles in those creatures where they are found arise on the inside betweene the coate gristle thereof Truly I could never observe and finde these foure muscles in a man though I have diligently and earnestly sought for them but I have alwayes observed them in beasts Therefore some have boldly affirmed that this litle body in swallowing lyes not upon the orifice of the Throttle unlesse when it is pressed downe by the heavines of such things as are to be swallowed but that at all other times by reason of the continuall breathing it stands upright the Throttle being open There remaine as yet to be considered two small bosomes or cavities or rather fissures which nature hath hollowed in the very throttle under the Epiglottis on each side one that if by chance any of the meat or drink should fal or slip aside in the Larinx it might be there stayed reteined Beside that the Aire too violently entring should be in some sort broken by these clifts or chinkes no otherwise than the blood and spirit entring into the heart through the Auricula or Eares thereof CHAP. XVI Of the Necke and the parts thereof FIrst we will define what the neck is then prosequute the parts therof aswel proper as common especially those of which we have not as yet treated For it were superfluous to speake any more of the skin the fleshy pannicle the veines arteries nerves gullet weazon muscles ascending descending to the parts into which they are inserted alongst the necke wherefore you must not expect that we should say any thing of the neck more than to describe the Vertebrae or rack bones being the proper parts therof the ligaments aswell those proper to the neck as those which it hath in common with the head lastly the muscles aswel those it hath in common with the head chest as those of its own Therfore the neck is nothing elss then a part of the head which is conteined between the nowle bone the first vertebrae of the back First in the neck the Vertebra's must be considered we must shew what they have proper peculiar what common amongst themselves that we may the more easily shew the originall and insertion of the muscles growing out of them ending in them The neck consists of seven Vertebrae or Rack-bones in which you must consider their proper body and than the holes by which the spinall marrow passes thirdly the Apophyses or processes of the Vertebrae fourthly the holes through which the nerves are disseminated into other parts from the spinal marrow besides the perforations of the transverse productions by which the veines arteries which we cal Cervicales ascend alongst the necke lastly the connexion of these same vertebrae or Rack-bones For the first by the body of the vertebrae we understand the forepart therof upon which the gullet lyes For the hole that is not alwaies the largest in those vertebrae which are nighest the head but it is alwayes encompassed with the body of the vertebrae besides with three sorts of processes except in the first Rack-bone that is right transverse oblique By right we understand these extuberancies in the Racke-bones of the necke which are hollowed directly in the upper part of them rise up crested on each side to susteine and receive the basis of the Rack-bone which is set upon it By the oblique processes wee understand the bunchings outby which these Rack-bones are mutually knit together by Ginglymos these are seated between the righr transverse processes By the transverse we understand the protuberations next the body which devide the Vertebra or Rackbone in a straight line These processes are perforated that they may give to the before described veines arteries which entring the Spinall marrow by the holes of the nerves nourish the Racke-bones parts belonging to them Besides you must note that the perforations of the Rack-bones of the neck by which the nerves proceed from the spinall marrow to the ourward parts are under the transverse processe that is growing or made by the upper lower vertebra contrary to all the other which are in the rest of the Rack-bones For the connexiō of the Rack-bones you must know that all the Vertebrae of the spine have six connexions two in their own bodies and 4 in their oblique processes By the two first connexions they are so mutually articulated in their owne bodies
inspiration But the first of the other muscles being as many in number which contract the Chest in expiration arising from the holy-bone and the oblique processes of the loines ascends firmely and confusedly adhering with the Musculus sacer or holy-muscle which we shall describe hereafter to the roots of the twelve ribbes imparting in the ascent a small tendon to each of them by which it drawes these ribbs towards the transverse processes and by reason of its Originall it is called Sacrolumbus that is the Holy loine-muscle The second third and fourth which we said were the oblique descendent right and transverse of the Epigrastium have beene formerly described in their place But by the way you must note that these three muscles of the Epigastrium helpe expiration rather by accident than of themselves to wit by driving backe the midriffe towards the lungs by the entrailes which also they force upwards by drawing the parts into which they are inserted towards their Originall The fifth which we called the Triangulus or Triangular may be called the Compressor of the gristles which proceeding from the inner sides of the Sternon goes to all the gristles of the true ribbes this is more apparent under the Sternon in beasts than in men though it be not very obscure in them neither For the internall Intercostall muscles in my judgement they arise from the lower sides of the upper ribbe and descending obliquely from the fore part backwards are inserted into the upper side of the ribbe next under it so that they may follow the production of the fibers of the externall Intercartilaginei as the sixe internall Intercartilaginei follow the site of the externall Intercostall proceeding from behinde forwards wherefore as well the Intercostall as the Intercartilaginei every where intersect each other after the similitude of the letter X. I know some have written that the internall muscles whether intercostall or Intercartalaginei ascend from the upper sides of the lower ribbe forwards or backwards But if this were true it would follow that these muscles admitted their nerves in their taile and not in their head seeing the nerve alwayes goes under the ribbe and not above it The last muscle of the Chest that is the Diaphragma or Midriffe is sufficiently described before wherefore it remaines wee describe the muscles of the Loines These are sixe in number on each side three equall in thicknesse strength and situation one of these bends and the other two extend the Loines it is called by reason of the figure the Triangulus or Triangular which bends the Loines it ascends from a great part of the hinde side of the Hanch-bone into the transverse processes of the Loines and the last of the Chest on the inside for which cause it is made of fibers short long and indifferent answering to the nearenesse or distance of the said processes The first of the extenders is called the Semispinatus because even to the middle of its body it takes the originall from the spines of the holy-bones and Loines this with its oblique fibers ascends from all the said spines to the transverse processes as well of the Loines as Chest The other is called Sacer the Holy-muscle because it takes its originall from the Holy-bone or the sides thereof it ascends with its oblique fibers to the spines of the Loines and of the eleaven lower Rack-bones of the Chest CHAP. XIX Of the Muscles of the Shoulder-blade NOw we must describe the muscles of the extreme parts and first of the Arme taking our beginning from these of the Shoulder-blade But first that we may the better understand their description we must observe the nature and condition of the shoulder-blade Therefore the blade bone on that part which lies next unto the ribbs is somewhat hollowed wherefore on the other side it some what buncles out It hath two ribbs one above another below by the upper is ment nothing else than a border or right line which looking towards the temples is extended from the exterior angle thereof under the collar-bone even to the Processe Coracoides which this ribbe produces in the end thereof By the lower the underside which lies towards the lower belly and the short ribbs Besides in this shoulder-blade we observe the basis head and spine By the basts we understand the broader part of the shoulder-blade which lookes towards the backe-bone By the head we understand the narrower part thereof in which it receives the head of the Arme in a cavity indifferently hollow which it produces both by it selfe as also by certaine gristles which there fastened encompasse that cavity This kinde of cavity is called Glene This receives and containes the bone of the arme by a certaine strong ligament encompassing strengthening the joynt which kind of ligament is common to all other joints this ligament arises from the bottome of the cavity of the shoulder-blade and circularly encompasses the whole joynt fastening it selfe to the head of the arme there are also other ligaments besides this which encompasse strengthen this articulation By the spine is ment a processe which rising by little and little upon the gibbous part of the blade from the basis thereof where it was low and deprest becomes higher untill it ends in the Acromion or upper part thereof Nature hath made two productions in this bone that is to say the Acromion from the spine and the Coracoides from the upper side for the strengthening of the articulation of the arme and shoulder-blade that is left the arme should be easily strained upward or forwards besides it is fastened to the clavicle by the processe Acromion The muscles which move the shoulder-blade are sixe in number of which foure are proper and two common The first of the foure proper seated in the forepart ascends from the bones of five or sixe of the upper ribbs to the Coracoides which it drawes forwards and is called Serratus minor that is the Lesser saw-muscle which that you may plainely shew it is fit you pull the pectorall muscle from the collar-bone almost to the middle of the Sternon The other first opposite against it is placed on the fore side and drawes its originall from the three lower spines of the necke and the three upper of the Chest from whence it extends it selfe and ends into all the gristly basis of the shoulder-blade drawing it backwards it is called the Rhomboides The third from its action is called the Levator or the heaver or lifter up seated in the upper part it descends from the transverse processes of the foure first Vertebrae of the necke into the upper angle and spine of the blade The fourth called Trapezius or the table-Table-muscle is seated in the backe part and is membranous at the originall but presently becoms fleshy it arises from almost all the backe-part of the head from all the spines of the
labour first to shew the bones and the dearticulation of these of the Thigh beginning with these bones which are knit with the upper part of the holy-bone And they are two in number on each side one commonly called the Ossa Ilium each of these is composed of three bones of which one is the upper another the lower and anteriour and the third the middle and after a manner the posteriour The upper by a particular name is called the Os Ilium the hanch-bone and it is the largest and biggest having a gristlely appendix in the compasse thereof even to the connexion it hath with the other neighbouring bones whose upper part we terme the right line thereof but the basis which is adjoyned to it by Simphysis we call the lippe or brow therof because it stands both somewhat out and in after the manner of the brow But that which lies betweene the basis and straight line we name the ribbe this same upper bone hath two hollow superficies the one internall the other externall The connexion thereof by Symphysis is two-fold the one with the upper part of the holy-bone the other with that bone wee called the middle and after some sort the posteriour which taking its beginning from the narrower part of the Os Ilium makes that cavity in which the head of the thigh is received this cavity the Greekes call Cotyle the Latines Acetabulum and it is ended by the side of the hole common to it and the share-bone this middle and in some sort posteriour bone is called properly and particularly the Os Ischij or huckle-bone and containes nothing else but the forementioned cavitie but that on the hinde and lower part thereof it brings forth a processe which adjoynes it selfe to the share bone at the lower part of the common hole in which place it appeares very rough and unequall and it is called the tuberositie of the huckle-bone at whose extremity also it brings forth a little head somewhat resembling the processe of the lowerjaw called Corone The third bone named Os pubis or the share-bone flretches it selfe even to the highest part of the pecten where meeting with the like bone of the other side it is united to it by Symphysis after which manner also all these three bones are united it is reported that this bone opens in women in their travell yet hitherto I can finde no certainety thereof The Figure of the Thigh-bone A 1 2. The head of the thigh going into the cup of the hip-bone B 2 A sinus in the head of the thigh into which is inserted a round Ligament C 1 2 The conjunction of the appendix of the thigh with the bone it selfe D 1 2 3 the necke of the thigh E F the two lower heads of the thigh G 1 2 The conjunction of the lower appendix H 1 12 A sinus betwixt the two heads of the thigh K 2 A part of the lower head of the thigh from whence the first muscle of the foote doth proceede L 2 Another part from whence the second and first muscles arise M 2 Another part to which the Tendon of the fift muscle of the thigh is infixed N 1 2 A sinus of the out-ward side of the head for the fourth muscle of the legge O 2 A sinus of the inside through which the tendons doe passe P 2 A protuberation at which the said tendons are reflected Q 2. the upper processe of the thigh and betwixt Q and D is the sinus R 1 2 the union of the processe with the thigh S S 2 a rough line from the impression of the externall processes T 1 the anterior impression of the internall processes e betwixt T and V another impression higher than the former V 1 2 the fourth impression in the toppe of the processe X 3. Foure X shew the foure appendices of the thigh Y 3 Three Y shew the three heads of the thigh Z Z 3 Two processes of the thigh a 1 the interior processe of the thigh b 1 the conjunction of the processe with the thigh c c 2 a line descending obliquely from the inner processe d d 2 a line running through the length of the thigh e 2 the largenesse of the thigh in this part f 1 a roughnesse from which the eight muscle issueth g h 5 a knub of the Whirle-bone going into the sinus marked with I which is betwixt the heads of the thigh i 5 a sinus sitted for the inner head of the thigh k 5 a sinus agreeing with the externall head of the thigh l 5 the lower asperity or roughnesse m 4 the foreside of the pattell or whirle-bone rough and unequall You may perceive a manifest separation of these three bones in the Sceleton of a child for in those who are of more yeares the gristles which runne betweene these connexions turne into bones Now followes the thigh-bone the biggest of all the bones of the body it is round and so bended that it is gibbous on the exteriour and fore part thereof that so it might be the safer from externall injuries but on the hinde and inner part it is hollow or simous like to the backe of an Asse whereby the muscles might have a more commodious originall and insertion That simous part a little below the midst thereof is devided into two lines the one whereof goes to the internall tuberositie the other to the externall of the lower appendix of the same thigh These are chiefely to be observed because the oblique fibers of the vaste muscles thence take their originall Besides this bone hath two appendices in the ends thereof as easily appeares in a childs thigh the upper appendix makes the round head of the thigh it selfe which as every other appendix seated upon a long necke is received in the cavitie of the hanch-bone by Enarthrosis it is staied and fastened there by two sorts of ligaments of which the one is common proceeding from the muscles which descend from above about the necke thereof the other is proper which is twofold that is one membranous and broad proceeding from the whole cavity of the orbe or cuppe descending about all the head of the thigh above the necke thereof the other thicke and round descending from the second cavity of the Cotyle it selfe which is extended even to the common hole at the top of the head thereof Besides under this head that bone hath two processes the one great and thicke the other little and short The greater seated in the hinde part is called the great Trochanter the lesser situate in the inner part is named the little Trochanter But you must note that the great Trochanter on the higher and hinde part thereof which lookes towards the head of this bone makes a certaine small sinus or bosome into which the twin muscles and others whereof we shall hereafter speake are implanted we must also consider the multitude of holes encompassing this necke betweene the head and
so that unlesse nature had otherwise provided a sufficient receptacle for the head of this bone as by the ligamēts of the neighbouring Muscles it would otherwise have bin in perpetuall danger of dislocation Thus the Arme-bone is fastened to the shoulder-blade Gynglymos when the bones mutually receive each other such like composition hath the Cubit and Arme-bone or more straitly as by synarthrosis whē the bones are more straitly knit so that they can performe no motions in the body Of this Articulation there are also 3 kinds that is Gomphysis as when one bone so receives another as a Pin is fastened in the hole made by a peircer thus the teeth are fastened in the Iawes Sutura like a Saw or teeth of a combe as the bones of the scul are mutually knit together or as scales or tiles are laid after which manner the stony bones are fastened to these of the Synciput Harmonis which is by interposition of a simple line which parts bones abutting one upon another as the bones of the Nose An Epitome or briefe recitall of all the Muscles of mans body As I have formerly reckoned up the bones so here I have decreed to recite the muscles of mans body Wherefore in the face we first meet with the broad or skin muscle arising from the flshy pannicle covering the whole necke almost all the face Then follow 4 perteining to the upper eye-lids In the Orbs of the eyes lye 14 that is 7 in each Orbe of which 4 are called right two oblique and one pyramidall Then succeed 4 of the nose two externall on each side one and two internall these draw it together and the other open it After these come the ten muscles of the lower Iaw of which two are called the Crotaphitae or Temporall two Masseteres or Grinders two round which seeme to me rather to perteine to the lips than to this Iaw two litle ones hid in the mouth arising from the winged processe of the wedge-bone two openers of the mouth being nervous or tendinous in their midst Then follow the 8 muscles of the lips that is 4 of the upper and as many of the lower shutting and opening the mouth The tongue with his ten muscles is hid as it were in the den of the mouth Wherfore the muscles of the whole face are 51. In the fore part of the neck are found the muscles of the bone Hyoides throtle now 8 muscles hold the bone Hyoides as equally ballanced of which there are 2 upper arising from the Chin 2 on the sides from the processe Styloides perforated in their midst through which the 2 openers of the mouth in that part nervous do passe 2 arise from the Sternō lastly 2 from the upper rib of the shoulder-blade to the Coracoides which also in their midst are nervous in which place the two Mastoidei lye upon them The Throtle composed of three gristles hath eighteene or twenty muscles of which sixe or eight are common and twelue proper Of the common there are two above two below and two at the sides of the first gristle to which wee may adde these two which serve for the opening of the Epiglottis which are alwayes found in great foure footed beasts for to presse downe the Epiglottis The proper are twelue which almost all of them come from the second gristle so to be inserted into the first and third of which some are before others behinde the Thyroides Besides these there are the Mastoidei which bend the head But in the backe part of the Necke there are twelue muscles also appointed for to move the head so that in all there are fourteene muscles serving for the motion of the head the two fore Mastoidei and the twelue hinde Muscles that is to say the two Splenij two Complexi foure Right and so many oblique which are very short so that they passe not beyond the first and second Vertebra The Necke hath eight Muscles of which two are called the long lying before upon the bodyes of the Vertebrae the two Scaleni which are at the sides the two Spinati which runne alongst the Spine the two transverse which goe to the transverse processes of the Chest The Chest hath 81 Muscles of which some are on the fore part some on the hinde others on the sides they are all combined or coupled together except the Midriffe Now of these there are the two Subclavij the two great Saw-muscles which proceed from the basis of the shoulder-blade the foure litle Rbomboides or square muscles that is two above and two below the two Sacrolumbi the two binders of the Gristles within the Chest Besides there are twenty and two externall and as many internall Intercostall muscles twenty foure Intercartilaginei that is twelue externall and as many internall so that the Intercostall and Intercartilaginei are 68 which with the twelue before mentioned make the number of 80 Muscles Adde to these the Midriffe being without an associate and you shall have the number formerly mentioned to wit 81. But also if you will adde to these the Muscles of the lower belly I will not much gainsay it because by accident they helpe inspiration and exspiration Wherefore of the eight muscles of the Epigastrium there are foure Oblique of which two are descendent and so many ascendent two right to which you may adde the two Assisting or Pyramidall muscles which come from the share-bone if it please you to separate them from the head of the right muscles There are sixe or eight Muscles of the Loynes of which two bend the loines which are the triangular the two Semispinati two Sacri two are in the midst of the backe which for that cause we may call the Rachitae or Chine-muscles Now that hereafter we may severally and distinctly set downe the muscles of the extreme parts will we come to the privities Where for the use of the Testicles there are two Muscles called the Cremasteres or Hanging Muscles At the roote of the yard or Perinaeum there are foure others partly for the commodious passing of the urine and seed and partly for erecting the yarde The Sphincter Muscle is seated at the Necke of the Bladder At the end of the right Gut are three Muscles two Levatores Ani or Lifters up of the fundament and one Sphincter or shutting Muscle Now let us prosequute the Muscles of the Extremities or Limbs But it will be sufficient to mention onely the Muscles of one side because seeing these parts of the body are double those things which are said of the one may be applyed to the other Wherefore the muscles of the Arme beginning with these of the shoulder-blade at the least are 42. for there are 4 of the shoulder-blade of the Arme properly or particularly so called seven or eight and there are three foure or five proper muscles of the Cubite that is appointed for the performance of the motions thereof in the
considered we say the fleshie Pannicle in its proper body is of a nervous or membranous substance as that which hath its originall from the coate Amnios which is next to the infant dilated neare to the navell and stretched forth for the generation of this Pannicle in which thing I thinke good to note that as the membranes Chorion and Amnios mutually interwoven with small nervous fibers encompasse and invest the child as long as it is contained in the wombe so the skinne and fleshie Pannicle knit together by such like bands engirt the whole body Therefore the fleshie Pannicle is equall in magnitude and like in figure to the true skinne but that it lies under it and is contained in it in some places mixt with the fat in others encreased by the flesh interwoven with it and in other some is onely a simple membrane The composition of it is such as the sight of it presents to our eye that is of veines arteries nerves and the proper flesh some whites mixed and interlaced with fat and sometimes with musculous flesh It is but one by reason of the use wee shall presently shew It is situated betweene the skinne and fat or common coate of the muscles annexed to these and the other parts lying under it by the veines nerves and arteries ascending from these inward parts and implanting themselves into the substance thereof and then into the true skinne The temperature thereof is diverse according to the varietie of the parts interwoven with it The use of it is to leade direct and strengthen in their passage the vessels which are disseminated into the true skinne and the whole superficies of the body But in beasts it hath another commoditie that is it gives a shaking or trembling motion to their skinne and backe for that cause we formerly touched CHAP. VI. Of the Fat. THe fat comming neare the condition of an excrement rather than of a part as we said when we treated of the simular parts is of an oily substance bred of the aiery and vaporous portion of the bloud which sweating through the pores of the coates or mouthes of the vessels becomes concreate about the membranes and nerves and cold bodies and turnes into fat by the coldnesse of the place Whereby we may know that cold or a more remisse heate is the efficient cause of fat which is manifest by contemplation not onely of creatures of diverse kindes but also by those of the same species and sexe if so be that the one be colder than the other By which we may understand that the fat is the more or lesse in quantity according to the different temper of the whole body and of its particular parts for its composition it consists of that portion of the blood which we formerly mentioned intermixt with certaine membranes nervous fibers veines and arteryes The greatest part of it lyes betweene the fleshy pannicle and the common coate of the Muscles Otherwiseit is diffused over all the body in some places more in some lesse yet it is alwaies about the nervous bodyes to which it delights to cleave Most Anatomists enquire whether the fat lye above or beneath the fleshy pannicle But me thinkes this question is both impertinent and idle being we often see the fat to be on both sides It is of a middle temper betweene heat and cold being it ariseth of the more aery portion of the blood although it may seeme cold in respect of the efficient cause that is of cold by which it concreats For the rest moisture is predominant in the fat The use therof is to moisten the parts which may become dry by long fasting vehement exercise or immoderate heat and besides to give heat or keep the parts warme Although it doe this last rather by accident than of its owne nature as heated by exercise or by some such other chance it heats the adjacent parts or may therefore be thought to heat them because it hinders the dissipation of the native and internall heat like as cold heats in winter whereby the bellyes are at that time the hotter I know some learned Phisitions of our time stiffly maintained that the fat was hot neither did they acknowledge any other efficient cause thereof than temperate heat and not cold But I thinke it best to leave the more subtle agitation of these questions to naturall Philosophers But we must note that at the joints which are more usually moved there is another sort of fat farre more solid and hard than that which we formerly mentioned often found mixed with a viscid and tough humor like the whites of Eggs that so it might be sufficient for a longer time to moisten these parts subject to be hurt by drynesse and make them slippery so fitter for motion in imitation whereof they usually grease hard bodyes which must be in frequent motion as coach wheeles and axeltrees And there is another kind of fat which is called Sevum seame in one thing differing from the ordinary fat that is much dryer the moister and softer portion of the fat being dissipated by the raging heat of the place For it is found principally about the midriffe where there are many windings of arteryes and veines and it is also about the reines Loines and basis of the heart The fat is wasted by long fasting is dryed and hardened by vehement exercise and immoderate heate Hence it is that it is much more compact in the palmes of the hands and soles of the feet about the eyes and heart so that it resembles the flesh in densitie and hardnesse because by the continuall motion and strong heat of these parts the thinner portion being dissipated diffused the more Grosse terrestriall remaine CHAP. VII Of the common coate of the Muscles NExt under the fat appeares a certaine coate spred over all the Muscles and called the common coate of the Muscles it is of a nervous substance as all other membranes are The quantity and breadth thereof is bounded by the quantity of the Muscles which it involves and fits it selfe to as that which encompasses the Muscles of the Epigastrium is of equall largnesse with the same Muscles The figure of it is round It is composed of veines nerves arteryes and its peculiar flesh consisting of three sorts of fibers the beginning of it is from the Periostium in that part where the bones give ligaments to the Muscles or according to the opinion of others of the nervous and ligamentous fibers of the Muscles which rising up and diffused over the fleshy superficies thereof are united for the generation of this coate But this membrane arising from the Periostium as every membrane which is below the head takes its originall from the Periostium either primarily by the interposition of no Medium or secondarily is stretched over the Muscles by their tendons But if any object that this membrance pluct
