priuate person for they will bidde that the member which they perceiue dislocated to be put into the ioynt agayne Also Achrocordonas or Warts to be taken awaie an Vlcer to be brought to a Cicatrize and a fluxible bellie to bée stopped but by what meanes those thinges may bée done trulie they doe not knowe And this is it which ought to bée knowen of the Phisition wherefore the indication which is taken of diseases is onelie the beginning and as I may tearme it the place from whence the waie of curing procéedeth béeing yet no portion of the arte of Physicke or no great or proper parte but such a one as is common to euerie vulgar person therefore he is worthilie called a curer of diseases that can of himselfe finde out those thinges by which may be performed that which is of the first indication shewed which if he doe it by experience then he is to be named an obseruer and an Emperike But if he doe it by a certaine reason and methode then he is to be called a Logitian Methoditian and Dogmatist Now there commeth to the Phisition a vulgar person I must repeate this thing againe willing him to put the mēber into the ioynt or perhaps to vnite and forme a broken bone or to haue Meliceris taken awaie But by what waies anie of these things are to be brought to passe that to find out is certainlie the office of the art of Phisicke And the Emperikes do boldlie contend that all things are to be found out by experience but we trulie doe affirme that they are found out partlie by experience and partlie by reason séeing that neither experience onelie neither yet reason can finde out all thinges Notwithstanding we think it not good to set out a confused and mixed doctrine but Experience by it selfe and Reason by it selfe that thereby it may easilie appeare of what force each of them is And now trulie we haue determined to speake of that inuention which springeth of Reason now therefore haue we anie method following how we may finde out euerie of the forenamed remedies I meane to take awaie that which is altogether against Nature and that is dislocated to put in his proper place and to vnite the solution of continuitie shall we require experience héereto I trulie am fullie perswaded that ther is a method by which thou maist finde out things required whose originall is that which euerie disease doth shewe to bee done For the solution of vnitie requireth vnition and the fracture of the bone called in Greeke Catagma in the fleshie parts an vlcer like as also a wound and ruption called Regma and conuulsion named Spasma for a wound truelie is a certaine solution lefte in the fleshie parte of wounding A ruption and conuulsion bée solutions made without wounding The first is diuision of the fleshie partes the other is of the neruous parts all these shew that there must be made vnion but whether in all it may be performed or that it cannot in many that onelie behooueth the Artist to consider for no common person doth know how that the Diaphragma or the smal intestines can attain the scope of which they giue indication also he is ignorant that the foreskin called Periputium and the thin part of the chéeks be of lyke condition Furthermore whether Caries in the bone the Gréekes call it Teridon may be cured like as erosion in the flesh he vnderstood not Againe whether a fracture will grow together like as a wound or doth further require to be adconglutinated with Callus he perceiueth not whether there is to be hoped the growing of Callus in fractures of the head or else is otherwise to be cured Further he is more ignorant whether there is anie hope of recouerie in wounds of the heart lungs stomacke and liuer And to conclude no common person knoweth anie thing beyond the first indication Therfore the first worke of this art is to consider whether we may performe that we take in hand or not and this is knowen two waies neither can the third be added or knowen The first is by experience which requireth long vse practise the other is by the nature of the thing it selfe for this doth set out both the substance of euerie part and also his action vse and scituation with which things procéeding he shall not onelie foresée what cannot be cured but also deliberate of inuenting remedies for that which maye bée cured The second Chapter THerefore it is manifest that we must begin of simple things and truelie there is nothing more simple than the wound in the vpper part of the flesh therefore the cure of this wound in that it is onelie a wound is vnition but if it be with hollownesse and putrefaction there is a double scope in as much as the effect is double that is to saie an vlcer which is solution of vnitie and hollownesse which springeth of the lost substance of the part in which kinde it cannot often chance that thou shalt fulfill both the scopes aforesaid as if not onlie the flesh but also the bone vnder it is perished for such hollownesse cannot exactlie be filled but you may bring it to a cicatrise but this is the cure of the vlcer and the hollownesse remaineth notwithstanding vncurable Therfore this thing it behoueth to know either by experience or else by reasons help But Thessalus vseth not these neither putteth he to a third yet is not he ashamed to trifle but let the passe rather let the Phisition who followeth Thessalus teach vs how to cure a hollow vlcer in the fleshie part nothing being hurt vnder the vlcer he answereth by applying medicines which do engender flesh they call them Sarcoticall Well said a greate facilitie peraduenture you may better tearme it stupiditie when he thinketh sufficientlie to haue answered the question by naming a sarcoticall medicine for if we know this Sarcoticall what doe we further require shew vs I praie thée what Sarcoticall is that thou wilt vse I suppose that thou wilt answere Olibanum or Iris or Aristolochia or Eruifarina or Panax for I will first make mention of drie medicines now go to By what meanes hast thou found these medicines thou answerest by Experience what is it then that thou hast added heereto for euerie person doth know that that which is holow must be filled but experience hath taught of what things and by what medicines that should be done trulie Thessalus knoweth not that medicine neither as an emperike neither as a logitian as an emperike because he will not as a Logitian because he cannot for I trulie doe vnderstand that he knoweth this medicine as an Emperike for séeing there are two instruments of euerie inuention that is to saie Experience Reason he which doth know that is inuented and yet can giue no reason thereof doth shew himselfe to haue found it by experience therfore that he may vnderstand how greatlie he hath erred let him a little giue
corruption bréedeth in it and occupieth the space that is betwéene the lippes of the wounde so that the ruption cannot close Wherefore these aboue rehearsed declare vnto vs all causes howe small so euer they bée For although some hath had rigour or though the bodie hath béene ouerthrowen by some Feauer so that there bath not bene good concoction or that it hath béene defatigated and wearied then immediatlie there shall bée paine in the part where the ruption and wound is because that the said ruption hath bene latelie ioyned together but not so substantiallie because of time Wherfore it followeth that a little thing may easilie part them fil the place againe with superfluous humours But what engendereth in such wounds or ruptions nothing but new Ecchimosis and much like vnto the first That is to saie when the flesh was first broken except that this Ecchimosis that is new of more and corrupter mattier than that which was at the beginning which came of bloud and therefore now this is more easilie digested and resolued than that which was at the beginning And thus the which we haue spoken hetherto shall suffice for the disputation of Vlcers thus we conclude this fourth Booke of our Therapeutike methode called Methodus Medendi FINIS THE FIFT BOOKE of Galen called in Greeke 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 and in Latine Methodus Medendi The effect of the same 1 The curation of vlcers which chaunce in the fleshie partes and then the curation of Vlcers in the Instrumentall partes 2 Of the ruption of a veine or Arterie 3 How a fluxe of bloud may staie by deriuation 4 The Medicaments that wil make a crust which doth much to the stopping of a flux of bloud 5 Of spitting and distillation of bloud 6 The curation of Vlcers in the pudend places 7 The curation of a veine or diuided Arterie 8 The reiecting of bloud both from other parts also from the lungs The first Chapter SEeing that in the two last bookes we haue taught how anie shall rightlie cure Vlcers we will by the waie shew that all other Phisitions which vse the arte not searching out the Elementes of those simple particulars in vs cannot cure anie thing onelie by reason but yet least of all other those which professe Thessalus doctrine The rest which are by méere experience onelie taught suppose that at the least those Vlcers which are in diuerse partes are to bée cured by diuerse reasons But those that followe Thessalus as their Captaine for his excellent wisedome thinke that euerie Vlcer in what parte of the bodie so euer it bée requireth like curation for if it bée hollowe they saie it must bée filled with flesh if it bée equall then to bée ciccatrized if there bée supercrescent flesh then that flesh must bée diminished if it bée bloudie and new then it must bée adglutinated As though he that knew this must of force cure rightlie or that this reason were vnknowen to the common people when as there is none that is héerein ignoraunt But they vnderstand not howe the hollownesse is to bée filled with flesh neither howe that which is filled ought to bée ciccatrized or to take awaie that is ouermuch encreased or to ioyne together that which is pure and bloudie without hollownesse such workes trulie are properlie appertaining to the art of Medicine found out by the helpe either of Reason or Experience or both Therefore repeating againe let