the boulder illustraete the operatione of his arte and give iudgement ther of vvithout anye scoffe or checke and be able to give a true reporte vvhen that by the aucthoritye of some learnede chyrurgiane or by the aucthorytye of some Potentate he shal be therin imployede ordayned to reporte his opinione ether of the vvounded persons life ordeath haultnes or criplenes Even as alsoe the foresayed Hippocrates sayeth in his Porrhet that the Chirurgiane must ende voure him selfe to have a vvise grave gesture Hippocratesin his Porrhet because that if it soe chaunce as he adiudged it shoulde he might reape honoure goodvvil not onlye of the patient but alsoo of all the circumstants and behoulders Contrarilye if that othervvyse it happened or chaunced then he sayed and iudged it shoulde and that his iudgemente fayle him he shal not onlye of all mē be hated but alsoe be esteemed as an ignorant sottishe fellovve Beyonde all this Galenus sayeth and testifyeth vnto vs that by our vpright and sincere iudgement by the frendes Kindrede of the patiēte althoughe he come to dye vve shal be liberated freede from all badde reportes sclaunders because that throughe the death vvhich consequentlye follovved nothinge shal be alleagede agaynst vs. What a Chyrurgiane ought to knovve in giving iudgemēt And for the givinge of such a perfect and complete iudgement it is necessarye for the chyrurgiane not to be ignorāt vvhich partes of the bodye beinge vvounded easylye or difficultlye may be cured vvhich of thē are praesent death and in fine the tokens hovv to knovve vvhat partes are vvounded or hurte because that out of ther natures quallityes dispositiōs vve may certaynlye hope or mistruste of theire health and safetye Such iudgemente therfore ought to be taken out of the verye beinge and substance or essence of the vvoūded parte alsoe of the vse the actione and situatione of the same there must alsoe be noted the proportione and figure of the same vvounde and the accidentes or other chaunces vvhich are incident vnto her consideringe alsoe the complexione and temperature of the bodye the sexe the age on his handelinge and trafiqve māner of livinge the contrye the constitutione of the time then praesent and one the time and season of the yeare All greate vyoundes are dangerous To conclude all men that have receaved a greate vvoūde are ether in daunger of death or in daunger of beinge mutilate VVe eesteme and accounte the vvounde to be large for thre occasions A great vvounde is taken three māner of vvayes The firste vvherof is because that through her latitude or vvidnesse circumiacente places shee hath a threefoulde survayinge and measuringe to vvit in length brédthe and debthe as some there are vvhich be deepe broadlye carvede or right overthvvarte or crosse vvyse vvholye percīge throughe the principalle muscles of anye parte by the vvhich alsoe somtimes the bones are hevved cutte quite through broken vvherfore some times they must be stitchte bound and ligated together or because that the vaynes the arteryes or the sinneus themselves come to be squised and plettered The secōde cōcerninge the vvorthynes of the vvounded parte for although the vvounde be but little in her meatinge yet notvvithstandinge vve esteeme her to be greate because that the strengthe and actione of the vvounded parte or member is verye necessarye for the vvhole bodye ' and for the vvhole lyfe of man vvhich parte havinge lefte his naturall vse and actione it consequentlye follovveth that the personne must immediatly discease dye as vve may by experience see that daylye chaunceth in the vvoundes of the Braynes of the Harte and in the vvoundes of the Liver Thirdelye because that some vvoundes are of a vvorser nature dispositione as beinge venoumede rebellious and entermingled vvith some badde and dolorous accidentes vvhich sometimes farre surpasse excell the vvounde it selfe as it is evidentlye planlye to be seene in the vvoundes of the Ioynctes vvhich immediatlye may fall into a verye exceedinge badde estate because that those partes and places are circumligatede or clothed vvith verye smalle store of fleshe beinge onlye decked co verede vvith the Tendones vvith sinnues vvith Ligaments that verye tender and sensible pellicle Perioflium by the vvhich these partes or members are in more daunger of fallinge into a convulsione of sinnues into Phrensye payne and inquietude as much as a farre more greater vvounde in anye other parte of the bodye Those vvoundes are accounted incurable vvhich doe happen in the Braynes Woundes vvhich are esteemed incurable or in the ventricle of the same in the Harte entrāce of the stomacke in the Vena Cava the entrāce of the Liver the backe bone quite throughe the Lunges in the small guttes or entralles the stomacke the Kidnies or in anye greate vaynes or arteryes about the throate Woundes that be difficulte to cure But these vvoūdes vvhich vvil difficultlye be curede are they by the vvhich the Longes the Liver the mēbrane of the Brayns the Milte the Matrix or vvombe the blather anye of the greate guttes or the Middelriefe are vvoūded vvith verye