¶ Galenes third Book of the composition of medicens.
GAlen (the father and light of Phisick) séeing the great abuse whiche was in his time in the curing of wounds and hurts of
Nerues or Sinewes: thought it necessary (in this his third Book of the composition of medicens) generally to intreate and write the method or maner of curing wounds in y
e
Nerues or Sinewye partes, which cure before
Galenes time was much abused, and many patients suffered bothe terrible torments with losse of their limmes and also gréeuous conuolsions and painful cramps, not without daūgerous feuers and great putrifaction, hastening vntimely death.
So that there was none that had the perfect cure therof, for at the beginning: they vsed conglutinatiue and knitting medicins,
The errors which haue been vsed before Galens time. which they ought not to haue doon. And if there chaunced any inflamation: then they fomented the afflicted place with hot water, and applyed
Cataplasmus
[Page] of whete meale, boyled with
Hedraelaeum, that is to say Oil and water boyled togither, in the which was a great error and contrary to all true method, for in so dooing: the diseased parte quickly corrupted, and came to putrifaction, by reason of vnnatural heat and to much moisture,
Hot and moist ingē dreth putrifaction and corruption. which are the onely and cheefest causes of putrifaction.
Neuerthelesse it dooth not followe that at all times drying & cooling things ought tobe vsed, because that the colde is an enemy to the Sinewes,
Hip. lib. 5 Aphoris 20. as
Hippocrates testifieth, wherfore there must be vsed drying things tempered with mode rate heat, or at the least more declyning to heat then to colde, which ought tobe of a suttle and percing substance, for heate alone dooth not ingender putrifaction, except it be mixt with abūdant moisture.
And after these things béeing well considered: there must be diligent regarde whether the Sinew be vncouered or not,
Method for the cure of Nerues. for if the sinew be vncouered: the medicen ought not to be so strong, for in such a case, gentle and milde medicens are most meet where the Sinew is bare otherwise it wil bring moste perrillous accidents.
These medicens that are héer rehersed are of a thin suttle substance or nature, as
Succus cerenaeus,
The qualities and faculties of Simples, which must be vsed in these medicens.
Succus medicus, Sagapenum of the East
Euphorbium of the West, and the iuce of
Tithimales. Of minerals or medicens which are found in the Earth, some be very suttle as
Aphromtrū id est Nitri spuma, the frothy parte of
Nitrum, which easely wil dissolue or be melted in water. Like wise these are suttle,
Nitrum beronicum and
Asia Petra, the floure of which among all earthly medicens is the most suttle. Of metalls
Lorpin and
Sulphur be both suttle and hot. After these
Misy, verdigrece and
Chalcitis a mineralls of Lime, the which be very hot and somewhat astringaunt.
Therfore in the compounding of suche suttle medicamentꝭ: we commonly burn or at the least wash and such like to mitigate the sircenes of their corosiue & fretting nature as
Chalcitis. And next to this are placed
Spodium, Pompholix, Psoicum &
Chrisocolla, medicens of suttle substance, without any smarting heate. And of the like qualities are
Succus laurinus and
Cedrinus, that is to say the iuce of
Bayes and
Cedre. Neuerthelesse
[Page] the
Bay is not so suttle as the
Cedre. And of the like qualities and kindes is the licour or water of
Lixiuii whiche the
Greeks call
Stacta, and yet Oile of
Cedron is of a greater and more excellent vertue, although that the said
Lixiuii be made of suttle things moste finely and artificially burnt.
The composition of this said Lixiuii.
Is of a wilde Figge trée, whiche the
Greeks call
Erineon, and of
Tithimales burnt. The best of y
e said
Tithimales is y
t which the Gréeks call
Characias, which is the male & the greatest moouer. The Corne which the Greeks call
Sitera that is to say Whete, and
Eruus or
Orobus is the moste suttlelest, considering that they haue no great facultie to heate.
You shall vnderstand that the moste parte of Simples whiche are suttle and fine are hot. And those which are of grocer substāce, colde, the reason is euident, for the heate is suttle and light, and the colde: thick and heauy, and dooth bothe represse and binde togithers.
Yet for all that some colde Simples haue a sharp qualitie with suttle substance, yet in operation it is cooling, as
[Page 9] Vinagre,
Cold is an agent qualitie aswel as heate. for among all the Simples it is moste suttlest.
Therfore it is necessary to haue good knoweledge in the nature and qualitye of simples,
Method for the knoweledge and facultie of Simples and how they must be vsed. wherof medicens haue their béeing. For without the knowledge therof: it is not possible to doo any thing in this art, and especially in the cure of Sinewes worthy commendation. It suffiseth not to haue great store of Receipts, except ye knowe the particuler nature of euery simple. And with hauing knowledge: he shalbe able to frame his composition him self, according as the nature of the gréef shall require.
The parfit knoweledge of Simples is in thrée thinges, that is to say, of plants, of metalles, and of liuing things, and it is not sufficient to sée them once or twise:
Euery this in his time but you must marke and beholde them often, as in their beginning, growing, state, and declination.
All things are kept in their place out of the which as soon as it is remoued it is y
e more subiect tobe corrupted. For by this beholding: you shall knowe in what time it is best to gather them, if they be not gathered in their due time: the heat of the Sun will burne and take away their vertue. And also the place where they must be kept ought tobe temperate in heat & moisture, for feare of chaūging
[Page] their nature or vertue, for without the knowledge therof it is not possible for a Chirurgian to haue the true vnderstanding and method to compound medicens nor to gouerne well the curation of diseases.
So then it is necessary to knowe the nature and facultye of Simples whiche is amply shewed in many good Bookes and especially by
Galen in his Booke of Simples.
I finde a certain history in the foresaid Author the which I think may wel and fitly be rehersed in this place,
The history for an example of the cōtusiō of ioints. to make this more plain to y
e reader. Vpon a certain time there was brought to
Galen a childe, hauing a cōtusiō or broose vpon the first ioynte of his middle finger in such sort y
t the whole ioint began to putrifye & corrupt, thē
Galen applyed to the putrified parte a
Cataplasme or
Pultise, made with Barly mele & wax, & fomēted it with the
Lixiuii roūd about the afflicted place, but where there was gréefe and pain: he made fomētation with hote Oyle, and then after the moisture was drawen out, by the applying of dry wul, he vsed a medicine made with Oil, wax and
Euphorbium, by the which meanes
[Page 10] he preserued the ioynt. The like he did to an other which came to him in winter which had great colde with pain in his Knée continually, the which he cured in like maner with Oile and
Euphorbium, for the Sinewes and tendones
The tendones are dryer then the sinewes doo receiue all one curation, and the accidents that chaunceth to the one: chaunceth to th'other. For the names of such passions or gréefs it is no matter, for because it is not the names that doo either good or harme. But it is the facultie of the medicins which doth all. Let vs return to the cure.
Afterwards the said Childes finger began to putrifie more and more, and he began to féel pain and gréef vpwarde in the whole places. Then
Galen in the place of Barly mele: y
e tenth day, did vse the mele of
Orobus w
t the said
Lixiuii, or
Stacta wherewith the Patient began to amend,
Stacte was made of stilled wild Fig leaues and within iij. dayes was eased of his pain, sauing that there remained in y
e brused place, a certain
Neruous or knotty substance muche like vnto a great tendone y
e which was redy to fall, & after béeing half rottē: fel all togithers, which did make many think, seeing this knotty substance: that the Sinew had
[Page] béen altogithers rotten, which was for lack of the knoweledge of their Anothomy, and for lack of that knowledge they did not consider how the Tendones
The tendones and their cituation. or Cordes are couered with the said
Nerues, Membrana as defensatiues, not only throughout the inside of the hād: but frō thence go in order to all the fingers.
Then after that
Galene had taken away that which was putrified from the said broose: the corde was very sound and clene, & then he vsed
Trosis dissolued in
Sapa, & applyed it in y
e foresaid
Neruous parte, & made particuler vnction again and in like maner vsed the
Pultis, and the anointing with
Euphorbium as afore said. And when he had thus doon: the fourth day, did think with him self what medicin that were best then to applye, and considering that if there were no inflamatiō or distēperance: it were best to apply skinning things, but if there were any inflamation: then he thought best to vse moderate drying things with out
Cicatrising or skinning.
And when he did see there was inflamation: he vsed the medicament that is called the gréen Plaister of
Epigoni, which the Gréeks call
Isis. The whiche
[Page 10] Emplaister you shall finde in his second book of composition of medicins in generall, then afterwards for to finish the cure: he vsed an other medicine composed as foloweth.
Rec. of wax,
drachmas 150.
Tereben thinae, drachm. 200,
Seui vitulini, drachmas. 50.
Galbani, drachmas 24.
Manne thuris, drachmas 24.
Salis amoniaci, drachmas 12.
Aeris vsti, drachmas 12.
Aloes, drachmas. 12.
Squame aeris, drachmas 24.
Alluminis rotundi, drachmas 24.
Alum plū, drachmas 8,
Chalchitis drachmas. 8.
Miseos. draehmas 8.
Apopenex, drachmas 8.
Erui, drachmas 6.
Ammoniaci, drachmas. 6.
Mineii rubi, drachmas 6.
A ceti, drachmas, 3.
Olei hemi. 2. consequently when
Galene had thus vsed it: thē he came to
sicatrisatises and for the outwarde parte he applyed
Euphorbium mingled with Wax & Rosin in forme of an Emplaister.
Method for the curation of the wounds of
Nerues or Sinewes and of what facultie the medicins which must be applyed ought tobe.
GAlen in his method of woūds of
Nerues, did vse Liquid medicins and sometime Emplaisters. And without the wound about the place, hee applyed very soft Wul with hot Oile. Sometimes also he vsed Oil with a little Vinagre.
Vinagre is an eneto sinewes.
But in such sort that the colde vertue of the Vinagre was without offence, neuerthelesse the suttlenes or persing vertue did remain, and two or thrée times a day did vnbinde the woūd to see if the medicine did make any fretting in the Vlcer or sore. And if it caused any greef or pain: then he fomented it with Oil as hot as the patient could indure.
All colde things are contrary to the NeruesFor if it be but warme: it wil doo more hurt then good, and much worse if it bee colde, for the colde dooth stop and hinder out breathing of the member. But the heate dooth resolue and make thinner. &c
As for the vse of water: it must bée in
[Page 12] such sort vsed that at no time in the curation it touch y
e Vlcer. Therfore when it dooth chaūce y
t there remaineth any cluttered or congeled blood tobe taken away out of the wound: it must be doon w
t Oil.
And for an example:
Galen reciteth an history of one which beeing hurt,
An history to prooue, that al cold is contrary to y
e woūds of Nerues. was foure dayes without the féeling of anye pain, and when he did sée that ther was no inflamation: he wēt abrode about certain ernest busines which he had to doo, the wether béeing very colde and taried somwhat long: then he returned to his house with great gréef and pain, euen to the very nape of his neck. Then
Galen béeing called after that he did sée the pain that the Patient was in: made fomentation with hot Oil all about the pained place, and applyed great quantitie of wul moistned in Oil, and the liquid medicins made with
Euphorbium and
Castorum, and by this meanes the paine was eased, and after that he had slept: all the accidents did cease.