vs briefelie ouer-runne those things wherby the beginning of these which are to be spoken may be ioyned with the aid of those which we haue alreadie set out Wée haue declared that euerie Vlcer requireth desiccatiue medicines but that which hath hollownesse beside that it needeth desiccatiues it also doeth require abstersiues that which requireth to haue the lippes ioyned together such is a gréene wound called in Gréeke Enema doth aske both more drying medicines and also that be gentle astringent without anie abstersion Furthermore those vlcers which néede to bée ciccatrized require not onelie yet more drying medicines but also strong astringent remedies and whereas there is supercrescent flesh against nature there are required sharpe and abating medicines such of necessitie bée hot and drie If anie accident bée ioyned with the Vlcer the Indication of curation must bée taken of the nature thereof and of this all the faculties of medicines also to bée had If there should superfluous mattier growe in the Vlcer it behooueth to haue medicines which should take it awaie and such haue a greate deale more abstersiue vertue than some incarnatiue medicines haue Also if there bée séene more copious moisture there is néede of a medicine more desiccatiue but yet not to exceede his kinde and if the medicine shoulde be glutinatiue it ought to bée drying and astringent if it shall incarnate it must be desiccatiue and some thing abstersiue and so in all other as is alreadie declared Also if the flesh subiect should be intemperate first truelie we must cure this intemperatnesse that which is drier by medicines humectiue the moist by desiccatiues Also that which is hot by refrigeratiues the colde by medicines that are hot And if by coniunction of two qualities the flesh bée intemperate it must be cured by ministring a contrarie medicine which hath double qualities for this one thing is common to all affects against nature that they cannot come againe to their owne nature without such medicines as haue contrarie qualitie Furthermore at this time the causes of these intemperatiues are to be considered whether these be common to all the whole bodie or else proper of some partes which should infest the vlcerate member by societie the Gréekes call it Simpathia First of all trulie the cause that nourisheth this intemperatnesse is to be cured and after that the intemperatnesse it selfe which is now made for this indication is common to all such as spring of anie cause We haue also declared that there are diuerse indications taken of the differences of vlcers and also those which are taken of the temparament of the sicke bodie haue a contrarie reason for those Indications séeing they are taken of those things which are against nature declare that all contrarie things must be applied these Indications because they are taken of natures selfe shew that like things must be vsed for if how much the part is drier so much the more it requireth to be dried that which is lesse drie is lesse to bée dried In like sort trulie it is declared in making hot or colde Neither haue we let passe that of the excellencie of the member or contrarie state Also to the sharpnesse or dulnesse of féeling there is to bée had a contrarie scope of curing The second Chapter THerefore we will now consider that which remaineth of the curation of this kinde of infirmities we call this kinde for more euident doctrines sake solution of vnitie neither is it anie matter if thou call it solution of continuitie This kinde doth not onelie
deuide this Arte but into two partes that is to say into Theorica and Practica Theorike doth consist in the exact and perfect knowledge of these foure partes which we haue spoken of before that is to saye in Phisiologia Pathologia Eugiena and Simiotica And the fiue parts named Therapeutica doth consist in the right practising vsing of cōuenient remedies to cure mans bodie with all by the helpe vnderstanding and true knowledge of those things aboue specified for as much as this part doth bring to passe by an operation and practise done with the hand or ministred by the hand therefore this part is called Practica that is to say practising and putting in vse all such necessarie things as may apperteine either for the curatiō or preseruation of mans bodie And for as much as these two thinges are brought to passe and done by certeine wayes and meanes which reason hath inuented and experience hath found true and without these things wée can not rightly cure or bring to passe the desired scope or ende of our Arte which we doe intend Therefore it followeth of necessitie that wée must néedes vse them either else wée shall not vse the practike part which is the onely ende and function of our vocation and Arte. And these things be cōmonly termed instruments which instruments are apointed of Almightie God to helpe vp in the time of néede for without these wée can doe nothing in this Arte. The first is dyet the second is medicaments the third is our handes to minister the same with all and these are named general instruments and also speciall for that that all the aunciēt fathers and most excellent men of this Arte did alwayes so vse them Wherefore I thinke there is no reasonable man or any that is learned in this Arte that will say the contrarie except he will wilfully and willingly condemne both reason and experience and not onely experiēce and reason but also these two most worthie and famous men Hippocrates and Galen This part or those that vse it hath also founde out many notable medicaments with their natures and hidden properties which otherwayes by the Theorike part could neuer be found out yet by long practise and experyence the natures qualities and hidden properties are foūd out to no small helpe of the Arte of medicine for by their natures and qualities they are methodically vsed and doe cure griefes and diseases as sicknesses which be hot are cured by cold thinges those that be moyst by drye thinges c. But those which doe cure by hidden properties are such as no reason can be made vnto as for example To expell venim either in the pestilence or in Morbo camilliontiaci in lepra or in biting of any venimous beast these are rather cured with medicaments which doth it of propertie rather then qualitie Thus it doth behoue the artist which will deale in this parte called Therapeutica or practica not onely to haue perfect knowledge in all these thinges aforesaide but also to haue a very exact knowledge of all such simples as he will make his medicaments of or as he doth intend to minister vnto mans bodie any maner of way not onely as is saide before their natures and temperaments but also their qualities and hidden properties and also the times when they should be gathered how they should be kept and preserued how long they will continue in ther vertue and strength and whether they be of more force and vertue when they be greene or when they be drye All these thinges doth apperteine vnto the Artist to know and also to what vse he ought to minister the same and what commoditie may come thereby These things as I haue sayde vnto you before are knowen two maner of wayes that is to say by reason and experience neither can they be knowen by any third way as Galen saith in his third booke named Therapeuticon Therefore it is requisit that this Artist be not onely learned in the Theorike part as we haue saide before but also to be learned and brought vp vnder some cunning man which hath good knowledge in the same arte or otherwaies it is not possible to come to the exact and perfect knowledge thereof which is chiefely principally required If I should tell you of the vngratious witchcraftes and of the foolish and mischiuous abuses misuses that haue bene in times past and yet in our dayes continually vsed ye would not a little maruaile thereat But for as much as it hath not only turned to the dishonor of God but also the state of the cōmon welth I haue thought it good to declare vnto you part of their wicked doings that it may be vnto you which professeth this Arte an example to auoyde the like most wretched deeds These things I do not speak to you of heresay but of mine owne knowledge In the yere 1562. I did sée in the two Hospitalls of London called S. Thomas Hospitall and saint Bartholomewes Hospitall to the number of CCC and odde poore people that were diseased of sore legges sore armes féete and handes with other parts of the bodie so sore infected that a hundreth and twentie of them could neuer be recouered without losse of a legge or an arme a foote or a hand fingers or toes or else their limmes crooked so that they were either maymed or else vndone for euer All these were brought to this mischiefe by witches by women by counterfait iauills that tooke vpon them to vse the Art not onely robbing them of their money but of their limmes and perpetuall health And I with certaine other diligently examining these poore people how they came by these gréeuous hurtes and who were their Chirurgiōs that looked vnto them and they confessed that they were either witches which did promise by charmes to make thē whole or else some women which would make them whole with hearbes and such like things or else some vacabound iauil which runneth from one countrie to an other promising vnto them health onely to deceaue them of their money This fault and crime of the vndoing of this people were layed vnto the Chirurgions I will not say by part of those that were at that time maisters of the same Hospitalls but it was saide that Carpinters women weuers coblers and tinkers did cure more people then the Chirurgions But what maner of cures they did I haue told you before such cures as all the world may wonder at yea I say such cures as maketh the diuell in hell to daunce for ioye to sée the poore members of Iesus Christ so miserably tormented What shall I saie here vnto but lamēt and pray vnto our Lord Iesus Christ for his precious bloud sake that he shed vpon the crosse to illuminate the hearts of the magistrates for amendement hereof And that this rablement of runagates with witches baudes and the diuells sothsaiers with tinkers coblers and sow gelders and all other their wicked coherents of