from the belly of the Muscle may seeme to end in a ligament I will answer that it is the condition of every nervous part so to binde or fasten it selfe to another part of his owne kinde as to a stay so that it can scarse be pluckt from thence We see the proofe hereof in the Peritonaeum or Rim in the Epigastrium or lower part of the lower belly That which covers the Muscles of the Epigastrium is but one unlesse you had rather part it in two the right and the left distinguished by the interposition of the Linea Alba or white Line It is scituate betwixt the fat and Muscles for it is fastened above and below to these parts with fibers which in smallnesse and fitnesse exceed the Spiders web But by its vessells it participates with the three principall parts and is of a cold and dry temper The use of it is to containe the Muscles in their naturall vnion and to keepe them as much as in it lyes from putrifaction which may happen to them from pus or matter which is often cast forth of the simular parts into the empty spaces and distances of the Muscles Wherefore going about to separate the fat of the Epigastrium where thou must begin the dissection of mans body you must have a care that you hurt it not with your knife but that before you touch the Muscles see you artificially take it away that you may the more easily separate the Muscles lying under it distinguished by a manifest space at the white Line which is made by the meeting together of the proper coates of all those muscles CHAP. VIII What a Muscle is and how many differences there be thereof A Muscle is the instrument of voluntary motion and simple voluntary motion is performed six manner of wayes upwards downewards forwards backwards to the right hand and to the left but the compound one way which is circularly the which is performed by the continuall succession of the motion of the Muscles ingirting the part Such a Motion Falconers use when they stretch forth their hand and Lure their Hauke We have some parts which have motion without a Muscle but that motion is not voluntary such parts be the heart stomacke gutts both the bladders that is that of the Gall and that of the urine and diverse other which have the motions of attraction expulsion and retention by the meanes of the three sorts of fibers for they draw by the right expell by the transverse and retaine by the oblique The differences of Muscles which are many and diverse are taken from their substance originall insertion into the part which they move for me or figure holes or openings magnitude colour site kind of fibers their conjugation or connexion heads bellyes tendons opposition in action and office Some in substance are nervous venous arterious because they have manifest nerves veines and arteryes as the Midriffe the Intercostall and Epigastricke Muscles and many more and that for their difference from other Muscles into which neither nerve nor veine or Arteryes are manifestly inserted although secretly they admit them all for sense and motion life and nourishment such are the Muscles of the wrest the wormy muscles of the hands and feet for if there be any nerves observed in them they are very small Some had rather make the difference of Muscles thus that some of them are fleshy some nervous others membranous From their Originall some arise from the bones as these which move the hands armes and Leggs others from gristles as the Muscles of the throat others from membranes which invest the tendons as the wormy Muscles of the hands and feet others from ligaments as the Extenders of the fingers others from other muscles as the two lower Muscles of the yard which proceed from the Sphincter Muscle of the fundament Others have no originall as the membrane which we call the fleshy pannicle assumes flesh in certaine places and degenerates into a Muscle such are the Cremaster or hanging Muscles of the testicles the large Muscles of the face and if you please the Midriffe as that which is composed of two coates the one in compassing the ribbs and the Peritonaeum hath flesh in the midst betweene the two membranes And moreover some Muscles have their originall from one onely bone as these which bend and extend the Cubite others arise of many bones as the oblique descending the Dorsall and many Muscles of the necke with arise together from many spondyls and sides of spondyls There be others according to the opinion of some men both from the bones and gristles of the Pubis at the right or direct Muscles of the Epigastrium yet by their favour I thinke otherwise Because by the Anatomicall and received axiome A Muscle is there thought to take his beginnings from whence he receives a nerve but these Muscles take a nerve from the intercostall muscles wherefore their originall ought to be referred to the sides of the brest blades as shall be shewed in due place From their insertion arise these differences some are inserted into a bone as those which move the head Armes and Legs others into a gristle as those of the Throtle eyelids nose and the obliqueascendant muscles of the Epigastrium some into a bone and gristle both as the right muscles of the Epigastrium and the Midriffe some into the skin as the muscles of the lips others into the Coates as the muscles of the eyes others into Ligaments as the muscles of the yeard But these differences following may be drawne both from their insertion and originall For some muscles arising from many parts are inserted into some one part as divers of these which move the arme and the shoulder which arising from many spondiles are inserted into the bone of the shoulder and the shoulder blade Others arise from one part and insert themselves into more as those which arise from the bottome of the shoulder blades are extended and inserted into some eight or nine of the upper ribbs to helpe respiration and the benders and extenders of the fingers and toes Others arising from many bones are inserted into as many as some of those which serve for respiration to wit those which we call the hinder Saw-muscles and the Semispinatus which sends a tendon into all the ribbs Others have their originall from many bones and end in gristles of the seven ribbs as those two which lye under the Sternon Moreover also these differences of muscles may be drawne from the originall and insertion that some proceed from bones and are inserted into the next bone to helpe and strengthen the motion thereof as the three muscles of the Hip others arise from an upper bone are not inserted into the next but into some other as the long muscles Some are named from the part they move as the temporall muscles because they move the temples others from their office as
the grinding muscles because they move the skin as a mill to grinde asunder the meale From their forme or figure because some are like Mice other like Lizards which have their Leggs cut off for that they imitate in their belly body or tendon the belly or taile of such creatures from whence the names of Musculus and Lacertus are derived Such are those which bend the wrest and which are fastened to the bone of the Leg which extend the foot Others are triangular as that which lifts up the arme called Epomis or Deltoides and that which drawes the arme to the breast called the Pectorall muscle Others quadrangular as the Rhomboides or Lozenge muscle of the shoulder blade and the two hindesum-muscles serving for respiration and two of the wrests which turne down the hand Others consist of more than foure angles as the oblique descending and that muscle with joynes it selfe to it from the shoulder blade others are round and broad as the Midriffe others circular as the Sphincter muscle of the fundament and bladder others are of a pyramidall figure as the seaventh muscle of the eye which compasses the opticke nerve in beasts but not in men Others have a semicirculer forme as that which shuts up the eye feated at the lesser corner thereof Others resemble a Monks cowle or hood as the Trapezius of the shoulder blade Besides others at their first originall are narrow but broad at their insertion as the Saw-muscle of the shoulder and the transverse of the Epigastrium others are quire contrary as the three Muscles of the Hippe others keepe an equall breadth or bignesse in all places as the intercostall muscles and these of the wrest others are long and slender as the long muscle of the thigh others are long and broad as the oblique descending muscles of the Epigastrium others are directly contrary as the Intercostall which are very narrow From their perforations for some are perforated as the Midriffe which hath three holes as also the oblique and transverse of the Epigastrium that so they may give passage forth to the preparing spermaticke vessells and to the ejaculatory vessells the Coate Erythroides associating and strengthening them others are not perforated From their magnitude for some are most large as the two muscles of the Hipp others very small as the eight small muscles of the necke and the proper muscles of the Throtle and the wormy muscles Others are of an indifferent magnitude From their colour for some are white and red as the Temporall muscles which have Tendons comming from the midst of their belly others are livide as the three greater muscles of the calfe of the leg which colour they have by the admixtion of the white or tendinous nervy coate with the red flesh for this coat by its thicknesse darkning the colour of the flesh so that it cannot shew its rednesse and fresh colour makes it seeme of that livide colour From their scituation for some are superficiary as those which appeare under the skin and fat others deepe in and hid as the smooth and foure twin muscles some are stretched out and as it were spred over in a streight and plaine passage as the muscles of the thigh which move the legge except the Ham-muscle others oblique as those of the Epigastrium other some transverse as the transverse of the Epigastrium where you must observe that although all the fibers of the muscles are direct yet we call them oblique and transverse by comparing them to the right muscles as which by the concourse of the fibers make a streight or acute angle From the sorts of fibers for some have one kinde of fiber yet the greatest part enjoy two sorts running so up and downe that they either are crossed like the letter X as happens in the pectorall and grinding muscles or else doe not concurre as in the Trapezij Others have three sorts of fibers as the broad muscle of the face From their coherence and connexion or their texture of nervous fibers for some have fibers somewhat more distant and remote immediately at their originall than in other places as you may see in the muscles of the buttocks Others in their midst and belly which by reason thereof in such muscles is more big or tumid their head and taile being slender as happens in most of the muscles of the arme and leg in which the dense masse of flesh interwoven with fibers disioynes the fibers in so great a distance in other some the fibers are more distant in the taile as in the greater saw-Saw-muscle arising from the bottome of the shoulder blade in others they are equally distant through the whole muscle as in the muscles of the wrest and betweene the ribbs From their head for in some it is fleshy interwoven with few fibers as in the muscles of the buttocks in others it is wholy nervous as in the most-broadmuscle common to the arme and shoulder blade and in the three muscles of the thigh proceeding from the tuberosity of the hucle bone in some it is nervous and fleshy as in the internall and externall muscle of the arme Besides some have one head others two as the bender of the elbow and the externall of the legge others three as the Threeheaded muscle of the thigh But wee must note that the word nerve or sinew is here taken in a large signification for a ligament nerve and tendon as Galen saith Lib de Ossibus and moreover we must observe that the head of a muscle is one while above another while below otherwhiles in the midst as in the Midriffe as you may know by the insertion of the Nerve because it enters the muscle by its head From their belly also there be some differences of muscles taken for some have their belly immediately at their beginning as the muscles of the buttocks others at their insertion as the Midriffe Others just at their head as those which put forth the Calfe of the leg in others it is somewhat further off as in those which draw backe the arme and which bend the legge in others the belly extends even from the head to the taile as in the intercostall muscles and these of the wrest in others it is produced even to their insertion as in those of the palmes of the hands and soles of the feet some have a double belly distinguished by a nervous substance as those which open the mouth and those which arise from the roote of the lower processe of the shoulder blade Moreover the differences of muscels are drawne also from the Tendons for some have none at least which are manifest as the muscles of the lips and the sphincter muscles the intercostall and those of the wrest others have them in part and want them in part as the Midriffe for the Midriffe wants a Tendon at the ends of the shorter ribs but hath two at the first Vertebra of the Loines
in which it is terminated Others have a Tendon indeede But some of these move with the bone some not as the muscles of the eyes and besides some of these have broad and membranous tendons as the muscles of the eyes and Epigastrium except the right muscles in others they are thicke and round as in the benders of the fingers in others they are lesse round but more broad than thicke such is the Tendon arising from the twin muscles and Soleus of the legge others have short Tendons as the muscles which turne downe the hand othersome long as those of the plames of the hands and soles of the feet besides others produce Tendons from the end of their belly which Tendons are manifest others from the midst as the Temporall muscles Besides also others diffuse many tendons from their belly as in the hands the benders of the fingers and the extenders of the feet Othersome put forth but one which sometimes is devided into many as those which bend the third articulation of the foot otherwhile many muscles by their meeting together make one Tendon as the three muscles of the Calfe of the leg and those which bend the cubit and leg All tendons have their originall when the nerves and ligaments dispersed through the fleshy substance of a muscle are by litle and litle drawne and meet together untill at last carried to the joynt they are there fastened for the fit bending and extension thereof From the contrariety of their Actions for some parts have contrary muscles benders and extenders Other parts have none for the Cods and fundament have onely lifters up From their function for some are made for direct motions as those which extend the fingers and toes others for oblique as the Supinators of the hand and the Pronators others performe both as the pectorall muscle which moves the Arme obliquely upward and downeward as the upper and lower fibers are contracted and also out right if all the fibers be contracted together which also happens to the Deltoides and Trapezius I have thought it good to handle particularly these differences of muscles because that by understanding them the prognosticke will be more certaine and also the application of remedies to each part and if any occasion be either to make incision or suture we may be more certaine whether the part affected be more or lesse nervous CHAP. IX Of the parts of a Muscle HAving declared the nature and differences of a muscle we must note that some of the parts thereof are compound or universall others simple or particular The compound are the head Belly and taile The simple are ligaments a nerve flesh a veine artery and coate For the compound parts by the head we understand the beginning and originall of a muscle which is one while ligamentous and nervous otherwhiles also fleshy By the belly that portion which is absolutely fleshy But by the taile we understand a Tendon consisting partly of a nerve partly of a ligament promiscuously comming forth from the belly of the muscle For asmuch as belongs to the simple which are sixe in number three are called proper and three common The proper are a Ligament from a bone a nerve proceeding from the Braine or spinall marrow and flesh compact by the concretion of blood The Common are a veine from the Liver or trunke arising from thence an artery proceeding from the Heart a Coate produced by the nervous ligamentous fibers spreading over the superficies of the muscle But for the simple use of all such parts the nerve is as it were the principall part of a muscle which gives it sense and motion the Ligament gives strength the flesh containes the nervous and ligamentous fibers of the muscle and strengthens it filling up all the void spaces and also it preserves the native humidity of these parts and cherisheth the heat implanted in them and to conclude defends it from all externall injuries for like a fan it opposeth it selfe against the heat of the Sunne and is as a garment against the cold and as a cushion in all falls and bruises and as a buckler or defence against wounding weapons The veine nourishes the muscle the arterie gives it life the coat preserves the harmony of all the parts thereof lest they should be any wayes disioyned or corrupted by purulent abscesses breaking into the empty or void spaces of the muscles as we see it happens in a Gangrene where the corruption hath invaded this membrane by the breaking out of the more acride matter or filth CHAP. X. A more particular inquisition into each part of a muscle HAving gone thus farre it remaines that we more particularly inquire into each part of a muscle that if it be possible nothing may be wanting to this discourse Wherefore a Ligament properly so called is a simple part of mans body next of a bone and gristle the most terrestriall dry hard cold white taking its originall immediatly or by the interposition of some Medium from the BOnes or Gristles from whence also the Muscles have their beginning wherby it comes to passe that a ligament is void of sense unlesse it receive a nerve from some other place For so the Ligaments which compose strengthen the Tongue and yeard are partakers of sense and it inserts it self into the bone and gristle that so it may bind them together and strengthen and beautifie the whole joynt or connexion for these three be the principal uses of a Ligament then diffusing it self into the membranes and muscles to strengthen those parts A nerve to speake properly is also a simple parte of our body bred and nourished by a grosse and Phlegmaticke humor such as the braine the originall of all the nerves and also the Spinall marrow endewed with the faculty of feeling and oftentimes also of moving For there be divers parts of the body which have nerves yet are destitute of all voluntary motion having the sense onely of feeling as the membranes veines arteries guts and all the entrailes A nerve is covered with a double cover from the two membranes of the braine and besides also with a third proceeding from the ligaments which fasten the hinder part of the head to the Vertebra's or else from the Pericranium Wee understand no other things by the fibers of a nerve or of a Ligament than long and slender threds white solid cold strong more or lesse according to the quantity of the substance which is partly nervous and sensible partly Ligamentous and insensible You must imagine the same of the fleshy fibers in their kind but of these threds some are straight for attraction others oblique for retention of that which is convenient for the creature and lastly some transverse for the expulsion of which is unprofitable But when these transverse threds are extended in length they are lessened in bredth but when they are directly contracted they are shortened in length But when they
are extended all together as it were with an unanimous consent the whole member is wrinkled as contracted into it selfe as on the contrary it is extended when they are relaxed Some of these are bestowed upon the animall parts to performe voluntary motions others upon the vitall to performe the agitation of the Heart and Arteries others upon the naturall for attraction retention and expulsion Yet we must observe that the attraction of no simular part is performed by the helpe of the foresaid fibers or threds but rather by the heat implanted in them or by the shunning of Emptinesse or the familiarity of the substance The flesh also is a simple and soft part composed of the purer portion of the blood insinuating it selfe into the spaces betweene the fibers so to invest them for the uses formerly mentioned This is as it were a certaine wall and Bulwarke against the injuries of heat and cold against all falls and bruises as it were a certaine soft pillow or cushion yeelding to any violent impression There be three sorts of flesh one more ruddy as the musculous flesh of perfect creatures and such as have blood for the flesh of all tender and young things having blood as Calves and also of all sorts of fish is whitish by reason of the too much humidity of the blood The second kinde is more pallid even in perfect creatures having blood such is the flesh of the heart stomacke weasond guts bladder wombe The third is belonging to the entrails or the proper substance of each entrail as that which remaines of the Liver the veines arteries and coate being taken away of the bladder of the Gall braine kidneys milt Some adde a fourth sort of flesh which is spongy and that they say is proper to the tongue alone A veine is the vessel pipe or channel of the blood or bloody matter it hath a spermaticke substance consists of one coate composed of 3 sorts of fibers An Artery is also the receptacle of blood but that spirituous and yellowish consisting in like manner of a spermaticke substance But it hath two coats with three sorts of fibers the utmost whereof is most thin consisting of right fibers and some oblique But the inner is five times more thicke and dense than the utmost interwoven with transverse fibers and it doth not onely conteine blood and spirit but also a serous humor which wee may beleeve because there bee two emulgent Arteryes aswell as veines But the inner coat of an Artery is therefore more thick because it may containe blood which is more hot subtle and spirituous for the spirit seeing it is naturally more thin and light and in perpetuall motion would quickly flye away unlesse it were held in a stronger hold There is other reason for a veine as that which containes blood grosse ponderous and slow of motion Wherefore if it had acquired a dense and grosse coate it could scarse bee distributed to the neighbouring parts God the maker of the universe foreseeing this made the coats of the vessels contrary to the consistance of the bodyes contained in them The Anastomosis of the veines and Arteryes that is to say the application of the mouthes of the one to the other is very remarkeable by benefit of which they mutually communicate and draw the matters contained in them and so also transfuse them by insensible passages although that anastomosis is apparent in the veine and artery that meet together at the Ioint and bending of the Arme which I haue sometimes shewed in the Physicke schooles at such time as I there dissected Anatomyes But the action or function of a muscle is either to move or confirme the parte according to our will into which it is implanted which it doth when it drawes it selfe towards its originall that is to say it 's head But wee define the head by the insertion of the nerve which wee understand by the manner of the working of the Muscle CHAP. XI Of the Muscles of the Epigastrium or lower belly NOw seeing that wee haue taught what a muscle is and what the differences thereof are and what simple and compound parts it hath and what the use action and manner of action in each part is it remaines that wee come to the particular explication of each Muscle begining with those of the lower belly as those which we first meet withall in dissection These are 8 in number 4 oblique 2 on each side two right or direct one on the right another on the left side and in like manner 2 transverse All these are alike in force magnitude and action so mutually composed that the oblique descendant of one side is conjoined with the other oblique descendant on the other side and so of the rest We may adde to this number the 2 little Supplying or Assisting muscles which are of a Pyramidal forme and arise from the share-bone above the insertion of the right muscles Of the oblique muscles of each side the one ascends the other descends whereupon it comes to passe that they are called the Oblique descendant and Ascendant Muscles Those oblique which wee first meet with are the descendant whose substance is partly sanguine partly spermaticke for they are fleshy nervous ligamentous veinous arterious and membranous Yet the fle shy portion is predominant in them out of which respect Hippocrates is wont to expresse the muscles by the name of fleshes their greatnes is indifferent betweene the large and the small muscles their figure 3 square They are composed of the fore-mentioned parts they are two in number their site is oblique taking their beginning from the touching of the great saw Muscle and from the sixt and seventh true ribbes or rather from the spaces between the sixe lower ribbes and rather on the forepart of the muscles than of the ribbes themselues from whence shunning the Veriebra's of the loines the fleshy parts of them are terminated in the externall and upper eminency of the Haunch-bone and the Membranous end in the lower eminency of the share-bone and the White-line Yet Columbus dissenting from this common description of the oblique Muscles thinks that they are onely terminated in the White line and not in the share-bone For saith he wherefore should they be inserted into the share-bone which is not moved But because it would bee an infinite labour and trouble to set downe at large the severall opinions of all Authors of Anatomy I haue thought it sufficient for me to touch them lightly by the way Their connexion is with the oblique ascendant lying vnder them and with the direct or right Their temperament is twofold the one hot and moist by reason of the belly and the fleshy portion of them the other cold dry in respect of their ligamentous and tendinous portion Their action is to draw the parts into which they are inserted towards their originall or els to unite them firmely Yet each of these
an indifferent bignes in length and thicknes Their figure is round and hollow They are composed of two coats one proper consisting of right and transverse fibers which comes from the emulgent veines and arteries the other common from the Peritonaeum besides they have veines nerves and arteryes from the Neighbouring parts They be two in number on each side one They are scituate between the Kidneyes out of whose hollow part they proceed and the bladder But the manner how the Vreters insert or enter themselves into the bladder and the Porus Cholagogus into the Duodenum exceedes admiration for the ureters are not directly but obliquely implanted neere the orifice of the bladder penetrate into the inner space thereof for within they doe as it were divide the membrane or membranous coat of the body of the bladder and inflnuate themselves into that as though it were double But this is opened at the entrance of the urine but shut at other times the cover as it were falling upon it so that the humor which is falne into the capacity of the bladder cannot bee forced or driven backe no not so much as the aire blowne into it can come this way out as we see in swines bladders blowne vp and filled with aire For wee see it is the Aire contained in these which fills them thus neither canne it bee pressed forth but with extraordinary force For as this skinne or coat turned in by the force of the humor giues way so it being pressed out by the body conteined within thrusts its whole body into the passage as a stopple like to this is the insertion of the Porus Cholagogus into the Guts The ureters have connexion with the above mentioned parts with the muscles of the loines upon which they runne from the Kidneyes to the bladder Wherefore nothing hinders but that the stone sliding through the ureters into the bladder may stupify the thigh as much as it did when it was in the Kidney They are of a cold and dry temper Their use is to serve as passages or channels for carrying the urine into the bladder CHAP. XXXI Of the Bladder THe bladder is of the same substance that the ureters that is nervous that so it may bee the more easily dilated It is of a large proportion in some bigger in some lesse according to the difference of age and habite of body It is of a round figure and as it were Pyramidall It is composed of two coats one proper which is very thicke and strong composed of the three sorts of fibers that is in the inner side of the direct without of the transverse and in the midst of the oblique The other common Coat comming from the Peritonaum hath veines and arteryes on each side one from the Hypogastrick vessels above the holy-bone also it hath nerves on each side from the sixt conjugation mixt with the nerves of the holy-bone For these nerves descend from the braine even to the end of the holy-bone It is but one and that scituate in men in the lower belly upon the light Cut and below the share bone but in women between the wombe and that bone to which it cleaves with its membranous ligaments as it doth to the yard by its neck and to the right gut by its common coate and proper vessels It is of a cold and dry temper The use and action thereof is by the fibers continually to draw the urine and containe it as long as neede requires and then to expell it by the necke partly by compression either of it selfe or rather of the muscles of the Epigastrium and Midriffe because this motion seeing it is voluntary cannot be performed unlesse by a muscle which the bladder wants partly also by the dilatation and relaxation of the sphincter muscle composed of transverse fibers like the sphincter of the fundament after the same manner to shut up the orifice of the bladder that the urine flow not out against our will But the bladder as it fils is dilated but as it is emptied it is contracted like a purse You may easily observe this Muscle in a Sowes bladder it is stretched from the orifice of the bladder and beginning of the urinarye passage even to the privities even in women but in men it is terminated in the Perinaeum as soone as it hath left the right Gut Besides this muscle is thus farre stretched forth that the urine by its compression should be wholy pressed out of the bladder which by too long stay would by its acrimony doe some harme This is the common opinion of Anatomists concerning the Sphincter of the bladder which never-the-lesse Fallopius allowes not of For saith hee if this muscle should bee scituate beneath the glandulous bodyes the seed in copulation could never be cast forth without some small quantity of urine Wherefore he thinkes that this muscle is scituate above the Prostats and that it is nothing els but the beginning of the necke of the bladder which becoms more fleshy whilest it is woven with transverse fibers The eleventh figure of the bladder and yarde AB 1 2 3 4 5 7 9. The two bodies which make the yard CC 2 3. The place where these two bodies do first arise D 1 2 4 5 7 9. The nut of the yard called glans penis EE 4 5. The fungous and redde substance of the bodies of the yard F 4 5. The mutuall connexion of the bodyes of the yard and the nervous outward substance of the same compassing round about the former fungous substance G 1 2 3 4 5 7 9. The passage of the urine or common pipe running under the yarde all along his length H. I. 1. 2. The first paire of Muscles of the yarde which in the first figure doe yet grow to it but in the second they hang from their originall K. L. 1. 2. The second paire of Muscles of the yard in the first figure growing in the second hanging from their insertion M 1. 2. The sphincter of the right gut N 3 7 8 9. The round sphincter Muscle of the bladder O O A Membrane which is over the holes of the share bone P 2. Arounde Ligament from the meeting of the share bones unto the head of the thgh Q. 3. 7. 8. The body of the bladder R R 3 7. The Prostatae into which seede when it is perfectly laboured is led SS 3 8. Portions of the ureters T T* 3 Portions of the vessels which leade downe the seed V V 7 8 The umbilicall arteries X 7 8 The ligament of the bladder cald Vrachus Y 7 8. The navel or umbilicus Z 7 8. The umbilicall veine aa 7 The veine and artery of the yard b 5. The artery distributed through the body of the yard For the necke of the bladder it differs nothing in substance composure number and temper from the bladder but onely in quantity which is neither so large nor round in