Therfore it is very profitable to applye the Wul very warme, and so continew it whether it be applyed with Oile, or Oile and Vinagre, which may wel be doon, if you apply also vpon it dry
[Page] Wul.
And if it be in the Winter: the patient must keep his house vntill the fift or sixth day of his greef. For if he be frée frō inflammation vntill the seuenth day, and that he feel no maner of pain or greef then he is without daunger.
Also you shall kéep in memory that in this maner of cure, colde Oile & astringent is contrary. But there must be vsed the suttlest Oile that may be gotten, as very olde Oile, for lack of the medicine that is made of
Euphorbium or Vinagre, or other such proper medicine:
Galen dooth teach to take in their rowme,
Propolis beeing very new, liquid and fat, and very olde Leuen, or els of the iuce of
Tithimall, with newe Leuen, or
Propolis liquified in Oile with Leuen, dissolued in very sharp Vinagre, and the Oile must be very olde.
The Floures that are tobe vsed to make
Pultasis or
Cataplasemus of:
The flours for to make Cataplasmus. are
Farina, Fabarū, Orobi, id est erui Lolii. Ciceris vel Lupinorum, Amarorum polenta, made of Barly with
Oximel, these
Cataplasmus bée not onely good in boisterous people: but also to all others, whether there be any inflamation or no.
For lack of these aforesaid medicins you may vse these
Cataplasmus folowing, that is to say
Propolis beeing new,
Liquid and fat, and apply it vpon the wound, somtime with Leuen alone and somtimes with bothe, & somtimes with mele of
Orobis and Leuen, but the Leuen must be very olde, and contrarywise the
Propolis must be new. If it be olde: you must soften it with Oile by the fire, or in the Sun, or els you may vse the iuce of
Tithimales mingled with Leuen or
Oxelam, the Vinagre must be very sharp wherwith the
Oxelam is made.
These be medicens which may soon be had in a redines for lack of others,
Medicine which are easy tobe prepared. whiche at necessitie
Galen did vse in woūds of
Nerues. By this you shall note then that the medicins whiche be applyed in wounds of
Nerues, in what maner so euer it be: ought tobe actually hot, and for the punctures or prickings of Tēdones, the medicen which is made of
Euphorbium and olde Oile, in the fourme of a
Liquid cerat is very good and proper.
And with the said medicin
Galen did heale one which was hurt in a tendone, within the space of foure dayes.
Then there was one y
t seeing the good
[Page] successe that he had with the
Euphorbium and Oile) thought to take an example by the said curation, and did vse new
Euphorbium wherof did folowe greate heat and pain with corrosion in the Vlcer in so much that he was constrained to call
Galene to remedy it, the whiche by fomentation of Oil and Vinagre did appease the pain and diminish the accidents, wherfore it dooth appéer (as before hath been said) that you must not neglect to haue the knoweledge of the faculties and kindes of approoued medicins, and of them whiche wil soon loose their strength,
Note this wil. from the others which doo kéep and maintain long time. For
Euphorbium
Euphorbiū to knowe whether it be olde or new. is one of these kindes y
t wil loose his heat very soon, which is easy (by the coulour) tobe knowen. For if it be new: it is of an asshie couloure. But if it be olde: it is of a pale or yelowe colour, & for that cause it is very dry, & wil hardly be dissolued in new Oil, for in y
e mingling it doth drink vp the Oile incontinent, wherefore to dissolue it wel:
The maner how to dissolue the Euphorbium and the nature and quality. it must not be mingled togither with Oile all at one time, but laboured in a morter by little and little for fear of running togithers.
Euphorbium is one of the Simples
[Page 14] which wil soon loose his heate, and dooth not kéep long, which is knowen easely only by the colours without tasting of it.
Euphorbium is hot in the ii ij. degree.
Truely when it is olde, it is not of an Asshye coulour as it is when it is new, but it dooth decline toward a pale or yelowish colour, and if it be new: in the tasting of it, it will bee so hot that it wil burn the tung But if it be olde: you shall feel no great heate in it, neuerthelesse,
Euphorbiū dooth keep his vertue longer then
Tapsia, for
Tapsia in i. yeer loseth his strēgth very much & in ij. yeers loseth his strēgth vtterly & is good for nothing. But
Euphorbiū if he be good when he is new, y
t is to say if he be hot & burning as safore said: he wil last thrée yéeres, somtimes foure yéeres & to the fifth, but the he dooth vi. loose all his force & strength.
For whiche cause
Galen did vse often times olde Oile without wax, for be cause that the
Euphorbium was of fiue or six yéeres of age. So that the vse of the
Euphorbium cannot be comprehended by waight, for when it is new: ye must put twise so much Oile, and three times so much Wax, and if it be olde, the more Oile shalbe put to it and the lesse Wax.
Wherfore if you will make the forsaid
[Page] medicament in fourme of a
Liquid cerat:
The maner how to vse the Euphorbium whether it be olde or new you shall put foure times so muche Oile as Wax. But if you wil make it in fourme of a Plaister: you shall put therto as much Oile as Wax, and principally if the Wax be olde and dry. For if the Wax be new: you shall not need so much Oile, and lesse in Summer then in Winter.
For to make Emplastrum Carotodes.
That is to say a Cerat or Ciroene, you shall take of the best wax, liquid it in Oile, then ad to the vi. parte of
Euphorbium, and temper it, as aforesaid, or els as foloweth.
Rec. Euphorbium, drachmas. 1. wax,
drach. 6. Oile,
drach. 5. or 6. And for because that the Wax is not so cleauing and viscus as Rosin or Pitch is ye shall ad to either of the
Cerats, Pich or Rosin,
The qualities and differences of Rosins. or of bothe, and then ye shall not need so much Oile as you should haue doon, if it had been made onely with Wax. And this is to be noted that you ought to haue a diligent regarde to the moisture or drynes of the Rosins, for you haue sōe more dryer then other some, and others again be more liquid. Of the dryest of these
[Page 15] kindes is that whiche some call
Fricta, and others
Colophonia. After the same kinde dooth folow, that which is brought in erthen pots, which is vnclarified, and when it is clarified: it is like the fore named
Fricta.
There is an other kinde which is called
Pityinon phisema, that is to say
German Pich which is more dryer then the other two aforsaid, the which
Galen did iudge not tobe vsed in this cure because of his vncleenes but did vse the (aforesaid)
Fricta.
Ther be diuers kindes of these (as before hath been said) of the which some wil remain more liquid thē other some,
The qualitie and faculties of Rosins according to their degres for the Turpentine wil remain moste liquid, the other dooth soon dry, as
Strobolina and
Abiotina, and of these two, the hottest is
Strobolina, and next vnto them in heat: is Turpentine.
As for the Rosin of
Cipres I doo not reken, for
Galene neuer durst nor would vse it in any Plaisters to be applyed to
Narues, because it is astringant. The b
[...]st and principall of all these kindes of Rosins: is Turpentine
The Turpentine is the moste principall of all Rosins. not for his heat, for
Strobolina and
Abietina (as before hath been said) are hotter.
The whiche Turpentine
Galene did vse by experiments, the great vtillitie that was in it to mundify, to resolue, and to drawe, and is very comfortable to the
Nerues: witnesses also therunto
Dioscorides and
Anabarzeus.
And when you wil haue the
Cerat very cleauing: you shall put to the more Rosin (as is afore said) and mix it according with the Oile and wax.
The Emplaister which Galen did vse.
YOu shall take of Turpentine, and put therto thrée times so much wax. Then ad to them the xij. parte of
Euphorbium, if you knowe not whether the
Euphorbiū be exactly hot or no: you must prooue when the medicine is made by this meanes, that is, ye shall strike a little of it vpon a linnen cloth, and apply it vpon the thigh or arme, and there let it remain for a certain time, and if you perceiue that it dooth somewhat warme: then is the midicine temperat, and if it doo cause no maner of sensible heat,
Note this wel. or els that he giue more feruent heat then he ought: it is certain y
t the medicine is either to weke or to strong. The heat may be diminished by adding the more of Oyl
[Page 16] and wax, and also it may be augmented by adding to of the
Euphorbium, for the confection of these kindes of medicins, the
Propolis is y
e best and most conuenible amōg all other kindes of Rosins,
The vtility and cōmoditie of Propolis. but it ought tobe new & fat, because it will the better drawe to the outwarde parte, the thick vapours, and superfluous humours, but Rosins are to be mingled with Wax, onely to giue thicknes and forme to plaisters, and are not so conueniable in this curatton as Propolis is.
Therfore you shall note that in tender & soft complexions: y
e medicins ought not tobe so strong, as in strong & boisterous complections. For y
e Cerat which is mingled with olde Oile is very conueniable in some, and likewise
Fermentum, that is to say Leuen, is very good so it be olde, for the older it is the better, be cause it dooth bothe resolue and attract more then new, moreouer
Sulphur Viuum is very good in these afore said compositiōs, and it may be vsed with
Tetrapharmacū. Also
Aphronitrum may be vsed and
Beronictum litrum, so that it be not grauely, which may also be mingled with
Tetrapharmacum.
Arsenicum wich is called in the Attique
[Page] tung,
Quenched Lime.
Arenicum, beeing mingled with
Tetrapharmacū is profitable, and for lack of these you shall vse
Sandaracha as of Lime quenched and vnquenched,
Metalla lo tione et adustione fuit mitiora. washed & vnwashed. But there must be lesse of the vnwashed then of that which is washed: for because that it is more sharper then that which is vnwashed.
Now then to haue the perfit knoweledge to heale wounds of
Nerues,
This ought to be knowē in the cure of Nerues. it is needful to knowe the end and intention of the cure, likewise the facultie of simple medicines the which in this cure ought to drawe and resolue without excessiue heat and without great sharpnes or byting. And likewise it is needful to know and vnderstand perfectly the Anathomye.
Note. And the nature and complexion of the members of the body, and perfectly to vnderstand and the difference betwéen the Tendones membranes & ligamentꝭ for when occasion shall serue to stich any wound: you must not touch the tēdones, for the Tendones and the muscles haue coniuncion togithers, therfore when the muscles be seperated: there must be very good heed taken in y
e stitching of them, lest
[...]ou cause pain, for if they doo indure any pain: it causeth conuulsion, and
[Page 17] then afterwarde turneth to putrifaction, and so all the partes there abouts dooth suffer the like accidents, yet neuerthelesse the musculous flesh may wel be stitched as shalbe héerafter said. Therfore to haue perfit knoweledge of the Tendons, this is to be vnderstanded, that therbe two kindes: that is to say, the one round like vnto acorde, for which cause the ancient writers haue so called them: the others be flat like vnto membranes, wherof some passe along by the thighe néer vnto the knee. Also they are within the palmes of the hands and the soules of the feet.
Of tendōs their
[...]de
[...]ormes & situations
Now we wil return to the matter, in woūds of
Nerues you must not make fomentation with hot water, as the Phisitions before
Galenes time did: nor yet vse
Cataplasmus made w
t wheat meal, and boyled with
Hidrelaeum, for
Galen made onely fomentation with Oile, and the medicines aforsaid, by which menes he healed many. And béeing but of the age of xxviij. yeeres, at whiche time hée came from
Alexandrin into his owe contrey, did inuent and deuise the maner to cure the wounds of
Nerues:
A note of Galen. and since that time hath been many goodly cures,
[Page] by the method and midicines aforesaid. And now for an example marke this history which is recited.