many wayes friuolous and foolish For our bodies doe not consist of little bodies called Atomes and of little passages or pores but if this were true it should not be possible to shewe in what maner musterd might change or alter the state of the same pores if any of them should shew the truth yet we would not agrée vnto their sect because they promisse that they wil be content with their apparent communities therefore lette them not vse these names neither let them hinder vs no more in our matters For it is lawfull without the name Metasincrisis to say in other wordes the curation of inueterate vlcers as the Emperickes doe Also we haue declared in the second booke how they talke of this woord Atonias that is to say imbecilitie yet know not what it meaneth For if they vse this name as the Emperickes do then it should signifie nothing else but that the actions are not kept for if they say that certaine faculties doe gouerne liuing creatures which we all the auncient writers doe affirme but yet notwithstāding they repugne against the precepts of Asclepiades also they propound vncertaine things to the which the authors doe not agrée they touch the truth a little yet they commaund to eschew it But tell me true Thessalus what meaneth this worde Metasincrisis if thou saie that it betokeneth to change the pores thou art deceiued and supposest vncertaine thinges But if thou saist that it is a great matter to cure the particle grieued of the bodie as the man thou saist no more thā the Emperikes except the name For they doe knowe that men are made whole by medicines but they know not the cause or reason by what meanes the remedies restoreth health For none of the Emperikes can tell if the facultie of the medicaments chaungeth the pores or if it maketh a Simitrie or if it altereth the qualitie of the Patients particle that is grieued Howbeit the Emperikes are discréete men if they saie that they know onelie one thing that is to saie if they haue noted and obserued the times how vtilitie hath followed when the medicament of mustard hath ben ministred to such vlcers and in what time Neuerthelesse they speake not of method neither yet repugne against it neither be displeased with the notise thereof nor dispraise the ancient writers neither Hyppocrates but rather praise him and affirme that he hath said all thinges well But Thessalus doth not onlie despise Hyppocrates but all the other auncient Phisitions neither doth he vnderstand that he hath written all the precepts of rebellious vlcers without reason emperiklie For if he had written them well then it should haue bene counted a worke most profitable But it appeareth not that he hath done so séeing that he peruerteth the right order of remedies and vseth his remedies to the grieued part before he hath prepared the bodie For this is an argument of great ignorance séeing that almost it is a principle in Chirurgerie that all the bodie must be purged of the euill excrementes before anie strong medicine be applyed vnto the affected parte For who is he that will iudge either by reason or experience for there is no other third thing to iudge by in what art so euer it be nor in anie part of life he shal finde that it is agréeable to reason for a man to minister strong hot medicines to anie particle of the bodie before he hath purged the bodie of all anoiance prepared the same to health for the said medicine draweth the excrements and superfluities from all the bodie like as boxing or Ventosis doth it doth so fasten to the affected part that it may be scarcelie remoued Therefore it must be asked of these Thessalions frō whence this opinion cōmeth to Thessalus to write fables as cōcerning the curatiō of rebellious vlcers séeing that none of the Emperiks nor yet Rationals haue written so before this time For neither Thessalus himselfe neither anie other of his sect dare affirme that the order of such remedies either doth agrée with experience or reason For neither can they giue Indication of time neither yet of the affect of the disease Yet for all that Thessalus is not all together ignorant because he iudgeth that the cause the hindereth the ciccatrise must be considered and taken awaie because also that he iudgeth that this must be done not onelie in vlcers but also in all other diseases as the ancient writers do admonish But they answere nothing to the purpose for they saie alwaies that we do not vnderstand them as if they knew perfectly the thought of Hyppocrates and of all the ancients And they affirme the Thessalus hath a good opinion when he saith that there is a communitie of inueterate vlcers that Hyppocrates vnderstood it so in his booke of Vlcers which writeth in this maner It is profitable that the bloud doe flowe continually from the inueterate vlcer when so euer it séemeth néedfull It were not farre from my purpose if I should speak of the iudgement and opinion of Hyppocrates though I haue not promised that I would so do in this place But that which I will saie shall be of the interpretation of the wit knowledge of the auncient Phisitions the which truelie as yet haue giuen no sect but studying with simple pure minde to inuent some thing profitable to mans health It is well perceiued therfore that they haue found some thing by reason and some thing by vse and experience Then dyd they write their inuentions many times without giuing reason thereto and sometime they did and if they did giue anie reason it was to profit the readers For if they intended to be profitable to their successors and when as they knew reason of inuēting things then diligentlie they set it forth and where they thought it obscure they thought it superfluous to rehearse and therefore let it passe Now it is well knowen vnto all men though I hold my peace that the ancients haue loued no verbositie For that cause afore recited not only Hippocrates but also all the other ancient Phisitions sometime not making mention of the middlemost speaketh of the third thing For if the first be a signe of the second the third of necessitie must followe after the second And thus oftentimes omitting the first and second they spake of the third I haue oftentimes declared how the ancients and chieflie Hyppocrates haue written after this manner But he that will know and perfectlie vnderstand the maner of curing ought to be exercised in their stile and manner of interpreting For this I will intreate of that which I haue purposed The fift Chapter FOr those Vlcers which after medicines to them ministred be not cured those the Phisitions cal in Gréeke Cachoethae but we cal them maligne and rebellious to cure But we haue spoken in the booke aforesaid what the curation of vlcers is Therefore in these kindes of vlcers that be
as it is diuerted to the contrarie partes or is deriued to the parte adiacent or by refrigeration either of the whole bodie or else of the affected partes so that colde potions haue often staied the fluxe of bloud as also colde things in fomentations outwardlie applied In like sorte Oxicratum and sowre Wine and anie other that haue either astringent vertue or onelie refrigeratiue facultie And the diuision is shut if that which is diuided be drawen together or closed or els stopped Trulie it is drawen together both by restriction and refrigeration and ligature and binding but it is stopped either inwardlie or outwardlie inwardlie by the bloud coniealed which the Gréekes call Thombros outwardlie both with this and also with Linamentes Spunges Askars and with such medicines as through the clammie and grose substaunce doe stoppe the pores the Gréekes call them Emplastica and also with putting the foresaide medicines to the hurt parte How euerie of these shall be done it is alreadie set out But the fluxes of bloud which breake out of the déepe partes of the bodie cannot be stopped either by binding or ligature no not with hot yrons and to bée briefe neither with such things as we goe about to touch the diuided bodie with or else the part but rather with reuulsion and deriuation to the partes which 〈◊〉 next Also meate and drinke which haue an Emplastique facultie and by astringent medicines Of these thou half plentie in their proper volumes what Indication is taken of the partes that happen to the common Indications curatiue rehearsed as it were an ouerplus in euerie affect for wée vse sometime Instrumentes according to the propertie of the part some to the Matrixe other to the Bladder and other to all the thicke Intestines for wée make mirtions of some profitable Medicines into the Intestines by a Clister and into the Matrixe by those which the Gréekes call Metrenchitas as into the Bladder by pipes directlie pearced through And truelie the fluxes of bloud by those partes are rare and yet sometime they chance And although they are not dangerous by the profuston it selfe yet when as they long continue they are not voide of perill For we did sée bloud flowe out of the Matrixe foure daies neither coulde it bée stopped by anie remedie vntill wée stayed it vsing the iuyce of Plantaine for this medicine is most profitable to such fluxes of bloud as come through erosion vnto which I doe vse to mixe in this case some more vehement medicine and sometime an other which is proper for the affected parte which thing is euer to be done and to be receiued in all fluxes for the chiefest document For in these fluxes of the Matrixe Bladder and Intestines the quantitie of the profusion is to be estéemed that we may take it as the first or second indication of curation and yet by the waie not neglecting the cause of the whole affect for if anie great vessell bée broken or vehementlie opened and doth gape wée néede astringent Medicines as Balaustium and Hiposistes and Rhoes and Omphacium and Acacia and vnripe galles and Malicorium but if it be a little vessell that is rupturned or but a little opened so that the bloud bée not much which floweth