small branches into the spinall marrow through the holes by which the nerves passe and also into the membranes ligaments gristles bones and neighbouring muscles Eightly the Musculosa or musculous which also ariseing out of the Subclavis is devided into two other branches the one whereof goeth upon the brest to the paps nourishing the foremost muscles wherefore in a bastard pleurisie Cupping glasses may be fitly applied in this place The other branch descends to the upper muscles of the chest but specially to that which is called Latissimus The tenth is the Axillaris The eleventh the Humeralis of which wee will treat in their place The twelfth and last is the Iugularis properly so called which is twofold the internall and externall The internall being the lesser doth presently on both sides from this very beginning ascend by the sides of the Aspera Arteria or weazon even to the mouth and skull yeilding nourishment to the parts by which it passes as to the next membranes and nerves But when it comes to the basis of the Cranium it is divided into two branches the greater whereof going back along the basis of the Cranium to the hind part thereof sending abranch to the long muscle scituate upon the oesophagus it enters the Cranium with the small Carotides through the hole of the nerves of the sixth conjugation where they become one common vessell The lesser sending a slippe to the organe of hearing by the hole called Cacum or the blind also enters the Cranium and is spent in the thicker meninx nere to the hole of the third and fourth conjugation of nerves The externall Iugular veine being greater and fairer most commonly simple yet sometimes double either presently at his beginning or a little after ascends superficially on both sides of the neck between the broad muscle or fleshy pannicle being there easie to be discerned and other muscles scituate at the sides of the neck into which as also into the skin it sends certaine branches for nourishment The Figure of the hollow veine whole and freed from the rest of the body A The trunke of the hollow veine the lower AA At this place of the Liver is seated the left part of the veine and distributeth branches to the left side B Sheweth how the trunke of the hollow veine in the chest to give way to the heart is curved or bowed to the right hand Betwix A. and B. that part of the hollow veine which is betwixt the gibbous side of the Liver and the Midriffe C. the left midriffe veine called Phrenica sinistra from which surcles doe run in a man unto the pursse of the heart for the midriffe and it doe grow together D The orifice of the hollow veine which groweth unto the heart E the crown-veine called coronaria which like a crowne compasseth the basis of the heart and sprinkleth his surcles on the outside therof as far as to the cone or point F F The trunke of the veine Azygos or non parill descending along the right side of the racke-bones unto the loynes GG the lower intercostall veines to the branches of the veine Azygos which go unto the distances betwixt the ribs afford surcles unto the muscles which lye upon the ribs the racke-bones the membranes of the chest H the division of the hollow vein into two subclavian trunks neare the Iugulum under the brest-bone ll the subclavian branch tending on either side unto the arme called by some Axillaris K the upper intercostall veine which commonly sendeth three slips unto the distances of the upper ribs unto which the first intercostall veine sent no branches LL the descending mammary veine this descendeth under the brest-bone unto the right muscles of the Abdomen affoordeth surcles to the distances of the griftles of the true ribs to the Mediastinum the muscles that lye upon the breast and the skin of the Abdomen M the coniunction of the mammary with the Epigastricke vein ascending about the navill under the right muscles N the veine of the necke called Ceruicalis ascending toward the Scull which alloweth surcles to those muscles that lye upon the neck O the veine called Muscula which is propagated with many surcles into the muscles that occupy the lower parts of the necke and the upper parts of the chest P Thoraeica superior the upper chest veine which goeth to the muscles lying uppon the chest to the skinne of that place and to the dugges Q the double Scapularis distributed into the hollow part of the shoulderblade and the neighbour muscles so also betwixt P and R sometimes small veines doe reach unto the glandules that are in the arme-holes R Thoracica inferior running downward along the sides of the chest and especially distributed into the muscle of the arme called Latissimus S the inner Iugular veine which entreth into the Scull after it hath bestowed some surcles uppon the rough artery T the externall Iugular veine V. the division of this veine under the root of the eare X. a branch of the externall Iugular which goeth into the inside of the mouth and is diversly divided into the parts therein contained Y. the exterior branch distributed near the Fauces into the muscles of the chops and the whole skinne of the head Z. a portion of the branch y reaching unto the face a ae the veine of the fore-head a. a portion of it creeping through the temples ae * a propagation that goeth unto the skin of the Nowle or Occiput a a. the veine called Cephalica or the externall veine of the arme which others call Humeraria b. Muscula superior a propagation of the Cephalica veine which goeth unto the backward muscles of the necke Betwixt b. and d. on the backeside jssueth a branch from the Cephalica which passeth unto the outside of the blade and a portion thereof runneth betwixt the flesh and the skin d. d a veine from the Cephalica which attaineth unto the top of the shoulder and is consumed into the muscle that elevateth or lifteth up the arme and into his skin e e. a small veine from the Cephalica dispersed through the skin and the muscles of the arme f. the division of the Cephalica into three parts g. the first branch runneth deep unto the muscles which arise out of the externall Protuberation of the arme h. the second branch which goeth to make the median veine i. i. the third branch running obliquely above the wand and the outside of the arme k. from this branch certaine circles are divided into the skin the chiefe whereof is marked with k. l. the third branch at the wrist which is joyned at l with the branch of the Basilica marked with x. m. the Basilica which on the right hand is called Hepatica on the left hand Lienaris n. o. a branch of the Basilica going to the heads of the muscles of the cubit at n and to the muscles themselves at o. p a notable branch of the
all the bones of the body and this on the head is called by a peculiar name the Pericranium by reason of the excellency of the Cranium or skull in other bones it is tearmed the Periostium And as the Pericranium takes its originall from the Crassa meninx propagating it selfe by certaine strings or threds sent forth by the sutures and holes of the skull so all other membranes of the body have their originall either from this Pericranium or the Crassa meninx sending forth their productions as well by the holes or passages of the head as by these of the spinall marrow or back bone it selfe even to the Holy bone Of which this is an argument for in what part soever of the body a membrane is hurt presently the hurt or sense thereof comes to the Crassa meninx For so those who have but their litle Toe hurt when they sneese or cough perceive an increase of their paine by the passage thereof to the braine The vse of this Pericranium is to cover the skull and to give notice of things hurtfull by the power of the quick sense which it is endued withall and the Periostium doth the like in other bones Besides it sustaines and fastens by the sutures the Crassa meninx to the skull least it should fall by reason of its weight upon the Pia mater and so hurt it and hinder the pulsation of the braine and arteryes that are plenteously spread through both the Meninges Wherefore the Pericranium hath most strait connexion with the Crassa meninx because it takes the originall from thence We must thinke the same of the other membranes of the body which thing is very notable in the solution of the continuity of the membranes CHAP. III. Of the Sutures THe Sutures do sew or fasten together the bones of the skull these be 5 in number Three are true and legitimate two false and spurious The Coronal the first of the true sutures is seated in the forepart of the head descending downewards overtwhart the forepart of the head to the midst of the temples it is so called because Corollae that is wreaths crownes or garlands are set upon that place The second is called the Sagittalis or right suture as that which running through the crowne devides the head into two equall parts as with a straigth line running the length of it from the Coronall to the Lambdoides or hinde suture But this third suture Lambdoides is so called because it represents this Capitall greek letter Lambda Λ. You must understand this description of the sutures not as alwaies but as for the greater part to be thus For there be some skulls that want the foremost suture othersome the hind somtimes such as have none of the true sutures but only the false spurious But also you shal somtimes find the Sagittal to run to the nose And oft times there be three or foure sutures in the backe part of the head so that indeed the number of the sutures is not certaine Which also we find observed by Cornelius Celsus where he writes that Hippocrates was deceived by the sutures by chance for that he conjectured that the bones of the backe part of the head were broken because his Probe thrust to the roughnes of the second suture Lambdoides staied as at a Cleft made in the bone by a stroake The other two are called the false stony and scaly sutures by reason they are made by a scaly conjunction of the bones but not by a toothed saw or combe-like connexion But if any aske why the head consists not of one bone that so it might be the stronger I answere it is that so it might be the safer both from internall and externall injuries For the scull being as it were the tunnel of the chymney of this humane fabrick to which all the smoky vapours of the whole body ascend if it had beene composed of one bone these vapours should have had no passage fourth Wherefore the grosser vapours passe away by the sutures but the more subtile by the pores of the scull some have their sutures very open but others on the contrary very close Therefore nature hath otherwise compendiously provided for such as want sutures For it hath made one or two holes some two fingers bredth from the Lambdoides through which the Vena pupis enters into the skull and they are of that largenes that you may put a points tagge into them that so the vapours may have free passage forth otherwise there would be danger of death thus nature hath beene careful to provide for man against internall injuries and in like manner against externall for it hath made the head to consist of diverse bones that when one bone is broken the other may be safe the violence of the stroak being stayed in the division of the bones Whereby you may know that if the skull chance to be broken in the opposite side to that which received the blow that it happens either by reason of the defect of Sutures or else because they are unperfect and too firmely closed otherwise it is unpossible such fractures should happen by reason of the separation of the bones which breakes the violence of the blow that it can goe no further And certainely as it is rare to find a skull without Sutures so it is rare to find such kinde of fractures Therfore Chirurgions must diligently observe the Sutures and site of them least they bee deceived and take them for fractures or unawares apply a Trepan to them whence by breaking the veines arteryes and nervous fibers by which the internall parts communicate with the externall there may ensue increase of paine a violent defluxion of blood upon the Crassa meninx and the falling thereof upon the braine the fibers being broken by which it stuck to the Pericranium and so consequently a deadly interception of the pulsation of the Braine CHAP. IIII. Of the Cranium or Skull THe Cranium or Skull covering the braine like an Helmet is composed and consists of seaven bones of which some are more dense thick and hard than other some The First is the Os occipitis or Nowle bone seated in the back part of the head more hard and thicke than the rest because we want hands and eyes behind whereby we may keep or save our selves from falling This bone is circumscribed or bounded by the suture Lambdoides and the Os basilare The eminencies and as it were heads of this bone are received into the first vertebra for upon this the head is turned forwards and backwards by the force of fourteene muscles and strong ligaments which firmely tye these heads of the Nowle bone in the cavityes of this first vertebra The Second bone of the skull is in the forepart and is called the Os coronale or Os frontis the forehead bone it hath the second place in strength and thicknesse It is bounded by the Coronal suture and the
scituate under the pituitary glandule by which the spettle is evacuated Sixthly that hole which is in the wedge bone made for the entrance of the internall sleepy Arteries composing the wonderfull Net and then passing into the braine by a great slit That perforation which we reckon in the seventh place is commonly double made for the entrance of one of the branches of the internall Iugular veine The eight hole is some-what long of an ovall figure by which part of the third conjugation and all the fourth conjugation passes forth The ninth are the auditory passages The tenth are very small holes and give way to the veine and artery going to the auditory passage above the for a men coecum In the eleaventh place are reckoned the perforations which yeild passage forth to the sixth paire of nerves to part of the sleepy Arteries and of the internall jugular In the twelvth those which yeild a way out to the seventh conjugation The great hole of the Nowle bone through which the spinall marrow passes is reckoned the thirteenth The fourtenth is that which most commonly is behinde that great hole by which the Cervicall veines and arteries enter in CHAP. XI Of the perforations of the externall Basis of the Braine THere is a hole on each side at the Eye-browes by which passes a small nerve from the third conjugation comming out of the cavity of the Orbe of the eye and going by the forehead bone to the eye-browes that it may give motion to the two muscles of the upper eye-brow and forehead Yet oftentimes the hole is but to bee seene on one side oft times there is a cleft instead thereof otherwhiles it is not perforated nor cleft at all The second is the perforation of the greater corner of the eye by which a portion of the nerves of the third coniugation descends to the coate of the nose in this hole the Glandula Lachrymalis is seated The third is seated under the eye that it may give way to the other portion of the nerves of the third coniugation going to the parts of the face and the teeth of the upper jaw The fourth is at the beginning of the pallate amongst the cutting or shearing teeth through which a veine an artery and the coate of the pallate passes out In the fifth order are reckoned the perforations of the pallate by which the nerves descend from the fourth coniugation to give or cause the taste In the sixt order are rancked the holes of the pallate serving for respiration and the flegme falling from the braine by the nosethrils And there is a cleft under the yoake bone ascending into the Orbe of the eye by which there is a way as wel for the nerves of the third coniugation to the Temporall muscles as also for certaine veines and arteryes But also there is noted another hole at the mammillary processe which is not perforated in the iudgement of the sense Besides there is thought to be another at the hinde roote of the same processe by which a certaine small veine passes from the Iugular to the Torcular But I have onely noted these three passages by the way because there is so much variety in them that nothing can be certainely said of them CHAP. XII Of the Spinall Marrow or Pith of the Backe THe spinall Marrow is like a River running from the fountaine of the braine This sends nerves for sense and motion to all the neighbouring parts under the head spreading its branches as from the body of a tree These branches as we shall hereafter shew are on each side thirty This same spinall marrow is covered with the two membranes investing the braine distinguished by no distance of place as in the braine But also it hath another membrane added to these being very hard and dense which keeps it from being broken and violated by the violent bending of the body forewards and about The diseases of this marrow doe almost cause the like Symptomes as the diseases of the braine For they hurt the sense and motion of all the parts lying beneath them as for example If any of the vertebra's of the back bone be moved out of their place there followes a distortion or wresting aside of the Marrow but then especially if it happen that one of the vertebra's be strained so sharpe and bitter a compression urges the marrow by reason of the bony body of the vertebra that it will either rend it or certainely hinder the passage of the spirit by it But by these same holes of the vertebra's the veines and arteryes goe to the spinall marrow for to give life and nourishment to it as the nerves by them passe forth into aâ—… the lower parts of the body Figure 1. sheweth the forme of the spinall marrow properly so called with its membranes and the nerves proceeding from it Figure 2. The spinall marrow naked and bare together with its nerves as most part of Anatomists have described it The tenth figure of the spinall marrow A The beginning of the spinall marrow where it fals out of the skull B The thicknesse thereof in the spondels or rack-bones of the loynes C The division thereof into strings or hairy threds D the seven nerves of the necke From D to E or from 7 to 19 shew the nerves of the backe From E to F the nerves of the loynes From F to G the nerves of the os sâ—crum or holy bone H the end of the marrow I K L do shew how the nerves doâ— issue from the marrow in strings M M the knots of the sinewes made of the conjunction of those strings N O the membranes that invest the marrow Figure 2. A The beginning of the spinall marrow in the scull 3 4 5 6 7 These Characters shew according to Vesalius opinion how the conjugations of the nerves of the braine doe take their originall from the marrow remaining yet within the Skull B The egresse of the spinall marrow out of the skull C The cords or strings whereinto it is divided D 7 The marrow of the necke and seven paire of sinewes E 19 twelve paires or conjugations of nerves proceeding from the marrow of the Chest F 24 The marrow of the loynes and 5. paire of sinewes G 30. the marrow of the holy-bone and 6 paire of sinewes H the extremity or end of the spinall marrow The End of the Fifth Booke THE SIXTH BOOKE TREATING OF the Muscles and Bones and the other Extreme parts of the Body The Preface PEradventure some may wonder that I have ended my fifth booke of Anatomie before I have fully described all the parts of the head the which seemed as it were onely appointed for that purpose Therefore I must yeeld a reason of this my intention I have a desire in one Treatise and as it were at one breath to prosequute the Anatomy of the Muscles Wherefore because the parts of the head not yet described principally consist of the Muscles
it directly to the upper so to shut the mouth But you must note that this muscle is tendinous even to his belly and that it fils and makes both the temples It is more subject to deadly wounds than the rest by reason of the multitude of nerves dispersed over the substance thereof which because they are nere their originall that is the brain◠they inferre danger of suddaine death by a convulsion which usually follows the affects of this muscle but also in like manner it causes a fever the Phrenzy and Coma. The Figure of the chiefe muscles of the Face A. The muscle of the forehead and the right fibers thereof B. The Temporall muscle α. β. γ. his semicircular originall D. The muscle of the upper lip G. The yoake-bone unaer which the temporall muscles passe I. The Masseter or Grinding Muscle K. The upper gristle of the nose M. A muscle forming the cheekes N. The muscle of the lower lip O. A part of the Fifth muscle of the lower Iaw called Digastricus that is double bellied Q. R. The first muscle of the bone Hyoides growing unto the rough Artery S. The second muscle of the bone Hyoides vnder the Chin. T. The third muscle of the bone Hyoides stretched to the law T. K. the seveneth muscle of the head and his insertion at T. V. V. The two venters of the fourth muscle of the hone Hyoides φ. The place where the vessells passe which go to the head and the nerves which are sent to the Arme. Therefore that it should be lesse subject or obvious to externall injuryes Nature hath as it were made it a retiring place in the bone and fortified it with a wall of bone raised somewhat higher about it The other Muscle almost equall to the former in bignes being called the Masseter or grinding muscle makes the Cheeke it descends from the lowest part of the greatest bone of the orbe which bends it selfe as it were back that it may make part of the yoake bone and inserts it selfe into the lower Iaw from the corner thereof to the end of the root of the processe Corone that so it may draw this Iaw forward and backward and move it like a hand-mill Wherefore nature hath composed it of two sorts of fibers of the which some from the neeke the cheek in that place under the eyes standing somewhat out like an aple arising from the concourse of the greater bones of the orbe and upper jaw descend obliquely to the corner and hinder part of the lower jaw that it may move it forwards Othersome arise from the lower part of the same yoak-bone and descending obliquely intersect the former fibers after the similitude of the letter X and insert themselves into the same lower jaw at the roots of the processe Corone that so they may draw it back Truely by reason of these contrary motions it is likely this muscle was called the Masseter or grinder The third which is the round Muscle arises from all the Gums of the upper jaw and is inserted into all the gummes of the lower investing the sides of all the mouth with the coate with which it is covered on the inside being otherwise covered on the outside with more fat than any other muscle The action thereof is not onely to draw the lower Iaw to the upper but also as with a Shovell to bring the meat dispersed over all the mouth under the teeth no otherwise then the tongue drawes it in The fourth being shorter and lesse than the rest arising from all the hollownes of the winged processe of the Wedge-bone is inserted within into the broadest part of the lower Iaw that so in like manner it may draw the same to the upper This is the muscle through whose occasion we said this lower iaw is sometimes dislocated The fifth and last muscle of the lower jaw from the processe styloides of the stony bone ascends to the forepart of the Chin nere to the connexion of the two bones of this Iaw to draw this Iaw downewards from the upper in opening the mouth This muscle is slender and Tendinous in the midst that so it might be the stronger but it is fleshy at the ends All these Muscles were made by the singular providence of nature and ingrafted into this part for the performance of many uses and actions as biting asunder chawing grinding and severing the meat into small particles which the tongue by a various and harmelesse motion puts under the teeth Thus much I thought good to say of the parts of the face as well containing as contained The Figure of the Muscles of the lower Iaw A. A hole in the forehead bone in the brimme of the seate of the eye sending a small nerve of the third paire to the muscles of the fore-head and the upper eye-brow B. The Temporall muscle CHAP. X. Of the Eares and Parotides or kernels of the Eares THe Eares are the Organs of the Sense of hearing They are composed of the skin a little flesh a gristle veines arteries and nerves They may be bended or folded in without harme because being gristlely they easily yeild and give way but they would not doe so if they should be bony but would rather break That lap at which they hang pendants and lewels is by the ancients called Fibra but the upper part pinna They have beene framed by the providence of nature into twining passages like a Snailes shell which as they come neerer to the foramen caecum or blind hole are the more straitened that so they might the better gather the aire into them conceive the differences of sounds and voices and by little and little leade them to the membrane This membrane which is indifferently hard hath growne up from the nerves of the fifth conjugation which they call the auditory But they were made thus into crooked windings least the sounds rushing in too violently should hurt the sense of hearing Yet for all this we oft find it troubled and hurt by the noise of thunder Guns and Bels. Other wise also lest that the aire too sodainely entring in should by its qualitys as cold cause some harme and also that little creeping things and other extraneous bodys as fleas the like should be staied in these windings and turnings of the waies the glutinous thicknes of the cholerick excrement or eare-waxe hereunto also conduceing which the braine purges and sends forth into this part that is the auditory passage framed into these intricate Maeanders The Figure of the eares and bones of the auditory passage Tab 10. sheweth the eares and the divers internall parts thereof Fig. 1. sheweth the whole external eare with a part of the Temple bone Fig. 2. sheweth the left bone of the Temple divided in the middest by the instrument of hearing whereabout on either side there are certaine passages heere particularly described Fig. 3 and 4. sheweth the three little Bones Fig. 5. sheweth
branches the one wherof descending alongst the Cubit is spent on the outside of the Wrest the other associating the Wand is on the outside in like manner in two branches bestowed upon the Thumbe and in as many upon the fore finger and by a fift upon the middle finger though more obscurely The fift branch being also lower than the rest sliding between the muscles bending and extending the Cubite when it comes behinde the inner protuberation of the Cubite in which place we said before the third branch meets with this it is communicated to the internall muscles of the same and then divided into three portions one of which on the outside alongst the middle of the Cubite goes in two sprigs to the litle finger so many to the middle finger and one to the Ring finger the other two the one without and the other within the Ring goe to the hand where after each of them hath bestowed what was requisite on the muscles of the hand they are wasted into other five small portions of which these which are from that portion which descends without the Ring send two sprigs to the litle two to the fore and one to the middle finger but these which come from that which passes under the Ring by such a distribution communicates it selfe to other fingers as two sprigs to the thumbe two to the fore and one to the middle finger The sixt the lowest and last runs betweene the skin and fleshy Pannicle by the inner protuberation of the Arme and then is spent upon the skin of the Cubit CHAP. XXV The description of the bone of the Arme and the Muscles which move it BEcause we cannot perfectly demonstrate the originall of the muscles of the Arme especially of the two Arme muscles not knowing the description of this bone first therefore we will describe it then returne to the originall of the muscles arising from thence The bone of the arme is the greatest of all the bones in the body except the Thigh-bone it is round hollow and filled with marrow with a great Appendix or head on the top thereof having an indifferent necke to which it is knit by Symphysis for appendices are no otherwise united to their bones In the lower part thereof it hath two processes or protuberations one on the fore side another on the hinde betweene which swellings there is a cavity like to halfe the compasse of a wheele about which the Cubit is moved The extremityes of this cavity ends in two holes of which one is the more externall the other more internall these cavityes receive the heads of the Cubite that is the fore or internall receives the fore processe when the arme is bended inwards but the externall or hinder the exteriour as it is extended For the head of the arme it hath a double connexion the one with its owne necke by Symphysis that is a naturall union of the bones without any motion the other with the lightly ingraven cavity of the shoulder-blade which we call Glene by that kinde of Dearticulation which is called Arthrodia this connexion is made firme and stable by the muscles descending into the arme from the shoulder-blade as also by the proper Ligaments descending from the circle and brow of the cavity of the Acromion and Coracoides to this head of the arme this same head of the arme is as it were more cleft and open on the inner side than on the fore side that so it may give way to one of the Ligaments comming from the shoulder-blade to the muscle Biceps For asmuch as belongs to the lower end of the bone of the arme which we said hath two processes we may say that it is fastened to the bones of the Cubit by two sorts of articulation that is by Ginglymos with the Ell or proper bone of the Cubit and by Arthrodia with the Radius or Wand which in a lightly engraven cavity receives the fore processe of the arme and is turned about it for the motion of the hand The hinder processe is chiefly added for the safety and preservation of the veines arteries and nerves These things thus showne it is worth our labour to know the figure of the arme it selfe as it lyes betweene the forementioned appendices and processes that in the case of a fracture we may know how conveniently to restore it therfore first we must understand that this bone is somwhat bended and hollowed on the inside under the cleft of the head thereof but bunching out on the out and fore side Table 24. sheweth the Braine together with the Aster-braine the spinall marrow and the Nerves of the whole body A That part of the braine that is 〈◊〉 the nosethrils B That part which is at the side of the ventricles C The back part of the braine D The Cerebellum or After-braine E The Mamillary processe in the right side F The originall of the opticke nerve G Their conjunctions H The coate into which the opticke nerve is extended I The second paire of the sinewes of the braine K The lesser roote of the third conjugation L The thicke roote of the same conjugation according to the common opinion M The fourth conjugatioÌ„ of the sinews N The lesser roote of the fift paire O The bigger roote of the same paire P The small membrane of the eare which they call the Tympany Q The lower branch of the bigger roote of the fift conjugation S The sixt paire of sinewes T The seventh paire V The beginning of the spinall marrow out of the middle of the basis of the braine X The right sinew of the midriffe cut off Y A branch from the fift paire creeping to the top of the shoulder Z The first nerve of the arme from whence there goeth a branch to the skin A The second nerve of the arme and a branch there from into the first muscle of the Cubite B The third nerve of the arme and a branch going to the skin on the outside C A branch from the 3. nerve to the 2. muscle of the Cubite D The congresse or meeting of the second nerve with the third E A small branch from the 3. nerve to the 2. muscle of the Radius F The distribution of the second nerve into two branches * The lesser branch of this division lengthened out to the skin as far as the thumbe a The place of the spinall marrow where it issueth out of the braine 1 2 3 c. Thirty paires of nerves arising from the spinall marrow are here noted by their Char. that is to say 7. of the necke 12 of the Chest 5. of the loynes and 6 of the holy-bone b The thicker branch of the 2 nerve divided into 2 parts c Branches of the 3 nerve sprinkled here and there d Nerves from the third paire to the thumb the forefinger and the middle finger â—e The 4 nerve of the arme f The passage hereof through the inside of the shoulder g A