Vpon a time (among others) there was a certain Captain af war, the whiche had a wound in his thigh, transuersales, the whiche wound was of a great deapth, that the one side was drawen vpwarde & the other downwarde towarde the knée, & for to heale the said wound:
Galen did not dout to stich it in the musculous partes. Neuerthelesse he gaue good respect in touching of any Tendon, for he knew that the muscles might wel be stitched without daunger and not the tendones, albeit that some ancient Phisitions doo stich but onely the vpper lips of the skin, though the wound be neuer so deep, for they did fear to stich y
e muscles, and there were others whiche would stich the fleshey parts of the muscles, but they were of the vpper parte of the woūd and not in the depth.
Wherfore when there did chaunce any déep wound béeing transuersales: he did boldely stitch the musculous partes. As for the other woundꝭ made according to the length of the member: it is not néedful to stitch them, for with good and
[Page 18] conuenient rowling the musculous parts may wel be agglutinated.
Therfore they which be ignorant in the Anothomy, doo fear to stich the membranes with the muscles, but
Galen beeing learned in that matter, did stiche them safely & without danger, although that the large Tendones are muche like the membranes, yet for all that, there is difference, for the Tendones be more hard and of a grocer substance, then the said membranes be.
The differēce betwen the tendōs and membranes. Except it be in the muscles of
Abdomen, which the Prince
Auicenna calleth
Mirac, for in y
t place they be very tender and suttle, as the membranes be in all points, except it be in the straight muscles.
By this it appéereth that the iij parte of Phisick which the gréeks call
Chirurgia that is to say, the which is exercised by handy operation.
Pharmaceutice, that is to say by medicines as to y
e
Apothecary. Diaitetice, by regiment of the life, haue néed one of the other: wherfore he whiche dooth take vpon him this profession: ought exactly to be exercised in these iij.
Note this place wel.
After that he first hath had the perfet knoweledge of the
Theorick, that is to say speculatiue, in the whiche is taught
[Page] the method to cure by reasons and Demonstrations, and if he be ignorant in any of these: he is not worthy to be called a good Chirurgion, and shall neuer be able to doo any thing, which shalbe to the profit or easement of his Patients.
The composition of medicines for wounds of the Nerues made of metalles.
AMongst the metalls you must auoid them which are astringant, and principally in the prickings of the Sinewes.
The substance of metalls.
But the abstersiues, as
Aeris squama, & others are profitable. And this must be noted y
t all metalls are partly of a groce and terrene substāce, because that there dooth contain in them, much earthy nature, wherfore they doo require to be prepared, to the end that they may be more suttle. One way to prepare them is this.
To prepare the metals.First the said metalls ought to be laboured in a morter, onely with very strong Vinagre, which hath a pearcing facultie, and ought to be so laboured very long.
Ther be some of the said metalls that
[Page 19] wil not wel be beaten, although they be very long labored. Neuerthelesse they may easely be dissolued as
Chalcitis, misy and such like, but others may be beaten and redused into poulder, as
Aeris Squama and such others. And this you shall note, that
Chalcitis &
Erugo if they be burnt: they haue lesse sharpnes in thē, wherfore the greater quantitie may be occupyed when any medicine is made.
The Pastils or
Trocis of
Andronis Poluidas and
Pacion, be right excellent and conueniable in wounds of Sinews, so that they be dissolued in
Sapa as they ought.
Excellent pastils.
Sapa is made of
Must,
Sapa and wherof it is made. that is to say sodden
Wine, but the said
Must ought to be made of swéet Raysons, and not of sower, which are Abstersiues and of the latter running of the Tub, the whiche wine must be boyled vnto the consumption of the half, and with the said Wine the Pastils may be dissolued, to be applyed vnto the
Nerues which lye bare. But when you vse them, you shall take that kinde of
Polidas, for they be moste temperate, and principally in these bodyes which are temperate & tender, in which bodyes all y
e kindes of Pastils ought not
[Page] tobe vsed, but medicins according, which we haue al redy spoken of, and wil speak héerafter, for all bodies be not of one temperature, for they differ in thrée things, that is to say, as for their temperature, secondly in the augmentation of their age, and last in their states and exersises, as they whiche woork much, or liue idlely. Wherfore it foloweth that no medicine can bee conuenient,
A method worthy to be noted. in all bodyes. And for this cause you must haue two sortes of medicines, the one strong: and the other weke, and then when necessitie dooth require,
According to the temperature of the body y
e midicine ought to be compounded, prepared and applyed. the mixtures may be according to the temperature of the body.
¶ Medicins for strong and boisterous people.
Rec. Aeris squama parte. 3.
Misyos crudi partes. 2.
Chalciteos cruda parte 1.
Cerae parte. 12. At the beginning when
Galene prepared this medicament: hée did put to it
Arsenicon, and after that when he sawe that it was superfluous: he left it out.
¶ Medicine for delicate and tender complexions.
Rec. Misyos combusti, Chalcitidis vsti ana, parte, 1.
Aeris squamae partes. 4.
Cerae, parte, 18.
Medicin for mean complectiōs whiche Galen did often vse.
Rec. Misyos vsti. Chalcities vstae, Erugini vstae ana, parte, 1.
Aeris squamae part, 3.
Cerae, part. 5.
For to make these medicines, the quantitie of the Oile ought to exceed the quantitie of the Wax,
Note that Galenes pound is but xii. vnces. as if there be viij. vnces of Wax, you shall put xij. vnces of Oile (which is a pound) and the Oile must be like the Oile of
Sauen, that is to say, of a suttle substance, and not astringant, and the olde Oile is best. Wherefore new Oil which the Greeks call
Homotribes, is neither good nor conuenient.
After that the metalles haue béene wel beaten long time with Vinagre: you shall ad to of
Thus, but it must be white and good, then again you shall beat it with the metalls, before y
t you ad to the
Cerot, but the quantitie of y
e
Thus shalbe the half of the medicins, for to make the medicine in a meane temperature. And if you wil make it more weak: you
[Page] shall ad to more then the half of
Thus.
And if you wil haue the medicin more sharper: you shall not put to the halfe of
Thus in the forsaid medicine. It is expedient that ye mingle some Rosin w
t the Wax and Oil, neuerthelesse you ought to consider, that if you doo put to it
Strobolina, that y
e medicin wilbe more stronger and sharper, and if you put to it of
Terebenthine: the medicin wilbe more softer and meane in sharpnes, and if you wil haue it betwéen bothe: you shall put to it
Abietine or
Beniamin larix,
The facultie and qualitie of Larix. which is one of the moistest Rosins, and is of substance like vnto liquid Pich, whiche some merchants and Factors sel for
Terebenthine, to them that knowe it not, nor can discerne the one from the other.
Yet not withstanding there is great difference which may be easely kowen by the taste and by the sharp smel which he hath more then
Terebenthine, neuerthelesse their strength dooth not differ much.
Wherfore if you wil make your medicine in forme of an Emplaster: you shall mingle with your Wax, the vi. parte of the said Rosin, which is for a pound of wax: ij. vnces of Rosin, and if it be liquid
[Page 21] and fat, half an vnce shall suffise. And when you wil not make the medicin in forme of an implaister: you may leaue out the said Rosin, but you may ad to of
Galbanum sōtimes asmuch as of
Thus according as need dooth require. For when you put to asmuch
Galbanum as
Thus: the medicament is the gentiller, and when you will haue it more stronger: you shall put to it but half so muche
Galbanum, and sometimes the lesser waight or quantitie, as if there be iiij.
dragmes of
Thus, and iiij.
drams of
Galbanum:
This is ment because the Galbanū is more liquid then the Thus. the medicine shalbe the more mitigatiue and gentle. But if you put to but ij.
drams of
Galbanum: the medicine wilbe somewhat stronger. Wherfore in sensible and tender bodyes or
Cacochime it is expedient to haue the medicine tobe prepared with the more quantitie of
Galbanum. Then when you wil make your medicine tobe applyed to the
Nerue béeing bare or discouered: you shall not put in so much
Galbanum for fear of causing pain, for the Sinews béeing bare may not abide any strong medicine.
Among the simples, Vinagre is sharp and very painful, and for that cause Oil
[Page] is applyed with it, and also sometimes
Galbanum, and for lack of
Galbanum: you may take such greaces that are of fine & suttle substāce, as of wilde beasts, that is to say, of Lions, wilde Bores, Leopards or Beares.
Likewise of flying foules, as of wilde Ducks and such other like,
The choise of the best greaces. in their sted you may take of Cocks, Hennes or Chikens, but this is tobe noted that the greaces of wilde flying fowles and whiche doo liue abrode in the feelds,
Note this for they which doo not exercise the body doth engender humorꝭ groce and colde and vndisgested are better then of them which be nourished about the houses, for those which be nourished within or about any houses: are more heauy, and their fat is of a more grose substance and more moist, for because that they are shut vp, & haue no scope to flye or run as the others doo, for the exercise & stirring of their bodyes dooth lighten and make fine their grose humours.
When you wil haue your medicin of the thicknes of a
Cerot: thē must be added to the third or fourth parte of Wax, or if the greace be very moist: you may put to the one half of Wax, and so after such sort as shalbe thought good, but if the greace be mene between bothe, that is to say neither to dry nor to moist: you
[Page 22] shall ad to the third part of wax, the whiche
Cerot shalbe proffitable for many purposes, and is called
Diasteaton, that is to say made with Talow and greace.
¶ The Medicine which is called Dieuphorbium.
WE haue spoken héertofore of the qualitie, nature and facultie of the
Euphorbium, and after what sorte it wil keep, & how in time he looseth his strēgth and how he must be knowen by his coulour and substāce. Now we wil intreat of the medicines whiche are compounded with the said
Euphorbium, and is made as foloweth.
Rec. Euphorbii, parte, 1.
Cerae partes 3.
Olei, partes, 4.
To the composition of this medicine the wax ought tobe triple, that is to say, iij. times so much in respect as of the
Euphorbium and the Oile the fourth part, but the
Euphorbium must be new and good. The vse of this medicine is profitable in the punctures of
Nerues,
The vertue of this medicine. and especially when it is feared y
t the woūd wil close vp, therfore it is necessary to haue a
[Page] respect to the strēgh of y
e medicin, for if it be to weke y
e quātity of
Euphorbiū may be augmented, somtimes there may be added to the half of
Euphorbium, & somtimes asmuch as of wax or more. Namely if the
Euphorbiū be olde, for it must be according to the strength of the patient. But if the medicine be to strong: you may weaken it by adding to of some Oil, or els to make an other more weaker according to the forme and maner aforesaid. And if you wil knowe whē the medicine is to strong: you shall marke these signes that folow, that is to wit, if the Patient féeleth great heat with
Erosion,
Signes for to knowe whether that the medicine be to strong. or if the partes about it be hotter then they were before, or if the pricking pain bee more raised vp then it ought to be, or if the side of y
e said prick haue any inflamation.