small vvounde Alsoe are those vvoūdes daungerous vvheras the greate vaynes Woundes that are daungerous Arteryes vnder the Emunctoria or arme pittes in the Hockes or bēdinge of the knees are vvounded and indeed all vvoundes are suspitious in all places vvheraboute anye greate Vaynes or Arteryes are situated placed because that throughe theire effusione of bloede the vvounded persone is berefte af all his abilitye forces the vvoundes of the Secrete partes or privityes and the vvoundes of the Testicles are alsoe by this reasone verye perillous daungerous as alsoe are these vvhich happen and chaunce to light betvveene the fingers The figure or forme of the vvoundes There is alsoe greate heede to be taken one the manner forme of the vvoūde for those vvoūdes vvhich chaunce or come by crushinge or pletteringe are farre vvorse then those vvhich are onlye hevvede so that it is much better to be vvoūded vvith a sharpe edgede or cuttinge svvorde thē vvith anye other blunte vveapone vvhich is not sharpe The rounde or circle vvoundes are vvorste difficultest to be curede but the certayneste easyeste to be cured are those vvhich passe by the lēngth of the fibres right like a linye or line The vvoundes of the Hippe vvhich are receaved in the membranous muscle What the vvoundes of the hippe are are verye exceedinge daungerous especiallye if it be a thruste or stabbe or else vvhē the apertione of the same is verye smalle hath noe issue but it is soe much the vvorse if it soe chaunce ther be anye fracture or separatione of bones it be vvhere it vvil in anye place of the hippe so farre forthe as if the vvounde be in anye internalle parte of the Hippe about the greate vaynes then the vvounde is passinge
melanckolye disseases In the legges are eight in each legge four vvherof the first is called Vena poplitis Vena Poplitis situated in the hockes or fovldinge of the knees is opened agaynst all disseases of the nethermost part of the bellye The second Saphena or mother vayne Saphena or Mother vayne vvhich vve opeÌ„ one the insyde of the legge vnder the anckle in all disseases of the kidnies of the vvombe to provoacke in the vvoemen ther monthlye sicknes or mestruousnes in all runninge of the raygnes and in Venus botches or as vve call them in lattin Bubones The third is the Schiaticke vayn vvhich externallye demonstrateth her selfe above the aÌ„ckle vvhich is only opened agynst the dissease called Sciatica The vayn Sciâ—tica The kidnye vayne agaynst all payne and doloure of the hippes and flanckes The fourth is the mediane or kidnyevayne situated belovve the foote and is phlebotomized agaynst all disseases of the kidnyes Amongst all the other vvhich are most coÌ„monlye opened are those three vvhich in the foulding of the arme are phlebotomized to vvit the head vayn Basilica the mediaÌ„ Basilica or liver vayne is daungerous to be phlebotomised VVe must dilligeÌ„tlye coÌ„sider that vvhen vve make an inscisioÌ„ theriÌ„ that vnder the Basilica or Liver vayne lyeth an artery or great harte vayne vnder the Median a synnue or tendone of the muscle Biceps or both of these together but vnder the Cephalica is nether synnue artery or tendone sitvated Cephalica or head vayne is opened vvithout daunger vvherfore amoÌ„gst all other vaynes ther is none vvhich vvith lesse perril dauÌ„ger may be opened If so be that through mischauÌ„ce in opening of the vayne Basilica vve chauÌ„ced to hurte the artery vvhich ther vnder is sitvated as I have knoovvne to have chauÌ„ced vve must praeseÌ„tlye for the stoppinge and restrayninge of the bloode and to the curing of the arterye vvithout leavinge anye Aneurisma Remedye for a vvouÌ„ded arterye cleave a bean in tvvo peeces laye the one halfe of the beane one the apertione of the vayne vvith a coÌ„presse therone gentlye tyed vvithout visitinge of the same in thre or foure dayes or once offer to touch it If so be in the apertion of the mediane vve chaunced to pricke the subter situated synnue or tendone vve must then immediatly phlebotomize the patient in the other arme and vve must droppe in the vvounde of the pricked synnue a little hott oyle of Terpentin and a little vvoolle beinge dipped therin vppon the same therby to keepe the apertione aperte then lay a playster of Diacalcitheos rovvnde aboute the vvounded parte of the vvhole arme vvhich hath biÌ„ne liquefacted vvith oyle of roses and vineger Of the Arteriotomia or apertion of the Arterys or hartvaynes Chap 5. COncerning the Arteriotomia or apertione of the Arteryes the praedicessors auncient professors vveare vvont to effect it especialle behinde the eares in the temples of the heade agaynst all continuall rebellious fluxions Rheumes of the eyes in like sort alsoe agaynst all diseases of the heade vvhich have takeÌ„ ther originall froÌ„ hotte dampishe or subtile rheumes as yet novv a dayes vve doe but not vvho lye as they vveare vvonte to doe in openinge of the same for soe farre forth as if the Arterye be small they then cut her cleane a sunder they also cut a peece therof avvay both the endes are dravven invvardes vvher by shee as then bleedeth noe more And if