out of it Aloes and Manna and the rinde of the Pine trée and Sigella Lemnia and the fruite of the Aegyptian Spine and Saffron and Lapis Haematites and such lyke bée profitable medicines giuen in redde and sowre Wine but if thou canst not get anie such Wine nor Plantaine nor Nightshade for they are also good wée maye boyle in water the sprigs of Rubus and of Caninus Rubus and Mirtus and Lentiscus and Iuie and to conclude all such as haue an astringent vertue whether it be roote or fruit or rinde or bud and by like reason the decoction of astringent apples and chiefelie Quinces Mixtiles and Medlers is a conuenient remedie The sixt Chapter AND if there happen a certaine fluxe of erosion the Gréekes call it Anabrosin it is not for the more part abundant but small and flowing by little and little therefore you must vse the Trochisce of Pasionis or Andronis or Polyeida or else of our inuention which haue in kinde the same force but more stronger These cease the erosion if regard be first had as is saide to the whole bodie But if the fluxe bée too abundant wée must vse those medicines which are most vehementlie astringent vntill the vehement force be broken then mixe the Trochisce with them and after you maye vse the Trochisce alone with anie of the forenamed iuyces or decoctions And truelie the medicines which are outwardlie applyed to the parte whether they be astringent or colde without astriction these I doe not alwaies allow as many Phisitions doe for they séeme to me to doe contrarie altogether to that which ought to be done to kéepe the bloud within and fill the vessells which are in the déep parts We did sée some of those which did cast forth bloud out of his lungs to be manifestlie hurt by refrigerating the breast so that some of them did vomit bloud because their bellie was refrigerated in like sorte some of them that blead in the nosethrils were worse by refrigeration of the head Therefore I counsaile not euer or without difference or in euerie time that the places which are about the parte whereas the bloud floweth to be refrigerated no not vntill thou hast first tourned it to the other partes As for example in fluxe at the nose when thou hast vsed as I sayde letting of bloud or frictions of the ioynts or binding or fixing cururbites vnder the ribbes But thou shalt not forthwith vse to the forehead and head refrigerating medicines but first reuulsion to the contrarie partes fixing in the toppe of the hinder part of the neck a cucurbite or boxing as it may be tearmed for there is a double euersion of the fluxe of bloud at the nose both that which is to the lower partes of the whole bodie and that which is made to the hinder parts of the head because the nose is placed both in the higher and also in the former parte for that part which is low is contrarie to that which is higher and that which is behinde to that which is before But of fluxe of bloud wée haue hetherto abundantlie spoken It is euident that the affect named Dyapedesis is to be cured with astringent and refrigeratiue medicines and if it chaunce at anie time through too thinne bloud you must vse grose dyet What this same diet is wée shall héereafter set out and we haue alreadie after a sorte set it out in our Booke which is entituled De Attenuante victu Nowe we must retourne to the curation of the forenamed affects Therefore the Vlcer which is in the veine if it bée in the ouer part hath the like curation to an vlcer in the flesh of which I haue disputed in the two bookes going before this For if
haue Pthoe For like as all other things are rightly set out of Hippocrates so also is that Aphorisme rightly sayd that vnto extreme diseases principally extreme remedies profit by what opinion therefore was Erasistratus so madde so slow dull in the beginning of such affects but after when occasion was past to be so diligent for being perswaded by a most fond reason he neuer doth let bloud when as bloud is required nor purgeth any man or yet doth exicate his head Frō which things if the patient being in daunger of that Pthoe kéepe and abstaine himselfe although all other things be rightly done I think he doth nothing more for he refuseth to let bloud and doth onely vse to diuert it with binding of the ioynts whereby as he himselfe saith there may remaine plentie of bloud against the time of inflammation and that we be not for want of it to nourish the patient but peraduenture some wil say sir how Erasistratus If after the ruptured veine the inflammation occupieth the lungs there is no cause why thou shalt hope to cure the man for considerations which I haue set out before Wherefore he shall now no more néede this trauell being betrayed or deceiued by thée at the beginning for he doth like to a gouernour of a shippe when through his negligence the ship is cast away he geueth to some one of the passengers a borde in his hande and perswadeth him so to saue his lyfe but Erasistratus perchaunce did suppose that an inflammation was in the number of those that necessarily follow a wound Notwithstanding if he so thought he was in great ignorance when any man may behold great woūds without inflammation to be glutinated of sixe hundreth such as dayly doe fight a combat so that the second or fourth daye they be in safetie and we haue cured many of those who had some vessells of the lungs ruptured by falling crying or stripe before that any inflammation sprang in the ruptured vessel and if he doe affirme any of these to haue inflammation of the lungs he doth repugne with his owne decrées affirming both that and the principall couering which is next to the heart to haue inflammation and also to be frée from a feauer also the inflammation being broken the man to voyde out nothing Therefore againe let him heare of vs that the Vlcer can not be adglutinated if the lungs be inflamed and that if inflammation commeth of force he shall haue a Feuer and that when the inflammation is broken the patient shall with coughing voyde mattier Therefore if one hath neuer a Feuer or cough nor voided no Sanies from the vlcer and inflammation by what reason is ther in the lungs of this man any inflammation Therefore both this principall remedie is vniustly of him condemned also he letteth slip purging without making mention of it it is no medicine of affect set out of him against any of the forenamed kinde of griefes but if the head send downe flux it shall be kept in the same state or if that cough followeth through intemperatenesse of the members seruing respiration that shall also so remaine so that Erasistratus shall be like vnto the Image maker who when the partes were perfectly made and finished he left the Image without eyes for to what beautie I pray you are the other parts when as thou wantest thine eies Afterward a Gods name séeing so excellent men haue erred that famous man Thessalus which doth not at all know the art iudgeth himselfe worthie to be called a Methoditian and we sée now almost all his disciples to let bloud not onely to many vnto whome bloud letting is not profitable but also to those kinde of remedies which ought to be iudged hurtfull especially if they should stand in their owne suppositions and also to those that are strong which reiect and put foorth bloud either by vomiting or coughing but how shall these hang together that both they byd to let bloud where there is reiecting of bloud and that in their Commentaries they write the remedie herein to agrée with adstrict diseases Now therefore let them call them selues no more Methodicians but Emperickes If setting apart reason which they thinck to be right to vse onely experience to the finding out of remedies are they not in these most clearely found neither by reason neither by any Methode to doe any thing Much more when as they say the parts are vnprofitable to the finding out of the cure But if any doth call to minde those thinges which wée haue taught of the Eares Nose Eyes Mouth Breast and Lungs also of that we haue said of the matrix bladder and stomacke he shall finde them to erre all the way such one was he that to the inflammation in the secrete parts he applyed the Macedonian medicine and with this also a relaxing Cataplasme euen that notable one that is made of Bread water and Oyle also a nother like to him who vsed the same medicines to the place exulcerate But we will speake of such when we shall dispute of inflammations but those Vlcers which are in the yarde or fundament without inflammation require no relaxing Cataplasme but a Ciccatrizing medicine not onely of that nature that may ciccatize the Vlcers in the flesh but that they may so much the more exciccate as these partes are dryer than the flesh yea and that which thou maist more maruell the Vlcers which are in the ende of the yarde called Pene are more to be dryed and those which are in the necke of the Bladder called Cole and those which are without the ende of it called the Acorne or Glans But the Vlcers in the fore-skinne are to be lesse dryed and yet lesse than these whatsoeuer are in the skinne which couereth Therefore when as one of these Methodlesse Phisitions I meane these Thessalians could not cure a moyst Vlcer in the Acorne or Glance with Epulotike medicines that is with such as doe make a ciccatrize He chose mée of counsel when he heard of mée the part required a more drying medicin because it was of drier nature he did forth with beleue me but being of force cōstrained to vse some of our medicines the vlcer was cured in 3. daies and it did well appere that the Phisition reioyced not so much in the health of the patient as he was sorowfull he was trained vp in ill kinde of doctrine for the medicines vsed of vs which is made of Paper combust cureth these kinde of vlcers like as Dill and Gourds being combusted and strowed vpon the grieued part and vsed as before and other like which in like sort doe vehemently drye if there be any such vlcer voyde of moysture to such onely Aloes is a conuenient medicine it must be sprinkled in but dryed and made into most fine pouder and it doth also cure well the vlcers of the fūdament with dry Cadmia washed in wine and dryed hath the same vertue and Litharge is of like