Therfore for to chuse apt and conuenient medicins: it is needful to make the composition in the which there is put iij. times so much wax as new
Euphorbium, the whiche is more stronger then the other. If there be v. times so muche Wax: the cōposition shalbe more weke and gentle. And if there be iiij. times so much wax: the composition shalbe mene
[Page 23] betwéen bothe. And if you wil haue your Vnguents such as the Phisitions call
Acopa,
Without labour. Vnguentū Acopa. that is to say taking away of werines or pain: you shall put to iiij. times so much Oile as Wax. But if you wil haue it in forme of a liquid
Cerot: you shall put to double of Oile to the Wax and if the Wax be dry: you shall put to of Oile ij. partes and a half, whiche is to say, for one pound of Wax, ij. pound and a half of Oile. And if you wil make it plaister wise: there must be added as much Wax as Oil, namely if the weather be temperat. And if the wax be to olde and dry, and that the weather be colde: there must be somwhat more Oil then wax. But if the wax be new and moist, and the weather hot: there must be somwhat more Wax then Oile, that is to say, for one pound of wax: xiij. vnces of Oile, & in the composition of the medicine, for the better mingling of the Oile and Wax togither: you shall ad to some Rosin and principally of
Terebenthine or in sted
Colophonia, and if you doo ad asmuch of it as of Wax: the Pich dooth make the consistance of the
Cerot, and note, that which is moste liquidest: is the best, euen in like sorte as of the Rosins.
[Page] And if the Rosin be liquid, as is the new
Terebenthine: it shall suffise to put in the third parte, in respect of the Wax.
When
Galen did compound any medicine, wherin is Rosin and wax, it is to be vnderstanded that hee ment not that which was dry and olde: but such kindes of Rosin and Wax that were of a ment substance, for els béeing mingled with the others wil soone dry and loose their strength, and that for two causes. The first by the intemperature of heat of the weather, and secondly by the reason of béeing to long kept. As for Propolis: it is no other thing but white Wax, and it is more conueniable in plaisters and
Cerots then Rosin or Pitch. And more
Galene dooth account
Terebenthine among the Rosins, and is moste conuenient of all the Rosins in the fore said plaisters and
Cerots.
¶ Medicines made of Simples whiche wil dissolue.
THese Simples which folowe are liquible, that is to say, which wil dissolue vpon the fire, and whereof
Cerots and Plaisters be made, and may
[Page 24] be boiled with moist things as with water, Wine and Vinagre.
The simples, which are these that folowe, Propolis, Wax, Rosin,
Ladanum and
Senum, that is to say, Talowe, and
Galbanum, whiche must be prepared in a double vessel cōmonly called
Balneum Mariae, whiche is asmuch to say, in putting of the foresaid simples within some vessel, and then to set it in a Cauldron of water vpon the fire. There are also simples y
t wil aswel dissolue without fire as with fire, in moist things as
Gutta Ammoniaci, y
e licour of
Sagapeni, Panacis, Cerapion and
Oppoponax.
Rec. Oppoponacis, Galbani, Terebenthine, Propolis, ana parte. 1
You ought to take good héed tbat your
Propolis be neither dry nor olde, but for lack of the other: you may put in such as may be gotten, but it must be double in waight and the other Simples must be new and liquid.
¶ Another of the same effect.
Rec. Aseti sexta 1.
Picis. 1, pound.
Oppoponacis 4. vnces, the Pitch must be boyled with the Vinagre.
Et fiat.
The vse and facultit of these medicines.These medicins afore named are good in punctures of
Nerues, and for biting of mad Dogs, and principally for a wound made by any venemous beast, by the reson that they are percing, and doo kéep the sides of the wound from shutting togither by the whiche meanes the venim which lyeth within: shall the more easely be drawen out. But for because that the said medicines are strong: you must vse them in strong & boisterous bodyes.
And if the said diseases, doo chaunce in tender and delicate people, as womē and little Children: then they must be liquified with some kinde of Oil, or resolutiue Vnguent, namely
Amaricum and
Oppobalsamum.
Then afterwards with
Irinum and
Comagenum, and in sted of these
Susinum and
Ciprinum, or if these be not to be had: you shall take Oil. Or if it be in
Alexandria, you shall take
Oleum recinum and
Rhaphaninum, for surely there is abundance of this aforesaid in
Alexandria, & also through all
Egipt. But there is not tobe found
Oleum sinapinum but with great disicultie, the which Oile if it be put in the afore said medicament: there is no dout but that it will be much more
[Page 25] stronger and better to kéep open the punctures of the
Nerues, and if you haue no
Oppoponax to make the said medicin withall: you may take
Sagapenum dissolued in Vinagre, Rosin or
Propolis, or some greaces,
The greaces which are moste requisite in this medicine. béeing very olde so that they be sharp, and of a suttle substance, as of a Lyon, Leopard, Beare or Fox or els of wilde Ducks.
Or els these greaces folowing béeing very olde, of a Bul or of a Gote. And this is to be noted, that the older the greaces be: the more sharper, and namely the greace of a Hog the whiche is more soft and moist then all the aforesaid. And of the like nature is Wine and Vinagre and Mary, but of all Maryes: the best is the mary of a Hart, or of a Calf. Of these aforesaid medicines
Galene dooth counsail to haue in a redinesse, the whiche he did alwaies vse in punctures of
Nerues, wherwith he had good successe.
The vse of Pigeons dung.
FOr because that Pigions dung is sharp: it must be vsed in the stead of
Euphorbium, neuerthelesse it is of a more suttle substance thē
Euphorbium, wherfore it is more conueniēt in strong
[Page]
[...]
[Page 25]
[...]
[Page] and boisterous people, as rusticall bodyes dryed with labours,
Galen sometimes did mingle metalls togithers beaten in Vinagre in the forme (as before hath béen said) and by that meanes the medicine was made more sharp, euen as though he had put in Verdegrece.
¶ Of Medicines called Diabotanum, that is to say, made of herbes.
GAlen the interpreter of Phisick and lerned in all thingꝭ: would omit nothing whiche did appertain to the curation of woūds of
Nerues, for whiche cause he hath taught diuers maners of curations, to the end that if the one should faile: they should haue others at all times when néed required, and also when vpon the suddaine a Chirurgian is called to visit any Patients, wheras the Simples requisit cannot be gotten, therfore
Galen right wisely hath taught the way to compoūd medicins for woūds of
Nerues with hearbes in stead of the mettalls aforesaid.
First the said
Galen did compound
[Page 26] medicines for wounded
Nerues of those herbes which were of a suttle substance,
Herbs and roots for the composition of medicines. that is to wit of
Dictamus, Amaracus, and
Malus terrae whiche is
Aristolochiae, moreouer he did make some in the which he did put in
Marou amaricum, which is
Margerum, Polium argemonae, whiche is called
Aigrimony, Chamapitis id est vina artetica centaurium Radicis omnium, Aristolochiarum, Draconculi, Ficus agrestis, Brionia, Althea, Iridis, Acori mei, Asari phoud est Valeriana, Gentiana and
Panacis. All the which herbes and roots afore named
Galen hath written and declared in his Books of Simples. And this you shall note, that because they haue a bitterish tast without abstersion or immoderate sharpnes: they are cōuenient in woundꝭ of
Nerues, and how they ought tobe vsed marke this that foloweth.
The maner for to compound medicins with the said herbes.
First they must be dryed, then stamped and beaten very fine, then searced through a fine searce. For if it be of a groce substance: it is not conuenient in wounds of
Nerues, which dooth require the moste suttle and finest that may be, (as before hath béen said) then after that these hearbes and Rootes be finely poudred:
[Page] they must be mingled with Wax and Oyle, in suche sort as we haue said of
Euphorbium.
Compositiōs for woūds of the Nerues, which the Greeks call Politeleis, that is to say sumpteous,
IT is not onely profitable to haue the knowledge to compound medicins of the simples aforesaid: but others sumpteous & of great price, for although y
t they be but seldom vsed, yet neuerthelesse it fortuneth somtimes, that if you haue a great number of medicines: you shal scant please the Patient, for he wil haue them made of such Simples as are very sumptuous. As for an example
Galen maketh mention of a very rich man whiche he dooth not name, in his first Book of the knowledge of the iudgement of the pulse, and this third Book. The which rich man did by all the menes possible he could, approoue to heale a maligne Vlcer vpon one of his seruants, then when he did sée that he could not heale it: he did commit it into
Galens hands, and after that he perceiued
[Page 27] that
Galen
An history of a cure which Galen did on a maligne Vlcer. had healed it: he did desire him to giue him the receipt of the midicine wherwith he did heal his foresaid seruant. The said rich man did not consider that there are many kindes of maligne Vlcers: but thought with one medicine to heale all maner of vlcers, yet neuerthelesse
Galen did giue to him the foresaid receipt. But when he had the composition: he said go thy waies and giue thy receipt to beggers, and let me haue an other more costlyer and of richer Simples.
And also at a nother time when hée could not heale a Childe that had a certain infirmitie about his eare (with his owne medicine whiche he vsed without method) did send him to
Galen, and afterwards he met with one by chaunce, of whome hee did vnderstand that the said Childe was healed: he was very desirous to knowe what maner of medicin
Galen vsed.
Then considering that he had séen many that haue béen wounded, bothe in
Nerues and other places, and hauing their fingers cut with putrifaction, and some of them haue dyed, and others lamed. And contrary wise he did vnderstand
[Page] that none of them whiche
Galene did dresse dyed, nor were in daunger of death, but that spéedyly did help them: he demaunded the receipt of same maner of sumptuous or odorifferous Vnguent for wounds of
Nerues,
An excellēt method to cure woūds of Nerues. then
Galene did giue to him many receipts faithfully dispensed, with the whiche hee healed many that had wounds in the
Nerues, for the which he gaue
Galen great prayse, and gaue him moste harty thanks for giuing of thē so liberally, for whiche cause he did present
Galen with a present, the receipts which he gaue him were these that folow.
Rec. Cinamomi, Dictamni, Mary, ana drach. 40.
Certainly these Simples are odorifferous and suttle, hee would not put in
Amaracum, because it had not a good smel, also at
Rome it was very hard to be found, as of
Marum. You must beat these Simples very fine and serce them as before hath béen said, and then temper them with the
Cerot made of very good
Oppobalsame, and
Tyrrhenique Wax, which
Cerot is made of viij. parts of Wax, and x. parts of
Oppobalsame.
¶ The composition of the receipt is thus.
Rec. Cerae, parte. 8.
Oppobalsame, parter. 10. ad to of the best Turpentine
parte 1. the
Terebenthine is added to in the end, and if you wil haue the medicine cleauing, and of a resonable forme: you may ad to also of precious
Mirrh.
Where the
Nerues were bare
Galen did vse the
Cerot which the Gréeks call
Mirepsice, & the Vnguents
The maner to prepare Vnguents. whiche the
Romains call
Vnguentum spicatum, and
Phuliatum, in adding to the xij. part of
Pompholigoes washed, which must be prepared with
Terrhenique, Wax, and burnt
Nardus in a double vessell, which is vulgarly called
Balneum mariae, and all Vnguents ought tobe prepared after the like sorte.