the Arterye be greate violentlye beateth it is the surest vvay that vve tye her vnder above and then betvveen both those ligations cut her of but the thredes vvhervvith vve binde her must be stroÌ„g closly tyed because that through the continvall beatinge of the arterye the thredes looseÌ„ the arterye openeth if so be it be not stiflye bovvnde because that she should not chaunce to corrupt before the inscision be replete grovveÌ„ full of flesh vvher through the mouth of the foresayed artery is stopped Hovv vve vse novv adayes to to open an artery But novv a dayes vve only make a simple inscision in the artery in such a manner as vve make an apertion in the vaynes vvithout cutting of the same clean of having dravven as much blood therout as vve desire vve theÌ„ lay a litle playster of masticke on the apertion a litle compresse tyed theron rovvnd abovt the vvhole head as close as is possible I knovve right vvell that ther are some vvhich houlde this apertione of the arteryes verye suspecte because it caÌ„ hardlye be stopped agayne and in doinge this ther remayneth a cicatrice in those partes vvhich are situated rovvnde about the foresayed arterye before the same is fullye cured and ther throughe often times an Aneurisma caused vvhich is verye troublesome Aneurisma is a daungerous dissese and daungerous for the patient But I may vvith verity affirme it to be true that oftentimes I have seene opened the arteryes of the temples of the heade vvithout any of the foresayed accidentes beinge happened thervnto the vvhich I couÌ„cel the yonge Chyrurgiane to doe it onlye in this place because such an inscisione is more fitter lesse daungerouse theÌ„ the vvhole cuttings of and ligature of the same ⧠Of the swellinge Aneurisma and of the meanes howe to binde and cut of the same Chap. 6. Discription of the tumefaction Aneurisma THis tumefactione Aneurisma is caused most commonlye throughe the dilatation of an arterye vvhich only vve must vnderstande of the smalle Aneurismata beinge impossible that the arterye shoulde so dilate as it vveare vnshutt in the greate Aneurismata vvhich oftentimes vve see vvherfor vve vvill rather say and houlde vvith the opinione of the auncieÌ„t professors that Aneurisma is then caused vvheÌ„ as the bloode and the vitall spirites are repulsed out of the arteryes throughe the apertion or orificia of the same vvhich vve call Anastomosin or els vvhen as the tunicle of the arterye is burst it be ether throughe a vvounde or by anye other occasione as vve may se vvhen as the Chyrurgiane purposinge to opene the vayne in the elbovve by chauÌ„ce prickethe the arterye vvhich is theruÌ„der sitvated the skiÌ„ne vvhich is theroÌ„ lyinge cicatrizeth it selfe and the perforatioÌ„ of the artery through her coÌ„tinvalle reverberatioÌ„e tarrieth vncured opeÌ„ is not stopt or vvith anye carnall substance replete as beinge vnprofitable for anye vse in noe sorte can be bound so close as the arterye of the temples of the heade but throughe the blood vitalle spirites vvhich by degrees issue therout are congregatede vnder the skinne soe conseqventlye cause the svvelliÌ„g supposinge they verye vvell did knovve therin to be matter or any other slimye substance or viscositye for vvhich reason they have made an apertione therin vvhervppon a little time therafter death hath follovved because of the bloode and of the vitall spirites vvhich in
astrolicalle venoume other funestall influences doe make the vvoundes incurable or els verye difficulte to be cured and chaungeth the habitude and complexione of men throughe the chaunginge of the time through the Astronomicall constellation vvhich over vs is praedominating As if so be the vvinter vvhich ought indeede to be coulde The irregulatede season of the yeare aultereth our bodyes vveare vvarme the summer vvhich ought to be vvarm is coulde Also vvhen it is novv hott theÌ„ could novv drye theÌ„ moyste vvithout the time of the yeare requiringe the same to be othervvyse then he ought to be vvhoe caÌ„ doubte therof but the same must be preiudiciall to the vvouÌ„ded patieÌ„t because our bodyes heere bye receave mervaylouse suddayne alterations chaunginges vvherthrough out vitall spirites humors are vvondrouslye vvith great daunger aultered observinge the sayinge of Hippocrates vvhich avoucheth that all repentine subite permutatioÌ„ hovv soever the same may be are vnto our bodyes very preiudicialle All repentine suddayne chaunge is daungerouse The divrnalle experience demoÌ„strateth the same vnto vs for if so be in the vvinter in stede of a drye coulde vvinde there respire a southvvest vvind vvith vvarmishe shovvres of rayne ther then coÌ„monlye follovve greate corruptiones in our humors vvherthroughe the vvoundes doe putrifye and gangraenize The infected ayre may also be an occasion of the death of manye vvounded persons hovv little soever they soÌ„times are vvounded because vvithout ayre vve can not Live vvhich allvvayes such as it is vve must receave We can not live vvithout ayre that not oÌ„ly through the mouth through all the conductes of our bodye poroâ—tyes of our skinne through our