manual tractation of fractures in Cranio called Chirurgia Now I will héereafter shew how much of that is to bée cut awaie that is affected that which is vehementlie fractured is to be all taken awaie and if certaine fragments come out further from it as sometime it is séene to happen it is not expedient to follow these to the end being assured that hurt or damage shall follow to them that haue it if all other thinges be rightlie done wée doing so not once or twice but often haue had our desire And the Indication of doing things is héere also taken of the nature of the affected partes for the ligature which in other fractures reason hath found out to kéepe backe inflammations thou canst not vse to the head Therfore thou canst not staie that which floweth neither expulse out of the affected partes that is in them contained without which remedies none of the other bones can bée conserued sound For imagine that in the arme the bone is broken vnto the marowe and that none afterward doe vind it as it becommeth a Fracture it must follow necessarilie that not onelie the matter which is gathered outwardlie vnder the skinne and muscles but also which is in the marow doth both first and principallie corrupt the marrowes it selfe also with it the whole bone Séeing that when all things are rightlie done this doth sometime chance How then may not such things happen to the head séeing that it cannot haue the ligature which is due to Fractures and also the matter sinketh downe in such sort as all lieth vpon the coate or pannicle in other Fractures when it is well rolled it is so farre that it suffereth no superfluous moisture to be gathered in the affected bone that it maketh the member leaner than for his naturall constitution The waie that is excogitated by ligature cannot both so exact the fractured bone the parts about it that they shall neither be inflamed or yéeld anie mattier neither is there anie medicine which in other partes can without ligature as we haue said kéepe the fractured bone drie frée from superfluities Wherefore we had néede first to make bare some part of the Fracture wherby we may mundifie wipe awaie the Sanies from the coate and when the time of inflammation is past and all is exactlie drie then to incarnate and ciccatrize the place Our talke is not héere naked voide of matter as the Sophists which knoweth not the workes of the art do demand why the fractures of the head hath no Callus they haue O good sirs a Callus and you be so mad that you do assigne causes of that which are not as though they were we in times past did sée the bone of the fore part of the head broken which next followeth this is called Os temporis in which it happeneth that the commissares are ioyned as it were like scales in it there was most long and manifest Fractures which I nothing touching but cutting out the bone of the fore parte of the head did cure the man that he now hath liued many yéeres but if I had in like sort let alone the bone of the fore part of the head the coate vnder it would sure haue putrified then the fracture to haue engendered Callus for if no Sanies should flow inwardlie from the affected parts it shuld haue bene néedlesse to haue cut out the bone therefore they as their manner is doe trifle for I truelie in another hauing the like fracture did thinke to let the higher bone alone and to take out that which was in the sides whereby the Sanies might flow out But when I did marke both the thicknesse and the hardnesse of the bone I did iudge it better to take out the bone than for regard of the fluxe to finite vehemently the braine and I also thought that it might happen that if there were a great hole in the side that the braine might perchance come to this part Further there that not in one place is in the sides a springing of nerues and that of no small quantitie when as in the high bones of the head there neuer springeth the least nerue of all and I being by these things warned did abstaine frō taking out the bone that was in the side of the head and it euer had Callus and if it were rightlie cured and now trulie there resteth that wée séeke out what is our principall scope of all both medicines and eke of all our diligence when as the bone is perforated whether that which is most delicate and answerable to the pleasure of the Patient which now the most part vse or else that which is héereto repugnant that is that which is done by most vehement exiccatiue medicines which Meges Sidonius doth praise and a certaine Citizen of ours doth alwaies vse insomuch that he forthwith applied to the bare coate or pannicle an emplaister called Isen and vpon this outwardlie Oximell trulie this old man was sufficientlie exercised in this part of the art but I did neuer sée anie other vse them neither yet durst I doe so Notwithstanding I can thus much witnes with Eudemus for that was the olde mans name they rather escaped which were of him cured than of those who vsed delicate medicines and I had also gone about to trie the like waie of curing if I had continuallie remained in Asia but séeing I haue bidde at Rome I doe followe the manner of the Citie committing the greatest part of such workes to those whom they call Chirurgions But iudging the nature of the things it selfe I conceiue that such certaine determination to be confirmed by our experience The auditorie cunduit which stretcheth not onelie vnto Dura mater but also toucheth the nerue which goeth from it to the braine this although it be so néere doth abide as it is said most vehement medicines Therefore it is no meruaile if after the perforation of Cranium Dura mater before it is much molested with inflammation doth desire most strong medicines hauing naturallie as it were a drie substance FINIS Thomas Gale vnto the friendlie Reader IT is requisite that euerie one that vseth this art of Medicine in the curation of diseases or sicknesses not onelie to know the diuisions natures of the same but also to knowe the names by meanas whereof euerie one of the same may be knowen from another and chieflie in this part for the better vnderstanding of Tumours against nature wherin Galen hath taken great paines not onelie in their true diuisions but also gathering together their most apt and auncient names giuen vnto them by the olde writers And if anie names did lacke for such sicknesses as raigned in his daies he did deuise most apt and conuenient names for the same Aristotle saith whosoeuer is ignorant in the tearmes of his art that he is ignorant in the whole arte Therefore it is necessarie for those that professe so noble an art as
greatly delighting them selues in the onely dignitie of the Arte not knowing what it meaneth which doe oftentimes let bloud their poore patients without any IndicatioÌ„ or councel of one learned in the same arte or of some graue and learned Phisition but also they will geue inward medicines a gods name a matter truely most worthie of publike punishment For as much as I haue séene many by such their rash and bold enterprises brought into daunger yea and some haue I séene miserably languished and depriued of lyfe Therefore let not that young Chirurgion which would be estéemed worthie of his arte presume to take in hande these thinges without the councell of an auncient maister learned in the same arte or else a graue Phisition such a one which is learned in the arte of medicine the matter it selfe geuing also such libertie or time But otherwise if there be no learned maister present or that any present necessitie doe constraine the same then truely the younger Chirurgions may boâ—…t bloud and also if néede bée minister a medicine so that he haue good erudicion iudgement and experience Moreouer the Vnguentes where with the Chirurgion ought to be furnished and the same to haue alwayes in his saluetorie as these Vnguentum Basilicum Vnguentum Apostolorum Vnguentum Aureum Vnguentum Album and Vnguentum de Althea as Basilicon to superate and materate and Apostolicon to mundifie and clense Vnguentum Aureum to incarnate and to fill Vnguentum Album to cicatrise Vnguentum de Althea to cease dolour and paine and to make soft Moreouer as for emplaisters pouders fomentations and such like the expert Chirurgion doth prescribe of them very many sortes according to the reason of curing And these are the medicinall instruments pertaining to the art of Surgerie By the manual instrumeÌ„ts ye shal chiefely vnderstaÌ„d instrumeÌ„ts of yron very méete most necessarie to the ChirurgioÌ„s vse wherof some are to make incisioÌ„ to cut of a thing other some are to draw out certaine are to search also some be properly to stitch or sowe and other some to make adustion to cut or make incision Forfices Nouacula rasorius scalpellum Chirurgicum for Phlebotomie seu lancetam forsipes to draw out called commoÌ„ly Tenaculae volcellae seu volcellae which in French they call pinsettas the crooked hooke vncus seu vncinus and that Yron instrument which the Grecians call Diocleum graphiscum is apt as Celcus writeth to draw out arrowes For to serch we doe fitly vse a probe for to sow a néedell and a quill are properly vsed and to adustion diuerse kindes of cauteries commonly called actuall are occupied and for the variable meanes of their vse they haue diuerse figures and diuers names for some be sharpe at the point and other be not and other cauteris they call myrtea oliuaria dactilica cultellaria so called of the similitude of thinges which these instrumentes doe represent for the cauteris called Mirtia doe imitate the figure of the leaues of Mirtills Oliuaria of an Oliefe dactilica of the Date as Cultellaria doth represent the forme of a knife these are the common instruments necessarie for Chirurgions There are certaine other instruments proper and appointed to certaine partes of the bodie as modioli which the common Chirurgions call Trepans malleus scalpri and the same are conuenient to scrape cut or pul out bones as well of the