In punctures of
Nerues the moste sharpest medicines are moste conuenient because they kéep the wound open, but in wounds of nerues discouered,
A note of punctures and woūds of Nerues discouered. it is conuenient to vse medicines whiche haue a mene astrictiō with resolute vertue, and without biting, as
Amomum. spicanardi, and
Folium Malabathri.
The composition of Medicines by other Phisitions which Galen maketh mention of.
THere was none before
Galens time which did write the reason and maner to cure the wounds of
Nerues, neuerthelesse some haue since his time, but without distinction and good order. Among other a Phisition of his time did prepare one as foloweth.
Rec. Cerae. 6, vnces.
Olei. vnces. 9.
Myseos. vnces. 6.
Chalcitidis. drach. 1.
Aeris squama. vnces 2. and a half.
Thuris half an vnce.
Galbani 1. vnce.
The Simples which may be liquified, that is to say, the Wax and the
Galbanum after that they be resolued: you shall mix them with the mettalls. first béeing beaten very fine with strong Vinagre.
Galene neuer knew the Author of this composition, and saith that he neuer found it neither in
Asclepiades Apothecary, nor in
Petron, nor in
Andromacus. Albeit that the ancient Phisitions did compound good medicins.
Another of Adromachus.
The whiche is good as
Asclepiades dooth write for wounds in
Nerues and Muscles, contusions and gallings, and for any member béeing broken, there may be made with it also
Collires, for diseases of the eyes, and is a good remedye for pain of the hed and for all greefs.
Rec, Argenti spuma,
Alius. 18
Cerae ana drach 144
Ammoniaci drach. 72.
Terebenthine drach. 36.
La
[...]oe succidae combustae drach. 12.
Aeris squamme, Thuris, Aristolochiae ana drach, 8.
Olei ricini hemi. 3.
The maner to prepare it is thus. First you shall boil the Oile and the
Litarge togither, af
[...]er that ad to the Wax and the Turpentine, and when it hath boyled till it come to a resonable consistance: you shall ad to
Ammoniacum. Note that this medicine
The facultie and vsage of this medicine. is not conueniable in punctures of
Nerues: for because it is astringant. Neuerthelesse it may be vsed where the
Nerues and tendones be discouered. And if there be any inflamation: it must be liquified with Oile of Roses, and if there be none: it may be liquified with olde Oil,
Recinum chamamelium
[Page] and others which are for soft and tender bodyes, and for the strong and boisterous: you shall vse strong Oile as
Oleum radicis,
[...]icus, Aggrestis, Brioniae, Asari, Dracunculi, Aristolochiae and
Panacis, but the
Aristolochia and
Panacis ar more strong then the others.
Another composed by Claudius Philoxenus Chirurgion for the foresaid greefs.
Rec. Argenti spumae, Cerae ana drach 160. Ammoniaci, drach. 80. Propoleos drach 40.
Alius. 18. Terebenthine, Resine, Siccae, Thuris, Squame aeris, ana drach. 16. Lanae succide▪ cōbustae, Squamae Stomomatis, ana, drach. 8. Oppoponacis dra. 4. Olei ricini hemi. 3.
A reddish medicine of
Halieus.
Rec. Argenti spumae, Cerae ana. drach 100,
Alius. 100
Terebenthinae, Mannae, Thuris, Galbani, Minii Cinoptici, ana drach. 8
Olei sexta. 1.
This implaister
The vtillitie of this Emplaister is good in gréene wounds, and for wounds of the
Nerues, and for Vlcers of the eyes, whiche bee hard to cicatrice. And to resolue all hardnes
[Page 30] and principally of the Dugs. It is likewise good for biting of mad Dogs, and for the stinging of Dragons, and the venimouse fish called in Greek
Trigon Thalassia, and in Latin
Pastinaca Marina, Asclepiades dooth write that it is onely for wounds, & maketh no mention for punctures of
Nerues although it wil serue in bothe.
Another catagmatique medicin composed by Moschion.
Rec. Argenti spumae, minam. 1. which is 160.
drach. Picis aride drach. 160,
Seue vitulinae dra. 160.
Resine Terebenthine drach. 80.
Manne thuris drach. 80.
Cerae drach. 40.
Eruginis oppoponacis, Galbani ana drach 8.
Olei ricini hemi 1.
Aceti hemi. 1.
Licorice cicamini hemi, 1.
Picis liquid, ciath. 3.
The manner to boil this Vnguent is thus. First you shall boile the
Litarge and the Oile togither, then ad to the Calues greace, and after that the
Manna and the
Thuris, let them be stirred continually til they be incorporated, thē you shall put to it the Pich, the wax and the Turpentine, and consequently the others, which must be boyled in fourme
[Page] of an Emplaister, after that you shall ad to the
Galbanum, Eruge and
Oppoponax, dissolued in Vinagre, then ye shall take the licour of
Cicamini, and the liquid Pich, and boil them in another vessel, and when they bee melted togither, and somwhat thick: you shall mingle them with the others, and set them on the fire again, til they come to a perfit consistance.
Then you shall let it stepe in white Wine the space of iij. dayes, after you may strike it vpon a linnen cloth to vse as an Emplaister.
This Emplaister
The vertues of this Emplaister is very good in gréen wounds, and for cutting and contusion of
Nerues, for a Fracture with a wound and with cōuenient ligature dooth cause calles to ingender in bones, it is likewise good in the beginning of an Hidropsye, for contufion of the Testicles, for
Rhagadies, for Tumours of the Throte called of the greeks,
Bronchocilas, to be bréef this is a right excellent medicine.
FINIS.
¶ The curation of wounds of Nerues, Tendons & ioints,
THe cause of solution of continuitie the whole and sound partes in
Nerueus places, may chaunce diuers waies, that is to say, by contusions, as blowes with Stones, Staues, Hammers, Clubs, Hargubush, Crossebowes, bitings and such other like. Likewise it may come by sharp and pricking Instruments. As a Bodkin, Speare, Dart, Thorne or venimouse Beast, or such like. Also by cutting with a swoord, or Knife. Of the which wounds some be made acording to the length of the Tendone,
Nerue or Sinew, Membrane or Caule, and others according to y
e bredth with great incision, and some meane or lesser, of the which hurts these accidentꝭ may folow.
As pain, vehement fluxion, inflamation, Feuer, losse of reason,
Sinope, Apostume,
Gangrena, and mortification of the whole parte, and oftē times death by reason of the communication and
[Page] consent that they haue with the Brain and other noble partes.
Moreouer it is to bee vnderstanded, that when the
Nerues or Tendones bee but half or little cut, the wound is more daungerous, then if they were cut quite a sunder.
That which couereth the Scul.And so is it with the
Periosten, pericranium and membranes, or because that the portion or parte that is cut doth drawe him self to his beginning, which causeth conuultions and Cramps, but when they be wholly cut: there foloweth no accidents. Insomuch that they haue no contrarietie when they retire, the which is manifestly seen in the woundꝭ of the head, for where the
Pericranium is but half cut: the accidents are more vehement then when it is wholly cut, as we may dayly sée by example, when we make incision to apply the
Traepan.
And amongst all the hurtes of the
Nerues, the prickings bringeth moste pernicious and terrible accidents, by reson that the orifice is so small, that the humour cannot issue out, but remaineth within and there gathereth a sharpnes, whiche drincketh into the
Nerues and Tendons, and dooth cause them to swel,
[Page 32] and by the swelling they are shortned, wherof commeth suche pain, that it causeth most painful cramps, and such other like accidents as before hath béen said.
The cure of punctures of the Nerues.
FOr the curation, there are two things to be considered, that is to say, to appease the pain, and to defend the parte afflicted from fluxions and Apostumation: for the accomplishing of the whiche, you shall applye vpon the wound at the beginning a dessiccatiue medicine, of a thin and suttle substance, to the end it may penetrate more easy the botom of the prick, and consume the moisture therin, which other wise wold cause an egre sharpnesse (as afore said) which sharpnes would bring great pain and accidents. Wherfore you shall apply Oil of Turpentine, with a little
Aquauitae wel rectified, or
Euphorbium and
Sulpher poudred and incorporated togither, and applyed very warme, or els Oile of
Vitroel and
Aqua vite, and round about the place this Cataplasma folowing.
Rec. Farine hord. & orrob. ana vnces 2.
Sirup. acetosi, vnces 3.
Flor. Camomil
[Page] two handfuls.
Lixiuii qui sufficien. fiat Cataplasma.
If by this order the paine dooth not ceasse, and that there be any contraction of
Nerue: you shall apply speedily hot seething Oil with lint beeing dipt in it, as well at the botome as the edges of the wound, which must be doon two or thrée times at one dressing, for by this kinde of
Cauterization: you shall ceasse the pain, by reason of the burning of the Oile, the
Nerues or Tendons dooth loose their sensible feeling.
Of the wounds of the ioints.
THe wounds of the ioynts are for the moste parte mortall by reason of their deneruations or Tendones and membranes, with the which is mingled
Nerues, for the which cause they haue greater feeling, for the
Nerues beeing mingled with them: causeth more pain, which pain bringeth this aforesaid accidents, and especially if they be in the interior partes, as vnder the arme holes, the bought of the arme, in y
e wrists or in the hammes, or groynes. By reason of the great Vaines, Arteryes and
Nerues whiche are in those partes, and by the
[Page 33] meanes of solution of continuitie, that are in those partes, causeth great pain, flux of blood and other like accidents.
For the ordering of the whiche: you must perseuer according to the nature of the said accidents, in staying the flux of blood and appeasing the pain asmuch as you can possible, and if the wound be great: you shall stitch it leauing an Orifice in the lower parte therof for to giue issue to the matter, this beeing doon: you shall apply this poulder folowing the space of ij. or three dayes to preserue the stitches.
Rec. Thuris sanguinis draco. Boli armenici, terrae sigil. ana drach 2.
Aloes, mast. ana drach. 1.
fiat puluis subtilis.
The whiche poulder you shall apply vpon the seme, and round about the ioint a defensiue made of the whites of Egges, Oil of Roses,
Bol, Mastick and Barly meale. And if you apply any tent: he must be short and not to big, lest hee should cause pain, which tent shalbe applyed with a disgestiue made with the yolk of an Egge, Oil of Roses and a little saffron.
Also if the said wound be little and straight (rather then to fal into these aforsaid
[Page] accidents) you shall inlarge it to the end that the humours which be come to the part (by reason of the pain) may haue a large issue.
Moreouer the afflicted part must haue rest and be kept frō colde, and also from medicines which dooth relax, soften or moist, but contrary wise they must be astringant and dry as this
Cataplasma folowing.
Rec. Furfuris maciris, farinae hordei, et fabar. ana vnces. 4.
Flor. Camomille Melliloti ana half an handful.
Terebent. vnces 3
Mellis communis vnces 2.
Olei mirh vnces. 1.
Oximel sump. vel Oxicrat, vel Lixiuij. qui suff. fiat Cataplasme ad formam pultis.
Or els this.
Rec. the lyes of wine, wheat Bran,
Cipres Nuts, Galles and
Terebenthine, with this make a
Cataplasma, many suche other like may bee made, but this shall suffise.
For those that be applyed on these parts must restrain, dry and corroborate or strengthen the ioints, this dooing you shall ceasse the pain, and keep the humor from the afflicted parte.