Arteryes vvhich are situated vnder the porosityes of our skinne froÌ„ vvhence the foresayed ayre doth dravve tovvardes our Lunges soÌ„vvhat to cool the harte refreshe it be as it vveare a nouriture vnto the same froÌ„ vvhence the sayed ayer is farther spreade devided throughe our vvhole bodye vvherby it theÌ„ chaunceth that if so be the same be corrupted infected consequently also the foresayed Harte vvith some other of the noble vvorthiest partes are polluted in steade of beinge praeserved mayntayned in theire forme virtue The malignante ayre polluteth the harte Galen in the ninth of his Methodes attributeth so much to the ayr that he sayeth that the especiallist principalist demonstratioÌ„ to cure anye dissease must be observed out of the ayre because vve caÌ„ in noe sorte be vvanting or missinge the communitye and vse therof Besydes al these occasiones there are yet certayne times of the yeare vvhich are irrepreheÌ„dable yet cleane contrarye to certayn disseases for vvhoe is he that doubteth that the starre Canicula doth not disturbe the vvynes Virtves of the doggedayes causethe the same to boyle vvhere he lyeth in the fellers as by experieÌ„ce vve finde in Plinio vve may reade that the same also causeth our blood to boyle vvithin our vaynes Lib. 14. Chap. 18. that soÌ„times there follovveth such a superfluous sangvinatioÌ„ that by noe meanes it can be restaygned by the vvhich meanes the same also flovveth tovvard the vvounded parte vvhich before vvas tormeÌ„ted vvith sufficient payne enoughe In like sorte also vve perceave the Autumne The Autumne is enimye to all pulmonicall vvoundes or Hurvest to be an enimye to all vvoundes of the Lunges as is appareÌ„t by the 10. rule the 3. of the Aphorismes becavse they oftentimes chaunge into fistles or into pectorall Apostemationes The penetrable coulde is allsoe a sore enimye to all vvouÌ„des in the Heade Aphor. 3. lib. 5. Farthermore Hippocrates dissuadeth vs Lib. de aere VVe must not purge in the dogg dayes aquis locis to administer any physicke vnto the patientes in the greate constellation of the starres vnder the Solsticium nor vnder the Aequinoctialles because of the greate perturbations alterations vvhich as then are in our bodyes by the vvhich meanes the vvoundes as theÌ„ are farre more molestious mortalle vvhich must al so be vnderstode of the greate vvyndes thunderinges the effectes vvherof are so admirable tirrible in inanimate thinges vvherbye vve may the lesse admire at the greate alterationes vvhich they doe cause in the vvoundes disseases of mens bodyes vvhich bodye is the most sensiblest and the most dilicatest amongst all the animate bodyes Besydes this vve have spoken of the times saysons of the yeare An excellent observation vve may also adde heeruÌ„to that the Carpenters the Architectors doe alsoe observe a choyse of the fellede cut dovvne vvoode vvhich at this time or at that saysone of the moone hath binne felled esteeminge the vvoode to be more moyste replete vvith vvormes more subiecte to corruptioÌ„ vvhich is felled in the ful Moone that more durable yea all most incorruptible The inanimate thinges doe feele the effectes of the Moone vvhich is felled in the decreace of the Moone as in Palladio vve may reade in his Treatise of Ianuary NoveÌ„bre Caesar also sayeth the same in his commentaryes on Arat that the Moone hath not onlye povver over that vvhich hath receaved seÌ„sibilitye but that alsoe the stones the bones and the VVoode doe perceave the effectes of the Moone vvhich being of the MooÌ„infected vvexeth full of vvormes vvherfor the common phraise of the Lavvyers or Iuristes is as yet observed de Lignis sua Luna caesis vvhich being soe vvherfore shoulde not vve also esteeme a vvounde to be more moyste in a fulle Moone more subiected to putrefactione then in the decreace of the Moone seinge that man is tender of fleshe farre more subiected vnder the domination subiectione of the Moone the influences therof then those thinges Man is subiecte vnto all inflvences vvhich are inanimate have nether life nor sensation Above all these praecedente reasons and experiences it is manifest a commoÌ„ axiome that all terrestrialle corps are ruled governed by the caelestiall or supernall influences Through all vvhich foresayed occasions the humors oftentimes being so corrupted polluted after death ther are certayn apostematioÌ„s foure in divers places of the body yea somtimes allso in some of the vvorthyest partes of the body as in the Liver in the Braynes in the Milte in the Lunges or in any ioynctes accordinge vnto the imbicillitye of any of the partes of the body vvhich have binne debile apt to receave such impurity of the bodye vvhich beinge thervvith out of all measure charged expellethe froÌ„ him the forsayed impure humors in anye of the sayed feeble partes vvhich therafter is chauÌ„ged into puruleÌ„t matter the vvhich there possessinge more place makinge more concavitye theÌ„ is requisite doe expell froÌ„ them certayne faetide venoumous vapours participate the same vnto all the other vvorthiest partes out of the vvhich insueth Inquietude Agues ConvulsioÌ„s or Spasmus Phrenesye