head as other parts euen as Falx is proper to the fundament speculum oris to the mouth and speculum matricis to the matrise there are innumerable other sorts of instrumentes conuenient to drawe out dartes gunshots other infixed things whereof to speake I doe now cease and will prepare my selfe to set out a Chirurgion what maner a man the best ChirurgioÌ„ should be which thing I often times haue declared to be the chefe effect of the matter for wée know what Galen hath saide of the Phisition aswell in his booke De institutione artis medicinalis as also in the third booke de naturalibus facultatibus and in his third fourth de methodo medendi Galen calleth him that cureth woundes and vlcers medicus that is to say a Phisition he saith that the Phisition ought to be prudent and well exercised and also he ought to be of quicke nature and of pregnant wit that he may promptly obtaine all thinges and verie well instructed in learning and moreouer appointed to the best maisters to learne of and one induring labor paine a great louer of the truth studious and most déeplie vnderstanding his art approoued by much vse and long experience and all this saie I must be applied to the Chyrurgion which will bée most excellent estéemed for an vndoubted Artist but beside these there be certaine things which doe pertaine priuatlie to a ChyrurgioÌ„ as to the manual Artist do not so much pertaine to the ancient maister of the art of Medicine for a Chyrurgion ought to be a young man or els but little past youth that is betwéene the same and auncient mans estate for the age flourisheth most in sense strength to exercise rightlie whatsoeuer belongeth to his art wherfore they which are aged men cannot so aptlie bring things to passe which arte requireth for the imbecilitie of their senses for they follow them rather by counsaile Furthermore he must haue a sure and strong hand and steadfast to all workes that hée shall doe whether it be to make incision adustion also for the cutting awaie of a member Also it behooueth him to haue a quicke and cléere eie and he must not be fearefull of mind but rather without pittie if he do intend to cure him that he taketh in hand Furthermore neither let him make the more hast neither let him cut Canteries or cut off lesse than néede requireth for the clamor or crying out or for the tendernesse of the sicke Patient but let him doe all things as though he heard not the clamors of the sicke neither let his minde be therwith anie thing troubled And wée haue declared that a Chyrurgion ought to excell in learning for therein chiefelie doth his erudition manifestly appeare if he vnderstand exactlie both the Theorike and the Practike parts that is to saie to know things naturall and not naturall and also those that are against nature Also if hée know what be the causes of wounds vlcers fractures and luxations with their accidents and also what be their conuenient remedies and how to remoue the same In lyke manner he shall excell in practise if hée haue had much and good exercise in the operations of his Arte by working spéedelie trimlie and readilie consulting with the auncient maisters of the same arte in those things that pertaine to Pharmaceuticen Diateticen And although he vse those things which be searched out by reason confirmed by frequent vse wherein truelie the faith and honestie of a Chyrurgion séemeth chieflie to consist The Chyrurgion ought to
discourse of our talke it is euident that both the nature of the Patient is to be considered and also that there is a proper curation for euerie man and yet furthermore the third thing that is to saie because there is an ineffable propertie of euerie nature neither comprehensible by the most exact knowledge he is the best Phisition of euerie perticular patient which hath gotten the method wherby he may discerne natures and also coniecture which are the proper remedies of euerie one For it is an extreame madnesse to iudge that there is a common curation of all men as these most foolish Thessalians doe thinke and for that cause they suppose that all the Theoremes of Phisick are ordained that is they are such as skilfull men doe and performe a farre knowledge of themselues and that the art is a certaine knowledge of communities and not properties as though they should cure a vniuersall and not a perticular man therefore lyke as in all other euen at the beginning they erre so they erre also in this for the generall or common man is not cured but euerie one of vs hauing another complection and nature But these truelie thinke ther is a cōmon cure of al men I trulie iudge cōtrarie for if I knew how to find out exactly euerie priuate nature I would think my self to be such a one as I conceiue in my minde was Aesculapius But forasmuch as that is impossible surelie I will goe as man maye doe and I haue decréed to exercise my selfe and doe also exhort others to doe the same and the emperickes as much as they can to learne those things that are common so to draw néere to those that are proper but yet how much they are wyde from the perfection of the thing it is before spoken For these notes for children or women or olde folkes or those that haue soft fleshe and white and such lyke are not to be put as they think for sure differences but rather how the bodie is affected in moystures and drynesse and it is conuenient as much as may to allow the Emperick Phisitions both for many other things and also for that they go as néere as they can to the propertie of the sicke For after all their other separations which they make they adde also that which is taken of custome as though hereby they shall finde remedies which are more proper for the pacient But we will speake hereafter more largely of custome when we shall proue the difference of custome inuented by the olde writers for the knowledge of the propertie of the pacients nature These with the rest the Empericks receiue and also do confesse that the Phisition which visiteth the pacient shall better cure him than he who hath not séene the sicke Yet for all that when as they haue added all these things they will not as yet saye that they haue a sound and skilfull knowledge of the proper curation of the pacient But that most impudent Thessalus onely vnderstāding that an hollow vlcer must be filled affirmeth the Theoremes of Phisicke to be constant and firme although as before is saide all men know at the least this thing not onely they which now be after this Thessalus as another Aesculapius was borne but I suppose also those that were before Deucalion and Phoroneus if these were reasonable and besides if they knew how a hollow vlcer is to be filled with flesh Further they were not ignorant that he is a Phisitiō which knoweth those medicines wherewith such an vlcer is to be filled with fleshe But if these medicines be inuented by experience it is most certaine that we must cure Empericklye but if they be found out by reason then we must cure reasonably for truely he findeth not out one medicine and vseth now an other aptly but if this our strife is with the emperikes that truely which I began to say true Phisicke it selfe doth make coniecture of the nature of the pacient I suppose the common sorte call it in gréeke Idiosyncrasian and all they confesse it to be incomprehensible and therefore they leaue the true arte of Phisicke to Aesculapius and Apollo Surely all this knowledge standeth of a double beginning for an obseruatiō the Emperickes take the beginning of those thinges which manifestly appeare the Logicians truely of the Elements themselues For that another medicine hath profited other very children doe now well néere vnderstād and reason which is grounded on the Elements doth also confirme the same For if thou doest make xv differences in the complexions of men by reason of excesse and defect and that onely in moyst nature truely it shall also be necessarie that thou knowest xv differences of medicines which thou wilt vse of which some drye more and some lesse whereby thou maist finde that agréeth to euery nature and if also in drye complexions there be put other xv differēces and thou require other xv medicines also to these thou shalt haue in all .xxx. medicines which shall agrée to xxx natures which onely he can rightly vse which hath diligently exercised himselfe in the temperaments of bodies Whether therefore if all the bodie be of a dryer complexion shal it be cured by medicines which doe more exciecate if any part of the same be dryer by nature than the rest shall it require lesse drying medicines Also whether is it here euident that what parte hath a dryer temperament requireth dryer medicines that which is more moist lesse desiccatiues And all this truely these methodlesse Thessalians doe let passe which thinke one medicine to agrée with euery part truely the Emperickes how much in this thing doe they excell these Thessalian Methodicians so much are they inferiour vnto true Methodicians and Logicians although they in déede being taught by vs haue also one medicine for Vlcers in the eyes another for those in the eares or ioyntes or flesh or onely skin but that in those they cannot go to an other medicine it may easely appeare by that we haue heretofore spoken The eight Chapter NOw seing that wée haue sufficiently spoken of these thinges let vs againe returne to the beginning of our disputatiō and let vs mixe with an vlcer all such affectes which are cōplicated with it beginning first with intemperatures If the exulcerate flesh either béefore by any occasion or in the time of the vlceration be made either more hot or colde than is méete it doth require a remedie which doth not onely moderately drye but doth also make hot or refrigerate so much as the part affected is gone from his naturall state when as it cannot come to passe that either there shall be flesh ingendred in the vlcer or the hollownesse filled or adglutination to be made or to ciccatrize well except the fleshe subiect be according to nature neither was it spoken in vaine that these are the woorkes of nature but filthie vlcers may be mūdified they that are supercrescent diminished the flesh not keping hir naturall state