Moreouer, this is to be noted, that neither within the wound nor without, you
[Page 34] shall applye any Oilly or greasy medicine, for asmuch as it relaxeth the substance of the muscles, membranes and
Nerues: by the which meanes it dooth make the place more apt to receiue defluxions. And also it dooth so relax and moisten the woūd, that it is a great hindrance to the consolidation.
Therfore the medicines (which ought to be vsed in this cause) must be desiccatiue and astringant as this that foloweth, which is bothe astringant, desiccatiue and glutinatiue.
Rec. Terebint. venic. vnces 2.
Aqua vitae parum. Pul. aloes. Mast. mirh, Bol armene ana. 2. scrupples. And so applyed as need shall require, or some other good Balme, beeing applied with desiccatiue poulder, so that the poulder be without any sharpnes, and if there come any accidents: it shalbe remedied by medicins contrary to the same, according as néede shall require.
And this is a principall thing to bee looked vnto, that you keep the wound from colde, the which is all togither contrary bothe to wounds and vlcers, by the which menes a great number haue perished as
Hippocrates
Hippo. 5. Aphoris. 20 testifieth, saying
[Page] that to all vlcers the colde is biting, it hardeneth the skin, it causeth pain and keepeth wounds from suppuration, (for asmuch as it dooth choke y
e naturall heat, which should bring suppuration) and causeth the place to be euil colored: with shakings, feuers, conuolsions and extentions. So that the excrements whiche doo auoid is a glittīg
Musceledge, thin or watrish humor, which dooth commonly folow in these kindes of wounds, for because it is a proper humor that floweth out of these woūds, for euery place dooth giue his proper humor: as for example the bone beeing broken, the nourishment of them engendreth a
Calus.
Now this humor whiche commōly issueth out of the neruous places, is mixed with colde, whiche causeth extreme pain, and resisteth y
e medicins, although they be potentiall hot.
To appease the foresaid pain, and to correct the intemperature of the colde humor: you shall apply warme thinges, not onely potentially: but also actually, as a Bullocks bladder béeing half filled with some resolutiue medicin and warmed, or of Bricks beeing made very hot and then quenched in Wine, and so applyed
[Page 35] about the ioint, and to heat them as often as need shall require.
By this actuall heat, nature is holpen to disgest and resolue the humor contained in the place, and dooth strengthen it, for because that the ioynts haue but little heat in them: for the whiche cause there be few medicins that wil profit, except they be actually hot. Wherfore I wil conclude that the offēce of the iointꝭ is increased rather of colde then of heat.
For the which cause the
Methodicall Chirurgian, must haue a great respect to these wounds, in taking his Iudication of things naturall, not naturall and against nature. And moreouer he must haue the knowledge how to place the wounded ioints, which shalbe shewed héer folowing.
The situation of the wounded Ioint.
IF the wound be in the fore parte of the shoulder:
This is ment by great woū des in the ioints. you shall lay vnder the arme hole a Boulster and cary your arme in a Towel bearing vp the elbow to the end that you may raise and holde vp the bone, and so to kéep him in his right place, for by this meanes, the glutination and consolidation, shall the better
[Page] and sooner be doon.
And if the wound be in the lower parte, then when you see that nature beginneth to ingender flesh, and that the lips of the wound beginneth to close: you shall haue good respect to cause the Patient often to lift vp and down his arme, for if you doo forslewe this, and that the
Cicatrice be once made: the patient shal neuer lift his arme hye, but with great pain.
The situation of the Elbow.
IF the wound be in the Ioint of the Elbow, you shall situate the arme in a meane forme, that is to say, neither to straight, nor to muche bowing in, for if the arme be healed in a meane forme: the diseased partie shall haue the vse of it a great deale the better, then otherwise he should haue had if it had béen to straight or to much bowing in.
The situation of the VVrists.
WHen the wound is in the outward or inward parte of the wrists, or in the ioints of the fingers. The hand and the fingers must be situated half bowing and you shall put within the hand some
[Page 36] round Ball or compressor, for because that if he keep his hands and fingers in a straight forme & nothing bowing: they wil remain without any office, for because that the action of the hand is to take. Wherfore you shall obserue the forme to the half bowing, and hauing the said forme, he shalbe able somewhat to help him self, in hādling of many things as a swoord, Pike, Halbart and the bridel of his Horse and suche other like, which is doon by the action of the hand.
The situation of the Hip.
IF the wound be in the Hip, you shall vse such order that the
Os femar. doo not come out of his place, the which may be doon by compressours and ligatures, and so to place the Patient vpon his back vntil such time, as it is growen to a perfit
Consolidation.
The situation of the Knee.
IF the wound bee in the Ioynt of the Knee, the Leg shall not be kept straight out: but a little bowing, for if he remain straight: the Patient shall go very il, also if it be to much bowing in: it wil be to short.
The situation of the Foot or Toes.
IF the wound bee in the Ioint of the Foot or Toes: the Patient shall keep them out straight, and not croked for if they be any thing bowing: the Patient shall neuer go so wel as when they bee straight.
FINIS.
A breef gathering to gither of certain errors which the cō mon Chirurgians vse: very necessary and profitable for all Chirurgians, which are desirous to haue the right method of curing.
The first error which they vse: is touching the dissease called in Latin, Lues Venerea, and in English the French Pocks.
THe errors which be vsed at this present (touching the
Venerian dissease) are very great, principally at the beginning, for when it beginneth it appéereth in the yard with inflamation, Vlcers and excoriation of the conduict of the Vrine, whiche commeth from the neck of the Bladder. And after that commonly foloweth Apostumes of the groynes, with pusshes and suche other like discouloured Pimples according to the infected humor, for the cure of the which, they begin with vehement or strong medicins, as
Colocinthis, confection
[Page] of
Hamech or such like. And the next day folowing they open a Vain in the right or left Arme (respecting not that there may folow a Lask of their vehement purgation) and then minister their Vnctions and suffumigations whiche is certainly a manifest error.
By the whiche meanes they drawe the infectious blood and humors to the noble partes, and féeling the inwarde anoyance of the same: sendeth it to diuers outward partes of the body. The which dooth ingēder hard tumors as knots and kernels not easely curable and moste sharp and fretting (rebellions against curation) botches with such other like.
And so by the malitiousnes of the humor: it corrupteth and eateth the bone, with such paines and torments that the poore patients are so afflicted: that they knowe not where to rest, and especially more in the night then in the day. Therfore at this present, I haue thought good according to my little skil: to teach a method for to bring these errors into a perfit order.
At the begining of this contagious dissease: you shall first begin this curation by euacuating of the body with gentle
[Page 38]
Lenitiues, which doo bothe coole the boyling rage of the blood: and also make it thinner, in mundifying the blood, this must be vsed according to the temperature of the body,
The whiche shalbe doon after that the body is prepared, to the end that the solutiues may the better work vpon the aforesaid humors. For in this case, nature must rule the Chirurgion, & not the Chirurgian nature. Then after that: it is necessary and profitable to open the Anckle vain, in the right or left foot, according as y
e Apostume dooth appéer & if therbe no apostume: according to y
e discretion of the lerned Chirurgion, this doon: you diuert or pul back y
e aforesaid infectius humors, frō the principall parts. And vpon y
e Apostume, you shall apply continually mollifying & drawing medicins, in dooing what may be to bring him to suppuration. This Indicatiōs beeing accomplished: you shall vse of the potion made with
Ebenum &
Guaiacum, prepared according to the temperature of the humors, which shalbe vsed the space of a moneth or there abouts.
And although that some learned men haue an opinion, that the decoction of
[Page]
Guaiacum ought tobe vsed without any other medicines, yet neuer the lesse it hath béen found by experience, that the vse of other Simples with it, (béeing fit and agréeing to the diseases) hath a great deale more profited, & béen found of better effect then if it had béen ministred alone, for in a compound dissease: a Simple remedy is not requisit.
Although that
Alphonsus Ferrus hath written to the contrary, the which
Alphonsus vseth this decoction of the wood in a manner to all disseases (whose oppinion is not to be folowed) which decoction is vsed in
Pthisi. etiam si dies placuerit in senio Philippi.
Moreouer they haue greatly erred, which haue set forth the
Radix chim béeing a root very deer, vnprofitable, and all togithers without taste, and the greatest error of all is committed among them, which haue brought in vse, the diet of the decoction of Box trée, whiche is an astringant wood, stinking and an enemy to all the principall partes. And if you wil haue a wood whiche is moste agréeable to the
Guaiacum: you shal vse of
Fraximus, the which openeth obstructions of the Liuer, of the Melt and of
[Page 39] the Rains, for I haue knowen many which by the vse therof haue recouered their helth.
¶ The second error touching the saide dicease vvhen it commeth to suppuration.
WHen this disease hath béen once taken in hand and euil handled, either by Ignorance of the Chirurgian or the negligence of the patient: The comon Chirurgians vse commonly new errors, that is, in giuing solutiues with out preparing of the euil humors. By the which meanes they take away the best and leaue the worst behinde, wherof ingendreth Nodes, olde and cancard fores, and such like. Then they (as euil or rather wursse) apply their vnctions or suffumigations before that the vlcers be made clean or the Nodes taken away, and somtimes leaue the bone foule. By the which menes they purchase to them selues both shame and infamy, for with in foure or fiue moneths the vlcers open with great corruption of the bone.
Moreouer they commit an erroure touching the vnction, for they anoint the hed, the Region of the hart, and other noble
[Page] partes, against all reason. And also all the whole body ouer, which is the occasion of many a mans death.
Therfore to amend these errors (when you sée that this dissease is confirmed, and that there are hard Vlcers, hard swellings or Nodes) it is the moste surest way to mundifye the said Vlcers and to open the Nodes with a cawstick, then you shall make incision in the node vnto the corruption of the bone, and then apply
Praecipitatum, or els pledgets with
Basilicon and
Presipitatum mingled togither, this doon: you shall take away the corruption of the bone.
And then after that you may safely vse your vnctions made with
Axungia Gummes,
Mineralls, Oiles and
Mercury, also if you ad thereto of fine Treacle or
Mithridatum, it wil be the better.
You shall anoint the shoulders, the muscles of the back, the Loines, y
e Hips, the Thighs, the knées, and all the outward members, as Legges and Armes.
But you must take very good héede that you touch not the head, the region of the hart, the Stomack, nor the ridge of the Back. Also yee must haue a good respect to ceasse your anointing, in
[Page 40] suche order that you bring not to muche accidents to the mouth, wherby the Pacient might vtterly lose the vse bothe of his tung and teeth.
Because that so many ignorant Chirurgians, haue taken vpon them this cure (without either discretion in applying the vnction, or ordering of y
e patient) I haue thought good to write ij, or thrée woords touching the ordering of the Pacient.
When the body is prepared of his humors, with apt and méet medicines, aswel Sirups,
Decoctions, purgings, and opening of the Vain according to the disposition of the body: the patient shalbe placed in a place naturally hot or els otherwise made warme, whiche must be frée from all colde, hauing the doores, windowes and other open places closely stopt, for the colde aire is very hurtful bothe for the Sinewy parts, and also for the woorking of medicines, for it wil deminish & hinder the actions therof. And in this case ther are many which commit great errors, which are worthy of reprehencion, for aswel in the winter as in the Summer: they anoint the Patients in great and large Chambers,
[Page] where very much ayre entreth.