tripartition of this branch where it toucheth the Cubit hh A branch distributed from the 4. nerve to the outward skin of the Cubite i the upper branch of the division of the 4. nerve kk A branch of i reaching to the outside of the hand ll the lower branch of the division of the 4. nerve passing through the backside of the Cubite m the 5. nerve of the arme n Branches of this nerve dispersed here and there oo A branch of the 5. nerve reaching to the inside of the hand and the fingers p. A surcle of the branch o derived to the outside of the hand and the fingers qq the 6 nerve of the arme and the course thereof under the skin rr the intercostall nerves there cut off where they are together with the ribs reflected forward ss branches on each side running backward tt Nerves attaining unto the Chest uu the commixtion of the nerves rr with the descending branch of the 6. conjugation of the braine xx Nerves from the loynes led unto this place y A branch going to the testicle here cut off z A nerve reaching to the 1. muscle of the thigh c the 1. nerve of the leg αβ A surcle of the former nerve derived to the skin at α and inserted into the muscles at β. γ the 2. nerve of the leg δδδ A nerve from the former allowed unto the skin as low as to the foot and passing along the inside of the leg ε a branch of the 2. nerve running unto the muscles ζ the 3 nerve of the leg n a surcle thereof unto the skin θ another surcle unto the muscles 〈◊〉 the 4. nerve of the leg xx the anterior propagations of the nerves proceeding from the holybone λ the end of the spinall marrow μ a branch from the 4 nerve inserted into the muscles arising from the Coxendix or hip bone ν another branch going to the skin of the thigh on the backside ξ a propagation derived to the 4. muscle of the leg and to the skin of the knee oo nerves attaining to the heads of the muscles of the foote 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 the division of the 4 crurall nerve into two trunks σ a branch from the trunke Ï€ dispersed into the outward skin of the leg Ï„ a surcle of the trunke Ï€ derived to the muscles ν another surcle to the skin of the leg on the foreside a branch of the trunke Ï to the skin of the inside of the leg and of the foot χ a surcle of the trunke Ï to the hindmost skin of the leg 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 a branch of the whole trunke Ï led along to the forward part of the leg and the soot ω the descent of the trunke Ï into the foot But to come to the originall and insertion of these muscles the one of these two which move the arme forwards called by reason of his originall the Pectorall arising from more than halfe of the Collar bone and almost all the Sternon and the 6 7. and 8 Rib goes up and fastens it selfe to the Coracoides by a membrane or a membranous tendon sufficiently strong for which cause it is said to be common to the shoulder arme and it goes into the arme betweene the muscles Deltoides and Biceps with a strong tendon composed of fibers crossing each other of which some descend from the Collar-bone and the upper part of the Sternon others ascend from the lower originall hereof that is from the 6 7 and 8 Ribs and although the action of this muscle be diverse by reason of the diversity of its fibers arising from divers places yet alwayes it drawes the arme forwards whether it be moved upwards downwards or to the Brest the other which is his companion descends from the whole lip or brow of the simous or hollow part of the Blade which it fills in the forepart of the arme neere the head thereof For the two Levatores or the Lifters up of the arme the first named Deltoides descends from almost halfe the Clavicle the processe Acromion and all the spine of the shoulder-blade into the foreside of the arme the bredth of foure fingers below the joynt It hath divers actions according to the diversity of the fibers as also every muscle hath yet howsoever it is contracted whether by the fibers from the clavicle alone or by the spinall alone or by both at once it alwayes lifts and heaves the arme upwards The other which is his associate descends from the gibbous part of the Shoulder-blade conteined betweene the upper rib therof the spine between the processes Acromion and Coracoides to the neck of the arme and this we will call the Epomis or Scapularis that is the shoulder Muscle But the first and larger of the two muscles which draw the arme backwards arises from the greatest part of the utter lip of the gibbous part of the shoulder-blade which is under the spine therof lying upon the blade it self it goes into the hind part of the arme above the neck thereof The other which is coÌ„tiguous to it his partner in working but lesser passes from the upper and exteriour part of the lower rib of the shoulder-blade and thence as it were in some sort extending it self upon the gibbous part therof neere unto that rib it goes into the arme This muscle seemes to be the same with the former being fleshy without even above the top of the shoulder One the lesser of these two which draw downwards enters out from the streight line of the lower Rib of the blade goes into the lower part of the arme about the neck therof The other called the Latissimus or broadest ascends from the spines of the holy-bone of the Loynes often also from the nine lower of the Chest by the lower corner of the shoulder-blade into which it is inserted by a membranous tendon as also it is into the inner part of the arme neere unto the necke by another strong tendon wherupon this muscle is called a common muscle of the shoulder and arme But when this muscle happens to be wounded the arme cannot easily be stretched forth or lifted up CHAP. XXVI The Description of the bones of the Cubit and the muscles moving them AFter these muscles follow those which bend extend the cubit but because their insertion cannot be fitly demonstrated unlesse the bones of the cubit be first described therefore first of all we will deliniate the bones themselves But verily lest this doubtful word cubit should cause obscurity first we must note that it hath a threefold significatioÌ„ for ofttimes it is used for al that part of the hand which lies between the arme wrest oft times for the lower bone of this part somtimes for the upper part of this bone which is turned within the Orbe or Cavity of the arme no otherwise than a cord in the wheele of a Pulley and this is called the Olecranon Here
truly we use this word Cubit in the first signification Wherfore we say the cubite is composed of two bones the one of which we call the Radius or Wand or the lesser Focile of the Arme the other we properly call the Cubit or Ell. These two bones sticke together at their ends being firmely bound together by strong Ligaments but the middle parts of them are a prety way distant from each other chiefly towards their lower ends for the better scituation and passage of the muscles and vessells from the inner side to the exteriour as shall be shewed in fit place The wand hath two Epiphyses or Appendices the one at the upper end the other at the lower The upper is round hollowed on the surface like a bason it receives the fore processe of the bone of the arme bound to the same by strong ligaments descending as wel from that processe of the arme as the Olecranon into the circumjacent parts of this appendix of the VVand This connexion is made for this use that we may turne our hand upwards and down-wards by the Cubit turned and twined about this processe But the lower appendix of this wand is hollowed on the inside that so it might more commodiously receive the bones of the wrest but gibbous without that it might be safer now this wand is softer and thicker at the lower end but lesser and harder above where on the inside it hath a swelling out wherby to receive the muscle Biceps besides on the outside of the mlddle therof it is somewhat gibbous and round so to become more safe from the injuries of externall bodies but it is hollowed or bended on the inside for the better taking or holding any thing in the hand But that side which lyes next to the Ell is flatted for the fitter originall and seat of the muscles lastly it is seated upon the bone of the Cubit or Ell just against the thumb But the Ell or bone of the cubit properly particularly so called hath in like maner two appendices the one above the other beneath The upper which also is the greater is fitted to the Orbe of the arme in which it goes to again for the extensioÌ„ bending of the arme no otherwise than a rope runs in a pulley but that it turnes not absolutly perfectly round which is caused by the two processes of unequal bignesse the which are therfore staied in the holes or cavities of the bone of the arme the greater processe which we called Olecranon is letted by the exterior hole that so the extension of the arme can be no further but the lesser processe by the inner hole makes the bending therof the lesse perfect The Composure of these bones is by Ginglymos it is strengthened not onely by common Ligaments comming from the muscles which move the bones themselves but also by proper Ligaments descending from the processes of the arme the lips of the holes and cavities standing about the Appendix of the Cubit The other lower and lesser appendix is in some sort hollow on the inside for the fitter receiving the bones of the wrest but the outside is round ends in a point whence it is called by the Greeks Styloides But now this Ell contrary in this to the wand is thicker towards the arme but slenderer towards the wrest And besides in the thicker part therof it is hollowed or bended towards the inside in the same place is gibbous or bunching forth on the out side but it is round straight unlesse on that side which lyes next the wand for the rest it is hollow full of marrow like the wand The site of the Radius or wand is oblique but that of the Cubit or Ell is right that the arme might be the better more easily moved because the motion by which the arme is exteÌ„ded beÌ„ded is according to a right line but that by which the inside of the hand is turned upwards downwards is performed obliquely circularly Wherfore it was expedient that the wand should be oblique the cubit streight for the cubit-bone is appointed for to extend bend the arme but the wand to performe the wheeling turning about therof this is the cause that it was fitting ther should be a different connexion of these bones with the arme These things were fitting to be spoken concerning the nature of these bones that in the cure of fractures we may worke the more safely happily taking indication from that which is agreeablâ— to nature wherfore now it remaines that we come to the description of the muscles which are seated in the arme the cubit-bone or Ell. These are 4 in number two extending it two bending it The first of the Benders is called Biceps by reason of its two heads the one wherof descends from the Coracoides that other from the lip of the cavity of the shoulder-blade by the fissure or clift of the head of the bone of the arme These two heads under the necke of this arme becoming fleshy are firmely united at the belly midst of the arme thus united are at length implanted by a strong tendon to the inner protuberation of the wand The other is called the Brachiaus by reason of the straite coherence therof with the bone of the arme this fastened under the Biceps descends obliquely on the backe and upper part of the bone of the arme into the top of the wand and the inner side of the Ell. But the first of the extenders is called the longus or Long muscle this descends from the lower Rib of the shoulder and cleaving to the bone of the Arme goes thither fastened and as it were alwayes most straitly joyned with his fellow muscle specially nere the Cubite where you shall presently heare The other termed the Brevis or short Muscle being the companion of the long descends on the hinde part of the necke of the bone of the Arme as it were growing to and lying under the former long muscle so that making one common broad Tendon outwardly â—â—eshy inwardly nervous they are inserted into the Olecranum so by mutuall assistance to extend the Cubite CHAP. XXVII The Description of the Bones of the Wrest Afterwrest and fingers WE said before that the Hand taken more particularly and properly is divided into the Wrest afterwrest fingers that the hand in this signification is bounded by the ends of the bones of the cubit and fingers All the parts of the wrest which it hath coÌ„mon with the afterwrest have bin already also plentifully explaned this only remaines to be noted that the skin aswell of the hands as of the feete is of a middle nature betweene pure flesh and pure skin no otherwise than that which covers the forehead but that this which covers the palmes of the hands soles of the feet is unmoveable But it is most thicke
the Legge or Shanke and the Foote By the thigh we meane that which lies betweene the hippe and the knee By the legge properly so called or shanke that which is contained betweene the knee and the foote By the foote all from thence to the ends of the toes Againe they devide the foote into three parts that is the Tarsus or Instep the Pedion or top of the foote and the Digitipedum or toes We understand by the instep that which is contained in the first seven bones which answers in proportion to the wrest of the hand By the top of the foot that which is comprehended in the five following bones which is answerable to the afterwrest That which remaines we call the toes But because all these parts have other common and proper parts we will onely follow the distribution of the veines arteries and nerves seeing we have sufficiently explained the rest when we described the containing parts of the body in generall CHAP. XXXI A Description of the Crurall veine THe Crurall veine begins then when the hollow veine passing forth of the Peritonaum and stretched to the hanch bone and the sides of the Pubis in the groine is first divided into two large branches the one of which descends on the inside alongst the bones of the whole legge together with the artery and nerve the other runnes downe outwardly and superficially alongst the legge betweene the fat lying under the skinne and the muscles even to the foote and is spent in the skinne thereof This because it is alwayes apparent and manifest is called properly by the Greekes Sapheia but commonly Saphaena This veine by the way presently at its originall is devided into two branches the one internall the other externall of which the internall is spent upon the Bubones and other glandules of that place and the skinne and by this branch come the defluxions called Bubones the other branch is waisted in the fore and utter skinne of the upper part of the thing then a little lower that is about the bredth of three or foure fingers it is gathered againe into one branch made of many little ones which is spent in the fore and hinde skinne of this thigh Thirdly a little below the middle of the thigh it is againe devided into two other branches of which the one goes into the skinne on the fore side and the other on the hinde side Fourthly it is distributed by two other small spriggs into the skinne on the fore and hinde part of the knee which oftentimes are not found especially when the Poplitea or ham veine is some-what larger than ordinary Fiftly a little below the knee it produces two other branches lying upon each other in their passage out into the fore and hinde skinne of that place You must note that branch which runnes into the skinne of the hinde part is carried by a certaine other sprigge which it produces into a branch of the Poplitea passing forth of the two twin muscles Sixthly in the bigger part of the calfe of the legge it is divided into two other branches which in like manner are distributed into the skinne as well in the fore side as the backe side of the legge At length after many other divisions which for brevitie sake I omit when it arrives at the fore and inner side of the ankle where it is commonly opened in the diseases of the parts below the midriffe which require bloud-letting it is parted into two other branches the lesser of which descends to the heele the other in many sprigs is spent upon the skinne of all the upper and lower part of the foote and toes The second branch of this Crurall veine which wee said descends within together with the artery and nerve even into the foote is devided first peircing some-what deepe in it produces foure divarications one internall descending below the originall of the Sapheia into the muscle called Obturator externus and into certaine other externall muscles The three other runne outwardly the first towards the huekle bone by which the Ischias is made the two other into the fore muscles of the thigh neither are these sprigs far remote from one another Secondly all that branch is devided into two other branches the one above the other below an artery alwayes accompanying it the lower of which is spent upon many of the hinder muscles of the thigh ending nigh the ham The upper besides that it bestowes many branches uppon the fore and inner muscles of the thigh descending to the ham it produces the Poplitea or ham veine made sometimes of two branches the one proceeding from above and the other from below This Poplitea descending by the bending of the ham is spent one while upon the skinne of the calfe of the legge another while upon the knee otherwhiles encreased with branches of the Sapheia it goes on the outside of the anckle to the skinne on the upper side of the foote and sometimes on the lower Thirdly a little below the originall of the ham veine and under the bending of the knee it brings forth the Suralis which is bestowed upon the muscle of the Sura or calfe of the legge and upon the skinne of the inner side thereof and of the foote continued sometimes even to the inner part of the great toe Fourthly under the head of the hinder appendix of the bones of the legge it produces betweene these two bones another veine which nourishing the fore muscle of the legge is consumed upon the foote Fiftly and lastly it brings forth the Ischiadica maior or greater Ischias which is devided into two branches of an unequall bignesse the larger whereof from his originall descending alongst the inner part of the legge bone insinuates it selfe under the muscles of the calfe betweene this and the heele into the sole of the foote upon which it is wasted devided into ten small sprigs two for each toe the other being the lesser descending alongst the Pâ—rone or shin-bone is consumed betweene it and the heele yet sometimes it is produced not onely even to the muscle the Abductor of the toes but also by five surcles even to the fourth toe and the sides of the middle toe CHAP. XXXII The Distribution of the Crurall Artery THe crurall artery arising from the same place whence the crurall veine proceeded and descending with the internall crurall veine is distributed as followeth First into the muscle of the thigh which spreading it selfe through the muscles therof meets with the utmost hypogastrica descending with the veine through the common hole of the huckle and share bone and is joyned with it Secondly when it arrives at the ham betweene the Condyles or processes of the legge it sends two branches into the knee Thirdly a little after it produces another branch which it sends to the exteriour muscles of the legge and when it arrives at the middle of the legge it is devided into
two branches betweene the twin muscles and Solaeus the one internall the other externall the internall some surcles communicated by the way to the parts by which it passes but specially to the joynt of the anckle stretches it selfe over the sole of the foote betweene the lower extremity thereof and hee le whither when it arrives it is divaricated into five surcles of which it bestowes two on the great toe two on the next and one on the middle toe The externall descending in like manner to the sole of the foote betweene the fibula and the heele besides other sprigs which it may spread by the way it produces one without on the joynt of the anckle another in the muscle the Abductor of the toes to the wrest and backe of the foote But the remainder is devided into five portions of which two are sent to the fourth and two to the little toe and one to the middle CHAP. XXXIII Of the Nerves of the Loynes Holy-bone and Thigh THere arise five conjugations of nerves from the loines devided into externall internal branches the externall are disseminated into the Rachitae or chin muscles the muscles Semispinatus and Sacer and the skinne lying over them The internall are sent into the oblique ascendent and transverse muscle of the lower belly into the Peritonaeum into the loine and chest muscles arising there but after a different manner for some are absolutely carried thither as the nerves of the first conjugation of the loines and oftentimes also of the second but that sometimes they send a small sprigge to the testicles when the Costall have sent none thither but some lower are partly distributed there and partly sent some other way for the greater portions first united amongst themselves then presently with the portions of these of the holy-bone goe into the thigh as we shall shew in the distribution of the nerves of the holy-bone Now from the holy bone proceede sixe conjugations of nerves reckoning that for the first which proceeds from the last Vertebra of the loines and first of the holy-bone and that the sixte which proceeds from the lowest part of the holy-bone and the first of the rumpe these conjugations of nerves are devided into externall and internall branches The lesser externall passing forth by the externall and hinder holes of the holy-bone are distributed into the parts properly belonging thereto to wit the muscles and skinne thereof for every nerve by the law of nature first and alwayes yeelds to the neighbouring parts that which is needefull then presently to others as much as it can Wherefore if thou wouldst know whence each part hath his vessels at the next hand that is the veines arteries and nerves thou must remember the site of each part and the course of the vessels and to consider this that the veines and arteries as speedily and conveniently as they can insinuate themselves into the parts sometimes at the head or beginning somewhiles by the middle or extremes thereof as there is occasion But a nerve principally enters a muscle at the head thereof or at least not farre from thence but never by the taile whereby it may easily be understood by what branch of each veine artery and nerve each part may have nourishment lift and sense The other internall branches of the foresaid conjugations goe especially the foure uppermost united from their originall with the three lowermost of the loines into all the legge as you shall presently heare But the two lower are consumed upon the muscles called Levateres Ani the Sphincter muscle of the same place besides upon the muscles of the yard and necke of the bladder in men but in women upon the necke of the wombe and bladder For these parts admit another in their bottome from the costall nerve being of the sixth conjugation of the braine these thus considered let us come to the nerves of the thigh which as we said from their first original as it werecōpacted and composed of the greater portion of the three inner and lower branches of the loines and the foure upper of the holy-bone are devided in the thigh into foure branches of which the first and higher descending from above the Peritonaeum to the little Trochanter is wasted upon the in ward and superficiary muscles of the thigh and the skin which covers them a little above the thigh The second descending with the crurall veine and artery by the groine is devided into two branches like as the veine the one internall the other external of which the internall descending with the veine and artery is sent into the inner and deepe muscles of the thigh ending above the knee But the externall descending superficially with the Saphaeia even into the foote gives branches by the way to the skinne which covers it The third seated under these former passing by the hole common to the share and hanch-bone sends certaine branches to the groines to the muscles called Obturatores to the Tricipites and sometimes to the muscles of the yard and it ends at the midst of the thigh The fourth which is the thickest solidest and hardest of all the nerves in the body descending wholely from the productions of the holy-bone and descending out-wardly betweene the lower part of the same bone and the Os Ilium or Hanch-bone to the thigh bestowes certaine sprigges to the hinde muscles thereof proceeding from the proturberation of the Ischium or huckle-bone and in like sort it gives othersome to the skinne of the buttocks and also to the skinne covering the forementioned muscles A little after it is parted into two branches descending undevided even to the bending of the knee they both are communicated by diverse surcles of the muscles of the legge yet so as the lesser produces another branch from the rest of the portion thereof descending on the fore part of the legge alongst the shin-bone unto the top of the foote where it is devided into tenne surcles scarse apparent to the sight two running to each of the toes The other greater descending in like manner in the remainder of its portion by the hinde-part of the legge into the sole of the foote casts its selfe with the veines and arteries betweene theheele and legge bone where first devided into two branches each of which presently parted into five send two sprigs to the sides of the toes And these are the most notable and necessary distributions of the vessels and nerves we purposely omit others which are infinite and of which the knowledge is impertinent CHAP. XXXIIII Of the proper parts of the Thigh HAving explaned the common parts of the legge in generall now wee must come to the proper beginning at the Thigh The proper parts of the Thigh are muscles bones and ligaments But because the demonstration of the muscles is somewhat difficult if we bee ignorant of the description of the bones from whence they arise and into which they are inserted therefore we judge it worth our
and two vaste muscles into the fore part of the thigh even to the whirle-bone of the knee But we must note that these foure last muscles make a common thicke and broad tendon with which they couer the Patella or whirle-bone and all the fore dearticulation of the knee that they cannot be separated without tearing wherefore we must thinke that this tendon serves the knee for a ligament now all these muscles performing their action together extend the legge The five hinde muscles follow to be spoken of of which three arise from the tuberositie of the huckle-bone going into the inner part the fourth from the middle of the Pubis called Biceps that is the two headed muscle into the outside of the legge Of the internall one passing frō the forementioned tuberositie descends ligamentous even into the midst of the thigh and then becomming fleshy is inserted by its tendon after the manner we formerly mentioned The other being slender passing forth also from the same place with its tendon is inserted with the tendon of the long muscle and ends in the inner part of the legge which with its companion it drawes inwardly and brings to the other which same thing it performes in the thigh by the helpe of the three headed muscle The third being the inner or hinder descends from the middle part of the share-bone with a broad and slender ligament and is inserted with a round tendon into the inner part of the legge after the manner of the fore-mentioned The fourth called Biceps takes one of the two heads of which it consists from the last mentioned tuberositie the other from the outer line of the thigh but is inserted into the externall part of the legge as we formerly said The fifth and last called the Popliteus descends obliquely fleshly from the externall condyle or knot of the thigh into the inner and hinder part of the legge at the joyning thereof to the shinne-bone the action thereof is to draw the legge after a manner inwards CHAP. XXXVIII Of the Bones of the Foote THe Order of Anatomy requires that we now prosecute the muscles moving the foote but because we should in vaine deliver their insertion the disposition and condition of the bones of the foote not being first known wherefore it first behoves us to set forth their description Therefore the bones of the foote are sixe and twenty in number distinguished into three ranks that is the bones of the Tarsus or Instep are seven these of the Pedium the afterwrest or backe of the foote five and those of the toes foureteene Of the seven bones of the instep there are 4. named and 3. unnamed The first of the named immediately following the bones of the legge is called Astragalus the pasterne or ankle-bone This hath three connexions one as we said before in the upper and broader part with the bones of the legge of which it is received the other in the lower and hinde part by which it receives the upper and inner processe of the bone of the heele the third on the foreside by which it is received in the cavitie of the Os naviculare or Scaphoides that is the boate-like-bone By the first connexion the foote is extended and bended by the second it is moved with the heele to the sides the two first connexions are by Diarthrosis the last by Synarthrosis But it is strengthened by strong and broade ligments descending and ascending from one bone into another also they are strengthened by membranes muscles and tendons descending to the foote above and under these joints But this bone hath 3. processes as 3. feete fastened to the bone of the heele of which the first and least is under the outer anckle the bigger which Galen saith makes a round head fastened on a long necke lookes towards the fore part of the foote over against the great toe and the next toe to it the middlemost is at the heele behinde the legge-bone I passe over in silence many other things as the smoothnesse and asperity or roughnesse of the bone which I had rather you should learne by ocular inspection than by booke The second bone lying under this is called the Calcaneum or heele-bone being the biggest of all the bones of the foote upon which all the body relies when we go It hath two upper processes the one great the other little The great is received in the hinde and outer processe of the Astragalus the lesser is received on the inside in the 3. processe of the same bone which we said had a round head fastened to a long neck Besides it is round on the hinde part and much disioyned from the legge-bone but on the fore and longer part it is knit by Synarthrosis to the Die-bone whose lower and inner part it seemes to receive the superficies thereof is wholy unequall and rising up with many swellings On the inner side it makes as it were a channell so to give way as well to the vessels as tendons going to the sole of the foote and toes Lastly we must consider the holes by which the vessels passe into that bone to give it nourishment by reason of which vessels the fracture of this heele-bone is very dangerous because of the pressing and contusion of the vessels as Hippocrates shewes For the ligaments of this heele or heele-bone they are such as these of the Astragalus to wit tendons membranes and ligaments properly so called comming from one bone to another The third bone of the foote is named Scaphoides or boate-like from the resemblance it hath to a boate for on that part which lookes towards the posterne bone it is hollow but on that part which is next the three Innominata or namelesse bones which it sustaines and of which it is received as it in the cavity thereof receives the head of the Astragalus it is gibbous like the bottome of a boate The connexions thereof are by Synarthrosis and they are strengthened by the fore-mentioned ligaments this same bone is arched on the upper part but somewhat hollowed or flatted below the inner part ends in a point like the prow of a ship but the outer obtuse like the sterne of a shippe The fourth bone of these which have names is called the Cuboides from the resemblance of a Die although that similitude be very obscure On the fore part it sustaines the toes which by a certaine proportion to the fingers of the hand may be called the Ring and little toes but it is sustained on the hinde part with the backe part of the heele on the inner side it is joyned with the boat-like-bone and that namelesse bone which sustaines the middle toe on the outside it produces a rising like the backe of an Asse which on the lower part is extended transversly all the length thereof at the two sides of this eminency or rising there are two small cavities in the forme of a channell