happen to the vlcerate partes as wel by the occasion of anie perticular member as of all the bodie wherevnto the bloud or anie ill humours doe resort first remedie must be had either to the particle that is cause of the fluxe or else to the whole bodie Thus then we shall cure first the varices that are often resorting vnto the vlcered place before you cure the vlcer and then afterward you may the easilier cure the vlcer Likewise in them that haue a disease in the splene or in anie other notable part first it behoueth to cure the sayd parte and then after to procéede to the curation of the vlcer howbeit none of the curations héereof is proper to the vlcer but some other affects or dispositions that either engendereth the vlcer or that nourisheth and conserueth it The third Chapter BVt now I thinke it time to define that there is no indicatiō of outward or as they terme it of primitiue causes of curation but the indication or curation to haue his beginning of the affects it selfe But those thinges that ought to be done perticularlie are found out either of that which the indication sheweth either of the nature of the affected part or of the temperature of the aire or other like things but to speake brieflie no indication may be taken of things that be not yet come But forasmuch as we ought to know the affect that is not manifest vnto vs by reason or wit we are often constrained to enquire of the extreme and primitiue cause For this occasion the vulgar people supposeth that the saide primitiue cause is Indication of curation which is altogether otherwise As it appeareth likewise in those where the affect may be exactlie knowen For if Ecchymosis or an Vlcer or Erisipelas or putrefaction or Phlegmon bée in anie parte it is a superfluous thing to enquire the efficient cause of these diseases except they be remaining For in so doing we shall cure that thing which is alreadie finished and shall prohibite the efficient cause to procéed anie further But if the said efficient cause which produced the effect hath no longer biding there then we shall remooue awaie the affect For to put awaie the cause that is not there it were impossible For curation appertaineth to the thing present as prouidence to the thing to come For that thing which doth not now hurt neither is to be feared that it will hurt héereafter is out from both the offices of the arte that is to saie from curation and prouidence Wherefore in such thinges there ought to bée no searching of anie indication neither yet to cure nor to prouide as is sayd before notwithstanding the knowledge of the primitiue cause is profitable to vs in things vnknowen Neuerthelesse the Emperikes take sometime the primitiue cause as parte of the course of the disease that the Gréekes call Sindrome wherein they haue obserued and experimented the curation as in that that hath bene hurt with a mad dog or venimous beasts Thus doth also some Dogmatists which doth affirme to cure such diseases by experience onelie without rationall Indication for they take the cause primitiue as part of all the Syndrome and vniuersall course but the primitiue cause serueth nothing to the indication of curing although it be profitable to knowe of the nature of the disease to them that haue not knowen the nature of venimous beasts by vse and experience and thereof taketh indication curatiue trulie the outward cause of curation béeing knowen doth nothing profite to the indication but to the knowledge of the present affect For put we the case that we knowe that the venime of a Scorpion is of a colde nature and for that cause as of a colde thing I take Indication for the remedye howbeit the case is suth that I haue no signe whereby I doe vnderstand that the bodie is hurt of a Scorpion it is manifest that if I doe knowe that the bodie is hurt of a Scorpion that then I would inforce me to warme all the whole bodie and also the part affected without abiding for anie experience in taking mine indication of the nature of the thing We haue declared in the booke of Medicaments wherein it behoueth them to be exercised that will take anie profit of these present Commentaries no such facultie can be foūd without experience Truelie it should be a gifte of felicitie if anie hauing the sight of Litargerium Castoreum or Cantarides forthwith to vnderstand their vertues For like as in all things is committed error as well by those that excéede as by those that lacke so héere as the Prouerbe is among the Gréekes this Thiapauson that is to saie they differ among themselues Also they affirme that the vertue of medicines is not yet knowen and that after so great experience the other that suppose and saie that the saide vertues be knowen onelie by experience The first speaketh vndiscréetlie if that be a thing imprudent to affirme a thing impossible the other be altogether stupidious sturdie and foolish But for this present time we will saie no more because I haue spoken more plainlie in the third booke of Temperamēts also in the bookes of Medicaments Neuerthelesse for the knowledge of diseases some primitiue causes are profitable but after that the present disease is altogether knowen then the cause primitiue is totallie vnprofitable Now we haue declared that it doeth not become vs to meddle and confound both the doctrines together but the Emperikes ought to be spoken by themselues and the rationals by themselues We must now call to mind because we haue purposed in this present Commentarie to intreate of the doctrine Rationall although to some things that we do saie we doe not adde absolutelie that all be not true but onlie after the sentence of the methodicall sort but that euery man ought to adde and reason that thing by himselfe And at this time we haue said that there is no cause primitiue which is profitable to the Indication curatiue although it serueth well to the knowledge of the disease And we confesse that the cause primitiue is part of the Syndrome and of all the Emperikes course that they cure all diseases by reason by experience But in all that we shall saie héereafafter it is not necessarie to adde such words Then let vs returne to our first purpose in taking the principall indication certaine and vndoubtfull whereof we haue also vsed héere before as we haue said that the disease that requireth to be cured iudgeth the end whervnto the Surgion ought to intend and of the same all other indications are taken Wherefore we haue begun to speake that the said indication hath no manner of affinitie with the cause primitiue for put we the case that anie vlcer be come of a fluxe in anie part then it is manifest that the sayde vlcer procéedeth of corrupt humours for nature is accustomed so for to doe in diseases when she purgeth the bodie
it come of a gréene wound thou must make it close with medicines called Enaema or if they come of erosion you must discerne them first by reason and what is spoken of the curation of rebellious vlcers to proue that by diligence they may be healed Also when as thou wilt vse binding or medicines stanching bloud or hot yrons that is the scope of curation that thou doest incarnate the places about the lyppes of the Vlcer and that thou vsest all together the sayde medicines which are set out of vs in the methode of hollow Vlcers The seuenth Chapter WE haue now saide that the arterie béeing wounded séemeth to many Phisitions impossible to be closed And that doe some of those affirme who be professours of onelie Experience and some vsing this reason For they saie the one coate of the arterie is hard and cartilagious but such bodies cannot vnite together when as the abilitie of vniting is onelie of soft bodies as may appeare in extreame thinges neuer stone ioyning to stone or shell with shell and also in our selues for neither Cartilage with Cartilage or bone with bone doth growe together for broken bones truelie doe not cleaue together by vnition but are ioyning together by Callus the Gréekes call it Poron as it were with Glew Therefore we will also beginne first with our Experience and put before your eyes those things that wée haue séene in women and children both the arteries to bée conglutinated and also to be compassed about with flesh and that in the forehead anckle ioynt of the arme and wrist such a like thing happened in time past to a rusticall young man when in the spring time he would be let bloud which our Countrie men haue in great vse but when the Phisition who should open the veine had bound the mannes arme it happened the arterie to rise bounching vp and the Physition opened it in stead of the veine trulie the Orifice was verie small the bloud straight waies issued out yeolowe thinne and hot and that as it were leaping pulse like and the Phisition truelie like as hée was a verie young man so was he little exercised in the workes of the Arte though he had opened the veine but when I with another of the auncienter Physitions that were present did beholde that which had chaunced preparing a medicine of the kinde of Emplaisters that staunch bloud I did both diligentlie ioyne the diuision and also by and by laide the medicine on and vpon it bound a most soft Spunge He which had cut the arterie meruailing of our straunge doing in this case I tolde him what we had done after we were out of the lodging of him that was let bloud and we commaunded him that he did not loose it wée béeing absent and that hée should not goe about it vntill the fourth daie but letting it remaine as it was onelie moistning the Spunge after we vnbinding it the fourth daie we found the Incision conglutinated and we bad him applie the same medicine againe and binde him in lyke manner as before and then after many daies to loose it and so the cut arterie of this man was healed Among all other I neuer sawe none cut in the Cubite but Aneurysma followed to some greater to other lesser But how Aneurysma ought to be cured we will héereafter in his proper place set out whereas