Wherfore at y
e beginning of this cure (if the place be not very close & warme) you shall make a Pauilion with Couerings and suche other like round about a fire, by the which meanes you shall keep the colde ayre from the Patient. But if it be possible: it is better to haue a little chamber close and warme, and also continually a pan with Coles in the midst of it.
If it bee so that the Patients be so weke that they cannot abide the heat of the fire, or would be loth to be séen naked (as women or maids) you shall anoint them lying in their beds. First the patient shall put out one Arme, and then the other, and so the rest of the partes shalbe anointed one after an other. And you shall vse the Patients from time to time according to the dissease.
The third error is concerning wounds pearcing into the Brest.
IT fortuneth often times, that the wounds pearce the holownes of the brest, so that great quantitie of blood dooth fall down into the bottome of the
[Page 41] same, and there dooth stay vpon the
Diaphragma,
Diaphragma
[...] two muscles which go
[...] the
[...]st & seperateth the hart frō the Liuer. also the heuinesse of the said blood oppresseth the
Diaphragma, and putrifieth and ingendreth an euill qualtitie. The which putrifaction sending vapours to the hart: causeth a continuall feuer, and commonly death within
[...] dayes. Of the which the common Chirurgians haue no consideratiō or els by their ignoraunce they knowe not the cause, and so the Patient is destitute of all help.
Wherfore when you sée that the wound perceth into the
Thorax or brest you shal take good aduisemēt, in searchīg out diligently, whether the blood be descended into the lower parte of the
Diaphragma, the whiche may bee knowen by the stinking of the breath, and by the relation of the Patient, which dooth féele the blood quiuering or shaking inwardly. And also commonly his face wil be of a reddish or hie coulour, by reason of the vapours which assend vp.
And note that at the which side the blood dooth moste remaine in lying vpon the same side: the patient shall feel lesse pain then vpon the other, because that the said blood oppresseth the Lungs and the
Diaphragma,
[Page] the Chirurgian ought to haue a good respect to y
e signes aboue written, and whilst that the strength of y
e patient is yet remaining: it shall bee needful to make way for the said blood to be
Euacuated, betwéen the fourth & v. rib, a hand breadth or a little more from the Ridge of the back, and your incision knife shall be very sharp, also you shall doo it by little and little very gentlely in cutting
Mesopleuria or y
e muscles betwéen the ribs, it ought to be doon towarde the lower part of the said muscles, for the vain whiche nourisheth them and the ligaments which giueth them their mouing and féeling: are placed more abooue then belowe.
After that the incision is made: you shall let out the corrupted blood by little and little, according to your discretion, and it shall suffise to euacuate euery dressing v. or vi. vnces, this doon: it shalbe very profitabe to vse the wunted potions which you shall finde in the writings of learned practitioners which haue largely written of the said potions, and by this meanes abooue written: I healed foure in one yéer. The whiche Cures, without the aforesaid remedyes: could
[Page 42] neuer haue béen holpen, for the whiche I giue vnto God moste harty thanks.
¶ The fourth error touching the applications of the Traepans Terebelles, for fractures of the hed.
IN the fractures of the Skul: there are committed great errors touching the applycation of the
Traepan, principally when the bone is broken in many partes, for they haue no consideration of the shiuering of the skul, but apply the
Trapan, by the which meanes, they presse down the shiuers of the bone vpon the
Dura mater, & rent or tere it in such order that it bringeth great & gréeuous accidents, wherby commonly deth ensueth. Wherfore in this case: you shal haue a good consideration, before that you apply the
Traepan, for it is better (if it be possible) in this case to vse other instrumētꝭ as Eleuiatories, Cisers,
Lenticulj or such other like, to make way for the brused matter which depresseth the
Duramater, it shalbe y
e better & lesse danger for the Patient. By this meanes I I haue many times forborne the applying of the
Traepan, to the profit of my Patients and my good name and estimation
Moreouer there bee many Ignorant Chirurgians which without consideration apply the
Traepan, vpon all partes of the hed aswel vpon the comistures or seames: as other places, whiche is the cause of the death of many Patients.
Wherfore they ought to haue a great consideration, and to be very diligent in this respect, and for to vse their art according to the true method.
The fift error touching the punctures of Nerues.
WHen it chaunceth that any is hurt by the punctures of
Nerues, if hee be not spéedily holpen by some cunning and expert Chirurgian: hee is in great danger to fall into conuolsions, which is the occasion of many a mans death whiche commonly chaunceth to them that be drest by the Ignorant and common Chirurgians, for when they begin the cure: they make fomentation, with hot water, wherein hath béen boyled Mallowes, Violets and such like, then after the fomentation they apply an appeaser of pain, made with the crummes of white Bread béeing mingled with the
[Page 43] yolke of an Egge, Oil of Camomil and Oil of Roses. The which things are altogither contrary to the Punctures of
Nerues.
For asmuch as their application dooth moistē to much the
Neruous places and retaineth or kéepeth in the matter whiche is all redy come to the place, and if there be any apostume it dooth augment and encrease him, and causeth the matter to assend vp to the brain, wherby ensueth conuolsion and finally death.
Wherfore to auoide this daunger, and to follow the cure methodically: you shall haue first a regarde to the
Euacuation of the body, and if the strength of the patient be good, to vse
Flebetonice Reuolsiue or according to the cause of the gréef. Then (to take a way that whiche is redy conioinct) you shall enlarge the
Orofice, to the end that the medicin may the better penetrate to the bottom, and take away the sharpnes of the humor. In this case I haue found very profiitable the Oil of
Hippiricon prepared in this forme that is to say with
Venice Turpentine, and for one vnce of the said Oil, you shall take half a scrupple of
Euphorbium, which shalbe applyed very
[Page] hot with pledgets, & vpon that a Plaister made with
Propolis, Gum ammoniack and Wax asmuch as shall suffise. By this meanes the matter (which is drunk into the
Nerues or tendons) shalbe drawen out to the outwarde partes.
Also for this intent I haue found profitable Linseed Oile and
Enphorbium of eche like muche, with the xx. parte of
Sulpher béeing very finely poudred, with
Perosin and wax as much as shall suffice to make an Vnguent.
This Vnguent dooth heat moderatly, attract and dissicate and is of a subtil facultie, with the which (by the help of God) the Chirurgians shall get bothe honor and profit,
The sixth error is touching the abuse of the runners about called cutters for the stone and Ruptors.
AMong the common Runnees about (which vse to cut for the stone and
Ruptures) is vsed a great abuse and to be lamented of any christian hart, for vnder this cure of cutting the
Hernyes they doo miserably take away the stone aswell in the
Hernia aquosa or
ventosa as in all the rest, the which is vnmanly
[Page 44] and against the wil of God, and they doo not only vse it in men, but moste of all in little Children, therfore it should be very good for the parents which haue their Children in any maner of wayes troubled with any kinde of
Hernies, that before they commit their Children to léese their stones, and some times liues, by any of these that bee Runnagates, (for so may I wel terme them) that they shew them to some learned Chirurgian to the end that he may sée what kinde of
Hernies they haue, and so to discerne the
Aquosa or
Ventosa, from
Intestinale or
Omentales.
For certainly I haue séen
Hernies in childrē which came by the relaxasion or deuision of y
e
Peretoneū, haue been perfitly healed by the apt applying of glutinatiue medicins & such otherlike, without cutting or taking away of the
Testicle. But such is the couetouse desire of these Runners whiche make the parents beléeue that it cannot bee helped without their butcherly cutting, and for to intrapmony, for they be as greedy after it as any liuing thing is after their pray, not hauing the fear of God before their eies, but like gréedy gripers catch what they
[Page] may for the time, and care not what become of them afterwardes, whether they liue or die, wee haue had it by experience of them what harme they haue doon bothe by the murdering cruelly and also laming with continual pain, for when they come rushing into England and haue suche a great name at their first comming. But after when their woorkꝭ be tried and then the proof of them seen: the people for the moste parte are wery of them, and many a fatherlesse childe and widdow which they haue made: may lament the time that euer they knewe them, and many others (which is not a few) bide tormentꝭ and pain by the dealing with them. I dare affirme they neuer did any cure in this Realme but that there be English men which haue doon the like and greater.
Suche is the folish fantasyes of our English nation that if he bee a Straunger: he shall haue more fauourers then an English man, though the English mans knowledge doo far passe the others as experience therin hath shewed, and this I wil stand to the proof that ther be English men that shall in all things doo
[Page 45] asmuch bothe by learning and experiēce as any of them all. Paraduenture you wil obiect and say, that there be Straungers which haue doon cures which some English men haue refused, I wil graunt that it may be so, for there bee a great many of vnlearned Chirurgians which take vpon them the art, & look what they doo it is by blinde chaūce, and so through their blindenes some are marred, wherby after it falls to a straungers chaunce to doo it, and then it is giuen out that all the Chirurgiās in London could not doo it, and so the whole company is defamed and euil thought of, but I could shewe to the contrary, where the straungers haue left and could not doo, English men haue doon it diuers times: which if néed be I can bring the proof and no small sort, whiche to name I will omit til another time more meet. And now to return to the matter, sée how long any of these cutters doo tarry in a place, some a quarter of a yéere, some half, and none scant a yéer, for it wil bee to hot for them: for after their beastlines is once knowē: then they must seek a new place, for if they should tary in one place they would bee hated like mad Dogs, & that they knowe
[Page] wel inough. Now for because that they shall not deceiue the cōmon people with their fair promises: I wil write all the kindes of
Ruptures or burstings and how to knowe euery one of them to the end that if any Chirurgiā which hath not the knowledge, may straight at the first sight knowe what may be doon, and so to enforme the parents of the Children the trueth of it, & what the Cutter may doo in it, for moste commonly they bee so ignorant that they knowe not the one from the other, therfore as I haue said before, it is néedfull for the Patients to haue an expert chirurgiā to aprooue him and sée whether hee be able to fulfill that which he promiseth or no. Now I will begin to treat of the kindes of
Ruptures and first I wil begin with the deuision of them in generall and then perticulerly.
Of the viij. kindes of Hernies.
THere be eight kindes of
Hernies or
Ruptures wherof sōe haue their proper names: and the others by similitude, the proper
Hernies doo moste commonly come by the relaxasiō or
Rupture, of the
Pretoneū, insomuch that the
Intestines and
Epiplocō or
zirbus dooth loose their
[Page 46] naturall place, and of these are vij. kindꝭ, that is
Enterocele otherwise called
Hernie Intestinale, Epiplocele or
Hernie Zirbale, Bubonocele or
Hernie Inguinale, the
hernies by similitude are whē there is some tumor against nature in the Cods or in some parte of the Groin, without the comming foorth of the
Intestines or
Zirbus, and of these there are v. kindes, the first is called
Hernie Aqueuse and of the Gréeks
Hidrocele, the second
hernie Charneuse or
Sarcocele, the third:
Variquese, the fourth
Venteuse which is called of y
e Gréeks
Pneumatocele, y
e fifth
Humorale, whiche shalbe spoken of pertitulerly in order, and first we wil begin with the proper kindes.