must then beginne from belovv the legge or Arme vpvvardes vvhich is the most farthest from the originall of the Vaynes and supernallye end the same to vvitt about the Harte the Liver vvhich are the originalls of all Vaynes Arteryes heerby to repell the humors vvhich are in that parte to praevent that there concurre noe more vnto that place As farre forth therfore as if that parte be rugged and vnsmoothe as is that Legge vvhich is farre more thicker in the Calfe therof then in the lovvermost partes therof vve must thē frō palme to Palmebreadthe a little more thē half throughe cutt the same and fovvlde both sydes cōtradictorilye the one to the other soe looslye sovve the same by vvhich meanes the sayed Ligament is made to be recurvated and croockedlye vvounde like a Bovve Having therfore stifflye rovvled op this foresayed ligature or rovvler An attractive Ligature vve may thervvith as smoothlye vvind involve a Legge vvithout makinge therin anye inaeqvalitye or furrovves causing that syde vvhich vvas cut of thē agayn sovved aeqvallye to agree vvith the thīnest parte the vvhol parte vvhich is the longest to agree vvith the greatest parte Above these tvvo foresayed Kindes differēces of Ligamentes vve may as yet adde thervnto a thirde Kinde The vvhich vve call an attractive Ligamēt vvhich vve may vse vvhen vve desire to retracte anye bloode nourishment or anye other vitall Spirites into that parte the vvhich the parte of it selfe can not dravve attracte vnto it because her attractive forces are debilitated very much feebled The secōde kinde of Ligament above rehearsed VVe vvill somvvhat alsoe speake of that ligament vvhich of it selfe is for noe vse profitable but accidentallye cureth throughe his continuāce of the remedyes vvhich are applyed vnto the dissease vvherfore vve may call it the retentive Ligament vvherin vve must consider thre especiall thinges First in vvhat disseases it is commodious Secondly on hovve manye fashones it may be composed made Thirdly Ligamēt for the dissease lastelye hovve vve ought to vse the same Touchinge the first vve ether vse the same consideringe the parte or the Dissease vvhich can tollerate noe other Consideringe the Dissease as anye vvounde or vlceratione accompanied associated vvith anye great payne or inflammatione or vvhen vve disire an Apostematione to be matured Consideringe the parte as vvhen a vvounde is in the Heade in the Necke in the Bellye or in the Testicles vvhich partes cā not indur to be stiffly tyed or bovvnd therfore neede noe ligatione but only to retayne the remedyes therone because that the other stiffe ligatures bringe vvith them great discommoditye Concerninge the seconde poyncte Ligamēt for the parte The retentive Ligamēt must have tvvo three or four endes accordinge to the forme situatione of the parte vvhich vve vvoulde dresse Touching the thirde poyncte that must be begunne in the dissease ended on the other syde of the same ⧠Of the Rules generall Instructions wheron we must consider in all Rowles Ligatures Chap. 3. THerfore convenientlye Tvvo thinges to be considered vvhen as decentlye vve desire to vvinde anye parte decentlye to vvinde or involve anye parte or mēbre vve must note cōsider on tvvo especiall thinges vvherof the first is the vvounded parte vvhich vve vvill vvinde the seconde is the aegritude or dissease Touching therfore the disseased parte vve take this for a generall Rule that shee must be tyed that in such a forme figure as vve vvil have her to cōtinue lye For if soe be vve vvind a foulded curvated parte vvhich therafter must be situated right and extented ther vvill as then conseqventlye insue such or the like Accidentes to vvitt that the Ligature vvill dissolve loosen that ther vvilbe caused great payn doloure in the parte because the Muscles Vaynes Arteryes Synnues the verye bones alsoe have an other situatione beinge erected extended then vvhen as they are recurved and croocked As in exāple If soe be a broken Legge Example being recurved soe on that manner be circumligated vvounde vvhich ought othervvyse to be tyed beinge stretched extended right forthe vvithout doubte all the Ligature vvill goe loose vvhen as vve desire to extende the same out of the vvhich vvill follovve great payn because the brockē Bones Vaynes Arteryes Synnues Muscles doe not as thē keepe the same place as they have done the parte beinge bovvnde tyed Contrarilye vve desiringe to dresse a fracture in an Arme he must then be shutt foulded together for if soe be vve dresse him beinge extended vvhē as therafter he shal be recurved bended then the Bones in therre lyinge vvith the other partes be turned into some other fashone vvherthroughe the Ligature vvil in one place be loosened in another spāned vvhich also suscitateth payne in that parte For it must necessarilye follovve that vvhen as a tyed parte be chaunged and then ether shutt bended or extended thē there are some of the Muscles extended crushed as in the rotunditye in the abbreviatione others vveackened vnited And vvhē they are exrected they must needes then be crushed throughe the Ligature