The first and the greater of the Ossa innominata or namelesse bones sustaines the great toe the lesser and second the next toe thereto the third and middle in bignesse the middle toe These three bones are arched on their upper part but somewhat hollowed below They are knit to the three forementioned bones by Synarthrosis of which they are received but on the hinde part with the boate-like bone which they receive Now we must come to the bones of the second ranke that is of the Pedium or backe of the foote these are five in number bearing up the five bone of the toes They are somewhat gibbous on their upper part but hollow below each of them hath two processes at the end thereof by the lower and first of which they receive the three namelesse and Die-bone but by the upper made into a round head they are received of the first bones of the toes Their connexions whether with the toes or bones of the instep are by Synarthrosis The ligaments as well proper as common are such as we said of the former The bones of the third order now remaine to be spoken of which wee said make the toes and they are foureteene two of the great toe but three of each of the other toes The first is somewhat longish but the rest are very short except that of the great toe all of them on the upper side are round and convexe but on the lower somewhat hollow and plaine longwise that the tendons which bend them may passe more straightly and safely without inclining to either side even to their furthest joynts although such passages are much helped by the membranous and common ligament which rising from the sides of these bones involves these tendons as we mentioned in the fingers To conclude each of these bones the last excepted have a double connexion by Diarthrofis they are all unequall in their bignes that is thicke at their beginning where they receive the heads of the precedent bones upon which they move as a doore upon the hinges and so they grow smaller towards the ends but by their ends they are received of the following bones at their ends they rise into two eminencies on their sides distinguished by a cavity betweene them through which occasion they are farre thicker at their ends than in their midle The Figure of the bones of the Foote properly so called Figure 1. and 2 shew the bones of the right foote fastened together their upper face and their neather face Fig. 3 4 5 and 6 shew the upper lower inner and outer sides of the Talus or pasterne Fig. 7 8 9 sheweth the same sides of the Heele Fig. 10 and 11. sheweth the forward and backward side of the boate bone Fig. 12 and 13 shew the fore and back part of the wrest made of foure bones ABCD 3 5 6. The protuberation of the Talus joyned to the appendix of the leg-bone and of this protuberation foure sides EE 3 A sinus insculped in the protuberation of the Talus FF 3 two bunching parts of the Talus G 3 the inner side of the protuberation of the Talus crusted over with a gristle joyned to the inner ankle H6 The outward sinus of the protuberation of the Talus covered over with a gristle and receiving the inner ankle I5 A rough sinus of the Talus receiving a gristly ligament from the inner ankle K6 a sinus of the Talus receiving a griftly ligament from the outward ankle LM 5 6 two sinus in the hinder part of the Talus N 3 4 5 6 the necke of the Talus or pastern bone O 3 4 5 6. the head of the Talus going under the sinus of the boate bone P 7 8 9. the head of the bone of the heele crusted over with a gristle and going under the sinus of the Talus or the pasterne bone Q 4. a large sinus of the Talus receiving the head of the heele R 7 8 9. a sinus of the heele whereto the lower part of the head of the Talus is joyned S 4 the lower part of the head of the Talus going into the sinus of the heele TT 4 a sharpe sinus of the heele receiving a gristly ligament from the pasterne bone XYZ 2 the place of the heele YZ 2 Y 8 Z 9. a processe of the heele made for the production of muscles a b 7 8 9 from a to b the distance of the upper part of the heele c 8 9. the hinder part of the heele d 2 8 the inner side of the heele e 8 the place where the tendons that run to the bottome of the foote are reflected f 7 8 the utter side of the heele g 1 7 9 here the tendons of the 7 and 8 muscles of the foote are stretched out h 7. the forepart of the heele which is joyned to the pasterne bone i 7 that part of the heele which is joyned to the Cube-bone k 11 the sinus of the Boat-bone receiving the head of the Talus Imn 10 three surfaces of the Boat-bone lightly prominent which are articulated to the bones of the wrest op 11 the upper part of the Boat-bone regarding the top of the foot q r 10 and q 11 his lower part q 10 11 A sinus through which the sixt muscle of the foote is led s t u 13. the plain surfaces of the three inner bones of the wrest whereby they are articulated to the Boat-bone x 13 a shallow sinus of the Cube-bone whereby it is articulated to the heele αβ 12 the place of the Cube bone to which that bone of the Afterwrest is joyned which supporteth the last Toe save one γ 12. 13 the place of the Cube bone where the third bone of the wrest is articulated δ 12 13. that part of the Cube bone which respecteth the outside of the foote ε 12 13. the surface of the Cube-bone in the upper part of the foote ζ 2 13 that part of the Cube bone which regardeth the earth ◠2 a sinus of the Cubebone at which the tendon of the seventh muscle of the foot is reflected B 13 a processe of the third bone of the wrest whereinto the fift muscle of the foot is inserted ◠12. the place of the inner bone of the wrest to which that bone of the Afterwrest which sustaineth the great Toe is coupled χ 12 the place of the second bone of the wrest whereto the bone of the Afterwrest that supporteth the fore Toe is articulated λ 12 the place of the third bone of the wrest whereto that bone of the Afterwrest which supporteth the middle toe is articulated μ 1 2 a small bone whereby that bone of the Afterwrest which sustaineth the little toe is joyned unto the Cubebone yy 1 2 the distances betwixt the bones of the Afterwrest ξξ 1 2 the heads of the bones of the Afterwrest which enter into the bosomes of the toes π 2 a processe of the bone of the afterwrest
inner part of the Cubite are seven and as many in the outer but those of the hand are reckoned thirteene at the least The fourth of the shoulder-blade are the Trapezius resembling a Monkes Cowle which moves it upwards and downewards and drawes it backwards the second is the Levator or Lifter-up the third the great Rhomboides lying under the Trapezius The fourth the lesser saw muscle which is inserted into the Coracoides The arme is moved forwards backwards upwards downewards and circularly The Pector all muscle arising from the Clavicle Breast-bone and neighbouring ribs drawes it forwards the Humilis or low-muscle comming from the lower rib of the shoulder-blade drawes it backwards the Deltoides upwards and the Latissimâ—… downewards and somewhat backe-wards But the three seated about the shoulder-blade move it about or circularly The Epomis or Scapularis upwards the Supcascapularis which may seeme two backwards and downewards the Subscapularis which is in the Cavitie of the shoulder blade forewards so that by a certaine vicissitude and succession of action they move it circularly Two muscles bend the Cubite the one named Biceps or Two-headed and the other Brachiaeus or the arme-Arme-muscle but one two or three muscles extend it for if you have respect to the originall this muscle hath two or three heads but one onely insertion In the inside of the Cubite are seven muscles one Palmaris two wrest-benders two pronatores one square another in some sort round two finger-benders and one Abductor or Drawer aside These fourteene internall and externall muscles of the Cubite doe not indeed move the Cubite but onely seated there move the wande and with it the hand These are the thirteene Muscles of the hand the Theu which may not only be divided into two but into sixe not only by the diverse actons it performes but also by the branches divided by a manifest space betweene them the second is called the Hypothenar which lyes under the litle finger as the Thenar doth under the Thumbe the third is the Abductor of the Thumbe then follow the foure Lumbrici and sixe Interosses although eight may be observed The whole Legge hath at the least 50. Muscles for wee reckon there are fourteene muscles in the thigh there are eleven made for the use of the Legge there are nine seated in the Legge three before and sixe behinde which serve for the use of the foot and toes in the foote are seated sixteene Therefore of the foureteene muscles serving the thigh two bend it one called the Lumbaris the other arising from the cavity of the Hanch-bone but the three which make the Buttocks and the Triceps or Three-headed muscle which if you please you may divide into three extend it Besides these the 4. twin muscles and two Obturators of which the one is internall the other externall turne the Thigh about The Legge hath eleven that is the Long the Membranous the foure Postici or Hinde muscles three of which come from the Huckle-bone but the other from the commissure of the Share-bone the Right the two Vaste the Crureus or Legge-muscle and the Poplitaeus or Ham-muscle These seated in the leg for the use of the foote and toes are three fore and sixe hinde muscles two of the fore bend the foote one of which is called the Tibiaeus anticus the other Peronaeus which you may divide into two The third the bender of the toes although it also partly bend the foote to which also the bender of the Thumbe may be revoked One of the hinde is the Toe-bender others extend the foote and are in this order Two twins one Plantaris one Soleus one Tibiaeus posticus and the great bender of the Toes to which may be revoked the bender of the Thumbe Of the sixteene seated in the foote one is above seated on the backe of the foote which wee call the Abductor of the Toes another in the sole of the foote to wit the litle bender of the Toes which goes to the second joynte of the Toes alongst the inside of the foote the other lends his helpe to the great Toe which you may call the Abductor of the Thumbe another is seated on the outside for the use of the litle Toe To these are added the foure Lumbrici besides the eight Interosses or if you had rather ten And thus much may suffice for the enumeration of the muscles The Figure of the Muscles when the skin with its veines the fat and all the fleshy membrane are taken away that part of the fleshy membrane excepted which takes upon it the nature of a muscle as being conjoyned with the muscles a the muscle of the fore-head b the temporall muscle c the muscle shutting the eye-lid d the muscle opening the wings of the nose e the fore part of the yoake-bone f the muscle of the upper lip tending to the nose g the beginning of the masseter or grinding muscle h the broad muscle consisting of a fleshy membrane i k the beginning therof which rises immediatly from the coller-bone the top of the shoulder l that part therof which bends forwards to l. m the muscle which lifts up the arme n the pectorall muscle o the membranous part of this muscle which is joyned to the nervous part of the first muscle of the Abdomen or belly q q the fleshy portion thereof from the 6. and 7. ribs and the insertion thereof r the muscle drawing down the arme s the oblique descending muscle of the lower belly t t t the insertion of the greater saw muscle u u. the linea alba or white line at which the two oblique descendent muscles meet covering the whole belly x the yard the skinne being taken away y the vessels of seed α the testicles wrapped in the fleshy membrane 〈◊〉 the fore muscle bending the cubite γ γ the hinde muscle bending the cubite δ the muscle extending the cubite 〈◊〉 the two-headed muscle extending the wrest 〈◊〉 the muscle producing the broad tendon on the backe of the hand ζ his tendon 〈◊〉 the muscle turning up the Wand θ the upper muscle flatting the Wand 〈◊〉 the. second of the arme-benders whose beginning is χ and tendon λ o a portion of the muscle whereof one part yeelds tendons to the wrest the other to the thumbe 〈◊〉 the fleshlesse articulation of the thumbe Ï a muscle inserted into the wrest lying neere to the following muscle σ a muscle devided into two tendons the one whereof is inserted into the first joint of the thumbe the other into the following Ï„ the first muscle of the thigh whose head is at ν and tendon at Φ and insertion at χ. Ψ the end of the second muscle of the thigh ω the end of the third muscle of the thigh 1 the sixt muscle of the legge his beginning at 2. almost wholy membranous at 3. 4 the ninth muscle of the legge 5 the eight of the legge 6 a portion of the sixth and seventh of the thigh 7
alimentary juice to the braine wanting marrow that is blood to nourish it as we have formerly shewed in our Anatomie But from hence proceeds the effluxe of blood running betweene the scull and membraines or else betweene the membraines and braine the blood congealing there causeth vehement paine and the eyes become blinde vomitting is caused the mouth of the stomacke suffering together with the braine by reason of the Nerves of the sixt conjugation which runne from the braine thither and from thence are spread over all the capacitie of the ventricle whence becomming a partaker of the offence it contracts it selfe and is presently as it were overturned whence first these things that are conteined therein are expelled and then such as may flow or come thither from the neighbouring and communne parts as the Liver and Gall from all which choler by reason of its naturall levity and velocity is first expelled and that in greatest plenty and this is the true reason of that vomiting which is caused and usually followes upon fractures of the scull and concussions of the Braine Within a short while after inflammation seizes upon the membranes and braine it selfe which is caused by corrupt and putrid blood proceeding from the vessels broken by by the violence of the blow and so spread over the substance of the braine Such inflammation communicated to the heart and whole body by the continuation of the parts causes a feaver But a feaver by altering the braine causes Doting to which if stupidity succeed the Patient is in very ill case according to that of Hippocrates Stupidity and doting are ill in a wound or blow upon the head But if to these evills a sphacell and corruption of the braine ensue together with a 〈◊〉 difficulty of breathing by reason of the disturbance of the Animall facâ—… which from the braine imparts the power of moving to the muscles of the Chest the instruments of respiration then death must necessarily follow A great part of these accidents appeared in King Henry of happy memory a little before he dyed He having set in order the affaires of France and entred into amitie with the neighbouring Princes desirous to honour the marriages of his daughter and sister with the famous and noble exercise of Tilting and hee himselfe running in the Tilt-yard with a blunt lance received so great a stroake upon his brest that with the violence of the blow the visour of his helmet flew up and the trunchion of the broken Lance hit him above the left eye-brow and the musculous skinne of the fore-head was torne even to the lesser corner of the left eye many splinters of the same trunchion being strucke into the substance of the fore mentioned eye the bones being not touched or broken but the braine was so moved and shaken that he dyed the eleaventh day after the hurt His scull being opened after his death there was a great deale of blood found betweene the Dura and Pia Mater poured forth in the part opposite to the blow at the middle of the suture of the hinde part of the head and there appeared signes by the native colour turned yellow that the substance of the braine was corrupted as much as one might cover with ones thumbe Which things caused the death of the most Christian King and not onely the wounding of the eye as many have falsly thought For wee have seene many others who have not dyed of farre more greevous wounds in the eye The history of the Lord Saint Iohns is of late memory he in the Tilt-yarde made for that time before the Duke of Guises house was wounded with a splinter of a broken Lance of a fingers length and thicknesse through the visour of his Helmet it entring into the Orbe under the eye and peircing some three fingers bredth deepe into the head by my helpe and Gods favour hee recovered Valeranus and Duretus the Kings Physitions and Iames the Kings Chirurgion assisting me What shall I say of that great and very memorable wound of Prancis of Loraine the Duke of Guise He in the sight of the Citty of Bologne had his head so thrust thorough with a Lance that the point entring under his right eye by his nose came out at his necke betweene his eare and the vertebrae the head or Iron being broken and left in by the violence of the stroke which stuck there so firmely that it could not be drawn or plucked forth without a paire of Smiths pincers But although the strength violence of the blow was so great that it could not be without a fracture of the bones a tearing and breaking of the Nerves Veines Arteries and other parts yet the generous Prince by the favour of God recovered By which you may learne that many die of small wounds and other recover of great yea very large and desperate ones The cause of which events is chiefly and primarily to be attributed to God the author and preserver of mankinde but secondarily to the variety and condition of temperaments And thus much of the commotion or conclussion of the braine whereby it happens that although all the bone remaines perfectly whole yet some veines broken within by the stroake may cast forth some bloud upon the membranes of the braine which being there concreate may cause great paine by reason whereof it blindes the eyes if so be that the place can be found against which the paine is and when the skinne is opened the bone looke pale it must presently be cut out as Celsus hath written Now it remaines that we tell you how to make your prognostickes in all the forementioned fractures of the scull CHAP. X. Of Prognostickes to be made in fractures of the scull VVEE must not neglect any wounds in the head no not these which cut or bruise but onely the hairy scalpe but certainely much lesse these which are accompanied by a fracture in the scull for oft times all horride symptomes follow upon them and consequently death it selfe especially in bodies full of ill humors or of an ill habite such as are these which are affected with the Lues venerea leprosie dropsie Pthisicke and consumption for in these simple wounds are hardly or never cured for union in the cure of wounds but this is not performed unlesse by strength of nature and sufficient store of laudible blood but those which are sicke of hecticke feavers and consumptions want store of blood and those bodies which are repleate with ill humors and of an ill habite have no affluxe or plenty of laudible blood but all of them want the strength of nature the reason is almost the same in those also which are lately recovered of some disease Those wounds which are brused are more difficult to cure than those which are cut When the scul is broken than the continuity of the flesh lying over it must necessarily be hurt broken unlesse it be in a Resoâ—itus
The bones of children are more soft thin and replenished with a sanguine humidity than those of old men and therefore more subject to putrefaction Wherefore the wounds which happen to the bones of children though of themselves and their owne nature they may be more easily healed because they are more soft whereby it comes to passe that they may bee more easily agglutinated neither is there fit matter wanting for their agglutination by reason of the plenty of blood laudible both in consistence and quality than in old men whose bones are dryer and harder and so resist union which comes by mixture and their bloud is serous and consequently a more unfit bond of unitie and aggluâ—ination yet oft times through occasion of the symptomes which follow upon them that is putrefaction and corruption which sooner arise in a hot and moyst body and are more speedily encreased in a soft and tender they usually are more suspected and difficult to heale The Patient lives longer of a deadly fracture in the scull in Winter than in Summer for that the native heat is more vigorous in that time than in this besides also the humors putrifie sooner in Summer because unnaturall heat is then easily enflamed and more predominant as many have observed out of Hippocrates The Wounds of the braine and of the Meninges or membranes thereof are most commonly deadly because the action of the muscles of the chest and others serving for respiration is divers times disturbed intercepted whence death insues If a swelling happening upon a wound of the head presently vanish away it is an ill signe unlesse there be some good reason therefore as blood-letting purging or the use of resolving locall medicines as may be gathered by Hippocrates in his Aphorismes If a feaver ensue presently after the beginning of a wound of the head that is upon the fourth or seaventh day which usually happens you must judge it to bee occasioned by the generating of Pus or Matter as it is recited by Hippocrates Neither is such a feaver so much to be feared as that which happens after the seaventh day in which time it ought to be determinated but if it happen upon the tenth or foureteenth day with cold or shaking it is dangerous because it makes us conjecture that there is putrefaction in the braine the Meninges or scull through which occasion it may arise chiefely if other signes shall also concurre which may shew any putrifaction as if the wound shall be pallide and of a faint yellowish colour as flesh lookes after it is washed For as it is in Hippocrates Aphoris 2. sect 7. It is an ill signe if the flesh looke livide when the bone is affected for that colour portends the extinction of the heate through which occasion the lively or indifferently red colour of the part faints and dyes and the flesh there abouts is dissolved into a viscide Pus or filth Commonly another worse affect followes hereon wherein the wound becomming withered and dry lookes like salted flesh sends forth no matter is livide and blacke whence you may conjecture that the bone is corrupted especially if it become rough whereas it was formerly smooth and plaine for it is made rough when Caries or corruption invades it but as the Caries encreases it becomes livide and blacke sanious matter withall sweating out of the Diploe as I have observed in many all which are signes that the native heat is decayed and therefore death at hand but if such a feaver be occasioned from an Erysipelos which is either present or at hand it is usually lesse terrible But you shall know by these signes that the feaver is caused by an Erysipelas confluxe of cholericke matter if it keepe the forme of a Tertian if the fit take them with coldnes and end in a sweat if it be not terminated before the cholerike matter is either converted into Pus or else resolved if the lips of the wound be somwhat swollne as also all the face if the eyes be red and fiery if the necke and chappes bee so stiffe that he can scarse bend the one or open the other if there be great excesse of biting and pricking paine and heate and that farre greater than in a Phlegmon For such an Erysipelous disposition generated of thinne and hot blood chiefely assailes the face and that for two causes The first is by reason of the naturall levity of the cholericke humor the other because of the rarity of the skinne of these parts The cure of such an affect must be performed by two meanes that is evacuation and cooling with humectation If choler alone cause this tumor we must easily bee induced to let blood but we must purge him with medicines evacuating choler If it be an Erisipelas phlegmonodes you must draw blood from the Cephalicke veine of that side which is most affected alwayes using advise of a phisition Having used these generall meanes you must apply refrigerating and humecting things such as are the juice of Night-shade Housleeke Purslaine Lettuce Navell wort Water Lentill or Ducks-meate Gourdes a liniment made of two handfulls of Sorrel boiled in faire water then beaten and drawne through a searse with ointment of Roses or some vnguent Populeon added thereto will bee very commodious Such and the like remedies must be often and so long renued untill the unnaturall heat be extinguished But we must be carefull to abstaine from all unctuous and oyly thing because they may easily be enflamed and so increase the disease Next we must come to resolving medicines but it is good when anything comes from within to without but on the contrary it is ill when it returnes from without inwards as experience and the Authority of Hippocrates testifie If when the bone shall become purulent pustles shall breake out on the tongue by the dropping downe of the acride filth or matter by the holes of the pallate upon the tongue which lyes under Now when this symptome appeares few escape Also it is deadly when one becomes dumbe and stupid that is Apolecticke by a stroake or wound on the head for it is a signe that not onely the bone but also the braine it selfe is hurt But oft times the hurt of the Braine proceedes so farre that from corruption it turnes to a Sphacell in which case they all have not onely pustles on their tongues but some of them dye stupide and mute othersome with a convulsion of the opposite part neither as yet have I observed any which have dyed with either of these symptomes by reason of a wound in the head who have not had the substance of their braine tainted with a Sphacell as it hath appeared when their sculls haue beene opened after their death CHAP. XI Why when the braine is hurt by a wound of the head there may follow a Convulsion of the opposite part MAny have to this day enquired but as yet as farre as I know
forth the scull A. Shewes the one legge of the cutting compasses which as you carry it about cuts the scull B. The screw which fastens the point to the legge of the compasses C. C. Two different points which may bee screwed to the legge of the Compasses as neede shall require D. A great screw which fastens upon an Iron string alongst which the one of the legges of the Compasse running may bee widened and straitned as you please Moreover it is fit that the one legge of such cutting compasses should stand firme and steddy whilest the other is drawne circularly to cut Wherefore it is fit you have an Iron plate made full of little holes wherein you may firmely stay that legge of the compasse least it waver against your will it is requisite that this plate be crooked because the head is round that so it may be fitted to any part thereof A crooked Iron Plate fit to sustaine and hold steddy one legge of the Compasse upon the head Another paire of Commpasses of the like nature and use which may be widened and straightned by a screw CHAP. XIX Of the places of the scull whereto you may not apply a Trepan FIrst of all you shal not apply a Trepan to a bone that is so broken that it is wholy or in the greater part thereof divided from the scull by the violence of the stroake least by your weight and pressing of the Trepan you force it downe upon Membrane Secondly you must not apply one to the fractured Sutures for the reasons mentioned in the former chapter Thirdly nor to that part of the forehead which is a little above the eye-browes for these reasons we gave you before in the twelfth chapter For there is in that place under the first table of the scull it selfe a large cavitie replenished with a certaine white and tough humor as also with a certaine spirituous and ayrie substance placed there by nature to prepare the aire which ascends to the braine by the Nose-thrills unlesse the Chirurgion observe and be mindfull hereof he may bee deceived supposing this cavity to be an Effracture of the bone and a depression thereof Fourthly neither in the lowest parts of the scull lest the marrowy substance of the Braine by reason of its weight should slide through the hole made by the Trepan Fifthly neither to the Bregma bones of Children as those which as yet have not acquired just soliditie to endure the impression of a Trepan Sixtly nor to the temples by reason of the Temporall muscle the cutting whereof in the opinion of Hippocrates causes convulsson of the opposite part For being cut athwart it looses its proper action that is to move and lift up the lower Iaw but then the opposite Temporall muscle being whole and perfect using its strength his Antagoniste suffering it and not resisting or labouring any thing at all to the contrary it drawes the same Iaw to it whereupon the mouth and all the parts of the face are drawne awry and suffer a Convulsion towards the sound part the other being resolved according to Hippocrates his rule For as often as the muscles of one kinde are equall in number magnitude and strength on each side the resolution of the one part causes the Convulsion of the other Neither doth this danger alone arise from the cutting of the Temporall muscle but also another which is that this muscle when we eate and speake is in perpetuall motion whereby it comes to passe that being once cut it is scarse ever united againe besides also the commissure or joyning together of the stonie bones lye under it But by the second caution we are forbid to Trepan upon the sutures moreover also many Veines Arteries and Nerves are spred over the substance thereof so that by cutting of them there is danger of many and maligne symptomes as paine inflammation a feaver a convulsion not onely of the part it selfe but also of the whole body whence lastly death ensues Wherefore let no Chirurgion be so foole hardy as to attempt the cutting of this muscle so to Trepan the bone which lyes under it rather let him apply his Trepan above it or on the side thereof or as neere to the affected part as he can as I did in a Gentleman caled Monsieur de la Bretesche He in the triumphant entrance of King Henry the second into the Citty of Paris was so hurt with a stone that the Os Petrosum or scaly bone was broken with the violence of the blow and the temporall muscle was vehemently contused yet without any wound I being called the next day viewing the manner of the hurt and the condition of the wounded part thought good to bring some Physitions and Chirurgions with me to consult hereof of whom when some thought it expedient presently to divide the Temporall muscle that baring the bone we might apply a Trepan and so take forth the broken bones I on the contrary begun earnestly to withstand that opinion citing that saying of Hippocrates ex librâ— de vulneribus Capitis wherein Chirurgions are forbidden to cut such muscles for feare of the forementioned symptomes also I cited experience how that I had often observed all those which had this muscle cut dyed with a convulsion but that it should be farre better that neere above the fracture the bone should be Trepaned not touching the Temporall muscle at all if he could When all of them at the last had inclined to my opinion I presently divided the musculous skinne which was over the upper part of the fracture with a three cornered section the day following which was the third of his disease I Trepaned him and after I had done some few dayes after I tooke out some foure splinters of the broken bone and I put in a plaine leaden pipe by which I wishing the patient ever when I drest him to hold downe his head to stoppe his mouth and his nose and then strive as much as in him lay to put forth his breath much sanious matter came forth which was gathered betweene the scull and Crassa Meniux Other filth which stucke more fast I washed out with a detergent decoction injected with such a syring as is heere exprest And I did so much God blessing my endeavours that at length he recovered A Plane leaden pipe for to carry forth the Sanies gathered under the scull A little syring fit to make injections withall The like chance and fortune befell Monsieur de Piâ—nne at the seige of Mets. For he as hee fought at the breach of the wall had the bone of his Temples broken with a stone strucke out of the adjacent wall by a peece of Ordinance shot from the Emperours campe he presently fell downe with the blow and cast blood out of his mouth nose and eares with much vomiting and remained dumbe as it were senselesse almost foureteene dayes so that he knew none of the by-standers He had