Of the hernie Intestinale.
FOr because that the
hernie Intestinale is the moste conuenientest, I wil speake first of it. This kinde is no other then a certain descending down of the
Intestines in
Scrotum, the cause of the whiche is when the
Peretoneum is broken or relaxed in the place wher the
Spermatike vessels doo passe, which cōs commonly by some vehement strain, as by vehement running, leaping, lifting,
[Page] or vehement crying, and such other like, the signes to knowe when the
Intestines is descended into
Scrotum, is when he lyes, they wil easely be put vp again without any maner trouble, or may bee reduced the patient standing with ones hands, and in the redusing you shall hear a gurguling or noise, & by this you may knowe it from
Zirbus because that whē the
zirbus is put vp it makes no noise, and also it is not so painfull: the other signes shalbe declared when we come to speak of the
hernie Zirbale.
When this kinde is not very farre gone, and that it be not complet: the best way is to cure it by medicines, aswel to be taken inwards: as to be applyed with out, that is to say with emplaisters and so by conuenient trussing and boulstering stipt in the Iuce of herbes conuenient for
Ruptures which are of astringāt and glutinatiue facultie. I haue seen many by these afore said medicines haue béen perfectly cured, yet neuerthelesse if for the oldenes of it y
t it be not tobe cured by these menes: then you must come to the last remedy which is by cutting, for the executing of the whiche I wish all men to chuse an expert woorkman, and
[Page 47] not to trust to much to these runners about, and as for this kinde it may be cut without taking away of the
Testicle.
Of hernie Zirbale.
HErnie Zirbale whiche the Gréeks doo call
Epiplocele, is a nother thing then the falling of
zirbus (whiche is a grece that couereth the Guts) into
Scrotum the which moste commonly falles within
Didimes, but yet sōtimes by the breaking of the
Didimes it falls out, the causes aswel inwarde as outwarde are the same which cause
hernie Intestinale, for look how the
Peretoneum is broken or relaxed in the other: euen so dooth it in this, the signes are much like also, sauing that it is much more softer, for in the touching it handleth like wul, and is also lesse painful, and it is more difficult to put vp thē the
hernie Intestinale, and in the redusing makes no noise, this kinde is lesse dangerous then the others by reason that the pain is lesse and also for because that the excrement is not in it as it is in the
hernie Intestinale.
Now héer is a speciall thing tobe noted in this kinde, which the common cutters doo vse, that is, they doo vse to cut away
[Page] the
zirbus whiche is descended within
Didime without either tying or cautrising, and so there foloweth a flux of blood which hauing no issue but is retained in the belly there dooth corrupt whiche causeth most perilous accidents and moste commonly the death.
Of the relaxacion of the Peretonium called hernie Inguinale.
HErnie Inguinale is a descending of the
Intestines or
zirbus into the Groynes, which the Latins cal:
Inguina, the which sort dooth neuer go further then the Groin, for when the
Intestines or
zirbus dooth passe thorow the
Peretoneum: then is it either
Intestinale or
zirbale, for this kinde is nothing but a relaxacion of the
Peretoneum. The causes are as of the others aforesaid, and it is easely to be knowen by the roundnes, and it will be more easely reduced then any of the others, you may knowe when the
Intestins is descended by noise that it wil make, though not commonly: yet moste oftennest as hath béen said of
Enterocele, but if it be the
zirbus it makes no noise, and is much more softer and not so great pain.
Of the kindes of Hernies which be by similitudes or improperly called.
HEertofore we haue spoken of those thrée kindes of
hernie whiche are properly called, now it remains to speak of the fiue kindes whiche are by similitudes, & first we wil begin with the
Aquose, whiche is no other thing then a certain watrish tumor of
Croton increaced by little and little, & for the most part lies betwéen
heritroides and y
e Spermatike vessels, how beit some times it may be contained betwéen
Dartos and
heritroides and betwéen
Dartos & the
Scrotum as many learned men haue written, the signes are, that the
Scrotū doth wax big by little and little and for the moste parte without pain, and the tumore is heauy and glistering and hard principally when the
Scrotum is filled: it waxes in length and dooth not return as doth the
Intestinale and
zirbale but remaines at one stay.
This kinde if that the water, haue long line there and so corrupted the
Testicle: it must be taken away.
Of hernie Charneuse.
HErnie Charneuse which y
e Gréekꝭ doo cal
Sarcocele is a tumor against nature in y
e
Scrotum which there dooth grow to a certain scireuse flesh, and dooth much resemble the
Verequeses or swelled Vaines, the causes of the which are by the gathering togithers of abūdance of grose humors, whiche nature cannot rule because of the weaknes, the signes are an vnequable hardenes, and inflation which dooth alwaies remain in the parte that is to say the
Dideme, and doth alwaies increace with pain béeing vnequall and not euen, wherefore
Guido saith that this kinde and
Vanqueuse ar very dangerous.
Hernie Verequese,
HErnie Verequese is an appéerāce of Vaines not accustomed about the
Testicles and other partes contayned with in
Scrotū. The causes ar grose humors gathered togithers as melancolike blood and such like, whiche nature cannot disparce because of wekenesse. The signes are, replecion of the vaines about like to the Twigs of Vines with softnes of the
Testicle or
Dideme.
This kinde if it be not very great and far
[Page 49] gone it may be healed by solutiue medicines.
The hernie Ventose.
HErnie Ventose is a tumor of the cods increaced of a windines, the cause is of the imbesility or weaknes of the parte, and is knowen by the swelling of the Coddes and yard, and glistereth like vnto a slikt paper, which comes sudainly and is round and light, so that there be not another humour adioyned with it,
This is to be cured with
Carnificatiues as
Oleum nucum, Oleum Anethinum, Costinum &c. and there may be added to of Séeds and hearbes, as
Semen, anisi, Carui, Faeniculi, Agni casti, Ruta, Calaminta, Origani. &c.
Hernie Humorale.
HErnie Humorale is an Apostume contained likwise in the cods whiche is ingendred of humors hot and colde not muche declining from his naturall habite, which may lye betwéen
Scrotum and
Dartos or betwéen
heritroydes and
Dartos or onely within
heritroydes, as for the causes, signes and curation are
[Page] like to other Apostumes.
Now that I haue declared the definition, causes and signes of
hernies: it shall not be amisse to expound in few woords those parts which must be opened when any of these kindes must be cured by handy operation, and this is tobe noted first, that the
Testicles are couered with three
Tunicles, the first of them takes his originall of the skin & is called
Scrotum or pursse, the second which takes his originall of the
Peretoneū and is called
Dartos, the third whiche is proper to the said
Testicle and is called
Heritroydes, these two last doo not onely couer the
Testicles but also the Spermatike vessels, aswell they whiche bring the substance where with the Sperme is made which are named
Preparans: as thē which bring the Sperme to the neck of the bladder which is called
Eiaculatoires or expelling, the which goes vp to
Osepubis.
The declaratiō of the waights and mesures vsed in Chirurgery.
HEer gentle Reader I thought good to declare certain waights and mesures for the better vnderstāding of this
[Page 50] book of
Galens and all other of his woorks to the end that yung Studients in this art should haue none occasion of let frō the perfit vnderstanding of it, and first I wil shew you how they were called in y
e olde time of the Greekꝭ & also of the Romains and as neer as I can how muche euery one dooth contain according to our measure. And as for the names of y
e simples: I thought it good to write them in the
Latin as they were, for by the searching of their english names: the Reader shall very much profit, and another cause is that I would not haue euery ignorant asse to be made a Chirurgian by my Book, for they would doo more harme with it then good.
First
Mina which y
e Gréeks call
Mna, there are of diuers sortes, for some are
Romain others
Attique, others
Egiptienne, others
Alexandrine, but
Romains is according to
Paulus Aegineta and
Galens 16. vnces.
The pound according to the
Romains is 12. vnces.
The
Attique and
Egiptienne is .16. vnces.
The vnce whiche is the 12. parte of a pound is 8. Drams.
Deunx is 11. vnces, which are .264. Scrupples, that is, 2. third partes and 1. fourth parte of a pound.
Dextans is the half and the third part of a pound, that is to say 10. vnces and 240. Scrupples,
Vitruuius in his third Booke saith that it is the measure of ten Inches.
Dodrans is the half and one quarter of a pound, which is 230. Scrupples,
Vitruuius in his Book afore said dooth call
Dodrans the measure of 12. Inches.
Bis is 2. third partes which is 8. vnces and 240. Scrupples.
Sextunx is 1. half and 1. twelf parte that is 7. vnces and 168. Scrupples.
Selibra is half a pound or
Semis, and 144. Scrupples.
Quincunx is 5. vnces.
Triens is the 3. parte of a pound which is 4. vnces and 120. Scrupples.
Quadrans is the 4. parte of a pound which is 3. vnces and 72. Scrupples.
Sextans is the 6. part of a pound whiche is 2. vnces and 48. Scrupples.
Vnsia is to say an vnce whiche is 8. Drams.
Semiuncia is half an vnce.
Denarius or
Drachma is the 8. parte
[Page 51] of an vnce and is 3. Scrupples which the Gréeks call
Grammata that is xxiiij. letters in the Gréek, and the vnce hath as many Scrupples as the Gréek hath letters.
Scrupple is as it were the beginning of all waights as an introduction and is 2.
Oboles, an
Oboles is 2.
Siliques, and a
Silique 2.
Chalces, & the
Chalces is 8. Graines.
The pound of liquid things as Wine, Oile, and such like, was in
Roome measured by a vessel of Horne whiche had xij. rundels about it, and euery one of them did signifie an vnce, and was called a mesured pound,
Galen makes mention in his first book
Decom. medic. secundum genera, in the making of the white plaister.
Amphora of the
Italy measure, dooth contain 72. pound of Oile, and of Wine 80, and of Hunny 108. the Hunny is the 4. parte more heuyer then is the wine, and the half more then Oile
The
Ceranium is of Wine and Vinagre 80. pound, and of Oile 72. pound, and of Hunny 120. pound.
The
Vrne is of wine & vinagre 40. l. of Oil 36. l. and of Hunny 60. pound.
The
Conge is of Wine and Vinagre 10. pound, of Oil 9. pound, and of Hunny 15. pound.
The
Sestier is of Wine and Vinagre 1. pound. 8. vnces, of Oil, 1. pound, and of Hunny 2. pound
The
Hemine is of Wine and Vinagre 10. vnces of Oile. 9. vnces, and of Hunny 1. pound.
The
Cotile is of Wine and Vinagre, 10. vnces of Oile 9. vnces, and of Hunny 1. pound.
The
Oxibaphus is of Wine and Vinagre 18. Drams, of Oile 18. Drams, and of Hunny 27. Drams.
The
Acetabule is of Wine and Vinagre .18. Drams, of Oile 18. Drams, and of Hunny 27. Drams.
The
Ciath is of Wine and Vinagre 12. Drams and 4. Scrupples, of Oile. 18 Drams, and of Hunny 20. Drams.
The
Cheme is of wine & Vinagre 3. Drams and one Scrupple and of Oile 3. Drams, and of Hunny 5. Drams.
The end of waights and measures of the auncient writers.