the curation shall bée set out of Tumours against Nature Now let vs finish our disputation begun Surelie the nature of the Arterie sheweth difficultie of conglutination of the harder coate but yet not such as may not be ouercome neither yet is it so drie and hard as a bone or cartilage yea it is a great deale more soft and fleshie than they are so that we néede so much lesse to dispaire of the vnition of the diuision when both the diuision is little and the mans bodie naturallie soft It seemeth that Experience onelie doth also subscribe to Reason when as I haue séene it glutinated in children and women by reason of their moisture and softnesse of their bodies and in one young man whereas is sayd the Arterie was but little diuided And although an Arterie bée harder to cure than a veine yet there is no contrarie vse of medicines in both yea they bée all one in kinde varying onelie by reason of excesse and defect For the Arterie doeth require so much more drying medicines than the veine howe much by his proper nature he is of dryer temperament than the veine But if thou wilt engender flesh about both they both require like medicines for flesh is in like sorte engendered in compassing the veines and arteries as is shewed in filling of hollow Vlcers And the veines and arteries that are in the matrix bladder or intestines séeing that they require medicines like in kinde when as they are exulcerated they also require Instrumentes whereby Iniections may bée made Metrenchitas that is Clisters from the matrice and a pipe bound right through and a Clister And to these Vlcers which are in the intestines you may make iniections of the liquide medicine bloud warme contayned in a bladder vnto the end of which is annexed a right pipe The substaunce of the medicines shall be varied according to the forme of the Instrument Neither is it méete to poure into these Instruments grose medicines but they require moisture and therefore for the more part moderatlie hot Therefore drie medicines are more apt than those that are named Liquide because they are easilie mixed either with the iuyce of Plantaine or anie other of like kinde Such be Saffron and Pompholix and Aloes and those that in Gréeke are called Cephalica In the first time of engendering flesh which is presentlie after the suppression of the bloud Terra Lemnia is an healthfull remedie The eight Chapter BVT the Vlcers that are in the lungs are more hard to be cured and truelie in some the cure is not onelie difficill but also séemeth not to be done at all as well to them that followe Reason as also to them that professe Experience by Reason so that among the inward partes it is thought to be continuallie mouing wheras those vlcers which are to be cured require rest and quietnesse as Experience sheweth because they neuer sawe anie cured that was so affected And peraduenture we maye doubt of Experience For it is méete that we beginne héere for knowledge sake for wée haue séene one for the hée cried loude another falling from an high place and another striken in wrestling not onely presently most grieuously to cough so that also with the cough some to vomite one or two pynts of bloud and some other more of those that were in this case Some of them were altogether without dolour and some complained on their brest Furthermore the bloud in those that complained was not cast out altogether neither was it much and lesse red or hot as that which came a farre of but to those that were voyde of griefe the
Furthermore Callus in Gréeke or Poron shal so luckely follow when it behoueth to the generation of it as it is afore declared some of the proper norishment of the bone to be gathered together and grow Therefore this is now to be cōsumed away from the lips of the fracture or else to be euapored for else truely it shall make solution of continuitie neither shalt thou let it slip so long time that thou knowest not how the fracture goeth forward for we haue often séene that when the bones were vehemently dryed Callus hardly dyd grow Wherefore it is méete to poure vpon these a little warme water the third or fourth daye leauing when as the flesh riseth in a red tumor and wée must leaue herein before it beginneth to asswage Contrarywise when as we will digest any thing we shall not leaue of before all the tumor be vanished which sprong of the perfusion and whereas the aboundant moisture is and let that Callus doth not better grow there we shall go about with cōuenient ligature to exicate as is before saide and with perfusion of water which must be altogether little or much for it shal be but little when it ceaseth and before any thing floweth to it the humors which be about be digested and doth dissolue those which are déepe fixed For it is expedient so to lose dissolue these which are to be expelled by rolling for a great deale of water doth more digest than attract Surely it is euident that in that ligature which doth expell the endes of the rolles are lesse to be coarcted but wheras we must nourish there the endes must be straiter and the other inuoluings more lose Now séeing we haue founde out not onely what time we must helpe the generation of Callus but also by what maner now there resteth to set out the vniuersall order of diet For in the beginning they ought to vse most thinne dyet as we will proue when we take in hand the proper curation of inflammations Furthermore we will declare that sometime it shal be expedient to let bloud and also to purge but what time Callus is ingendred the bodie is to be nourished with good iuyse which may much nourish of which there accustometh to follow not onely good iuise but that which is also tough of which principally Callus is made for séeing that it cannot grow of a serous and thin moisture that it can spedely grow of that which is grose and brickle and voide of fatnesse but yet in time waxeth drye it is made friable and apt to breake The bignesse of Callus shal be such as it were a safe band to the bones yet not compresse the muscles for that Callus which is to little is not sufficiēt for the bones that which is to great bringeth dolor to the muscles so that diligent hede must be had to encrease it if it groweth to little and to let it if that it doth increse to much And thou shalt doe these both by the quantitie of the perfusion and also qualitie and quantitie of meates and also the faculties of medicines which are to it outwardly applyed but we haue before spoken of perfusion and order of dyet of medicines and such as haue an emplastike substāce do moderately heat they doe both bring forth Callus and also increaseth them But such medicines as haue a digestiue facultie doe deminish those Callus which are now great but if thou studiest that neither Callus shal be encreased or deminished but art content to let it grow further vse thou some of those medicines which are applyed to gréene wounds which because they doe moderately drye they cause Callus moderately to coagulate and grow and this is sufficient touching ouerthwart fractures Now of those that are in length the cure is in all points as the other but yet the ligature must be straiter made in the fractured place and that which is a sunder must be inwardly thrust to those which are diuersely fractured and chiefely with a wound as it doth cōmonly happen to these Hippocrates willeth that splents bowed like a sawe and dipped in redde and auster wine chiefely in sommer be put about it For if any doth vse either Oyle or Serot they doe putrifie because the affect being goeater than the rest doe more drye than they require to be dryed And let all the medicines as he commaundeth be drying but yet considering the meane of excication he willeth such medicines to be of the kinde of Enema But if any shall at the beginning vse an Enemon medicine let it be such a one as is apt to be poured in and all other thinges are to be done after his precepte not onely in these rehearsed but also if the bare bone requireth to be cut with a saw or that thou shalt take away some fragment or that it behoueth to minister to nature expelling it what so euer Hippocrates doubted of those instruments which the legges are to be layde in called Solenas whether they are to be vsed or not all men doe know that I iudge the reasons laudable and Glosconum which is inuented of the later Phisitions we doe account it as worthie of praise as anie other doe vse it when in the time of engendering flesh Yet it séemeth that Hyppocrates knew not that although otherwise he was not negligēt in excogitating instruments which should be profitable but the instruments in which the legs are placed was rightly deuised of them that by one axiltrée which was placed in the end of the instrument at the lower parte caused by a double extension a contrarie indeauour to the whole member the one of thē which extendeth the member right out is called in Gréeke Eutigporos the other which extendeth it first vpward afterward backward is called Translatiue in Greeke Metaleptice both are done by bands or cordes that band is most aptest to this vse that hath two ends for this being put about the member the armes being put about the axiltrée of it maketh the first extension called Eutigporos and when as the band is put about the parts of the broken member it maketh the translatiue extension called Metaleptice the armes of him being moued first vpward after backward for these are also to be put about the axiltrée Furthermore the armes with the bands being put about as it were bowed the extention which is made frō the higher parts to the lower ought to be done by the pulley or vice which are placed in the sides of Glottocomon thou maist call this instrument Solena with his adiection Solena Machanicum or Glottocomon Mechanicum but we shal more largelie speake of instruments whē we set out the cure of luxations where also we will no lesse speake of the varietie of ligatures which are to be put about Now séeing I haue made mention of Solena Mechanicū which doth much profit the leg but when it is reposed otherwise put or whē as the