out of the vvhich must necessarily follovve intollerable payne because of the Compresse vvhich in ferreth vvith it in that parte great fluxiones other accidentes mischaunces The dissease Novv for as much as cōcerneth the dissease vve must circumligate involve an Arme or a broken Legge vvith a vvounde on an other manner and fashon then a Fracture vvith out vvoūde on an other fashon a Legge vvhich hath but a simple Vlceratione then a Legge vvhich hath a concavouse or Fistulouse vlceratione And a Ioyncte vvhich is full of payne must one an other manner be tyed then that vvherin is noe payne Decētlye to vvind Therfore cōvenientlye decentlye to ligate or vvinde the Ligature must be right closely rovvled vp because vve may houlde him the faster stedyer in the hāde vvithout stirring or glidinge this vvay or that vvaye as he might chaunce to doe the same not being stiffly rovvled vp because that throughe his hardenes he may the better be handled conduced so that all ligationes farre cōvenienter more decēt to more contentment of the Patient and the circumstantes or standers by may be effected then other vvyse vvhē as the Ligature is layed dubble croocked curved vneven ⧠Howe we ought to tye the Ligament agayne make loose the same Chap. 4. Wherone vve ought to consider in the fasteninge of the ligature THe Chyrurgiane must cōsider note that ther be no seames knottes or anye vnevennes in the Ligament vvhich might chaūce to crushe the vvound and the Ligatione alsoe being finished consideringe that the end of the Ligature be not fastened one the vvounde nether one anye place vvher ther is any payne for vnles vvith
the vvounded or hurte entralies not so pungent and sharp but somvvhat more surde and benumde The occasione of the bloodyeflixe is the venoumouse puissance and force Occasion cause of the Dysenteria Dynamis of the acute saulte and mordicant humoures vvhich beinge as it vveare on the iournye to descende right to the guttes but they come recurvared in form of this lettre S. as in the situatione they must passe by manye recurvationes cōcavityes vvher they cleaving fast first of al crudifye and excoriate the foresayed guttes in the end throughe theire acuitye corrode the same as is the cholericke humiditye the melancholycke humors and the saulte Petuita the vvhich is ether ingēdred internally in the guttes or els congregate together in other place are soe driven that vvay as it happeneth commonlye in the Pestilentialle agues in Causo colliqvanti Phthisi Athrophia in the Cacochimia in the inflammatione and in the colliquation of the vvorthyest partes The humors are also irritated and provoacked through causticke and venoumouse medicamentes as throughe the Coloquintida Scammonia or throughe the Sublimated poulder of a Diamante Ravve fruicte causeth the Bloodyflixe Also through anye viciouse acute grosse cibaryes and those vvhich are apte vnto corruptione or els is not sufficientlye dressed Alsoe throughe any fruicte as by cherryes Blackecherryes Plumbes Peatches Coucoumbres Milions such like vvhich vve call Hotatij Fructus vvhich more throughe the constitutione of the ayre vvhich ether is to moyste and pluviouse or raynye to coulde or to hott in others through intemperature and other inordinate victitatione or debacchatione by the vvhich it inseparablelye happeneth as vvell in the VVinter as in the Summer that this dissease of the bloodyeflixe afflicteth man kinde It is right true that this dissease Indicati◠hovv vve may easilye or difficultlye attayn to the Bloodyeflixe oftentimes reagneth in the Prime or vernall time of the yeare and especially in the Harvest or Autumne in the vvhich time the humors doe most impeach hurt vs vvith the qvallityes Havinge observed all these thinges vve must consider one the quantitye and quallitye of the dissease as on the greatnes of the vlceratiō and the superfluitye of bloode and one the greate corrosione and one the violence of the dissease therbye to iudge vvhether the dissease vvith anye facilitye difficulty or impossibilitye may be repelled and cured VVe esteeme the cure of the Dysenterya to be of more facilitye the same beinge in the great guttes or intestines Caecum Colon Rectum thē it being in the smalle entralles Duodenum Ieiunum and Ileum VVe take also the same to be lesse daungerouse in yonge persons and in the men then in yonge children and vvoemen In a longevalle or longe continuing Dysenterye it is a badde signe vvhē the appetite is departed yet a farre more vvorse signe vvhē as ther are associated vnto the same Agues or Imflammationes They vvhich are of most experiēce may iudge of this poyncte As is that vvhich is caused out of anye Apostemation beinge burst out of the Liver or of the Milte vvhich verye rarelye happeneth and yet more rare out of the pulmonicalle Apostemationes vvherof the matter disgorgeth it selfe in the left ventricle of the Harte and soe into the Artery called Aorta the truncke or body of all other Arteryes frō thence into the Vaynes of the Mesentery vvhich are extēded to the entralles the vvhich passage or vvay vve can not then throughe imagination compraehend