of Reeds some are blunt headed others have piles or heads of Iron Brasse Lead Tinne Horne Glasse Bone In figure for that some are round others cornered some are sharpe pointed some barbed with the barbs standing either to the point or shafts or else acrosse or both wayes but some are broad aad cut like a Chissell For their bignesse some are three foote long some lesse For their number they differ in that because some have one head others more But they varie in making for that some of them have the shaft put into the head others the head into the shaft some have their heads nailed to the shaft others not but have their heads so loosely set on that by gentle plucking the shaft they leave their heads behind them whence dangerous wounds proceede But they differ in force for that some hurt by their Iron onely others besides that by poyson wherewith they are infected You may see the other various shapes here represented to you in the following Figure The Figures of divers sorts of Arrowes CHAP. XVII Of the difference of the wounded parts THe Wounded parts are eyther fleshy or bony some are neare the joynts others seated upon the very joynts some are principall others serve them some are externall others internall Now in wounds where deadly signes appeare its fit you give an absolute judgement to that effect least you make the Art to be scandalled by the ignorant But it is an inhumane part and much digressing from Art to leave the Iron in the wound it is sometimes difficult to take it out yet a charitable and artificiall worke For it is much better to try a doubtfull remedy than none at all CHAP. XVIII Of drawing forth Arrowes YOu must in drawing forth Arrowes shun incisions and dilacerations of Veines and Arteries Nerves and Tendons For it is a shamefull and bungling part to doe more harme with your hand than the Iron hath done Now Arrowes are drawne forth two wayes that is either by extraction or impulsion Now you must presently at the first dressing pull forth all strange bodies which that you may more easily and happily performe you shall set the Patient in the same posture as hee stood when he received his wound and hee must also have his Instruments in a readinesse chiefely that which hath a slit pipe and toothed without into which there is put a sharpe iron style like the Gimblets we formerly mentioned for the taking forth of Bullets but that it hath no scrue at the end but is larger and thicker so to widen the pipe that so widened it may fill up the hole of the Arrowes head where into the shaft was put and so bring it forth with it both out of the fleshy as also out of the bony parts if so bee that the end of the shaft be not broken and left in the hole of the head That also is a fit Instrument for this purpose which opens the other end toothed on the outside by pressing together of the handle You shall finde the Iron or head that lies hid by these signes there will be a certaine roughnesse and inequalitie observable on that part if you feele it up and downe with your hand the flesh there will be bruised livid or blacke and there is heavinesse and paine felt by the patient both there and in the wound A deliniation of Instruments fit to draw forth the heads of Arrowes and Darts which are left in the wound without their shafts A hooked Instrument fit for to draw forth strange bodies as peices of Maile and such other things as it can catch hold of which may also bee used in wounds made by Gunshot But if by chance either Arrowes Darts or Lances or any winged head of any other weapon bee run through and left sticking in any part of the body as the Thigh with a portion of the shaft or staffe slivered in peices or broken off then it is fit the Chirurgion with his cutting mullets should cut off the end of the staffe or shaft and then with his other mullets plucke forth the head as you may see by this Figure CHAP. XIX How Arrowes broken in a wound may be drawne forth BVt if it chance that the weapon is so broken in the wound that it cannot bee taken hold on by the formerly mentioned Mullets then must you draw or plucke it out with your Crane or Crowes bill and other formerly described Instruments But if the shaft be broken neare the head so that you cannot take hold thereof with your Cranes bill then you shall draw it forth with your Gimblet which we described before to draw forth bullets for if such a Gimblet can be fastened in Bullets it may farre better take hold of wood But if the head be barbed as usually the English arrowes are then if it may be conveniently done it will be very fitting to thrust them through the parts For if they should be drawne out the same way they went in there would bee no small danger of breaking or tearing the Vessells and Nerves by these hooked barbes Wherefore it is better to make a section on the other side whither the head tended and so give it passage forth if it may bee easily done for so the wound will bee the more easily clensed and consolidated But on the the contrary if the point tend to any bone or have many muscles or thicke flesh against the head thereof as it happens sometimes in the Thighes Legges and Armes then you must not thrust the head thorough but rather draw it out the same way it came in dilating the wound with fit Instruments and by skill in Anatomie shunning the larger Nerves and Vessells Therefore for this purpose put a hollow Dilater into the wound and therewith take hold of both the barbes or wings of the head and then take fast hold of the head with your Cranes-bill and so draw them forth all three together A Dilater hollowed on the inside with a Cranes-bill to take hold of the barbed head CHAP. XX. What to be done when an Arrow is left fastned or sticking in a bone BVt if the weapon be so depact and fastned in a bone that you cannot drive it forth on the other side neither get it forth by any other way than that it entred in by you must first gently moove it up and downe if it sticke very fast in but have a speciall care that you doe not breake it and so leave some fragment thereof in the bone then take it forth with your Crowes bill or some other fit Instrument formerly described Then presse forth the blood and suffer it to bleed somewhat largely yet according to the strength of the Patient and nature of the wounded part For thus the part shall be eased of the fulnesse and illnesse of humors and lesse molested with inflammation putrefaction and other symptomes which are customarily feared When the weapon is drawne forth and the
proceede from any other than a venenate matter yet the hurt of this venenate matter is not peculiar or by its selfe For oft times the force of cold whether of the encompassing ayre or the too immoderate use of Narcoticke medicines is so great that in a few houres it takes away life from some of the members and diverse times from the whole body as we may learne by their example who travell in great snowes and over mountaines congealed and horrd with frost yce Hence also is the extinction of the native heate and the spirits residing in the part and the shutting forth of that which is sent by nature to ayde or defend it For when as the part is bound with rigide cold and as it were frozen they cannot get nor enter therein Neither if they should enter into the part can they stay long there because they can there finde no fit habitation the whole frame and government of nature being spoyled and the harmony of the foure prime qualities destroyed by the offensive dominion of predominant cold their enimy whereby it commeth to passe that flying back from whence they first came they leave the part destitute and deprived of the benefit of nourishment life sense and motion A certaine Briton an Hostler in Paris having drunke soundly after supper cast himselfe upon a bed the cold ayre comming in at a window left open so tooke hold upon one of his legges that when he waked forth of his sleepe he could neither stand nor goe Wherefore thinking onely that his leg was numbe they made him stand to the fire but putting it very nigh he burnt the sole of his foote without any sense of paine some fingers thicknesse for a mortification had already possessed more than halfe his legge Wherefore after he was carried to the Hospitall the Chirurgion who belonged thereto endeavoured by cutting away of the mortified legge to deliver the rest of the body from imminent death but it proved in vaine for the mortification taking hold upon the upper parts he dyed within three dayes with thoublesome belching and hicketting raving cold sweate and often swounding Verily all that same winter the cold was so vehement that many in the Hospitall of Paris lost the wings or sides of their nose-thrills seazed upon by a mortification without any putrefaction But you must note that the Gangreene which is caused by cold doth first and principally seaze upon the parts most distant from the heart the fountaine of heate to wit the feete and legges as also such as are cold by nature as gristly parts such as the nose and eares CHAP. XIII Of the signes of a Gangreene THe signes of a Gangreene which inflammation or a phlegmon hath caused are paine and pulsation without manifest cause the sudden changing of the fyery and red colour into a livid or blacke as Hippocrates shewes where hee speakes of the Gangreene of a broken heele I would have you here to understand the pulsificke paine not onely to be that which is caused by the quicker motion of the Arteries but that heavy and pricking which the contention of the unaturall heate doth produce by raising a thicke cloud of vapours from these humours which the Gangreene sets upon The signes of a Gangreene caused by cold are if suddenly a sharpe pricking and burning paine assaileth the part for penetrabile frigus adurit i peircing cold doth burne if a shining rednesse as if you had handled snow presently turne into a livid colour if in stead of the accidentall heate which was in the part presently cold and numbenesse shall possesse it as if it were shooke with a quartain feaver Such cold if it shall proceede so farre as to extinguish the native heate bringeth a mortification upon the Gangreene also oft times convulsions and violent shaking of the whole body wondrous troublesome to the braine and the fountaines of life But you shall know Gangreenes caused by too streight bandages by fracture luxation and contufion by the hardnesse which the attraction and flowing downe of the humors hath caused little pimples or blisters spreading or rising upon the skinne by reason of the great heate as in a combustion by the weight of the part occasioned through the defect of the spirits not now sustaining the burden of the member and lastly from this the pressing of your finger upon the part it will leave the print thereof as in an aedema and also from this that the skinne commeth from the flesh without any manifest cause Now you shall know Gangreenes arising from a bite puncture aneurisma or wound in plethoricke and ill bodies and in a part indued with most exquisite sence almost by the same signes as that which was caused by inflammation For by these and the like causes there is a farre greater defluxion and attraction of the humors than is fit when the perspiration being intercepted and the passages stopt the native heate is oppressed and suffocated But this I would admonish the young Chirurgion that when by the forementioned signes hee shall finde the Gangreene present that hee doe not deferre the amputation for that hee findes some sense or small motion yet residing in the part For oft times the affected parts are in this case mooved not by the motion of the whole muscle but onely by meanes that the head of the muscle is not yet taken with the Gangreene with mooving it selfe by its owne strength also mooves its proper and continued tendon and taile though dead already wherefore it is ill to make any delay in such causes CHAP. XIIII Of the Prognostickes in Gangreenes HAving given you the signes and causes to know a Gangreene it is fit wee also give you the prognosticke The fearcenesse and malignity thereof is so great that unlesse it be most speedily withstood the part it selfe will dye and also take hold of the neighbouring parts by the contagion of its mortification which hath beene the cause that a Gangreene by many hath beene termed an Esthiomenos For such corruption creepes out like poyson and like fire eates gnawes and destroyes all the neighbouring parts untill it hath spred over the whole body For as Hippocrates writes Lib. de vulner capitis Mortui viventis nulla est proportio i There is no proportion betweene the dead and living Wherefore it is fit presently to separate the dead from the living for unlesse that be done the living will dye by the contagion of the dead In such as are at the point of death a cold sweat flowes over all their bodyes they are troubled with ravings and watchings belchings and hicketing molest them and often swoundings invade them by reason of the vapours abundantly and continually raysed from the corruption of the humors and flesh and so carryed to the bowells and principall parts by the Veines Nerves and Arteries Wherefore when you have foretold these things to the friends of the patient then make haste
danger lest the bone bee forced out againe and removed from its place whereinto it was restored by art and the hand Which thing Hippocrates so much feared that on the contrarie he willed that the set bone should be drawne somewhat more unto the part contrary to that whereunto it was driven by force than the naturall and proper site thereof should require But to returne to our former discourse of the three Ligatures The first under-binder being put on wee then take the second with which wee in like sort begin at the fracture but having wrapped it once or twice about there for that as we formerly said wee must not force backe and presse so much blood towards the extremities as wee must doe towards the body and bowels Wherefore this Ligature shall be drawne from above downe-wards gently straining it to presse forth the blood contained in the wounded part When by rowling you shall come to the end of that part then you shall carry back againe that which remaines thereof to wit upwards But otherwise you may take the third under-binder wherewith you may beginne to rowle whereas you left with the second and you may carry it thus rowling it from below upwards These under-bindings thus finished apply your boulsters after them your over or upper-bindings which are oft times two but sometimes three The first hath two heads and is wrapped both from the right hand and the left for the preservation of the first under-binder and the boulsters and restoring the muscles to their native figure The two other which remaine consist of one head the one of them must be rowled from below upwards the other from above downwards after such a manner that they may bee directly contrary to the under-binders as if they were rowled from the right hand then these must be from the left Now this is the manner of Hippocrates his Ligation which for that it is now growne out of use we must here set downe that which is in common use They doe not at this time use any over-binders but that which we termed the third under-binder serves our Surgeons in stead of the three forementioned over-binders Wherefore they carry this third under-binder wrapped from below upwards as we formerly said contrary to the first and second under-binder as if these begunne on the right side this shall be rowled from the left and shall end whereas the first under-binder ended And you must not only draw it indifferently hard but also make the spires and windings more rare This third rowler is of this use in this manner of Ligation that is it restores the muscles to their native figure from whence they were somewhat altered by the drawing and rowling of the two former Ligatures But you must alwaies have regard that you observe that measure in wrapping your Ligatures which reason with the sense of the patient and ease in suffering prescribes having regard that the tumor become not inflamed Also the habit of the body ought to prescribe a measure in Ligation for tender bodies cannot away with so hard binding as hard Verily in fractures and luxations the humors by too strait binding are pressed into the extreme parts of the body whence grievous and oft times enormous Oedema's proceede for healing whereof the Ligature must bee loosed and then the tumified parts pressed by a new rowling which must bee performed from below upwards and so by forcing the matter of the Tumor thither it may be helped for there is no other hope or way to drive the humor backe againe He which doth this forsakes the proper cure of the disease so to resist the symptome which the Surgeon shall never refuse to doe as often as any necessarie cause shall require it For this cause Hippocrates bids that the Bandages bee loosed everie three dayes and then to â—oment the part with hote water that so the humors which drawne thither by the vehemency of paine have settled in the part may be dissolved and dispersed and itching and other such like symptomes prevented The feare of all accidents being past let the Ligation bee sooner or later loosed and more slacked than it formerly was accustomed that so the blood and laudible matter wherof a Callus may ensue may flow more freely to the affected part CHAP. IIII. Of the binding up of Fractures associated with a wound IT sometimes happens that a Fracture is associated by a wound and yet for all this it is fit to binde the part with a Ligature otherwise there will be no small danger of swelling inflammation and other ill accidents by reason of the too plentifull affluxe of humors from the neighbouring parts But it is not fit to endeavour to use that kinde of binding which is performed with manie circumvolutions or wrappings about For seeing the wound must bee dressed everie day the part must each day necessarily be stirred and the Ligature consisting of so many windings loosed which thing will cause paine and consequently hinder the knitting and uniting which is performed by rest Therefore this kinde of binding may be performed by one onely rowling about the wound and that with a rowler which consists of a twice or thrice doubled cloth made in manner of a boulster and sewed with as much conveniencie as you can that it may be so large as to encompasse and cover all the wound for these reasons which shall bee delivered at large in our Treatise of Fractures But if the wound runne long-wayes let the boulsters and splints be applyed to the sides of the wound that so the lipps of the wound may bee pressed together and the contained filth pressed forth But if it be made over-thwart we must abstaine from boulsters and splints for that in Galens opinion they would dilate the wound and the purulent matter would be pressed out and cast back into the wound CHAP. V. Certaine common precepts of the binding up of Fractures and Luxations IN everie Fracture and Luxation the depressed hollow and extenuated parts such as are neere unto the joynts ought to be filled up with boulsters or cloaths put about them so to make the part equall that so they may be equally and on every side pressed by the splints and the bones more firmely contained in their seates So when the knee is bound up you must fill the ham or that cavity which is there that so the ligation may be the better and speedilier performed The same must be done under the armepits above the heele in the arme neer the wrest and to conclude in all other parts which have a conspicuous inequalitie by reason of some manifest cavitie When you have finished your binding then enquire of the patient whether the member seeme not to be bound too strait For if he say that he is unable to endure it so hard bound then must the binding be somewhat slackned For too strait binding causes paine heate defluxion a gangrene and lastly a sphacell
is betweene prone and supine for so the Wand shall lye directly under the Ell as we have read it observed by Hippocrates The reason is for that by a supine figure or situation both the bone and muscles are perverted for first for the bone the Apophysis styloides and Olecranum of the Cubit ought to be in an equall plaine and to be seated each against other which is not so in a supine figure as wherein the Processus styloides of the Cubit is set against the inner processe of the arme bone But in muscles for that like as the insertion and site of the head of a muscle is such also is the site of the belly thereof and lastly such the insertion of the tayle thereof but by a supine figure the muscles arising from the inner processe of the arme bone and bending the cubit shall have their tayle placed in an higher and more exteriour site In the interim you must not omit but that the Patients arme may with as little paine as possibly you can be bended and extended now and then lest by the too long rest of the tyed up part and the intermission of its proper function the bones of the joynt may be sowdred together by the interposition and as it were glue of the defluxion which fals abundantly into the joynt of the Ell-bow and neighbouring parts whence the stiffenesse and unmoveablenesse thereof as if there were a Callus growne there from whence it may happen that the arme thereafter may neither be bended nor extended which I have observed to have happened to many Whereof also Galen makes mention and cals this kinde of vitiated conformation Ancyle and Ancylosis If a wound also associate a fracture of the arme then see that you put about it plates of Latin or Past-bord and make a convenient Ligature and that the fragments of the bones be kept in the same state wherein they were set and restored Moreover let him lay his arme upon a soft pillow or cushion as the following Figure shewes you The figure of a fractured Arme with a wound bound up and seated as is fit CHAP. XIX Of the fracture of a Hand THe bones of the Wrest and After-wrest may bee broken but in Hippocrates opinion chiefly by that kind of fracture which is called a Sedes now if they shal happen to be broken this shal be the maner of restoring them Let the Patient lay forth his hand upon some even and smooth table then let your servant stretch forth the broken bones the work-master restore them thus extended and put them in their proper seats But being restored they must be kept in their places by such remedies as are used in other fractures to wit cerates compresses linnen clothes and splints Now the fractured fingers shall be tyed or bound to their neighbours that so they may the more easily as bound to a stake be kept in that state wherein they have been put by the hand of the Workeman But these bones seeing they are of a rare and spongie nature are in a short time and easily strengthened or knit by a Callus These things being done the hollownesse or palme of the hand shall be filled with a Tennis ball for thus the broken bones shall not only be more easily kept in their places but also the fingers themselves shall be kept in a middle posture that is not wholly open nor quite shut If they be kept in any other figure the ensuing Callus will either deprave or quite abolish that action of the hand wherby we take hold of any thing The case stands otherwise with the fractured Toes for they shall bee kept straight and even out lest they should hinder our going or standing CHAP. XX. Of the fracture of a Thigh IT is a hard thing to bring the fragments of the broken thigh together to be set by reason of the large and strong muscles of that part which whilest they are drawne backe towards their originall by a motion both naturall and convulsive they carry together with them the fragment of the bone whereinto they are inserted Therefore when as the fracture of this bone shall be restored the Patient must lye upon his back with his legge stretched forth and the Surgeon must strongly and with great force extend the thigh but if he alone shall not be able sufficiently to extend it he shall imploy two other strong attendants by whose joynt-helpe the fragments may be fitted and set each against other For this purpose when as the strength of the hand was not sufficient the Ancients used an Instrument called a Glossocomium whereof this is the figure The figure of a Glossocomium or Extender In stead of this Glossocomium you may make use of my pulley for Hippocrates in this bone when it is broken doth approve of extension so great that although by the greatnesse of the extension the ends of the fragments be somewhat distant a-sunder an emptie space being left betweene yet notwithstanding would hee have ligature made For it is not here as it is in the extensions of other bones whereas the casting about of Ligatures keeps the muscles unmoveable but here in the extended thighes the deligation is not of such force as that it may stay and keepe the bones and muscles in that state wherein the Surgeon hath placed them For seeing that the muscles of the thigh are large and strong they overcome the ligation and are not kept under by it The Surgeon in setting it shall also consider that the thigh-bone is hollowed on the inner side but gibbous on the outside therefore it must be set in its native figure Otherwise if anie unmindefull of this consideration would have it straight he shall make his Patient halt all his life after wherefore this inner and native hollownesse must be filled up and preserved by putting in a compresse or boulster spread over with unguentum rosatum or the like glutinous thing that it may not fall off for thus also the ligation shall the more faithfully keep the fragments of the bone in their places Moreover compresses shall be applied to the more slender and lesse protuberating parts of the thigh as those which are next the ham and knee that so the whole ligation may be alike and consequently the more firme Now ligatures as we formerly noted are ordained for three things The first is that the bones may bee kept in that state wherein they were set untill they be strengthened by a Callus The second is to hinder defluxion which easily fals into the broken and luxated parts both by reason of paine as also by weaknesse The third is to stay and hold fast the splints and medicines which are applied Inflammation is hindred by repressing and hindring the blood and other humours ready to flow downe from entring into the part and by pressing those humors which are preternaturally contained in the part into the neighbouring parts above and below