and vvhich is very obscure And if soe be ther follovved any peculiare thinge therout besides the causticke and venoumouse matter it might thē inferre fearefull daungerouse accidentes to the hart of the Patiēt vvhich is the vvelspring of lyfe the onlye originall of vitall spirites vvhich are diffused over the vvhole body are occasione of the actione motione also all other agilityes of the bodye The evomitiō of the choloricke humors in the beginning of the dissease doe beare vvitnes alsoe of the daunger follovvinge The bloody flixe vvhich is caused out of any melācholicke humors is esteemed to be vvithout anye hope The convulsiō of synnues the Hickough the parbraking are forerunners as it vveare embassadoures of death In like sorte allsoe vvhen vve espye a blacke spott behinde the left eare as bigge as a Vetche vvherbye is great alteratione that allso is a signe of Death as Hippocrates vvithnesseth vnto vs. If soe be this dissease through negligēce or through malice or aulteration or by any other meanes came to be inveterated the Patient as then vvill vvholye consume vvexe so feeble that vvithout great difficultye he shall not be victor therof This therfor is the cause or occasiō the species kindes of this dissease the afflicted opressed parte beinge aperte and knovvne vve must novv proceede to the resanatione of the same The finall end of the curatione is ether generalle or specialle The generall end is to be noted ether on the dissease or on the Physitione as on both the especiallist most principall personages vvhich acte and sett forth the Historye of this dissease In all the kindes of Dysenteria Cure of the Dysenteria the patient must keepe himselfe reposed and quiet because all vlcerationes desire to be quietlye kepte and in ease Notvvithstandinge Hippocrates in his third boocke de Diaeta councelleth that vve shoulde cause the Patient vvhich hath the bloodye flixe to vvalke alsoe cause him to stirre his bodye vvherby he meaneth that vve ought to doe the same before the foresayed Dysenteria become because of the Prophylactica therthroughe to prevent the procreatiō of all badde humors to defend the same out of the intestines cause them to vvithdravve themselves into other externall partes of the bodye Farthermore the patient must allvvayes retayne his stooles as longe as he possibly may or can vvithout constraygninge himselfe thervnto The Chyrurgian must first of al consider on the vse of the astringent medicamentes What astringent medicamētes the Patient must vse vvhich before repast or comestion are vsed for he cōtayninge the viandes or cibaryes they helpe also to the digestiō of the same but by the astringent thinges I vnderstande meane vvhich are reasonablelye fortifyinge and confortative and those vvhich are helpefulle to the concoctione For it vveare the greatest absurdest error of the vvorlde if soe be in the first especiallye in an vnhealthfulle bodye to vse violent stopping astringent medicamētes for it vveare nothinge els thē to shutt keepe our enimye or theefe vvithin doores VVherfore his viandes or meate drincke What his meates drinckes must be must onlye be Diureticke astringent causinge to voyde vrine because through the vrine especially all aquositye of the blood is evacuated but if so be you perceave that the great toughenes of the acute sharp adusted Pituita or aquosity vvhich is verye retardatelye expelled
vvhich are made of freshe milcke vvher in vve must contunde some yolckes of Egges oftentimes reiteratinge of the same and thē vsinge the absterginge clisteryes vvhich gentlelye vvil purifye the intestines VVe make also divers other of divers fashons formes vvher vnto this shall serve for an example of one rum Rosar rub Tapsibarbati Furfuris Hordei ana P.j. fiat decoctio in Lacte in colatura ad lib. j. vel ad quartastres dissolve oleiras colati Sacchari albi ana ℥ ij Syrupirosar siccarū ℥ ij fiat Clyster additis duobus ovorum vitellis VVe may vse this clister reiterate the same as often as vve perceave it to be necessarye but vvhen vve must vse some astringent Clisterye vvhich vve may not doe vnles that the repeccating humors be cleanlye purged out and then vve may vse this subseqvent clisterye or anye other such like rum Furfuris macri paleae Hordei tapsi Barbati Centinodiae Chamemillae summitatū Anethi ana M j. fiat decoctio in aqva Chalibeata velin Lacte vstulato in colatura ad lb j. vel ad quartes tres dissolve syr rosar siccarum vel mirtillorum ℥ ij Vitellorum ovorū iij. pulveris Mastiches sang draconis ana ℥ iij. fiat Clyster VVe may also cōstitute exordinate to this end divers Sundrye potiones Electuaryes also the Kindes of Diacorallum nature of a Harte fine Bolus sealed earth iuyce of Berberis Ribes conserve of Roses The Empiricke medicamētes vvhich the Methodicall Physiciones doe so disdayne esteeme of little vvorth are those vvhich vve throughe experience throughe the divturnall vse have fovvnde to be most excellēt vvhich being vsed vvith iudgemēt are not vvholye to be disdayned seinge that Galen testifyeth that the Physition must be established one tvvo fundamētes or foundations to vvitt on the reason on the experiēce vvherof the Reason is as it vveare the Soule of the same vvhich measureth ponderateth all thinges and the Experience the body as a providēt tutor Schoolmaster Experiēce teacheth vs that the Rubarbe on vvhat manner soever vve administre the same but especiallye the infusione therof is verye commodious profitable in this dissease as in like sorte also is the Spiritus Vitrioli vvith Rose-vvater vvithe Plantinevvater also beinge administred vvith Cynamomevvater Ther is a sugerye dulcor or svveetnes extracted out of Leade vvhich never deceaved the hope of the right vvorshipfull Mr. Duion Mons r. Duion an expert Phisition vvhich is a verye experte learned Physition vvherof I have attayned the best of this discours The Tincture of Coralle and of yellovve Ambre extractede vvith Aquavitae is in his operation admirable also Crocus Martis Flos sulfuris being administred vvith cōserves of the betryes of the Cornus Cōserve of Roses Marmalade Citronpeelinges vvith manye other such like thinges are all together verye commodiouse Because amongst naturall thinges I knovv nothing that exsiccateth more oppugneth it selfe more agaynst all corruptiones And to conclude ther are an innumerable sortes of remedyes vvhich vve must so compounde that they may have one similitude or one Analogye vvith the dissease Finallye vve must in an extreame Dysenteria for the last remedye endevoure to mitigate the payne vvith Narcoticall thinges as is the Oleum Iusqviami Mandragora the could seedes the Philounium Reqvies Nicolai manye othes such like compositiones vvhich are vnto this dissease vsed vvhich may not be administred thē vvith great iudgment and advice had therone The end of this Treatise of the Dysenteria or Bloodyeflixe An Apologye for the Chirurgians wher throughe is apparantlye evidentlye demonstrated shewed which be the occasions or causes of death in divers sundry wounded Persons although notwithstandinge their woundes weare smalle wher by the Chyrurgians may be liberated excused from all calumnes sclaunders wher with falsely they are accused reproched THe common discourses of Chyrurgery are novve adayes farre more meane idle more fabulouse vncertayne thē the Nativityes of the Goddes the Historyes of the Giantes or the doctrines of the Philosophicall stone yea a thousand other phantasticall sommationes Ther is but one experte Chyrurgiancinal Fraunce dreames There is novvadayes in all Fraunce but one expert Chyrurgiane vvhome everye potentate and great Lorde endevoureth to retayn by them vvherthrough they are vvont to say I have the best expertest Chyrurgian vvhich is living vvherfore they also laude extoll him to have a million of knackes vvhich vveare never before herde or knovvne The one boasteth that his Chyrurgiā in a verye shorte time hath cured one vvhich hath binn shott clean throughe his head althoughe the very substāce of the Braynes Divers fictions Lyes issued therout the other stedfastlye affirmeth that his Chyrurgiane hath agayn imposed the Eye of a man vvhich frō the earth he tooke vp vvithout beinge deprived of his sight in that Eye or els that he cut of a peece of ones Liver or Milte yet hath praeserved the life of the man Farthermore an other vvill bouldlye periure himselfe say that they are but nugationes Childrens play for his Chyrurgian to cure a harqueboushed or shotten vvounde of the Harte the Liver the Milte the Blather and the stomacke and the Intestins and of the great vaynes yea is noe more molested thervvith thē vveare the Sould lours of Iulius Caesar vvhich never interrogated hovv forcible strong theire enimies vveare but vvheare they vveare nether one vvhat place of the Citye the breach vvas bartered but vvhether īdeed it vve are shott or not Comparasion So that novvadayes the Chyrurgianes also doe not anye more aske nether doe any more endevoure to knovv the nature the conditiō the necessity the vse or the vvorthines or excellencye of the vvounded partes but aske only vvhether the man be vvouded althoughe all the ossicles of his Legge vveare crushed yet vvithī the space of 14. dayes at the farthest vvith theire vvater of shottē vvoundes they are able to cure them although I my selfe doe not disdayne the same the same beinge administred vsed vvith discretton And breefly to cōclude each lord supposeth that he hath by him an Hippocrates an Aesculapius a Podalirus a Machaon Out of vvhich ignorāce persuasion as not to knovve vvhat vvoundes are mortalle or curable vvhat vvoūdes are little or greate vvhich are of an easy or difficulte resanation ther must then necessarilye heerout follovve that vvhēas any body seemeth to be little hurt dyeth vnder the hādes of a most expert Chyrurgiā ether because of the greatnes of the vvound through any vnhealthfullnes of the bodye through any concursione of humours or els because of any vnexpected accidentes he is then vvithout all compassione blamed disdayned and diffamed notvvithstandinge all his greate paynes or dilligence accordinge to the arte he in curinge of the foresayed Patient hath done that because they are ignorant of the causes of