so to apply one on each side of the dislocated vertebrae and so with your hands to presse them against the bunching forth vertebrae untill you force them backe into their seats just after the manner you see it here delineated In the meane while have a care that you touch not the processes which stand up in the ridge of the Spine for they are easily broken You may know that the vertebrae are restored by the equall smoothnesse of the whole Spine It is fit after you have restored it to binde up the part and lay splints or plates of Lead neatly made for that purpose upon it but so that they may not presse the crists or middle processes of the vertebrae which I formerly mentioned but only the sides then the Patient shall be layd upon his backe in his bed and the splints long kept on lest the vertebrae should fall out againe CHAP. XVII A more particular inquirie of the Dislocation of the Vertebrae proceeding from an internall cause THe vertebrae are in like sort luxated by the antecedent cause as wee have formerly said which is caused by the naturall imbecillitie of the parts principally of the nervous ligament by which all the vertebrae are bound each to other this ligament comes not to the spinall marrow but onely bindes together the vertebrae on their outsides For besides the two membranes proceeding from the two Meninges of the Braine wherewith the marrow is covered there is a third strong and nervous coate put upon it lest whilest the spine is diversly bended the bended marrow should bee broken This third coate arises from the pericranium as soone as it arrives at the first vertebrae of the necke Now that Ligament wherewith we said the joynts of the vertebrae were mutually knit and fastened is encompassed with a tough and glutinous humor for the freeâ—r motion of the vertebrae Sometimes another cold crude grosse and viscide humor confused and mixed herewith by great defluxions and catarrhes begets a tumor which doth not only distend the nerves proceeding forth of the holes of the vertebrae but also distends the ligaments wherewith they are bound together which so distended and as it were drawne aside do draw together with them the vertebrae one while towards the right side another while to the left somewhiles inwards otherwhiles outwards and thus move them out of their seats and dislocate them A dislocated vertebra standing forth and making a bunch is termed in Greeke Cyphosis Those thus affected we may call Bunch-backt But when it is depressed it is named Lordosis Such we may terme Saddle-backt But when the same is luxated to the right or left side it maketh a Scoliosis or Crookednesse which wresting the spine drawes it into the similitude of this letter S. Galen addes a fourth default of the vertebrae which is when their joynts are moved by reason of the loosenesse of their ligaments the vertebrae yet remaining in their places and he cals it a Seisis or shaking They also note another defect peculiar to the Spinall marrow which is when as it the vertebrae being not moved whereto it adheres is plucked and severed from them this disease is occasioned by a fall from on high by a great stroake and by all occasions which may much shake and consequently depresse the spinall marrow or by any other meanes remove or put it forth of its place Scarce any recovers of this disease for many reasons which any exercised in the art may easily thinke upon But let us returne to the internall cause of Luxations Fluid and soft bodies such as Childrens usually are very subject to generate this internall cause of defluxion If externall occasions shall concurre with these internall causes the vertebrae will sooner be dislocated Thus Nurses whilst they too straitly lace the breasts and sides of girles so to make them slender cause the breast-bone to east its selfe in forwards or backwards or else the one shoulder to bee bigger or fuller the other more spare and leane The same error is committed if they lay children more frequently and longupon their sides than upon their backs or if taking them up when they wake they take them only by the feete or legges and never put their other hand under their backs never so much as thinking that children grow most towards their heads CHAP. XVIII Prognosticks of the Dislocated Vertebrae of the backe IF in Infancie it happen that the vertebrae of the backe shall bee dislocated the ribbs will grow little or nothing in breadth but runne outwards before therefore the chest loseth its naturall latitude and stands out with a sharpe point Hence they become asthmaticke the lungs and muscles which serve for breathing being pressed together and straitened and that they may the easâ—ier breathe they are forced to hold up their heads whence also they seeme to have great throats Now because the weazon being thus pressed the breath is carried through a strait passage therefore they whease as they breath and snort in their sleepe for that their lungs which receive and send forth the breath or ayre be of lesse bignesse besides also they are subject to great distillations upon their lungs whereby it commeth to passe that they are shorter lived But such as are bunch-backed below the midriffe are incident to diseases of the kidneyes and bladder and have smaller and slenderer thighes and legges and they more slowly and sparingly cast forth haire and have beards to conclude they are lesse fruitfull and more subject to barrennesse than such as have their crookednesse above their midriffe The Bunches which proceede from externall causes are oft times cureable but such as have their originall from an inward cause are absolutely uncureable unlesse they be withstood at the first with great care industrie Wherefore such as have it by kinde never are helped Such as whilest they are yet Children before their bodies bee come to perfect growth have their Spine crooked and bunching out their bodies use not to grow at the Spine but their legges and armes come to their perfect and full growth yet the parts belonging to their breasts and backe become more slender Neither is it any wonder for seeing the veines arteries and nerves are not in their places the spirits doe neither freely nor the alimentarie juices plenteously flow by these straitned passages whence leannesse must needs ensue but the limbs shall thence have no wrong for that not the whole bodie but the neighbouring parts onely are infected with the contagion of this evill When divers vertebrae following each other in order are together and at one time dislocated the dislocation is lesse dangerous than if one alone were luxated For when one only vertebrae is dislocated it carries the Spinall marrow so away with it that it forces it almost into a sharpe angle wherefore being more straitly pressed it must necessarily bee eyther broken or hurt which is absolutely deadly for that it is
mens shoulders or two standing posts The fifth with a Ladder The sixth with an Instrument called an Ambi. Wee will describe these sixe waies and present them to your view CHAP. XXII Of the first manner of setting a Shoulder which is with ones fist FIrst let one of sufficient strength placed on the opposite side firmly hold the Patient upon the joynt of the Shoulder lest he move up and downe with his whole bodie at the necessarie extension working and putting it in then let another taking hold of his arme above the elbow so draw and extend it downe-wards that the head thereof may be set just against its cavitie hollowed in the blade-bone Then at last let the Surgeon lift and force up with his fist the head of the bone into its cavitie Here this is chiefly to be observed that in fresh luxations especially in a bodie soft effeminate moist and not over corpulent that it sometimes comes to passe that by the only meanes of just extension the head of the bone freed from the muscles and other particles wherewith it was as it were intangled will betake it selfe into its proper cavitie the muscles being by this meanes restored to their place and figure and drawing the bone with them as they draw themselves towards their heads as it were with a sudden gird or twitch wherefore in many whilest we thought no such thing it sufficed for restitution only to have extended the arme But if the Luxation bee inveterate and the hand cannot serve then must the Patients shoulder be fastned to a Poste with the forementioned Ligature or else committed to ones charge who may stand at his backe and hold him fast Then the arme shall presently be tyed about a little above the elbow with a fillet whereto a cord shall be fastened which being put or fastened to the Pulley shall be drawne or stretched forth as much as need shall require Lastly the Surgeon with a towell or such like Ligature fastened about his necke and hanging down and so put under the Patients arme-pit neare to the Luxation shall raising himselfe upon his feete with the whole strength of his necke lift up the shoulder and also at the same time bringing his arme to the Patients breast shall set the head of the shoulder-bone forced with both his hands into its cavitie as you may see by this ensuing figure An expression of the first manner of putting a Shoulder into Joynt Then must you cover all the adjacent parts with a medicine made ex farina volatili bolo armenio myrtillis pice resina alumine beaten into powder and mixed with the white of an egge Then must the hollownesse under the arm be filled with a clew of Woollen or Cotton yarne or a linnen cloth spred over with a little oyle of Roses or Myrtles a little vinegar and unguentum rosatum or infrigidans Galeni lest it sticke to the haires if there be any there The part must afterwards be bound up with a ligature consisting of two heads of some five fingers breadth and two ells long more or lesse according as the bodie shall require The midst thereof shall be put immediately under the arme-pit and then crossed over the lame shoulder and so crossing it as much as shal be fit it shall be wrapped under the opposite arme And lastly the arme shall be layd upon the breast and put in a scarfe in a middle figure almost to right angles so that by lifting up the hand hee may almost touch his sound shoulder lest the bone newly set may fall out againe neyther shall the first dressing be stirred untill foure or five daies be past unlesse the greatnesse of some happening symptome divert us from this our purpose CHAP. XXIII Of the second manner of restoring a Shoulder that is with the heele when as the Patient by reason of paine can neither sit nor stand THe Patient must be layd with his backe on the ground upon a Cover-lid or Mat and a clew of yarne or leathern-ball stuffed with tow or cotton of such bignesse as may serve to fill up the cavitie must be put under his arm-pit that so the bone may straight-wayes the more easily be forced by the heele into its cavitie Then let the Surgeon sit beside him even over against the luxated shoulder and if his right shoulder be luxated he shall put his right heele to the ball which filled up the arme-pit but if the left then the left heele then let him forthwith draw towards him the Patients arme taking hold thereof with both his hands and at the same instant of time strongly presse the arme-pit with his heele Whilst this is in doing one shall stand at the Patients backe who shall lift up his shoulder with a towell or some such thing fitted for that purpose and also with his heele presse downe the top of the shoulder-blade another also shall sit on the other side of the Patient who holding him shall hinder him from stirring this way or that way at the necessary extension in setting it as you may see it exprest by the following figure The expression of the second manner of restoring a Shoulder CHAP. XXIV Of the third manner of restoring a Shoulder SOme one who is of a competent height and strength shall put the sharpe part of the toppe of his shoulder under the Patients arme-pit and also at the same time shall somewhat violently draw his arme towards his owne breast so that the Patients whole bodie may as it were hang thereby In the meane time another for the greater impression shall lay his weight on the luxated shoulder shaking it with his whole bodie Thus the shoulder drawne downe-wards by the one which stands under the arme-hole and moved and shaken by the other who hangs upon it may bee restored into its seat by the helpe of the Surgeon concurring therewith and with his hand governing these violent motions as the following figure shews The figure of the third manner of putting a Shoulder into Joynt CHAP. XXV Of the fourth manner of restoring a dislocated Shoulder YOu must take a perch or piece of Wood somewhat resembling that which the Water-bearers of Paris use to put on their shoulders some two inches broad and some sixe foote long in the midst hereof let there bee fastened a clew of yarne or ball of sufficient bignesse to fill up the cavitie of the arme-hole Let there be two pins put in one on each side of the ball each alike distant there-from with which as with stayes the shoulder may be kept in and upon the ball that it slip not away from it Let two strong men taller than the Patient eyther by nature or art put this perch upon their shoulders then let the Patient put his arme-pit upon that place where the ball stands up the Surgeon must be ready to pull his hanging arme downe-wards Thus the Patient shall as it were hang on the perch with his shoulder and so
formerly mentioned dislocations The arm on one side and the hand on another must be extended upon a hard resisting and smooth place so that it may lye flat and you must have a care that the part whence the dislocated bone fell bee the lower in its site and place and the part whether it is gone the higher Then to conclude the prominencies of the bones must be pressed down by the hand of the Surgeon untill by the force of compression and site the luxated bones be thrust and forced into their places and cavities CHAP. XXXVI Of the dislocated bones of the Wrest THe wrest consists of eight bones which cannot unlesse by extraordinary violence bee put or fall out of their places Yet if they shall at any time fall out they will shew it by the tumor of the part wherto they are gone and by the depression of that wherefrom they are fled They may bee restored if the diseased hand bee extended upon a table and if the bones shall be dislocated inwards the hand shall bee placed with the palme upwards then the Surgeon shall with the palme of his hand presse downe the eminencies of the bones and force each bone into its place But if the luxation bee outwards he shall lay the palme next to the table and presse it after the same manner To conclude if the luxation shall be toward either side the luxated bones shall be thrust towards the contrary and the restored bones shall be presently conteined in their places with fit remedies binding rowling and carrying the hand in a scarfe CHAP. XXXVII Of the dislocated bones of the After-wrest THere are foure bones in the Palme or After-wrest the two middlemost whereof cannot be dislocated sidewayes because they are hindred and kept from falling aside by the opposition of the parts as it were resisting them Neither can that which answereth to the little finger nor that whereon the forefinger rests bee dislocated towards that side which is next the middle bones whereof wee now spake but onely on the other side freed from the neighbour-hood of the bones but all of them may be dislocated inwardly and outwardly They may be restored as those of the Wrest CHAP. XXXVIII Of the dislocated Fingers ALso the bones of the fingers may bee foure severall waies dislocated in wardly outwardly and towards each side To restore them they must bee laid straight upon a table and so put into joint againe For thus they may bee easily restored by reason their sockets are not deepe and their joints are shorter and ligaments lesse stronge In twelve dayes space they will recover their strength as also those dislocations that happen to the Wrest and After-wrest CHAP. XXXIX Of a dislocated Thigh or Hipp. THe Thigh or Hipp may be dislocated and fall forth towards all the foure parts But most frequently inwards next to that outwards but very seldom either forwards or backwards A subluxation cannot happen in this joint as neither in the shoulder especially from an externall cause contrary to which it usually happens in the elbow hand knee and foot The cause hereof is for that the heads of the thigh and shoulder-bone are exactly round and the sockets which receive them have certaine borders and edges encompassing them hereunto may be added that strong muscles encompasse each dearticulation so that it cannot come to passe that part of the heads of such bones may bee conteined in the cavity and other parts stand or fall forth but that they will quickly bee restored to their places by the motion and wheeling about of the joint and the strength of the encompassing muscles But a subluxation may seeme to happen in these parts from an internall cause For then the ligaments and tyes being softened and relaxed cannot draw and carry back the head of the bone standing forth so far as the edges of the socket If the Hip be dislocated towards the inner part that leg becomes longer and larger than the other but the knee appeares somewhat lower and looks outwardly with the whole foote neither can the patient stand upon his leg To conclude the head of the Thigh-bone bewrayes it selfe lying in the groin with a swelling manifest both to the eye and hand now the legge is longer than that which is sound for that the head of the thigh is out of its socket or cavity and situated lower to wit in the groin therefore the leg is made by so much the larger Now the knee stands forth because necessarily the lower head of the thigh-bone stands contrary to the socket For this is common to all dislocated bones that when as the dislocation happens towards the one side the other end of the bone flyes out to the contrary Whence it is that if the upperhead of the Thigh-bone shall fall inwards then the other head which is at the knee must necessarily looke outwards The like happens in other dislocations The leg cannot be bended towards the groine for that the dislocated bone holds the extending muscles of the same part so stiffely stretched out that they cannot yeeld or apply themselves to the benders For flexion or bending ought to precede extension and extension flexion CHAP. XL. Prognosticks belonging to a dislocated Hipp. THere is this danger in the dislocations of the Hipp that either the bone cannot bee put into the place againe at least unlesse with very much trouble or else being put in that it may presently fall out againe For if the tendons of the muscles the ligaments and other nervous parts of the member be hard and strong they by reason of their contumacy and stiffenesse will hardly suffer the bone to returne to its place If that they bee soft loose effeminate and weake they will not containe the restored bone in its place Neither will it be any better contained if that short but yet strong and round ligament which fastens the head of the Thigh-bone on the inside in the Socket or Cavity of the huckle bone bee broken or relaxed Now it may be broken by some violent shocke or accident it may bee relaxed by the congestion and long stay of some excrementitious tough and viscous humour lying about the joint through which meanes it waxeth soft But if it be broken how often soever the bone be restored it will presently fall out againe If it bee relaxed there is onely this hope to containe the restored bone that is to consume and draw away the heaped up humidity by application of medicines and Cauteries of both kindes for which purpose those are more effectuall which doe actually burne for that they dry and strengthen more powerfully Leanenesse of the body and the want of Aponeuroses that is of broad tendont and externall ligaments wherof many encompasse the knee encreases the difficulty of containing it in the place But the parts adjoyning to the dislocated not set bone fall away by little little and consume with an Atrophia or
thigh lyeth towards the share whence the groines swell up and the buttocke on the contrary is wrinkled and extenuated by reason of the contraction of the muscles the patient cannot extend his leg without paine no verily not so much as bend it towards the groine for that the fore muscle which ariseth from the haunch-bone is so pressed by the head of the thigh that it cannot be distended neither can the ham be bended without very much paine But the lame legge is equall at the heel with the other leg yet the patient cannot stand upon the setting on of the toes therefore when he is forced to goe hee toucheth the ground with his heel only yea verily the sole of his foot is lesse inclined to the fore side neither doth it seldome happen that the urine by this accident is supprest because the head of the thigh oppresses the greater nerves from whence those arise which are carryed to the bladder which through the occasion of this compression is pained and inflamed by consent now when inflammation shall seaze upon the Sphinct muscle the urine can scarcely flow out for that it is hindred by the swelling CHAP. XLIII Of the thigh-bone dislocated backwards SEldome also is the thigh-bone dislocated backwards because the hind part of the cavity of the huckle-bone is deeper and more depressed than the fore whence it is that the dislocation of the thigh to the inner part is more frequent than the rest The patient can neither extend nor bend his legge by reason of the much compression and tension of the muscles which encompasse the head of the thigh by this kind of luxation But the pain is encreased when he would bend his ham for that then the muscles are the more strongly extended The lame leg is shorter than the sound when the Buttocks are pressed the head of the thigh is perceiued hid amongst the muscles of that part but the opposite groine is laxe soft and deprest with a manifest cavity The heele touches not the ground for that the head of the thigh is plucked backe againe by the muscles of the buttocks amongst which it lyeth hid but principally by that which is the larger and which is said to make as it were the pillow or cushion of the buttocks for this is much more pressed in this kinde of dislocation than the rest whence it is that the patient cannot bend his knee because the extension of the nervous production or large tendon which covers the knee is so great But if the patient will stand upon the foot of his luxated legge without a staffe he shall fall down backwards for that the body is inclined to that part the head of the thigh being not directly underneath for the propping or bearing up of the body wherefore he is forced to sustaine himselfe upon a crutch on his same side Having premised these things of the differences signes symptomes and prognosticks it now remaineth that we briefly describe the different wayes of restoring them according to the difference of the parts whither it is fallen First you must place the patient upon a bench or table groveling or with his face upwards or upon one side laying some soft quilt or coverlid under him that he may lye the easier Now you must place him so that the part unto which the bone is flown may be the higher but from whence it is fled the lower For if the thigh-bone bee dislocated outwards or backwards then must the patient bee laid groveling if inwardly upon his backe if forwards then upon his side Then must extension and impulsion be made towards the cavity that so it may bee forced thereinto but if the dislocation be fresh in a soft body as a woman childe and such like whose joynts are more laxe it shall not bee any waies needefull to make great extension with strong ligatures for the restoring it the Surgeons hand shall suffice or a List or towell cast about it In the interim the bone shall bee kept fast with compresses applyed about the joynt then the Surgeon shall extend the thigh taking hold thereof above the knee in a straight line and so set it directly against the cavity and then presently thrust it thereinto For thus shall he restore it if so bee that in thrusting it hee lift up the head thereof somewhat higher lest the lips of the cavity force it backe and hinder it from entring Now because unlesse there bee just extension there can be no restitution hoped for it is farre better in that part that is to extend it somewhat more than is necessary yet so that you doe not endanger the breaking of any muscles tendon or other nervous body For as Hippocrates writes when as the muscles are strong and large you may safely extend them if so be that you displace nothing by the force of the extension If your hand will not suffice to make just extension you must use the helpe of an Engine such as is our Pulley fastened to two postes so much of the rope being let forth and drawn up again as shall suffice for the businesse in hand in the performance whereof it is fit that the patients friends absent themselves from this sad spectacle and that the Surgeon bee resolute and not deterred from his businesse by no lamentation neither of the patient nor his friends But for that we write these things chiefely for the benefit of young practicioners it seemeth meet that having delivered these things in general of restoring the thigh-bone that we run over these generalities in each particular beginning with that dislocation which is made inwardly CHAP. XLIV Of restoring the Thigh-bone dislocated inwards IT is fit to place the patient after the foresaid manner upon a table or bench in the midst wherof shall stand fastned a woodden pin of a foots length and as thick as the handle of a spade useth to be but it must be wrapped about with some soft cloth lest the hardnesse hurt the buttocks betwixt which it must stand as we read that Hippocrates did in the extension of a broken leg The woodden pin hath this use to hold the body that it may not follow him that draweth or extendeth it that the extension being made as much as is requisie it may go between the perinaeum the head of the dislocated thigh For thus there is no greatneed of counter-extension towards the upper parts and besides it helpeth to force back the bone into its cavity the help of the Surgeon concurring who twining somewhiles to this otherwhiles to that side doth direct the whole work But when the extension hath need of counter-extension then it is needfull you have such ligatures at hand as we have mentioned in the restoring of a dislocated shoulder to be drawn above the shoulder One of these shall be fastned above the joynt of the hip extended by a strong man another shal be cast above the knee by
and bignesse which is greater in a sanguine and phlegmatick than in the rest by the change and lastly by things helping and hurting And there bee some who for the knowledge of these differences wish us to view the patients urine and feele their pulse and consider these excrements which in each particular nature are accustomed to abound or flow and are now suddenly and unaccustomarily supprest For hence may be taken the signes of the dominion of this or that humour But a more ample knowledge of these things may be drawne from the humours predominant in each person and the signes of tumours formerly delivered Onely this is to be noted by the way that the gout which is caused by melancholy is rare to be found CHAP. VIII Prognosticks in the Gout BY the writings of Physitians the paines of the gout are accounted amongst the most grievous and acute so that through vehemency of pain many are almost mad and wish themselves dead They have certain periods and fits according to the matter and condition of the humour wherein this maligne and inexplicable gouty virulency resides Yet they more frequently invade in the Spring and Autumne such as have it hereditarie are scarce ever throughly free therefrom as neither such as have it knotty for in the former it was borne with them and implanted and as it were fixed in the originall of life but in the other the matter is become plaister-like so that it can neither be resolved nor ripened that which proceeds from a cold and pituitous matter causeth not such cruell tormenting pain as that which is of a hot sanguine or cholerick cause neither is it so speedily healed for that the hot and thin matter is more readily dissolved therefore commonly it ceaseth not untill fourty dayes bee past besides also by how much the substance of the affected part is more dense and the expulsive facultie more weake by so much the paine is more tedious Hence it is that those gouty paines which molest the knee heele and huckle bone are more contumacious The gout which proceeds of a hot matter rests not before the fourteenth or twentieth day That which is occasioned by acride choler by the bitternesse of the inflammation and pain causeth a difficulty of breathing raving and sundry times a gangrene of the affected part and lastly death and healed it often leaves a palsie behinde it Amongst all the gouty paines the Sciatica challengeth the prime place by the greatnesse of the paine and multitude of symptomes it brings unquietnesse and watching a feaver dislocation perpetuall lamenesse the decay of the whole legge yea and often times of the whole body Now lamenesse and leannesse or decay of the part are thus occasioned for that the decurrent humour forceth the head of the thigh-bone out of the cavity of the huckle-bone this being forced out presseth the muscles veines arteries and that notable and large nerve which runs alongst the thigh even to the furthest joynts of the toes and by the way is diversly dispersed over the muscles of the whole leg Therefore because the head of the thigh is put out of its place the patient is forced to halt because the vessels and nerves are oppressed the nourishment and spirits doe not freely flow into the parts thereunder whence proceeds their decay Yet it sundry times happens that the head of the thigh being not displaced many halt because the viscide humour which is naturally implanted in that place and continually flowes thither both for the nutrition of these parts and the lubrication of the joynt for quicker motion is hardened by heat and idlenesse and the other unprofitable humours which flow downe do there concrete and so intercept the liberty of motion A grosse and viscide humour into what joint soever it falleth and stayeth doth the same For by concretion it turnes into a plaister like nature at or neare the joynt possessing the cavities thereof and it depraveth the figure of the part making it crooked and knotted which formerly was streight and smooth Furthermore every distemperature caused by the defluxion of humours if it shall lye long upon any part depraves all the actions and oft-times wholly abolisheth them so that there may bee three causes of the leanenesse or decay of the joint by the gout the obstruction or compression of the vessels idlenesse and a hectick distemper but two of lamenesse dislocation and the concretion of an adventitious humour impact in the joynt If contrary to custome and reason the paines of the gout doe not goe away or returne at their accustomed periods most grievous and dangerous diseases thereon follow for the matter accustomed to flow downe into the joints if it seaze upon the substance of the liver causes a Phlegmon if it stay in the larger veines a continuall feaver if it flow into the membrane investing the ribs a Pleurisie if it betake it selfe to the guts and adhere to their coats the Collick or illiaca passio and to conclude it produceth divers other symptomes according to the diversity of the parts whereto it flowes and abides For thus sundry that have beene troubled with the gout become paralitick because the matter which formerly flowed downe into the joints stayes in the substance and pores of the nerves and so hinders the spirit that it cannot freely in its whole substance passe though them hence therfore comes the resolution of the part whereinto the nerve is inserted Old men can never be quite or absolutely cured of the gout for that the masse of their bloud is so departed from its primary native goodnesse that it can no more bee restored than dead or sowred wine The gout which proceeds from a cold cause invadeth slowly and by little and little and is helped by the use of hot things that which is from a hot matter quickly shewes it selfe and is helped by the use of cold things Now although the gout more frequently returnes in the spring and fall yet it comes in the midst of winter the nerves being weakened by the excesse of cold and the humours pressed out otherwhiles in the midst of summer the same being diffused and dissipated Lastly it comes at any time or season of the year if those who are subject to this disease feed plenteously and do all things according to their owne mindes and desire Those who are troubled with the gout feele and perceive change of weather stormes raines snowes windes and such like before they come A southerly constitution of the aire for example fils the body with humidities and stirs up the humours that lye quiet in the body and therefore cause defluxions upon the weaker parts such as the joints both by nature as being without bloud and flesh as also by accident for that they a long time have been accustomed to bee so tormented therefore their paines are increased in a wet season Many of these that are troubled with the gout desire venery in the
thought to comfort the stomack and citron seeds to defend the heart from malignity liquerice to smooth the throat and hinder hoarsnesse and cause sweat But these things shall be given long after meat for it is not fit to sweat presently after meat some there bee who would have the child wrapped in linnen clothes steeped in this decoction being hot and afterwards hard wrung forth Yet I had rather to use bladders or spunges or hot bricks for the same purpose certainly a decoction of millet figges and raisons with some sugar causeth sweat powerfully Neither is it amisse whilest the patient is covered in all other parts of his body and sweats to fan his face for thus the native heat is kept in so strengthened and fainting hindred and a greater excretion of excrementitious humours caused To which purpose you may also put now and then to the patients nose a nodulus made with a little vinegar water of roses camphire the powder of sanders and other odoriferous things which have cooling faculty this also will keepe the nose from pustles CHAP. III. What parts must be armed against and preserved from the Pocks THe eyes nose throte lungs and inward parts ought to be kept freer from the eruption of pustles than the other parts for that their nature and consistence is more obnoxious to the malignity of this virulency and they are easilyer corrupted and blemished Therefore lest the eyes should be hurt you must defend them when you first begin to suspect the disease with the eye-lids also moistening them with rose-water verjuice or vinegar and a little Camphire There are some also who for this purpose make a decoction of Sumach berbery-seeds pomgranate pills aloe sand a little faffron the juice of sowre pomgranates and the water of the whites of egges dropped in with rose-water are good for the same purpose also womans milke mixed with rose-water and often renewed and lastly all such things as have a repercussive quality Yet if the eyes bee much swolne and red you shall not use repercussives alone but mixe therewith discussers and cleansers such as are fit by a familiarity of nature to strengthen the sight and let these bee tempered with some fennell or eye-bright water Then the patient shall not looke upon the light or red things for feare of paine and inflammation wherefore in the state of the disease when the pain and inflammation of the eyes are at their height gently drying and discussive things properly conducing to the eyes are most convenient as washed aloes tuttye and Antimonie in the water of fennell eye bright and roses The formerly mentioned nodulus will preserve the nose and linnen clothes dipped in the fore-said astringent decoction put into the nosthrils and outwardly applyed We shall defend the jawes throate and throttle and preserve the integrity of the voice by a gargle of oxycrate or the juice of sowre pomgranates holding also the grains of them in their mouths often rouling them up down therein as also by nodula's of the seeds of psilium quinces the like cold astringent things We must provide for the lungs respiration by syrupes of jujubes violets roses white poppyes pomgranats water-lillies and the like Now when as the pocks are throughly come forth then may you permit the patient to use somewhat a freer dier and you must wholly busie your selfe in ripening and evacuating the matter drying and scailing them But for the meazels they are cured by resolution onely and not by suppuration the pocks may bee ripened by annoynting them with fresh butter by fomenting them with a decoction of the roots of mallowes lillies figs line-seeds and the like After they are ripe they shall have their heads clipped off with a paire of sizzers or else bee opened with a golden or silver needle lest the matter conteined in them should corrode the flesh that lyes thereunder and after the cure leave the prints or pockholes behinde it which would cause some deformity the pus or matter being evacuated they shall be dryed up with unguent rosat adding thereto cerusse litharge aloes and a little saffron in powder for these have not onely a faculty to dry but also to regenerate flesh for the same purpose the floure of barly and lupines are dissolved or mixed with rose-water and the affected parts annoynted therewith with a fine linnen ragge some annoint them with the swathe of bacon boiled in water and wine then presently strow upon them the floure of barly or lupines or both of them Others mixe crude hony newly taken from the combe with barly floure and therewithall annoint the pustles so to dry them being dryed up like a scurfe or scab they annoint them with oyle of roses violets almonds or else with some creame that they may the sooner fall away the pustles being broken tedious itchings sollicite the patients to scratch whence happens excoriation and filthy ulcers for scratching is the occasion of greater attraction Wherfore you shall bind the sick childs hands and foment the itching parts with a decoction of marsh mallowes barly and lupines with the addition of some salt But if it bee already excoriated then shall you heale it with unguent albumcamphorat adding thereto a little powder of Aloes or Cinnabaris or a little desiccativum rubrum But if notwithstnding all your application of repelling medicines pustles neverthelesse break forth at the eyes then must they be diligently cured with all manner of Collyria having a care that the inflammation of that part grow not to that bignes as to break the eies that which somtimes happens to drive them forth of their proper orbes If any crusty ulcers arise in the nosthrils they may be dryed and caused to fall away by putting up of oyntments Such as arise in the mouth palate and throat with hoarsenesse and difficulty of swallowing may be helped by gargarismes made with barly water the waters of plantaine and chervill with some syrupe of red roses or Diamoron dissolved therein the patient shall hold in his mouth sugar of roses or the tablets of Elect. diatragacanth frigid The Pock-arres left in the face if they bunch out undecently shall be clipped away with a paire of sizzers and then annointed with fresh unguent citrin or else with this liniment â„ž amyli triticei amygdalarum excorticatarum an Ê’iss gum tragacanth Ê’ss seminis melonum fabarum siccarum excorticat farinae hordei an â„¥ iiii Let them all bee made into fine powder and then incorporated with rose-water and so make a liniment wherewith anoynt the face with a feather let it bee wiped away in the morning washing the face with some water and wheat bran hereto also conduceth lac virginale Goose ducks and Capons grease are good to smooth the roughnesse of the skin as also oile of lillies hares bloud of one newly killed and hot is good to fill and plaine as also whiten the Pock-holes
portion of the nostrils from the nose it cannot bee restored or joyned againe for it is not in men as it is in plants For plants have a weake and feeble heate and furthermore it is equally dispersed into all the substance of the plant or tree neither is it easie to be consumed or wasted for when the boughes or branches of trees are broken torne or cut away they live neverthelesse and will grow againe when they are set or grafted neither is there any seate for the heart rightly prepared in them from whence the heat must necessarily run and disperse it selfe continually into all the parts thereof But contrariwise the separated parts of more perfect living creatures as of men are incontinently deprived of life because they have their nourishment life sense and whole sustentation not of themselves by faculties flowing or comming unto them from some other parts neither are they governed by their own heat as plants but by a borrowed heat so that above or beside the naturall faculty of the liver another vitall faculty commeth unto it from the heart Wherefore in stead of the nose cut away or consumed it is requisite to substitute another made by Art because that nature cannot supply that defect this nose so artificially made must be of gold silver paper or linnen clothes glewed together it must bee so coloured counterfeited and made both of fashion figure and bignesse that it may as aptly as is possible resemble the natural nose it must be bound or stayed with little threeds or laces unto the hinder part of the head or the hatte Also if there be any portion of the upper lip cut off with the nose you may shadow it with annexing some such thing that is wanting unto the nose and cover it with the haire on his upper lippe that he may not want any thing that may adorne or beautifie the face Therefore I have thought it necessary to set downe the figure or forme of both these kindes The forme of a nose artificially made both alone by it selfe and also with the upper lip covered at it were with the haire of the beard There was a Surgeon of Italy of late yeares which would restore or repaire the portion of the nose that was cut away after this manner Hee first scarified the callous edges of the maimed nose round about as is usually done in the cure of hare-lips then he made a gash or cavity in the muscle of the arme which is called Biceps as large as the greatnesse of the portion of the nose which was cut away did require And into that gash or cavity so made he would put that part of the nose so wounded bind the patients head to his arm as if it were to a poast so fast that it might remain firme stable and immoveable and not leane or bow any way and about forty dayes after or at that time when he judged the flesh of the nose was perfectly agglutinated with the flesh of the arm he cut out as much of the flesh of the arme cleaving fast unto the nose as was sufficient to supply the defect of that which was lost then he would make it even bring it as by licking to the fashion forme of a nose as near as art would permit in the mean while he did feed his patient with ponadoes gellies all such things as were easie to be swallowed digested And he did this work of curing the place where the flesh was so cut out only with certain balmes agglutinative liquors A younger brother of the family of St. Thoan being weary of a silver nose which being artificially made he had worn in the place of his nose that was cut off went to this Chirurgian into Italy by the means of the fore-named practice he recovered a nose of flesh againe to the great admiration of all those that knew him before This thing truly is possible to be done but it is very difficult both to the patient suffering and also to the Chirurgian working For that the flesh that is taken out of the arme is not of the like temperature as the flesh of the nose is also the holes of the restored nose cannot be made as they were before CHAP. III. Of the Placing of teeth artificially made in stead of those that are lost or wanting IT often times happeneth that the fore teeth are moved broken or stricken out of their places by some violent blow which causeth deformity of the mouth and hinders plain pronunciation Therfore when the jaw is restored if it were luxated or fractured and the gums brought unto their former hardnesse other teeth artificially made of bone or Ivory may bee put in the place of those that are wanting and they must bee joyned one fast unto another and also so fastened unto the naturall teeth adjoyning that are whole and this must chiefly bee done with a thread of gold or silver or for want of either with a common thread of silke or flaxe as it is declared at large by Hippocrates and also described in this figure following The figure of teeth bound or fastned together CHAP. IIII. Of filling the hollownesse of the Pallat. MAny times it happeneth that a portion or part of the bone of the pallat being broken with the shot of a gun or corroded by the virulency of the Lues venerea falls away which makes the patients to whom this happeneth that they cannot pronounce their words distinctly but obscurely and snuffling therefore I have thought it a thing worthy the labour to shew the meanes how it may be helped by art It must be done by filling the cavity of the pallat with a plate of gold or silver a little bigger than the cavity its selfe is But it must bee as thick as a French Crowne and made like unto a dish in figure and on the upper side which shall be towards the braine a little spunge must bee fastened which when it is moistened with the moysture distilling from the brain will become more swolne and puffed up so that it will fill the concavity of the pallat that the artificiall pallat cannot fall down but stand fast and firme as if it stood of it selfe This is the true figure of those instruments whose certain use I have observed not by once or twice but by manifold triall in the battel 's fought beyond the Alpes The figure of plates to fill or supply the defects of the Pallat. The figure of another plate for the Pallat on whose upper side there is a button which may be turned when it is put into the place with a small Ravens bill like this whose figure is here expressed CHAP. V. How to helpe such as cannot speake by reason of the losse of some part of the tongue CHance gave place and authority to this remedy as to many other in our art A certaine man dwelling in a village named Yvoy le Chastean being
wrapped them in Cotton cloathes glewed together with a certaine gumme then their kinsemen placed them thus ordered in a wooden Coffinne carved like to a man This was the sacred and accustomed rite of embalming and burying dead bodyes amongst the Aegyptians which were of the richer sort Our Countrie-men the French stirred up with the like desire embalme the bodyes of their Kings and Nobles with spices and sweete oyntments Which custome they may seeme piously and christianly to have taken from the Old and New Testament and the ancient and laudible custome of the Iewes for you may reade in the New Testament that Ioseph bought a fine linnen cloath and Nicodemus brought a mixture of myrrhe and Aloes about 100. pound weight that they might embalme and bury the body of Iesus Christ our Saviour for a signe and argument of the renovation and future integrity which they hoped for by the resurrection of the dead Which thing the Iewes had received by tradition from their ancestors For Ioseph in the old Testament commaunded his Physitions they should embalme the dead body of his father with spices But the body which is to be embalmed with spices for very long continuance must first of all be embowelled keeping the heart apart that it may bee embalmed and kept as the kinsfolkes shall thinke fit Also the braine the scull being divided with a saw shall be taken out Then shall you make deepe incisions alongst the armes thighes legges backe loynes and buttockes especially where the greater Veines and Arteries runne first that by this meanes the blood may be pressed forth which otherwise would putrifie and give occasion and beginning to putrefaction to the rest of the body and then that there may be space to put in the aromaticke powders the whole body shall be washed over with a spunge dipped in Aqua vitae and strong vinegar wherein shall be boyled wormewood aloes coloquintida common salt and Alume Then these incisions and all the passages and open places of the body and the three bellyes shall be stuffed with the following spices grossely powdered R. pul rosar chamaem melil balsami menthae aneâ—hi salviae lavend rorismar majoran thymi absinthij cyperi calami aromat gentianae ireos florent assae odoratae caryophyll nucis moschat cinamoni styracis calamitae benjoini myrrhae aloes santal omnium quod sufficit Let the incisions be sowed up and the open spaces that nothing fall out then forth with let the whole body be anointed with Turpentine dissolved with oyle of roses and Chamomile adding if you shall thinke it fit some Chymicall oyles of spices and then let it be againe strewed over with the forementioned powder then wrap it in a linnen cloath and then in ceare-cloathes Lastly let it be put in a Coffin of Lead sure soudred and filled up with dry sweete hearbes But if there be no plenty of the forementioned spices as it usuall happens in beseiged townes the Chirurgion shall be contented with the powder of quenched lime common ashes made of Oake wood For thus the body being over and above washed in strong vinegar or Lie shall be kept a long time if so be that a great and dissolving heate doe not beare sway or if it be not put in a hot and moyst place And this condition of time and place is the cause why the dead bodyes of Princes and Kings though embalmed with Art and cost within the space of sixe or seaven dayes in which they are kept to bee shewed to the people after their embalming doe cast forth so greevous a sent that none can endure it so that they are forced to be put in a leaden Coffinne For the ayre which encompasseth them groweth so hot by reason of the multitude of people flowing to the spectacle and the burning of lights night and day that the small portion of the native heate which remaineth being dissipated they easily putrefie especially when as they are not first moystened macerated in the liquor of aromaticke things as the Aegyptians anciently used to doe steeping them in brine for 70 dayes as I formerly told you out of Herodotus I put in minde hereby use that so the embalming may become the more dureable to steepe the bodyes being embowelled and pricked all over with sharpe bodkinnes that so the liquor hindring putrefaction may penetrate the deeper into them in a woodden tubbe filled with strong vinegar of the decoction of aromaticke and bitter things as Aloes Rue Wormewood and Coloquintida and there keepe them for twenty dayes pouring thereinto eleven or twelve pinâ—s of Aqua vitae Then taking it forth and setting it on the feete I keepe it in a cleare and dry place I have at home the body of one that was hanged which I begged of the Shriffe embalmed after this manner which remaines sound for more than 25 yeeres so that you may tell all the muscles of the right side which I have cut up even to their heads and plucked them from those that are next them for distinctions sake that so I may view them with my eyes and handle them with my hands as often as I please that by renuing my memory I may worke more certainely and surely when as I have any more curious operation to be performed the left side remaines whole and the Lungs Heart Diaphragma stomacke spleene kidneyes beard haires yea and the nailes which being pared I have often observed to grow againe to their former bignesse And let this be the bound of this our immense labour and by Gods favour our rest to whom Almighty all powerfull immortall and invisible be ascribed all honour and glory for ever and ever Amen Labor improbus omnia vincit The end of the Treatise of reports and embalming the dead THE APOLOGIE AND TREATISE CONTAINING THE VOYAGES MADE INTO DIVERS PLACES BY AMBROSE PARE of Laval in Maine Counsellor and cheefe Chirurgion to the King THE TVVENTI NINTH BOOKE TRuely I had not put my hand to the penne to write on such a thing were it not that some have impudently injured taxed and more through particular hatred disgraced me than for zeale or love they beare to the publicke good which was concerning my manner of tying the Veines and Arteries writing thus as followeth Malè igitur nimiùm arrogdnter inconsultus temerarius quidam vasorum ustionem post emortui membri resectionem a veteribus omnibus plurimùm commendatam semper probatam damnare ausus est novum quendam deligandi vasa modum contra veteres omnes medicos sine ratione experientia judicio docere cupiens nec animadvertit majora multo pericula ex ipsa vasorum deligatione quam acu partemsanam profunde transfigendo administrari vult imminere quà m ex ipsa ustione Nam si acu nervosam aliquam partem vel nervum ipsum pupugerit dum ita novo inusitato modo venam absurde conatur constringere nova inflammatio necessariò
kinds 982. by the craft of the Devil 985. Of the Sea 1001. 1002. c. Morse Sea-calfe or Elephant 1005. 1006 Mortification and the signes thereof 475 Mother see Womb. Mothers fittest to nurse their own children 907. their milk most familiar to them ib. Motion which voluntary 25. taken for all manner of exercise 34 Mouth and the parts therof 193. the ulcers and their cure 478. how to prevent heal them in cure of the Lues venerea 735 Mummie frequently used in contusions 447. not good therein 448 Mundificatives 1043 Muscles what 92. their differences and whence taken 93 c. their parts 95. a further enquirie into the parts of them 96. Muscles of the Epigastrium 97. of the fundament 106. of the testicles 120. of the bladder 124. of the yard 125. the broad muscle 180. that open and shut the eye ibid. of the eye 182. of the nose 186. of the face ibid. of the lower jaw 188. of the bone Hyoides 191. of the tongue 192. of the Larinx 194. of the Epiglottis 195. of the neck 199. of the chest loines 205 206. 207. of the shoulder-blade 207. of the arme 214. of the cubit 217. moving the hand 220. of the inside of the hand 222. moving the thigh 229. of the legge 232. moving the foot 237. of the toes 238. An epitome or briefe recitall of all the muscles 244. 245. Musculous skinne of the head 160. the wounds thereof and their cure 360. Musculosae venae 117. Arteriae 153. Mushromes their hurtfull and deadly quality and the cure 805. Musicke the power thereof 49. Mydriasis a disease of the eye the cause and cure 650. N. NAiles why added to the fingers 209. why grow continually ibid. whence generated 220. Napellus the poysonous quality cure 805 Narcotickes 257. cautions in their use 264 improperly termed Anodines 1048. Nata what 272. Nates 168. Nature oft doth strange things in curing diseases 385. Naturall parts and their division 84. Naturall see Things Faculties Actions Navell what the figure and composure 133. the generation thereof 891. the relaxation thereof in children 959. the swelling or standing forth thereof 303. the cure 304. Nautilus or sayling-fish 1011. Neck the parts therof 196. the wounds thereof 386. the dislocation therof 603. Necrosis or mortification 457. Nerves what 96. their distribution to the naturall parts 115. of the sixth conjugation and their distribution 152. Ramus costalis ib. recurrens ib. stomachicus 153. their seven conjugations 170. Nerves of the neck back and armes 212. of the loines holy-bone and thigh 226. Nerves and nervous parts their wounds 399. their cure 400. Night-shade the deadly night-shade his poysonous quality and the cure 805. Nightingales sing excellently 72. Nipples 138. how to help their soreness 912 Nodus what 272. Nodules their forme and use 1053. Northren people how tempered 20. Nose and the parts thereof 186. the wounds thereof 384. their cure ib. how to supply the defect thereof 871. the ulcers thereof 477. their cure ib. the fracture 567. Nurses their error in binding and lacing of children 606. they may infect children with the Lues venerea and be infected by them 724. participate their diseases to their children 907. the choice of them 908. 909. of their diet and other circumstances 910. Nutrition what 22. 24. Nymphae 130. O. OBlique descendent muscles 97. ascendent muscles 98. Obliquator externus musculus 221. Obturatores musculi 230. Oedema what 267. which tumors referr'd thereto 254. the differences thereof 267. the causes ib. signs prognosticks cure 268 Oesophagus or Gullet the substance attractive force c. thereof 157. the magnitude figure site temper and action 158. Oile of whelps the description and use therof 409. 423. it helps forward the scailing of bones 751. Oiles and the severall making of them 1054. 1055. 1102. by distillation 1103. out of gums 1106. 1107. Ointments their differences descriptions and use 1056. 1057. 1058. Old age and the division thereof 9. it is a disease 32. Old wives medicines 991. Olecranum what 217. Omentum or the Kâ—ll the substance magnitude figure and composure thereof 101. the connexion temper and twofold use 102. it somtimes hinders conception ibid. Operations of Surgery of what nature 4. why some which are mentioned by the Antients are omitted by our Author 1138. 1139. Opium why not used in poysoning 806. the symptomes caused by it and their cure ib. Order to bee observed in eating our meate c. 33. in lying to sleepe 34. Organicall parts which 81. What observable in each of them ibid. Orifices of the heart 146. Orpiment the poysonous quality thereof and the cure 810. Os ossa occipitis 162. Basiliare ibid. Coronale ib. Bregmatis sive parietalia ib. Petrosa ibid. Cuneiforme sive sphenoides ib. Ethmoides cribrosum seu spongiosum ibid. Zygoma sive jugale 178. Hyoides ypsiloides c. 191. Sesamoidia 220. Ilium 227. Ischium ibid. Pubis 228. Innominata 234. See Bones Ozaena a filthy ulcer of the nose the cause and cure 477. P. PAine and the causes thereof 250. It must be asswaged 256. The discommodities thereof 257. In wounds how helped 329. Pallate the nerves holes and coat thereof c. 193. How to supply the defects thereof 873. Palmaris musculus 222. Palsie the differences causes c. thereof 332. The cure 333. Followes upon wounds of the necke 386. Pancreas the substance site c. thereof 109. The tumours thereof 929. Pannicle see Fleshy Pappe how to be made for children 911. and the condition thereof ibid. Paracentesis and the reasons for and against it 301. The place where and manner how 302. Parassoupi a strange beast 1018. Parastates their substance c. 120. Paronychia what 314. The cure ibid. Parotides their site and use 191. Their difference prognosticke cure c. 291. 292. Partridge their care of their young 60. Parts similar 81. Organicall ibid. Instrumentall 82. Things considerable in each part ibid. Principall parts which and why so called ibid. Of generation 82. 886. distinguished into three 83. The containing parts of the lower belly 87. Of the chest 137. Passions of the minde their force 39. They helpe forward putrefaction 820. Pastinaca marina or the sting-Ray 802. Patella what 231. Pectoralis musculus 208. Pedium what 234. Pediosus musculus 238. Pelvis the site and use thereof 168. Pericardium and the history thereof 143. Pericranium what and the use thereof 160. Perinaeum what 125. Periostium 160. Peritonaeum the substance and quantity thereof 100. The figure composure site use c. 101. Perone 231. Peronaeus musculus 237. Perturbations of the minde see Passions Pessaries their forme and use 1053. 1054. Pestilence see Plague Pestilent feaver how bred 837. Pharinx what 194. Phlebotomy the invention thereof 56. Necessary in a Synochus putrida 261. The use scope c. thereof 691. How to be performed 693. See Blood-letting Phlegme the temper thereof 11. is blood halfe concocted 13. Why it hath no proper receptacle ibid. The nature
The compound or organicall parts Foure particles to be observed in â—aâ—â— organicall paâ—â— Foure sorts of instrumentall parts Nine things to be considered in each part Why the three principall parts are so called 〈◊〉 de Artâ— medica The use and function of the parts serving for generation What the soulâ— is and with how many faculties it is endewed All the parts of mans body are distinguished into three What parts are here called Animall Lib. 6. Epidem What parts are called vitall The devision of the animall parts The devision of the vitall parts The devision of the naturall parts The vulgar division of mans body Why the belly is not bony The devision of the lower belly The Hypochondria A most certaine note of the part affected by the place where the paine is The containing parts of the lower belly The skinne twofold From what parts the skin cannot be separated The matter of the Cuticle The quantitie The figure The composure The number The temperatuer The use Why the cuticle cannot be restored in scars The substance Magnitude Figure Composure The skinne of it selfe is void of sense The number Connexion Temperature Vse The reason why the skin is blacker and rougher in Winter What a membrane is Why it is sometimes called a coate sometimes the fleshie and fattie Pannicle Why beasts have this pannicle wholy fleshie or musculous The substance The magnitude and figure Number Composure The temperature The use The fat is rather an excrement than a part The substance The efficient cause of fat The quantity The composure The site * I was presâ—…at the opening a body Feb 1630 〈◊〉 which the â—at in the lower part of the lower belly was in thicknesse above 8 inchâ—s upon the brest betweene a and 5 nche whichâ— I thought good to remember in this place both for the rarity of the thing as also because it was encreased by report and the place mâ—staken some saying the Oâ—…um or Call was so thicke which was false for it did not much exceed the quantity of that part in other faâ—men The Temper The use The solider fat or seame In what parts and for what cause the fat is more dense The substance The quantity The Composure The Original The number The site The use What the white lime is What a Muscle is How the circular motion is performed From whence the differences of muscles are drawne Differences of muscles from their substance Differences of Muscles from their original Where a muscle hath its originall Differences of muscles from their insertion Differences of muscles taken from their figure Differences from their perforations From their magnitude From their Colour From their site From their fibers From thire connexion From their head From their belly From their Tendons From their Action From their function The compound simple 〈◊〉 of a muscle What use each simple particle hath in a muscle The nature of a Ligament The three fold use of a Ligament What a nerve is What wee meane by the nervous and Ligamentous fibers By what power the simular parts principally draw or attract What and of how many sorts the flesh is What a vein is What an artery is Why an Artery is more thicke and dense than a veine The mutuall Anastomosis of the veines and arteryes Where it is manifest From whence a muscle hath its beginning or head eight muscles of the Epigastrium The Oblique descendant Their substance Their greatnesse and figure Their composur and fite Their connexion Their temperament Their action The oblique ascendant Their site and connexion Their Action The right muscles of the Epigastrium Their site Originall The meeting together of the Epigastrick and mamillary veines and arteryes Their action Their use The Pyramldal or assisting muscles The transverse muscles of the Epigastrium Their figure and site Their Action The common use and action of the eight muscles of the Epigastrium Why when the mouth is open the excrements go more slowly forth Why when the mouth is open the excrements go more slowly forth What the white line is What the Peritonaeum is The substance and quantity The figure The composition The number Lib. de 〈◊〉 The fite and connexion Lib. 6 Meth Vse The substance magnitude figure The composure The connexion Lib. Anatom â—dminist The tempor The use two-fold Lib. 4 de usu partium A cause of frustrating conception What the ventricle is The substance The magnitude The figure The composure The cause of the consent of the mouth and stomacke The number Lib. 〈◊〉 vsu partium The connexion The temper Lib. 9. Meth. Notes of a hot stomacke The action twofold The two orifices of the stomacke The 〈◊〉 The glandudulous ring of the Pylorus The falling downe of the stomacke Their substance Figure Their number The Duodenum The Iejunum Ileon Caecum Colon. Rectum Their site The distinction betweene the collicke and the stone in the kidnies Their connoxion Why vomiting haâ—pens in the collicke The Sâ—incter muscles of the fundament Gal. lib. 5. de usu partium â—ap 〈◊〉 Levatores Ani. The action of the guts Their fibers How the guts become fit to retaine Their length The substance magnitude Figure Composure Number The connexion The temper The action and use All the meseraicke veines come from the liver Substance of the glandules Quantitie and figure Composition Number Connexion Temper Action and use The substance of the Pancreas The â—ite What the liver is It s substance and quantity Why cowardâ— have great livers The figure The composure The vessels The number and site The connexion The temper The action The ligaments The substance greatnesse and figure thereof The composition Number and connexion Temper Action The channels of the gall Lib. 2. de temper The substence Magnitude Figure Composition Number and site Connexion Temper and use The substance and figure Compositiors Number end Site Temper and Action Division thereof into 6 branches of which 4 simple 1â— Cysticae genellae 2 Gastrica 3 Gastrepiplois 4 Intestinalis Two compound 1 Ramuâ— splenicus sending â—orch 1 Coronali◠〈◊〉 2 Haemorrhoidal interna 3. Gastrepiplois majâ—r â—…stra 4. Epiplois simplex 5. Vas breve scu venosum Lib. 4. de â—sâ—… partium 2 Ramus mesentericus devided into three parts The originall of arteries The division of the great descendant artery is into these 1 Arteria interâ—… 2 Phrenica 3. Caeliaca 4. Emulgent 5. Spermatica Haemorrhoidaliâ— seu mesenâ—â—rica inferior 7. Lumbaris 8 Iliaca The originall of the nerves which are carryed to the naturall parts Their magnitude and use The originall of the hollow veine It is divided into two trunkes The division of the greater branch of the hollow veine 1. Adipos 2. Emulgent 3 Spermatica 4. Lumbaris 5 Iliacae which are divided into 1 Musculosae 2 Sacrae 3 Hypagastrica which produce the Haemorrhoidales externae 4 Epigastrica 5 Pudenda Their substance Magnitude Figure Composition Number Site Connexion Temper Action Their strainer Their substance Quantity Figure and composure